Carriage of Staphylococcus aureus in the nose of patients on regular dialysis treatment using hemodialysis catheters.

In the hemodialysis population, the incidence of Staphylococcus aureus colonization has been documented to be as high as 80%; effective prophylaxis of vascular access infection and bacteremia is a worthwhile goal in the management of hemodialysis population. Surveillance of 50 hemodialysis patients for S. aureus-positive nasal cultures was performed by monthly nasal swabs over a 12-month period. All patients were performing dialysis using hemodialysis catheters thrice weekly. All positive cultures were treated with a prophylactic antibiotic regimen. Thirty-one patients (62%) had one or more positive cultures. The surveillance period was longer in the S. aureus nasal carriers (p < 0.01). The frequency of positive cultures correlated with the duration of surveillance (p < 0.05). The incidence of S. aureus bacteremia was greater in patients with three or more positive cultures (p < 0.05). This study suggests that continuous surveillance for S. aureus nasal colonization is essential to properly identify all hemodialysis patients using catheters at risk of developing S. aureus bacteremias.