Determination of Staphylococcus aureus carriage in hemodialysis and peritoneal dialysis patients and evaluation of the clonal relationship between carriage and clinical isolates

BackgroundThis study was coinducted to investigate Staphylococcus aureus carriage in patients undergoing hemodialysis and peritoneal dialysis and to evaluate the clonal relationship between carriage and clinical isolates.MethodsSurveillance for S aureus carriage was performed in 30 hemodialysis patients, 40 peritoneal dialysis patients, 13 workers in the unit, and 40 controls. The clonal relatedness of isolates was assessed by pulsed-field gel electrophoresis.ResultsScreening cultures yielded 8 (26.6%) isolates from the hemodialysis patients, 9 (22.5%) from the peritoneal dialysis patients, 4 (30.7%) from the staff, and 8 (20%) from the controls. All of the isolates were methicillin-susceptible except one from a hemodialysis patient. There was no significant difference in carriage rate among the study groups. A history of hospital admission in the previous 6 months and a history of infection was associated with an increased carriage rate. A total of 23 genotypes were established for the 28 isolates, demonstrating high clonal heterogenecity. Six clinical isolates from 4 hemodialysis patients and 4 clinical isolates from two peritoneal dialysis patients were molecularly evaluated to compare isolates obtained from infection with carriage isolates of the same patients. All but one of these clinical isolates were “indistinguishable/closely related” to the isolates obtained from the same patients as carriage isolates.ConclusionOpur data show a clear association between S aureus carriage and S aureus infection. Determining the S aureus carriage state of patients undergoing dialysis can help guide infection prevention measures and treatment strategies.