الفهرس 
Staphylococci
Determinants for colonisationOnly 14 pages are availabe for public view
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Abstract
The Staphylococcus aureus are considered as the most causing of such
infections being one of the important and principal morbid factors that cause the
blood infections among Hemodialysis populations.
Nasal carriage of Staphylococcus aureus is a recognized risk factor for the
development of hemodialysis CRBSIs of endogenous origin. The vestibulum nasi
are the main ecological niche where the organisms colonize and then disseminate to
the other parts of the body.
This work included 40 patients who were received hemodialysis with inserted
temporary dialysis catheters in Ain Shams University Hospitals, Egypt. All
patients who were received temporary dialysis catheters were observed for the
occurrence of any local or systemic infections.
All Patients were subjected to the following:
1- Full medical history .
- Personal history.
- Dialysis-session length in-hours. All patients had 3 dialysis sessions per week.
- Co-morbidities like diabetes mellitus (as a disease accompanied with
infections).
2- Clinical examination particularly for fever, any local (at catheter exit
site) or systemic infection.
3- Laboratory investigations.
Our results demonstrated that more than half of the participants (52.5%) were
between 40-59 years; while (37.5%) were 60 years or more and only 10.0% were
between 20-39 years. The mean age of the participants was 54.6 + 11.3 and their ages range from 22-81 years, and relation between Staphylococcus aureus nasal
carriage and Age of the participants of ( 40- 59 y) 47.6% and patients > 60 years
were 46%.
55% of the study participants were males while 45.0% were females. In
addition there is no statistically significant difference between the studied
participants as regard their gender (P>0.05).
Our results demonstrated that Moreover (100%) of study participants were
having chronic kidney disease, (35%) were hepatitis c virus positive, (22.5%) were
hypertensive and (20%) were diabetics, finally the majority of participants (87.5%)
of the participants stayed 4 hours duration on the dialysis session, while (12.5%)
stayed 3 hours; The mean duration of the dialysis session was about 3.87 + 0.33
hours and the duration of dialysis ranged from 3-4 hours. In addition to that there is
a highly statistically significant difference between study participants as regard
duration on dialysis session (P<0.01).
Our results demonstrated that (12.5%) of the participants had fever as a
presenting symptom, (12.5%) had chills, & (10%) had hypotension, In addition to
that (45.0 %) of the participants had Positive nasal swab, (27.5%) had positive
central blood culture and 3 patients had positive peripheral blood culture from 5
patients by (60%), moreover (75.0%) don’t have catheter exit site manifestations
while it is present in (25.0%) of patients .
Our results demonstrated that (81.8%) of the participants who had Positive
central blood culture had positive nasal swab. In addition to that participants with
positive nasal swab are 1.818 times more liable to develop positive central blood
culture than patients with negative nasal swab (RR=1.818; 95%CI= (1.125-2.940).
Our results demonstrated that shows that there is a statistically significant
Relation between Staphylococcus aureus nasal carriage and CDC Criteria for infection including Fever, Chills and Hypotension (P<0.05); on the contrast there is
no statistically significant Relation between Staphylococcus aureus nasal carriage
and presence of catheter exit site (P>0.05).
Our results demonstrated that Staph Coagulase –ve was the most frequent
organism found in Central Blood Culture (45.5%), followed by Staph Coagulase
+ve (36.4%), Ecoli and Pseudomonas each account for (9.1%) respectively. And
shows that the presence of the three organisms Staph Coagulase –ve, Staph
Coagulase +ve and Ecoli was the same in peripheral blood culture each one
accounts for (33.3%) respectively.
Data obtained show organisms retrieved from nasal swabs were most sensitive
to Vancomycin & DA Our results demonstrated that (94.4% & 77.8%) respectively
while 77.8% were resistant to FOX while 72.2% were resistant to E & SXT
respectively., and organisms retrieved from central venous line were most sensitive
to Vancomycin, DO & DA (100.0%, 90.9% & 81.8%) respectively while 100.0%
were resistant to SXT while 63.7% were resistant to FOX and Erythromycin.
Finally, organisms retrieved from peripheral line were most sensitive to
Vancomycin, DA & CN (100.0%) sensitivity; while 100.0% were resistant to
Erythromycin.
Our results demonstrated that relationship between Central Blood Culture
Organism and Peripheral Blood Culture Organism revealed that results of Peripheral
Blood Culture Organism & Central Blood Culture Organism agreed on the same
organism by 33.3% of cases did central and peripheral cultures and the organism
Staph +ve coagulase.