[Nasal carriage of Staphylococcus aureus at a hemodialysis unit in Dakar]. / Etude du portage nasal de Staphylococcus aureus dans une Unité d'Hémodialyse à Dakar.

Infectious diseases are the most common complications of the hemodialysis unit patients. Staphylococcus aureus (SA) is the main cause and is supposed to be lodged in the nostrils. The purpose of this study is to assess the importance of the SA presence in the patients and the medical staff nostrils in a senegaleese hemodialysis unit. In this regard, we performed a six-month prospective study on 12 patients on going hemodialysis (11 males and 1 female) and 7 medical agents (4 nurses, 2 physicians, and 1 nurse assistant). On patients we reported the initial nephropathy, the problems of vascular access, the infectious episodes prior to the study, and the duration of dialysis. Three sample series of nostril swabbing were carried out on patients and medical staff at a rate of one series every other month. Blood culture was systematically carried out on patients, with body temperature higher than 38 degrees C, every two months and. Sensibility to several antibiotics was tested for each stain. We found six cases of clinical nephroangiosclerosis, one Wegener granuloma and five unknown causes. All patients had Brescia Cimino arteriovenous fistula vascular and the mean time underdialysis was 36 months (from 7 to 55). Bacteriologically, 124 nostril specimens were performed, 80 on patients, 44 on medical staff. SA was isolated in 64 specimens (52 %) on patients and 34 specimens (24.4 %) on staff. Strains from forty five patients (70.32 %) were sensitive to methicillin versus 23 stains from staff ( 67.6 %). The difference was not statistically significant. Sensibility profil for other antibiotics was the same for patients and staff. All blood culture were negative. Despite nostril carriage noted on patients and staff, there were no infections during this period. However, the presence of permanent infection sites make it mandatory to be on the alert in order to control some of the behavioral changes of the germs, and to put into place an adequate prevention system.