背景:鼻道中金黄色葡萄球菌定植的患者有更高的感染风险,特别是如果他们是免疫功能低下或有合并症,如慢性肾功能衰竭进行血液透析(HD)。
目的:本研究旨在利用7周的采样方案报告HD患者中金黄色葡萄球菌鼻腔携带的患病率,并评估这些分离株对各种抗菌药物的敏感性。
方法:连续七周,收集了47例HD患者的鼻拭子样本,共产生329个样本。使用生化方法鉴定微生物,并通过圆盘扩散和微量稀释技术进行抗微生物药敏试验。
结果:在分析的所有患者中,25个人(53.19%)被金黄色葡萄球菌定植,其中21个显示间歇性定殖。此外,38%的金黄色葡萄球菌仅在第6或第7周取样时显示阳性结果。在58个分离株中,17.2%(n=10)表现出甲氧西林(苯唑西林)耐药,25.86%(n=15)表现出万古霉素MIC值升高(2µg/ml)。根据结果,发现达托霉素和庆大霉素是有效的治疗选择。然而,31%的分离株(n=18)对达托霉素的MIC为1μg/ml。
结论:超过一半的患者被金黄色葡萄球菌定植,但主要是间歇性的。苯唑西林耐药性和高万古霉素和达托霉素MIC的鉴定可作为在这些患者中管理由金黄色葡萄球菌引起的菌血症的未来可能并发症的警告。
BACKGROUND: Patients colonized with Staphylococcus aureus in their nasal passages have a higher risk of acquiring infection, especially if they are immunocompromised or have comorbidities such as chronic renal failure undergoing hemodialysis (HD).
OBJECTIVE: This study aimed to report the prevalence of nasal carriage of S. aureus among HD patients utilizing a seven-week sampling protocol and to assess the susceptibility of these isolates to various antimicrobial agents.
METHODS: Over seven consecutive weeks, nasal swab samples were collected from 47 HD patients, resulting in a total of 329 samples. The microorganisms were identified using biochemical methods and subjected to antimicrobial susceptibility testing via disk diffusion and microdilution techniques.
RESULTS: Out of all the patients analyzed, 25 individuals (53.19%) were found to be colonized by S. aureus, with 21 of them displaying intermittent colonization. Additionally, 38% showed positive results for S. aureus in only the 6th or 7th week of sampling. Within the 58 isolates, 17.2% (n=10) exhibited methicillin (oxacillin)-resistance and 25.86% (n=15) displayed elevated vancomycin MIC values (2 µg/ml). Based on the results, daptomycin and gentamicin were found to be effective treatment options. However, 31% of the isolates (n=18) exhibited a MIC of 1 µg/ml for daptomycin.
CONCLUSIONS: Over half of the patients were colonized by S. aureus, but mostly on an intermittent basis. The identification of oxacillin resistance and high vancomycin and daptomycin MICs serve as warnings for possible future complications in managing bacteremia caused by S. aureus in these patients.