Roubicek C, Brunet P, Mallet M N, Dussol B, Gonzales A, Andrieu D, Merzouk T, Jaber K, Berland Y
Service de néphrologie, Hôpital de Sainte-Marguerite, Marseille.
Nephrologie. 1995;16(3):229-32.
We evaluated nasal carriage of Staphylococcus aureus (S. aureus) in 114 hemodialysis patients by performing two nasal swab cultures at a one month interval. The incidence of bacteremia was then followed for one year. Other factors associated with infections in hemodialysis patients, such as diabetes, central venous catheter, and high serum ferritin levels were also evaluated. Nasal carriage of S. aureus was present in 29.8% of patients (34/114). Six S. aureus bacteremia occurred in 6 patients. This represents an annual incidence of 0.058 bacteremia/patient-year. The incidence of bacteremia was higher in patients with S. aureus nasal carriage (0.0945) than in patients without (0.0417), but the difference was not significant. The relative risk (RR) was 2.35. On the contrary, bacteremia were significantly more frequent in patients with diabetes (RR = 11.41; p = 0.004) or in patients with central venous catheter (RR = 14.29; p = 0.002). In conclusion, in our population, diabetes and central venous catheter are more significant risk factors of bacteriemia than S. aureus nasal carriage.
我们通过每隔一个月进行两次鼻拭子培养,对114例血液透析患者的金黄色葡萄球菌鼻腔定植情况进行了评估。随后对菌血症的发生率进行了为期一年的跟踪。还评估了血液透析患者感染的其他相关因素,如糖尿病、中心静脉导管和高血清铁蛋白水平。29.8%的患者(34/114)存在金黄色葡萄球菌鼻腔定植。6例患者发生了6次金黄色葡萄球菌菌血症。这代表菌血症的年发病率为0.058/患者-年。金黄色葡萄球菌鼻腔定植患者的菌血症发生率(0.0945)高于无定植患者(0.0417),但差异无统计学意义。相对风险(RR)为2.35。相反,糖尿病患者(RR = 11.41;p = 0.004)或中心静脉导管患者(RR = 14.29;p = 0.002)的菌血症明显更频繁。总之,在我们的研究人群中,糖尿病和中心静脉导管比金黄色葡萄球菌鼻腔定植是更重要的菌血症危险因素。