Identifying Hemodialysis Patients With the Highest Risk of Staphylococcus aureus Endogenous Infection Through a Simple Nasal Sampling Algorithm
Abstract
In contrast to Staphylococcus aureus intermittent nasal carriers, persistent ones have the highest risk of infection. This study reports the usefulness of a simple nasal sampling algorithm to identify the S. aureus nasal carriage state of hemodialysis patients (HPs) and their subsequent risk of infection.From a cohort of 85 HPs, 76 were screened for S. aureus nasal carriage once a week during a 10-week period. The S. aureus nasal load was quantified by using either culture on chromogenic medium or fully automated real-time polymerase chain reaction assay. Molecular typing was used to compare strains from carriage and infection.The algorithm based on quantitative cultures was able to determine the status of S. aureus nasal carriage with a sensitivity of 95.8%, a specificity of 94.2%, a positive predictive value of 88.5%, and a negative predictive value of 98.0%. Of note, the determination of the S. aureus carriage state was obtained on the first nasal sample for all the 76 HPs, but 1 (98.7%). The algorithm based on quantitative polymerase chain reaction assay directly from the specimen yielded similar performances. During the 1-year follow-up after the last sampling episode, HPs classified as persistent nasal carriers with the algorithm were found to have a higher risk of S. aureus infection than those classified as nonpersistent carriers (P < 0.05), especially for infections of endogenous origin (P < 0.001).This simple algorithm is reliable for determining the S. aureus nasal carriage status in clinical practice and could contribute to characterize at an early stage of take-up patients with the highest risk of S. aureus infection.
Related
- Quantification by Real-Time PCR Assay of Staphylococcus aureus Load: a Useful Tool for Rapidly Identifying Persistent Nasal Carriers
- An algorithm based on one or two nasal samples is accurate to identify persistent nasal carriers of Staphylococcus aureus
- Arsenic Resistance Protein BcArs2 Modulates Endogenous ROS Homeostasis in Infection Cushions to Enhance the Virulence of Botrytis cinerea Toward Host Plants
- Preserving Nanotherapy-Induced Allogeneic Murine Islet Graft Tolerance During Distal Methicillin-Resistant Staphylococcus aureus Skin Infection
- Community-Acquired Staphylococcus argenteus Sequence Type 2250 Bone and Joint Infection, France, 2017
BibTeX
@article{verhoeven2026identifying,
title = {{Identifying Hemodialysis Patients With the Highest Risk of Staphylococcus aureus Endogenous Infection Through a Simple Nasal Sampling Algorithm}},
author = {Paul Verhoeven and Julie Gagnaire and Cyrille Haddar and Florence Grattard and Damien Thibaudin and Aida Afiani and Céline Cazorla and Anne Carricajo and Christophe Mariat and Eric Alamartine and Frédéric Lucht and Olivier Garraud and Bruno Pozzetto and Elisabeth Botelho-Nevers and Philippe Berthelot},
journal = {Medicine (Wolters)},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000003231},
url = {https://hal.science/hal-05780061v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Identifying Hemodialysis Patients With the Highest Risk of Staphylococcus aureus Endogenous Infection Through a Simple Nasal Sampling Algorithm
AU - Paul Verhoeven
AU - Julie Gagnaire
AU - Cyrille Haddar
AU - Florence Grattard
AU - Damien Thibaudin
AU - Aida Afiani
AU - Céline Cazorla
AU - Anne Carricajo
AU - Christophe Mariat
AU - Eric Alamartine
AU - Frédéric Lucht
AU - Olivier Garraud
AU - Bruno Pozzetto
AU - Elisabeth Botelho-Nevers
AU - Philippe Berthelot
PY - 2026
DA - 2026/10/06
JO - Medicine (Wolters)
DO - 10.1097/md.0000000000003231
UR - https://hal.science/hal-05780061v1
AB - In contrast to Staphylococcus aureus intermittent nasal carriers, persistent ones have the highest risk of infection. This study reports the usefulness of a simple nasal sampling algorithm to identify the S. aureus nasal carriage state of hemodialysis patients (HPs) and their subsequent risk of infection.From a cohort of 85 HPs, 76 were screened for S. aureus nasal carriage once a week during a 10-week period. The S. aureus nasal load was quantified by using either culture on chromogenic medium or fully automated real-time polymerase chain reaction assay. Molecular typing was used to compare strains from carriage and infection.The algorithm based on quantitative cultures was able to determine the status of S. aureus nasal carriage with a sensitivity of 95.8%, a specificity of 94.2%, a positive predictive value of 88.5%, and a negative predictive value of 98.0%. Of note, the determination of the S. aureus carriage state was obtained on the first nasal sample for all the 76 HPs, but 1 (98.7%). The algorithm based on quantitative polymerase chain reaction assay directly from the specimen yielded similar performances. During the 1-year follow-up after the last sampling episode, HPs classified as persistent nasal carriers with the algorithm were found to have a higher risk of S. aureus infection than those classified as nonpersistent carriers (P < 0.05), especially for infections of endogenous origin (P < 0.001).This simple algorithm is reliable for determining the S. aureus nasal carriage status in clinical practice and could contribute to characterize at an early stage of take-up patients with the highest risk of S. aureus infection.
SN - 0025-7974
SN - 1536-5964
ER -