Staphylococcus aureus nasal carriage in hemodialysis centers of Fez, Morocco

Idrissa Diawara; Khadija Bekhti; Driss Elhabchi; Rachid Saile; Naima Elmdaghri; Mohammed Timinouni; Mohamed Elazhari

Staphylococcus aureus nasal carriage in hemodialysis centers of Fez, Morocco

Iran J Microbiol. 2014 Jun;6(3):175-83.

Authors

Idrissa Diawara¹, Khadija Bekhti¹, Driss Elhabchi², Rachid Saile³, Naima Elmdaghri⁴, Mohammed Timinouni⁴, Mohamed Elazhari⁴

Affiliations

¹ Department of Biology, Faculty of Science and Technology, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
² Department of the Food safety and the sanitary hygiene, Pasteur Institute of Morocco, Casablanca, Morocco.
³ Laboratory of Biology and Health URAC34-Metabolic and Immunologic Pathology Research Team, Faculty of Science, Ben M'sik, Hassan II University, Casablanca, Morocco.
⁴ Molecular Bacteriology Laboratory, Pasteur Institute of Morocco, Casablanca, Morocco.

PMID: 25870751
PMCID: PMC4393494

Abstract

Background and objectives: Staphylococcus aureus (S. aureus) nasal carriage may be responsible for some serious infections in hemodialyzed patients. The main target of this study was to estimate the prevalence of S. aureus nasal carriage in hemodialysis outpatients and medical staff in hemodialysis centers specifically in Fez region. The second target is to identify the risks of colonization, resistance pattern of isolates and their virulence toxin genes.

Patients and methods: Nasal swab specimens were obtained from 143 hemodialyzed outpatients and 32 medical staff from January to June 2012. Each participant completed a short questionnaire. Nasal carriage of S. aureus was demographically related (age, gender, hemodialysis duration), comorbidity (diabetes, malignancy) and exposure to health care (dialysis staff, hospitalization). PCR (Polymerase Chain Reaction) were used on all the isolates in the research of twelve staphylococcal enterotoxins genes. Also the PCR was used to investigate on the three factors epidermal cell differentiation inhibitors; three exfoliatin toxins; two leukotoxins; the toxic shock syndrome toxin-1 and the hemolysin beta genes.

Results: Nasal screening revealed 38.16%, 50% and 18.75% S. aureus carries in chronic, acute hemodialysis patients and medical staff, respectively. Only young participants were likely to be S. aureus carries (p = 0.002). But there were no gender differences between the isolate carriers and non-carriers or some comorbidity factors such as viral hepatitis B and C, HIV (Human Immunodeficiency Virus) infections, diabetes, chronic smoking, recent hospitalization or antibiotic therapy. Out of all isolates, only one (1.61%) was methicillin-resistant and Twenty-one (33.87%) had at least two virulence toxin genes.

Conclusions: Knowledge and monitoring of antibiotic resistance profile and virulence of S. aureus carriage are essential in the treatment of infections generated by this pathogen, as well as in the control of clonal dissemination and prevent the spread of S. aureus resistance.

Keywords: Nasal carriage; Staphylococcus aureus; antimicrobial susceptibility; hemodialysis; toxin genes.