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Prevalence of Bacterial Colonisation in Patients Undergoing Hemodialysis: Experience from a Tertiary Care Centre

Geetanjali Loomba, Nitya Batra, Manju Dhandapani, Sukhpal Kau, Sandhya Ghai, Manisha Biswal, Raja Ramachandran

Abstract


Routine surveillance of patients on hemodialysis is necessary to prevent and control skin colonization and staphylococcal infections. To assess the prevalence of bacterial colonization on various skin sites in patients undergoing hemodialysis. A cross-sectional study was conducted on adult patients at a tertiary care center of North India. Study was conducted from July 2016 to September 2016 on adult patients with newly diagnosed end stage renal disease (ESRD) on maintenance hemodialysis via internal jugular vein catheter. Pre-Moistened, sterile cotton swabs were used to collect samples from various sites (anterior nares, throat, dialysis catheter insertion site, axilla and toe webs) for colonization study. Identification of isolates received was done by the Bruker Biotyper MALDI-TOF. Species level identification was considered reliable at identification score of more than 2.0 and genus level identification was considered acceptable with identification score of more than 1.7 and less than 2.0. Primary outcome of the study was prevalence of bacterial colonisation in patients undergoing hemodialysis at various skin sites. Seventy two patients were enrolled with mean age of 42.4±13.41 years and 66% were males. Coagulase negative bacteria were more predominant at all the skin sites of patients as compared to coagulase positive bacteria. S. aureus was most prevalent at anterior nares (6.9%) followed by site of catheter insertion (4.2%), throat (2.8%), toe webs (2.8%) and axilla (1.4%). Methicillin resistant S. aureus was found at anterior nares (60%) and throat site (50%). Microorganism colonisation is prevalent among ESRD patients undergoing hemodialysis. Preventive strategies should be employed for such patients in order to prevent occurrence of infections. Early identification will aid in reducing the prevalence of infection related complications in this population.


Keywords


Colonisation, end stage renal disease, hemodialysis, Staphylococcus

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References


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