Staphylococcus aureus colonization increases the risk of invasive infections in different groups of patients. We analyzed the dynamics and factors associated with S. aureus colonization in hemodialysis patients. A longitudinal study was conducted at a dialysis center associated with a tertiary health care institution. S. aureus colonization was assessed three times in nostrils and on the skin and was classified as absent, intermittent or persistent. The molecular analysis included pulsed-field gel electrophoresis (PFGE) and spa-typing. Clonal complex was inferred from spa-typing. A model of generalized estimating equations was performed to determine the factors associated with colonization. A total of 210 patients were included. Colonization by methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) isolates was 29.1 % vs. 4.8 %, 29.2 % vs. 6.7 % and 24.1 % vs. 7.1 % in the first, second and third screenings respectively. Most of the colonized patients were intermittent carriers (77.8 %, n = 63). PFGE and spa-typing revealed a high genetic diversity. One third (33.3 %) of the carriers classified as persistent had different clones during follow-up. Clonal complex 8 was frequent among MSSA (28 %) and MRSA (59 %) isolates. Current smoking (OR:7.22, 95 %CI 2.24–23.27), Charlson index (OR:1.22, 95 %CI 1.03–1.43) and previous infection by S. aureus (OR:2.41; 95 %CI:1.09−5.30) were associated with colonization by this microorganism. Colonization increased the risk of bacteremia (HR = 4.9; 95 % CI: 1.9–12.9). In conclusion, the colonization by S. aureus in hemodialysis patients changes over time and acquisition of new clones is a frequent event. These results evidence that patients are repeatedly recolonizing from hospitals, dialysis units and their homes. On the other hand, factors not associated with healthcare, as smoking, can increase the risk of colonization.

金黄色葡萄球菌定植增加了不同组患者的侵袭性感染风险。我们分析了血液透析患者中与金黄色葡萄球菌定植有关的动力学和因素。在与三级医疗机构相关的透析中心进行了纵向研究。在鼻孔和皮肤上评估金黄色葡萄球菌定植3次，分类为不存在，间歇或持续。分子分析包括脉冲场凝胶电泳（PFGE）和spa分型。从spa推断克隆复合体-打字。进行广义估计方程模型以确定与定植有关的因素。总共包括210名患者。在第一次，第二次和第三次筛选中，对甲氧西林敏感（MSSA）和耐甲氧西林（MRSA）分离株的定殖分别为29.1％对4.8％，29.2％对6.7％和24.1％对7.1％。大多数定植的患者是间歇性携带者（77.8％，n = 63）。PFGE和水疗分型显示出很高的遗传多样性。被归类为持久性的携带者中有三分之一（33.3％）在随访期间具有不同的克隆。在MSSA（28％）和MRSA（59％）分离株中，克隆复合物8很常见。目前吸烟（OR：7.22，95％CI 2.24–23.27），Charlson指数（OR：1.22，95％CI 1.03–1.43）和以前感染过金黄色葡萄球菌（OR：2.41; 95％CI：1.09-5.30）与该微生物的定殖有关。定植会增加发生菌血症的风险（HR = 4.9； 95％CI：1.9-12.9）。总之，血液透析患者中金黄色葡萄球菌的定植随时间而变化，并且新克隆的获得是经常发生的事件。这些结果证明，患者在医院，透析单位及其家中反复定居。另一方面，与医疗保健无关的因素（例如吸烟）会增加定植的风险。