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


Correspondence to: H.A.H. Maamoun, MD, Internal Medicine and Nephrology Department, Cairo University, Cairo 11451, Egypt. E-mail


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.