بررسي ميزان حاملين استافيلدكدك طلايي در بيني بيماران تحت همودياليز و تعيين ارتباط آن با عضويت محل شانت

A Survey of Nasal Carriage Rate Staphylococcus aureus in Hemodialysis Patients and Communication with Shunt Site Infection

Staphylococcus aureus(S.aureus) is the most common cause of cutaneous pyogenic infection. The main source of the bacteria is human body that is commonly colonized in the anterior nares of nose. Some groups of individuals seem to be particularly prone to colonization with S.aureus. For example, physicians, nurses , patients undergoing chronic hemodialysis & users of illicit intravenous drugs,etc. The purpose of this study was determination of nasal carriage rate of S.aureus in hemodialysis patients & communication with shunt site infection & antibiogram of all isolates S.aureus from nasal carriers. This survey was carried out in a descriptive analytic cross-sectional research in 2002. 77 patients of chronic renal failure were selected who had undergoing hemodialysis in dialysis ward of Ekbatan hospital. Specimens with swabs were performed from anterior nares nose of the patients & culture on blood agar broth then antibiogram were performed for all the isolated of S.aureus to 9 types of antibiotics. The patients were 41 females (53.2%) & 36 males (46.8%). The mean of age in patients was 48.43 years & the mean of duration of dialysis was about 23.54 months. 31 cases were nasal carriers of S.aureus (40.3%) versus 46 cases of noncarriers (59.7%). There was no significant statistical correlation between duration of hemodialysis in nasal carriers S.aureus & noncarrier patients (P-value=0.78).12 patients (7 carriers & 5 noncarriers) died (15.6%) showed no significant statistical correlation between the death in nasal carriers & noncarrier patients (P-value=1.93). Follow-up of patients in 3 months showed 2 cases (6.45%) with shunt site infection in carrier cases. There was no shunt infection in noncarrier patients. Antibiogram was done for all isolated of S.aureus from individuals who were sensitive to vancomycin, rifampin , trimethoprim/ sulfamethoxazole, gentamycin & cephalotin 100%, 96.8%, 93.6%, 90.4% &80.6% respectively. Resistance to penicillin, cloxacillin & oxacillin has been respectively 100%,100%,90.3% that indicate higher rate of resistant species of S.aureus to methicillin. In this survey, the nasal carriage rate of S.aureus in dialysis patients were more than the other similar studies. We recommend all the hemodialysis patients to be considered as nasal carriers of S. aureus and if possible, all the nasal carrier patients should be treated with effective antibiotics such as rifampin, trimethoprim/ sulfamethoxazole or the other similar drugs.