title: Access-Related Infections Involving the Buttonhole Technique.
abstract: OBJECTIVE
  In this study, we discuss a mechanism of development of access-related Staphylococcus aureus infections in patients on buttonhole (BH) method and logically construct a measure to prevent such infections on the basis of the mechanism.
  
  
  CONCLUSIONS
  S. aureus can colonize a BH track. Once S. aureus colonizes a BH track, access-related infections may develop when the equilibrium is upset between the factors of host resistance and a level of bacterial growth in a BH track. Thus, the logically constructed measure to prevent access-related infections are as follows: (1) decolonization of S. aureus from a BH track by applying mupirocin ointment to a BH entry site when a patient has been proven to be a carrier of S. aureus in the track, (2) prevention of bacterial invasion of the BH track by a new method to remove a scab completely, and (3) control of bacterial growth in the BH track by disinfecting the site with diluted povidone-iodine solution (0.1% povidone-iodine solution) before access vessel cannulation.
authors.affiliation: Toma Clinic, Okinawa, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Toma
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shinzato
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hayakawa
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D055499:Catheter-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D016712:Mupirocin / Q000627:therapeutic use; D011206:Povidone-Iodine / Q000627:therapeutic use; D006435:Renal Dialysis; D013203:Staphylococcal Infections / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D016712:Mupirocin