Nasal and Skin Colonization of Staphylococcus Aureus in Hemodialysis Patients in Northeast of Iran

Abstract

Introduction. Staphylococcal infections are a major cause of morbidity and mortality in patients on hemodialysis. We conducted a study of nasal and skin colonization in patients receiving maintenance hemodialysis.

Materials and Methods. From September 2003 through June 2004, we evaluated 69 patients who were receiving maintenance hemodialysis via an internal fistula or graft. Four samples were obtained for culture from both nares and needle insertion sites on the skin by standard methods. The growth of Staphylococcus aureus was recorded during the study.

Results. Of the 69 patients, 28 (40.5%) had S aureus present in the nose and 9 (13.0%) had it present on the skin around the access site at some times during the study period. The presence of S aureus on the skin of the access site was significantly related to the simultaneous presence of this organism in the nose (P = .03).

Conclusions. From our observations, it can be concluded that the nose provides an environment in which S aureus can propagate and maintain itself for prolonged periods. As skin colonization with S aureus is a risk factor for the development of staphylococcal infection, it could be recommended that effective removal of S aureus from the nose would be critical for prevention of vascular access site infection.