Extranasal <i>Staphylococcus aureus</i> colonization predisposes to bloodstream infections in patients on hemodialysis with noncuffed internal jugular vein catheters

Devraj, Anand; Pinnamaneni, Venkata Siva Tez; Biswal, Manisha; Ramachandran, Raja; Jha, Vivekanand

doi:10.1111/hdi.12450

Cited by 11 publications

(9 citation statements)

References 17 publications

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“…Staphylococcus was also found to occur in RO water by Gomila et al [38]. Moreover, it was revealed that Staphylococcus aureus could increase the risk of invasive infection of hemodialysis patients [39,40]. The high level of these genera alerts the existence of certain occult microbial contaminations in RO effluent that could generate enormous risk to dialysis patients, and prompts the remedy of the insufficient traditional method that ignores the detection of uncultured or VBNC bacteria [38].…”

Section: Structure and Diversity Analyses Of Microbial Communitymentioning

confidence: 99%

Profiling Total Viable Bacteria in a Hemodialysis Water Treatment System

Chen

Zhu²,

Zhang

et al. 2017

Journal of Microbiology and Biotechnology

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Culture-dependent methods, such as heterotrophic plate counting (HPC), are usually applied to evaluate the bacteriological quality of hemodialysis water. However, these methods cannot detect the uncultured or viable but non-culturable (VBNC) bacteria, both of which may be quantitatively predominant throughout the hemodialysis water treatment system. Therefore, propidium monoazide (PMA)-qPCR associated with HPC was used together to profile the distribution of the total viable bacteria in such a system. Moreover, high-throughput sequencing of 16S rRNA gene amplicons was utilized to analyze the microbial community structure and diversity. The HPC results indicated that the total bacterial counts conformed to the standards, yet the bacteria amounts were abruptly enhanced after carbon filter treatment. Nevertheless, the bacterial counts detected by PMA-qPCR, with the highest levels of 2.14 × 10 copies/100 ml in softener water, were much higher than the corresponding HPC results, which demonstrated the occurrence of numerous uncultured or VBNC bacteria among the entire system before reverse osmosis (RO). In addition, the microbial community structure was very different and the diversity was enhanced after the carbon filter. Although the diversity was minimized after RO treatment, pathogens such as could still be detected in the RO effluent. In general, both the amounts of bacteria and the complexity of microbial community in the hemodialysis water treatment system revealed by molecular approaches were much higher than by traditional method. These results suggested the higher health risk potential for hemodialysis patients from the up-to-standard water. The treatment process could also be optimized, based on the results of this study.

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Section: Structure and Diversity Analyses Of Microbial Communitymentioning

confidence: 99%

Profiling Total Viable Bacteria in a Hemodialysis Water Treatment System

Chen

Zhu²,

Zhang

et al. 2017

Journal of Microbiology and Biotechnology

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“…Also, in another study carried out by Devraj et al S. aureus colonization in throat were observed in 11.4% of hemodialysis patients [14].…”

Section: Discussionmentioning

confidence: 99%

Nasal and extra nasal MRSA colonization in hemodialysis patients of north-west of Iran

et al. 2019

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Objectives Methicillin resistant Staphylococcus (S.) aureus colonization is one of the main causes of serious infections in hemodialysis patients. This cross-sectional study was performed to examine prevalence of MRSA colonization and evaluation of risk factors in hemodialysis patients. A total of 560 swab samples from nasal, the skin around catheter and throat were collected from 231 hemodialysis patients in Tabriz. The standard biochemical tests were used for identification of S. aureus isolates. Antimicrobial susceptibility profile was determined against 11 antibiotics by the disk diffusion method. Phenotypic test of S. aureus was performed using novobiocin 30 μg/disc, and methicillin sensitivity test was performed by cefoxitin 30 μg/disc. Results Overall, 50.65% (118/231) hemodialysis patients were positive for S. aureus which 34.93% (80/231) of patients were MRSA carriage. The MRSA colonization in patients with a catheter (44.06%) was more than individuals utilizing a fistula (24.57%, p = 0.030). Among sampling sites, the highest MRSA was related to nasal samples (30.70%, p < 0.00001). Extra nasal colonization of S. aureus was observed in 12.71% patients. The highest rates of resistance were observed against ampicillin (93.98%) and the highest sensitivity was against linezolid antibiotic (5.42%). These findings highlight the necessity of prophylaxis against S. aureus in individuals under dialysis.

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“…17 The risk of infections in nasal carriers of this microorganism is real and well defined. 18 It is important to point out that the small number…”

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Staphylococcus aureus Isolates Obtained from Hemodialyzed Patients at the Hospital de Clínicas of Paraguay: A pilot study

et al. 2017

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Background: Patients undergoing hemodialysis are susceptible to the nasal carriage of Staphylococcus aureus, increasing the risk of developing infections associated with higher morbidity and mortality. The objective of this study was to describe the frequency of S. aureus carriage in hemodialysis patients and to perform molecular analysis of isolates by applying multiple-locus variable analysis. Methods: We conducted a descriptive cross sectional study with non-probabilistic sampling that included 28 hemodialysis patients attending the Nephrology Department of Hospital de Clínicas in Asunción, Paraguay. We obtained clinical data from medical records and interviews with patients. Nasal swabs were collected and analyzed by microbiological and molecular methods. Results: The frequency of S. aureus carriage was 50% (14/28), 93% of which (13/14) were methicillin resistant, 57% (6/14) were gentamicin resistant and 36% (5/14) were resistant to more than 4 antibiotic classes. S. aureus carriers showed higher frequency of rhinitis (p=0.02 odds ratio [OR]=6.6 (1.2- 34.4)). Seven methicillin-resistant S. aureus isolates had been analyzed by multiple-locus variable analysis, two of them showed identical pattern bands. Conclusion: We found a high frequency of methicillin-resistant Staphylococcus aureus colonization and the presence of two isolates with identical profile in the multiple-locus variable analysis indicating the possibility of transmission between patients.

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Extranasal Staphylococcus aureus colonization predisposes to bloodstream infections in patients on hemodialysis with noncuffed internal jugular vein catheters

Abstract: Extranasal S. aureus carriage is as significant a risk factor as nasal carriage for staphylococcal infections in patients on HD through catheters. The study is limited by lack of molecular phenotyping.

Cited by 11 publications

References 17 publications

Profiling Total Viable Bacteria in a Hemodialysis Water Treatment System

Profiling Total Viable Bacteria in a Hemodialysis Water Treatment System

Nasal and extra nasal MRSA colonization in hemodialysis patients of north-west of Iran

Molecular Characterization of Staphylococcus aureus Isolates Obtained from Hemodialyzed Patients at the Hospital de Clínicas of Paraguay: A pilot study

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