Abstract:
Infection is one of the important factors affecting morbidity and mortality in hemodialysis patients. Access to dialysis, frequent hospitalizations, and contact with healthcare personnel increase the risk of infection. Nasal Staphylococcus aureus and other staphylococci may cause vascular access infections through carrier patients and staff. In this study, nasal S. aureus and coagulase- negative Staphylococcus (CNS) carriers were detected in hemodialysis patients and staff, and methicillin resistance in isolates was investigated by various methods. In this way, it was aimed to contribute to the assessment of nosocomial infection risk. Between November 2019 and March 2020, 93 hemodialysis patients, 41 female, 52 male, and 15 dialysis personnel treated at Nevşehir State Hospital, H. Mustafa and Türkan Öbekli Dialysis Center were included in the study. Nasal swab samples were obtained after the informed consent form was signed. Methicillin resistance in staphylococci isolated from the samples was determined by the Kirby-Bauer disk diffusion method, PBP-2a latex agglutination (LA) test, and real-time polymerase chain reaction (RT-PCR). Of the patient samples (n=93), 18 (19.3%) had S. aureus, 11 (11.8%) had CNS; of the personnel samples (n=15) CNS was isolated from three (20%) and S. aureus from one (6.6%). It was determined that one of the S. aureus isolated from the patients was methicillin-resistant (1%); the rest (18.2%) and all CNS (11.8%) were methicillin-susceptible by disk diffusion method. While all of the CNS (20%) in the personnel samples were susceptible to methicillin, only S. aureus was resistant (6.6%). The PBP-2a LA test and RT-PCR were performed on all S. aureus isolates (n=19); the PBP-2a
LA test and mecA gene were positive in both isolates identified as methicillin-resistant S. aureus via disk diffusion. In conclusion, porter screenings should be done regularly to control infections in hemodialysis units. Alternative methods to determine the resistance profiles of isolated microorganisms might be preferred according to the needs and equipment of the health institution.