title: Staphylococcus colonization, mortality and morbidity in hemodialysis patients: 10 years of observation.
abstract: Colonization with Staphylococci is widely distributed among patients with end-stage renal disease who are receiving hemodialysis (HD). In addition to more intensive care and use of artificial devices, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection has increased. Such colonization has recently been associated with a more than doubled mortality rate in HD patients. However, it is not clear whether the (presumably increasing) incidence of methicillin-sensitive Staphylococcus aureus (MSSA) colonization is associated with MRSA and/or morbidity and mortality. We therefore established a screening program in our HD population (n=156) and followed these patients over 10 years. We discovered eighty-eight MSSA-colonized patients and one MRSA-colonized patient by cross-sectional and admission-related screenings between 2000 and 2010. The morbidity and mortality of the HD patients was not related to MSSA colonization. The MSSA colonization rate decreased slightly during the 10-year observation period. We conclude that the incidence of MRSA colonization in our unit was lower compared to that reported in the literature. The reasons for this finding are complex and require further investigation. The incidence of MSSA colonization was frequent but did not impact morbidity or mortality.
authors.affiliation: Department of Infectious Diseases and Nephrology, Hospital St. Georg, Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Grünewald
authors.forename: Margareta
authors.initials: M
authors.lastname: Lindner
authors.forename: Susanne
authors.initials: S
authors.lastname: Weiß
authors.forename: Iris
authors.initials: I
authors.lastname: Ruf
authors.forename: Till
authors.initials: T
authors.lastname: Treutler
authors.forename: Bernhard
authors.initials: B
authors.lastname: Ruf
authors.forename: Joachim
authors.initials: J
authors.lastname: Beige
mesh_terms: D000368:Aged; D002353:Carrier State; D003428:Cross Infection / Q000382:microbiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000254:growth & development*; D008875:Middle Aged; D006435:Renal Dialysis; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality
keywords: Access; Catheter; Dialysis; MRSA; MSSA; Mortality; Staphylococcus