Optimizing screening procedures for Staphylococcus aureus nasal carriage in patients on haemodialysis.

the major pathogen, accounting for 70‐96% of bacBackground. So far it remains unclear what the terial infections [1‐4]. optimal screening method for detection of S. aureus The anterior nares are the main reservoir for S. nasal carriage in patients on haemodialysis is with aureus and nasal carriage can maintain skin infections regard to number of cultures performed, culture inter- and thus contribute to the risk for subsequent invasive val, and necessity of a broth-enrichment procedure. infections [5,6 ]. Measures to eradicate nasal carriage Methods. A prospective, uncontrolled study was per- by means of topical bactericidal ointments or antiformed at the renal unit of a tertiary care centre, biotics to prevent these infectious complications have including all haemodialysis patients (n=91) attending been shown to be eVective in haemodialysis patients the unit during the study period. The purpose was to [1,7]. Hence, adequate establishment of S. aureus nasal determine the optimal screening method for S. aureus carrier status is essential in these patients. Truenasal carriage in patients on haemodialysis. negative cultures can be found in non-carriers, but also Results. When compared to the conventional culture in patients who intermittently carry S. aureus. Falsemethod, inclusion of a broth-enrichment procedure negative culture results may arise from sampling errors increased the number of cultures positive for S. aureus or insensitive culture methods. Van Ogtrop reported significantly (31 vs 24%, P 24-h) sampling carriers have to be isolated in order to prevent transprocedure showed no significantly diVerent results. mission of MRSA. Conclusions. S. aureus nasal carriage in haemodialysis The aim of this study was to optimize the method patients can be conveniently established with three for assessment of the S. aureus nasal carrier status in nasal cultures taken with 1-h intervals, and the inclu- the patients on haemodialysis at our unit. sion of a broth-enrichment procedure.