Prevalence of Nasal Staphylococcus aureus Carriage in Patients Undergoing Hemodialysis and Assessment of Risk Factors: A Cross-Sectional Study of Outpatients at a University Hospital

Abstract

Background/Objectives: Infection poses a significant threat of mortality in patients with chronic kidney disease (CKD) undergoing hemodialysis. Staphylococcus aureus (S. aureus) is a common etiological agent, with prior nasal colonization identified as a risk factor for infection. The aim of the present cross-sectional study was to determine the prevalence of nasal S. aureus carriage among patients with CKD undergoing dialysis at a university hospital and identify potential factors associated with colonization. Methods: Nasal swabs were obtained, and bacterial isolates were identified using matrix-assisted laser desorption/ionization time-of-flight spectrometry and antibiogram testing with the Vitek 2 system. Demographic and clinical data were collected for the investigation of risk factors associated with colonization. Results: Among the 96 patients analyzed, 34 were carriers of S. aureus. Among these carriers, three (8.8%) harbored oxacillin-resistant strains. More than half of the S. aureus strains exhibited resistance to clindamycin but susceptibility to oxacillin. Colonization was associated with age and the use of corticosteroids/immunosuppressants. Conclusions: The prevalence of nasal S. aureus carriage was high among patients undergoing dialysis at the university hospital, exceeding that found in the general population. Nasal colonization by S. aureus was linked to corticosteroid use and age. Understanding factors associated with S. aureus nasal colonization in patients on dialysis can assist healthcare providers in preventing the spread of infection and cross-contamination, while reducing risk in this population.