Staphylococcus aureus infections during peritoneal dialysis.
Peritoneal dialysis is in widespread use for the treatment of chronic renal failure. Infection is still one of the major complications and can include peritonitis and pericannular problems. The rate of peritonitis is currently 0.5 episodes per patient year with disconnect systems, and there are about 0.4 exit-site infections (ESIs) per patient year. ESI is associated with a high rate of catheter removal and replacement. Staphylococcus aureus is a common cause of peritonitis and accounts for more than half of all ESIs. Nasal carriage of S. aureus is associated with a much higher rate of ESI. Treatment of ESIs is unsatisfactory. The type of exit-site care, however, does influence the rate of infection and prophylaxis with oral rifampicin and local or nasal mupirocin has been claimed to reduce ESIs. A large multicentre double-blind trial of nasal mupirocin has just been completed and preliminary results show a reduction in the incidence of S. aureus-induced ESI. The cost benefits of such a regimen are being evaluated.
Coles
G A
GA
Institute of Nephrology, Cardiff Royal Infirmary, Wales, UK.
D006801:Humans; D009666:Nose / Q000382:microbiology; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000302:isolation & purification