title: Sources of Staphylococcus aureus for patients on continuous ambulatory peritoneal dialysis.
abstract: OBJECTIVE
  This study was designed to determine whether family members and health care workers are a source of Staphylococcus aureus for patients on peritoneal dialysis.
  
  
  METHODS
  Over 36 months, cultures were obtained from the nares of patients, family members that cared for the patients' catheters, and health care workers in a dialysis unit. Pulsed-field gel electrophoresis was performed on all S. aureus isolates.
  
  
  METHODS
  A university-based peritoneal dialysis program.
  
  
  METHODS
  74 patients, 32 family members, and 17 health care workers.
  
  
  METHODS
  None.
  
  
  METHODS
  The number of patients that acquired S. aureus strains during the study period.
  
  
  RESULTS
  Of the 48 patients whose initial nares cultures were negative, 7 (15%) acquired S. aureus strains. Overall, 24 of 53 (45%) patients that had 2 or more cultures obtained during the study gained strains. Potential sources were not identified for strains gained by 11 (46%) patients. Five patients appeared to acquire their strains from family members; however, other patients also shared related strains; 8 patients acquired strains shared by other patients.
  
  
  CONCLUSIONS
  Family members and other patients appeared to be important sources of S. aureus for patients on peritoneal dialysis. Health care workers that carry S. aureus transiently may be important intermediaries. Good hand hygiene is essential to prevent transmission of S. aureus to these susceptible patients.
authors.affiliation: Department of Internal Medicine, University of Iowa College of Medicine, and University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242-1081, USA. loreen-herwaldt@uiowa.edu
authors.forename: Loreen A
authors.initials: LA
authors.lastname: Herwaldt
authors.forename: Linda D
authors.initials: LD
authors.lastname: Boyken
authors.forename: Stacy
authors.initials: S
authors.lastname: Coffman
authors.forename: Linda
authors.initials: L
authors.lastname: Hochstetler
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Flanigan
mesh_terms: D017028:Caregivers; D002353:Carrier State / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D009296:Nasal Cavity / Q000382:microbiology*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D013203:Staphylococcal Infections / Q000635:transmission*; D013211:Staphylococcus aureus / Q000302:isolation & purification*