title: Body site Staphylococcus aureus colonization among maintenance hemodialysis patients.
abstract: BACKGROUND
  Patients on maintenance hemodialysis therapy are at high risk for health care-associated infections. Staphylococcus aureus is a common cause of health care-associated infections among maintenance hemodialysis patients. It is established that S. aureus colonization is associated with an increased risk for subsequent infection in this population. There is an increasing number of reports that extranasal S. aureus colonization is more common than previously believed and in certain body sites even more common than nasal colonization. There are few data describing extranasal colonization among maintenance hemodialysis patients.
  
  
  METHODS
  We surveyed 100 patients at 3 body sites (anterior nares, oropharynx, and inguinal region) for S. aureus colonization. Participants were also administered a standardized survey to assess risk factors for S. aureus colonization.
  
  
  RESULTS
  We found that 42% (95% CI 32-52) of patients were S. aureus colonized in >1 body site. Extranasal colonization was found among 32% (95% CI 23-41). There were trends suggestive of an association between S. aureus colonization and younger age (OR 0.97, 95% CI 0.94-1.001, p = 0.06) and not having been hospitalized in the previous 12 months (OR 0.44, 95% CI 0.19-1.06, p = 0.14).
  
  
  CONCLUSIONS
  Extranasal S. aureus colonization is common among maintenance hemodialysis patients with a prevalence of approximately one third. Future S. aureus decolonization efforts may need to consider not just nasal decolonization but also decolonization of the skin and oropharynx.
authors.affiliation: Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center,Torrance, Calif., USA.
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Eells
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.forename: Michael A
authors.initials: MA
authors.lastname: Bolaris
authors.forename: Larissa
authors.initials: L
authors.lastname: May
authors.forename: Loren G
authors.initials: LG
authors.lastname: Miller
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology; D009960:Oropharynx / Q000382:microbiology; D015995:Prevalence; D006435:Renal Dialysis; D012307:Risk Factors; D012874:Skin Diseases, Infectious / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult