Staphylococcus aureus nasal carriage and infection in patients on continuous ambulatory peritoneal dialysis

Article Abstract:

Some patients requiring dialysis can benefit by receiving continuous ambulatory peritoneal dialysis (CAPD). This technique, which frees the patient from bondage to a chair next to a large hemodialysis machine, requires the insertion of a catheter (a flexible tube) into the abdominal cavity. The largest single cause of catheter failure is infection around the catheter exit-site, and the organism responsible for the most infections is Staphylococcus aureus. S. aureus is a common organism, but can cause serious infection if given an appropriate foothold. Patients who develop infection around catheters often carry Staphylococcus aureus in their noses, and it is thought that constant shedding of bacteria from the nose may be the source of infection for the peritoneal catheter. To clarify the role that nasal carriage of the organism might play in the development of catheter infections, 140 patients due to begin CAPD were examined for S. aureus carriage. The external nasal passages were cultured, and 63 of the patients were found to carry S. aureus in the nares. Carriage of S. aureus was much more common among diabetic patients, occurring in 77 percent of the 30 patients with this disorder. The CAPD patients were followed for a median of 10.4 months. Analysis revealed that patients with no S. aureus colonization had a 92 percent chance of avoiding catheter exit-site infection, whereas those who carried S. aureus had only a 54 percent chance of remaining infection-free. The randomness of bacterial shedding from the nose may account for the fact that not all nasal carriers of S. aureus became infected, yet carriers are clearly a higher-risk group for infection during CAPD. The ease of performing a S. aureus culture recommends it as a routine screen to identify CAPD patients at high risk for infection. Further studies may determine whether prophylactic antibiotic suppression of nasal S. aureus will reduce the risk of catheter exit-site infection in high risk patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Complications and side effects, Physiological aspects, Staphylococcus aureus, Peritoneal dialysis, Continuous ambulatory peritoneal dialysis

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Nasal carriage as a source of Staphylococcus aureus bacteremia

Article Abstract:

In many cases of Staphylococcus aureus infection in the blood, the bacterium probably came from the patient's nose. This was documented by researchers who used molecular methods to show that over 80% of the patients they studied had the identical strain of bacterium in their blood as they did in their nose.

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Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus

Article Abstract:

The efficacy and safety of daptomycin as compared with standard therapy for Staphylococcus aureus bacteremia and endocarditis are assessed. The results have shown that daptomycin is not inferior to standard therapy for Staphylococcus aureus bacteremia and right-sided endocarditis.

United States, Drug therapy, Dosage and administration, Endocarditis, Daptomycin (Medication)

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