Epidemiology of Staphylococcus Aureus Infections in Patients on Hemodialysis

Abstract

Objective: To determine the epidemiology of Staphylococcus aureus infections in hemodialysis patients.Method: S aureus isolates from surveillance cultures and from sites of infection were evaluated by both bacteriophage typing and restriction endonuclease digestion of plasmid DNA.Setting: A hemodialysis unit in Brugge, Belgium.Organisms: S aureus isolates from 11 chronic hemodialysis patients who had participated in the placebo arm of a previously reported placebo-mupirocin comparative study.Results: Of 75 S aureus isolates evaluated, 63 were from cultures of nares and 12 from infections (three arteriovenous fistula infections, four wound infections, and five bacteremias). All isolates were typed by bacteriophages and 56 (75%) had plasmids. Three patients developed 12 infections. Eleven infections were caused by isolates previously identified in surveillance cultures. Only one infection was caused by a strain not identified previously in surveillance cultures.Conclusion: These results support the hypothesis that S aureus isolates causing infections in hemodialysis patients are of endogenous origin.