Staphylococcus aureus nasal carriage among the diabetic and non-diabetic haemodialysis patients

Int J Clin Pract. 2006 Oct;60(10):1204-9. doi: 10.1111/j.1742-1241.2005.00789.x.

Abstract

Staphylococcus aureus is the most common cause of serious infections in patients undergoing long-term haemodialysis (HD). S. aureus infections in HD patients are associated with considerable morbidity and mortality. Especially, methicillin-resistant S. aureus (MRSA) strains are becoming increasingly multidrug-resistant and have recently developed resistance to vancomycin, used successfully to treat MRSA for more than 30 years. In vitro determination of resistance patterns of S. aureus is critical in terms of administering suitable antimicrobial treatment. The objective of this study was to identify the frequency of S. aureus among diabetic and non-diabetic HD patients and to investigate resistance patterns against various antibiotics used broadly for treatment. This study was carried out between January 2004 and December 2004. In the present survey, 261 patients undergoing HD treatment from three HD units in Hatay were examined. A total of 148 Staphylococcus aureus strains were processed to assess their occurrence rates and antimicrobial susceptibility profiles. S. aureus positivity was determined in 148 (56.7%) of the 261 HD patients and 26 (16.2%) of the 160 individuals in the control group. The difference was significant (p < 0.001). HD length was found to be 38.4 +/- 24.3 months in the patients of S. aureus carrier and 27.3 +/- 18.5 months in non-carrier patients. Significant correlation was also identified between durations those on HD and the isolation of S. aureus (p < 0.001). However, the carrier state was unrelated to the presence of diabetes mellitus (DM), age or sex. In conclusion, nasal carriage of S. aureus was found to be more prevalent in HD patients than that in those in the control group. Also, it is concluded that DM was not a risk factor for the nasal carriage of S. aureus. In addition, the rates of antibiotic resistance of S. aureus strains were found to be quite higher in HD patients than in the control group (p < 0.05).

MeSH terms

  • Case-Control Studies
  • Diabetes Mellitus / microbiology*
  • Female
  • Humans
  • Male
  • Methicillin Resistance / physiology*
  • Middle Aged
  • Nose / microbiology*
  • Renal Dialysis*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / isolation & purification*