Investigation of Factors Influencing the Prognosis of MRSA Infection in Hemodialysis Patients

• Published in: Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) Vol. 31; no. 9; pp. 695 - 700
• Main Authors: Nishikawa, Midori, Hirata, Sumio, Kawaguchi, Hiroshi, Izumi, Satoshi, Furukubo, Taku, Ohta, Miyuki, Fujita, Minori, Matsunaga, Chiharu, Yamakawa, Tomoyuki, Takara, Kohji, Ohnishi, Noriaki, Yokoyama, Teruyoshi
• Format: Journal Article
• Language: English; Japanese
• Published: Japanese Society of Pharmaceutical Health Care and Sciences 2005
• Subjects: hemodialysis; inflammation; MRSA infections; nutritional status
• ISSN: 1346-342X; 1882-1499
• DOI: 10.5649/jjphcs.31.695

This study involved 180 hemodialysis (HD) patients using anti-MRSA antibiotics. The subjects were divided into a survival group (n=100) and a dead group (n=80), and the factors affecting the prognosis were investigated and compared between the two groups. Factors examined were age, sex, dry weight (DW), duration of HD, presence of DM, and laboratory data {Alb, BUN, Cr, IP one month before starting administration of anti-MRSA antibiotics, and the maximum CRP, WBC and neutrophil fractions (maxCRP, maxWBC and maxNeut, respectively) from one month before to after starting the administration of anti-MRSA antibiotics}. A decrease in DW, increase in age, presence of DM, decrease in Alb, BUN, Cr and IP (taken as markers of the nutritional status of the HD patients) and increase in maxCRP, maxWBC and maxNeut (taken as inflammatory markers) were significant factors in exacerbating the prognosis of MRSA infections. Further, a decrease in DW and IP, presence of DM and increase in maxCRP were found to be significant factors in death due to MRSA infections, as determined by multiple logistic regression analysis. Also, when the factors of total fat mass (TFM), body mass index (BMI) and estimated-lean body mass (E-LBM) were compared between the two groups, while TMF was not significantly different between them, a decrease in BMI and E-LBM were significantly associated with death due to MRSA infections. Thus, muscle content appears to be a more important factor than TFM. These results suggest that nutritional supervision can play an important role in the prevention of MRSA infections in HD patients.