Prevalence, persistence, and microbiology of Staphylococcus aureus nasal carriage among hemodialysis outpatients at a major New York Hospital.

TitlePrevalence, persistence, and microbiology of Staphylococcus aureus nasal carriage among hemodialysis outpatients at a major New York Hospital.
Publication TypeJournal Article
Year of Publication2011
AuthorsAlexander EL, Morgan DJ, Kesh S, Weisenberg SA, Zaleskas JM, Kaltsas A, Chevalier JM, Silberzweig J, Barrón Y, Mediavilla JR, Kreiswirth BN, Rhee KY
JournalDiagn Microbiol Infect Dis
Volume70
Issue1
Pagination37-44
Date Published2011 May
ISSN1879-0070
KeywordsAdult, 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.

DOI10.1016/j.diagmicrobio.2010.12.005
Alternate JournalDiagn Microbiol Infect Dis
PubMed ID21334154
PubMed Central IDPMC3534839
Grant ListK08 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