title: Epidemiology and prevention of Staphylococcus aureus nasal carriage in hemodialyzed patients.
abstract: Nasal carriage of Staphylococcus aureus may be responsible for some serious infections among hemodialyzed patients. Its pathogenic potential and commensal nature allows for an easy transmission both in and out of hospital environment.
  
  
  OBJECTIVE
  This study was to assess the prevalence of S. aureus nasal carriage, to determine its frequency and nature in hemodialyzed patients of the Rabat Ibn Sina University hospital, in Morocco.
  
  
  METHODS
  The study began in March 2008 according to the following protocol: screening of nasal carriage with five samplings, performed once a month three times, then once a month two times again after an interruption period of three months. Screening was performed weekly during the first month in hemodialyzed patients treated with mupirocin (Bactroban(®) 2%), and then monthly, to monitor the kinetics of S. aureus eradication.
  
  
  RESULTS
  The study included 54 hemodialyzed patients with a mean 44.16±14 years of age, sex ratio of 0.54, and mean hemodialysis duration of 118.7±67 months. Permanent and intermittent S. aureus carriage was found in respectively 18.52% and 25.92% of patients. Eighty-one strains of S. aureus were identified, 14.81% of which were methicillin resistant. Eradication was sustained beyond 20 months in patients treated with mupirocin.
  
  
  CONCLUSIONS
  This investigation allowed us to identify hemodialyzed patients at risk, so as to implement the rules of individual and collective hygiene, and to extend mupirocin antibiotic prophylaxis in our hemodialysis unit.
authors.affiliation: Service de microbiologie, hôpital Avicene, CHU Ibn Sina, Rabat, Morocco. sl.karim@hotmail.fr
authors.forename: K
authors.initials: K
authors.lastname: Souly
authors.forename: M
authors.initials: M
authors.lastname: Ait el kadi
authors.forename: K
authors.initials: K
authors.lastname: Lahmadi
authors.forename: H
authors.initials: H
authors.lastname: Biougnach
authors.forename: A
authors.initials: A
authors.lastname: Boughaidi
authors.forename: M
authors.initials: M
authors.lastname: Zouhdi
authors.forename: S
authors.initials: S
authors.lastname: Benasila
authors.forename: Z
authors.initials: Z
authors.lastname: Elyoussefi
authors.forename: T
authors.initials: T
authors.lastname: Bouattar
authors.forename: N
authors.initials: N
authors.lastname: Zbiti
authors.forename: Z
authors.initials: Z
authors.lastname: Skalli
authors.forename: H
authors.initials: H
authors.lastname: Rhou
authors.forename: N
authors.initials: N
authors.lastname: Ouzeddoun
authors.forename: R
authors.initials: R
authors.lastname: Bayahia
authors.forename: L
authors.initials: L
authors.lastname: Benamar
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002353:Carrier State / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008403:Mass Screening; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D016712:Mupirocin / Q000008:administration & dosage / Q000627:therapeutic use; D009296:Nasal Cavity / Q000382:microbiology*; D015995:Prevalence; D006435:Renal Dialysis; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin