Title | Prevalence, persistence, and microbiology of Staphylococcus aureus nasal carriage among hemodialysis outpatients at a major New York Hospital. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Alexander EL, Morgan DJ, Kesh S, Weisenberg SA, Zaleskas JM, Kaltsas A, Chevalier JM, Silberzweig J, Barrón Y, Mediavilla JR, Kreiswirth BN, Rhee KY |
Journal | Diagn Microbiol Infect Dis |
Volume | 70 |
Issue | 1 |
Pagination | 37-44 |
Date Published | 2011 May |
ISSN | 1879-0070 |
Keywords | Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Carrier State, Cohort Studies, Female, Hemodialysis Units, Hospital, HIV Infections, Humans, Male, Middle Aged, Nasal Mucosa, New York, Outpatients, Prospective Studies, Risk Factors, Staphylococcal Infections, Staphylococcus aureus, Vancomycin |
Abstract | The study aimed to determine the natural history of Staphylococcus aureus nasal colonization in hemodialysis outpatients. Surveillance cultures were taken from patients presenting for hemodialysis or routine care to identify S. aureus nasal carriers. A prospective cohort study was performed to identify risks for persistent colonization. Detailed microbiologic and molecular studies of colonizing isolates were performed. Only 23/145 (15.9%) dialysis patients were persistently colonized, and only HIV-positive status was associated with persistence (P = 0.05). Prior hospitalization was the only risk factor for methicillin-resistant S. aureus carriage (OR 2.5, P = 0.03). In isolates from patients with ≤ 42 days of vancomycin exposure, vancomycin minimum bactericidal concentrations (MBCs) increased with duration of exposure. Among dialysis patients, S. aureus colonization was limited and transient; only HIV status was associated with persistence. Nevertheless, duration of vancomycin exposure was associated with increasing vancomycin MBCs. Vancomycin exposure in S. aureus carriers may be involved in increasing resistance. |
DOI | 10.1016/j.diagmicrobio.2010.12.005 |
Alternate Journal | Diagn Microbiol Infect Dis |
PubMed ID | 21334154 |
PubMed Central ID | PMC3534839 |
Grant List | K08 HS018111 / HS / AHRQ HHS / United States UL1 RR024996 / RR / NCRR NIH HHS / United States K08 HS18111-01 / HS / AHRQ HHS / United States T32 AI 007613 / AI / NIAID NIH HHS / United States UL1RR024996 / RR / NCRR NIH HHS / United States T32 AI007613 / AI / NIAID NIH HHS / United States |