RESEARCH ARTICLE Persistent nasal methicillin r f S Background

Despite great technological advances in hemodialysis in HD patients and has become increasingly resistant to antibiotics worldwide [2]. Schmid et al. BMC Nephrology 2013, 14:93 http://www.biomedcentral.com/1471-2369/14/93hospitalization, a history of repeated antibiotic adminis-2Clinic and Policlinic IV, Section of Nephrology, University of Munich, Munich, Germany(HD) therapy mortality rates of HD patients remain un-satisfactorily high [1]. Next to cardiovascular diseases, infections are major causes of morbidity, hospitalization and mortality in this population. Staphylococcus aureus (S. aureus) accounts for the majority of bacterial infections Elevated Methicillin-resistant S. aureus (MRSA) coloni-zation rates are well recognized in long-term HD patients and are associated with a high risk of blood stream infec-tions (BSI) [3,4]. Particularly vascular catheter access rep-resents a primary risk for BSI in HD patients [5]. Colonization of S. aureus in the anterior nares hazards patients for subsequent infection of endogenous origin [6]. HD patients at risk for nasal MRSA carriage are par-ticularly those with higher age (≥75 years), prolonge