Effects of "isolating hemodialysis" on prevention of methicillin-resistantStaphylococcus aureus cross-infection in a hemodialysis unit

Aim: To evaluate the effects of a contact isolation program against methici llin-resistant Staphylococcus aureus (MRSA) cross-infection among patients in a hemodialysis unit. Clinical setting and methods: In all patients maint aining hemodialysis therapy were tested for MRSA infection and who had MRSA infection, not only inpatients but also outpatients were separated into a designated area (isolating hemodialysis). Clinically isolated MRSA strains were clonotyped with coagulase typing, staphylococcal enterotoxin typing an d restriction enyzme analysis of plasmid DNA. Results: The frequency of pat ients with MRSA infection was 4.5% before starting this protocol and was re duced to 2.9% two and a half years later. At this time, MRSA was isolated f rom the 8 patients. These 8 clinical strains were differentiated into 6 clo notypes and 3 strains showed the same patterns. Two of 3 were isolated from inpatients and the other was from a patient with community onset MRSA coli tis. In this case, most MRSA infections were independent under prophylaxis control and cross-infection was observed only once between hospitalized pat ients who stayed in a same ward. Conclusion: This "isolating hemodialysis" should be useful to prevent cross-infection among patients in end-stage ren al disease in a dialysis unit.