Background Methicillin-resistant Staphyloccocus aureus (MRSA) is a major cause of nosocomial infections in the United States. It is unclear if former Soviet republics face similar levels of MRSA as Western nations. Our study objectives were to determine the prevalence of and identify risk factors for colonization with MRSA and S. aureus at the time of hospital admission among patients in Tbilisi, Republic of Georgia.
Methods Anterior nares cultures were obtained from patients within 48 hours of admission to 1 of 5 hospitals (including general hospitals, a pediatric hospital, an oncology clinic, and a sepsis center) in Tbilisi over 1 month in 2004. S. aureus was identified by standard methods, and susceptibility was determined using agar plates containing 6 μg/mL of oxacillin. Demographic data, medical and social history, prior hospitalizations, antibiotic usage, and residential status were obtained through patient interviews. Characteristics of patients were compared using Pearson chi-square test and Fisher's exact test as appropriate.
Results S. aureus was present in 74 (23.5%) of 315 patients from whom anterior nares cultures were obtained at the time of admission; 3 (1%) patients had a positive culture for MRSA. The demographic and clinical characteristics of persons with a positive nasal culture for S. aureus did not differ significantly from those persons with a negative nares culture; the median age was 29 years (range 1-91); 130 (41%) were male; 69 (22%) were diagnosed with bacterial or viral infection at admission; 50 (16%) had a history of previous hospitalization within 12 months; and 165 (53%) had a history of antibiotic use over the prior 12 months. Persons colonized with MRSA were more likely to report a history of bacterial or viral infection within the past 12 months (p = .04).
Conclusion The overall prevalence of nasal colonization with S. aureus in Tbilisi was similar to the prevalence observed in the U.S. However, the prevalence of nasal MRSA colonization (1%) was substantially lower than that observed at our urban public hospital in Atlanta, GA, where rates exceed 7%. Further studies are needed to assess the prevalence of MRSA in the Republic of Georgia and to determine why rates of MRSA colonization remain lower than those reported from the U.S. and a number of countries in Europe.