Understanding your nasal swab pathology result
Why do I need to have a nasal swab?
You need to have a nasal swab to see if you carry the bacteria staphylococcus aureus in your nose as this places you at risk of an infection in your dialysis access.
Infection may occur:
- where your haemodialysis catheter (permacath) enters the skin; or
- in your arteriovenous fistula needle hole; or
- in your bloodstream.
What is staphylococcus aureus?
Staphylococcus aureus is a bacteria. Approximately 40 percent (or 4 in 10) of patients with Chronic Kidney Disease carry these bacteria in their nose. Approximately one third of the general community also carry these bacteria in their nose.
Most of the time, these bacteria do not cause any problems or only result in relatively minor skin infections. This bacteria is NOT “Golden Staph”.
Staphylococcus is transmitted through air droplets. When a person who carries the bacteria in their nose, coughs or sneezes, he or she releases numerous small droplets of saliva that remain suspended in air.
This bacterium could cause an infection at your catheter entry site, your arteriovenous fistula needle site or in your bloodstream.
Staphylococcus aureus infections in the blood stream are serious and can be fatal.
What do I need to do?
You will be provided with Mupuricin ointment and Chlorhexidine body wash. This treatment is called a de-colonisation treatment.
The instructions are:
- Insert nasal Mupuricin ointment into each nostril 3 times daily for 5 days.
- Use the Chlorhexidine 4% body wash to wash yourself in the shower every day for five days.
What follow up will be required?
Your nose will be swabbed again two weeks after the treatment is complete. This is to check that the treatment has been effective.
If the follow up nose swab confirms that bacteria remains in your nose, the de-colonisation treatment will be repeated.
What happens if the bacteria remain after attending the de-colonisation treatment twice?
A further follow up nose swab will be done following the second treatment. If the bacteria remain, the bacteria will be classed as “colonised” (ie the bacteria are present but do not cause infection) and the de-colonisation treatment will be ceased.
Infection can occur at the site where the catheter enters the skin, where the fistula needle has been removed or in your bloodstream.
The signs of infection are:
- redness;
- tenderness and/or pain;
- discharge;
- a temperature and
- feeling unwell or dizzy.
What do I do if I think I have an infection?
Go to your nearest hospital emergency department if there are any signs of infection or contact your local renal unit.