Abstract
Staphylococcus aureus is the most common cause of peritonitis in patients undergoing peritoneal dialysis in Brazil. Using restriction endonuclease analysis of plasmid DNA, we investigated the importance of chronic carriage of S. aureus in the development of peritonitis in patients on continuous ambulatory peritoneal dialysis at the Division of Nephrology, Escola Paulista de Medicina, Sao Paulo, Brazil. A total of 117 isolates (30 patients) of S. aureus were available for typing, including 51 isolates (22 patients) from the nares, 58 isolates (27 patients) from pericatheter skin, and 8 isolates (6 patients) from peritoneal fluid, from patients with peritonitis. Restriction endonuclease subtyping showed that although most patients harbored more than one subtype of S. aureus, in the majority of patients nasal and/or pericatheter skin isolates with identical restriction endonuclease digest patterns were recovered on more than one occasion. Furthermore, 95% of patients with both nasal and pericatheter colonization were colonized with the same subtypes at both sites. All of the patients with peritonitis were infected with a subtype which colonized the nares, pericatheter skin, or both. These results demonstrate the importance of an endogenous source of S. aureus in the development of continuous ambulatory peritoneal dialysis-associated peritonitis.
Full text
PDF




Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Archer G. L., Mayhall C. G. Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections. J Clin Microbiol. 1983 Aug;18(2):395–399. doi: 10.1128/jcm.18.2.395-399.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Collins J. K., Smith J. S., Kelly M. T. Comparison of phage typing, plasmid mapping, and antibiotic resistance patterns as epidemiologic markers in a nosocomial outbreak of methicillin-resistant Staphylococcus aureus infections. Diagn Microbiol Infect Dis. 1984 Jun;2(3):233–245. doi: 10.1016/0732-8893(84)90036-1. [DOI] [PubMed] [Google Scholar]
- Davies S. J., Ogg C. S., Cameron J. S., Poston S., Noble W. C. Staphylococcus aureus nasal carriage, exit-site infection and catheter loss in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Perit Dial Int. 1989;9(1):61–64. [PubMed] [Google Scholar]
- Eisenberg E. S., Ambalu M., Szylagi G., Aning V., Soeiro R. Colonization of skin and development of peritonitis due to coagulase-negative staphylococci in patients undergoing peritoneal dialysis. J Infect Dis. 1987 Sep;156(3):478–482. doi: 10.1093/infdis/156.3.478. [DOI] [PubMed] [Google Scholar]
- Gaston M. A., Duff P. S., Naidoo J., Ellis K., Roberts J. I., Richardson J. F., Marples R. R., Cooke E. M. Evaluation of electrophoretic methods for typing methicillin-resistant Staphylococcus aureus. J Med Microbiol. 1988 Jul;26(3):189–197. doi: 10.1099/00222615-26-3-189. [DOI] [PubMed] [Google Scholar]
- Gruer L. D., Bartlett R., Ayliffe G. A. Species identification and antibiotic sensitivity of coagulase-negative staphylococci from CAPD peritonitis. J Antimicrob Chemother. 1984 Jun;13(6):577–583. doi: 10.1093/jac/13.6.577. [DOI] [PubMed] [Google Scholar]
- Hartstein A. I., Morthland V. H., Eng S., Archer G. L., Schoenknecht F. D., Rashad A. L. Restriction enzyme analysis of plasmid DNA and bacteriophage typing of paired Staphylococcus aureus blood culture isolates. J Clin Microbiol. 1989 Aug;27(8):1874–1879. doi: 10.1128/jcm.27.8.1874-1879.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hill R. L., Duckworth G. J., Casewell M. W. Elimination of nasal carriage of methicillin-resistant Staphylococcus aureus with mupirocin during a hospital outbreak. J Antimicrob Chemother. 1988 Sep;22(3):377–384. doi: 10.1093/jac/22.3.377. [DOI] [PubMed] [Google Scholar]
- Rhinehart E., Shlaes D. M., Keys T. F., Serkey J., Kirkley B., Kim C., Currie-McCumber C. A., Hall G. Nosocomial clonal dissemination of methicillin-resistant Staphylococcus aureus. Elucidation by plasmid analysis. Arch Intern Med. 1987 Mar;147(3):521–524. [PubMed] [Google Scholar]
- Rubin J., Rogers W. A., Taylor H. M., Everett E. D., Prowant B. F., Fruto L. V., Nolph K. D. Peritonitis during continuous ambulatory peritoneal dialysis. Ann Intern Med. 1980 Jan;92(1):7–13. doi: 10.7326/0003-4819-92-1-7. [DOI] [PubMed] [Google Scholar]
- Sesso R., Draibe S., Castelo A., Sato I., Leme I., Barbosa D., Ramos O. Staphylococcus aureus skin carriage and development of peritonitis in patients on continuous ambulatory peritoneal dialysis. Clin Nephrol. 1989 May;31(5):264–268. [PubMed] [Google Scholar]
- Sewell C. M., Clarridge J., Lacke C., Weinman E. J., Young E. J. Staphylococcal nasal carriage and subsequent infection in peritoneal dialysis patients. JAMA. 1982 Sep 24;248(12):1493–1495. [PubMed] [Google Scholar]
- Vas S. I. Microbiologic aspects of chronic ambulatory peritoneal dialysis. Kidney Int. 1983 Jan;23(1):83–92. doi: 10.1038/ki.1983.15. [DOI] [PubMed] [Google Scholar]
- West T. E., Walshe J. J., Krol C. P., Amsterdam D. Staphylococcal peritonitis in patients on continuous peritoneal dialysis. J Clin Microbiol. 1986 May;23(5):809–812. doi: 10.1128/jcm.23.5.809-812.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yu V. L., Goetz A., Wagener M., Smith P. B., Rihs J. D., Hanchett J., Zuravleff J. J. Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. N Engl J Med. 1986 Jul 10;315(2):91–96. doi: 10.1056/NEJM198607103150204. [DOI] [PubMed] [Google Scholar]
- Zuccarelli A. J., Roy I., Harding G. P., Couperus J. J. Diversity and stability of restriction enzyme profiles of plasmid DNA from methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 1990 Jan;28(1):97–102. doi: 10.1128/jcm.28.1.97-102.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]



