Related Experiment Videos
The epidemiology of peritonitis caused by coagulase-negative staphylococci in continuous ambulatory peritoneal
H A Ludlam1, W C Noble, R R Marples
1Department of Microbiology, UMDS, St. Thomas' Hospital, London.
Abstract:
The epidemiology of 10 episodes of CAPD peritonitis caused by coagulase-negative staphylococci was studied. The infecting micro-organism was found in prospective skin swabs in six episodes, widely distributed and as the predominant, or equally predominant, organism at each site but was not detected in swabs taken more than 12 weeks before the episode of peritonitis; this suggests recent acquisition. Infecting strains were no more likely to be adherent or to produce slime than non-infecting strains, nor had they any other characteristic detected in our typing scheme that might lead to their detection before peritonitis developed.
Insights
Coagulase-negative staphylococci causing peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients are likely recently acquired. Pre-episode skin swabs did not predict infection, as infecting strains lacked distinct characteristics.
Area of Science:
- Nephrology
- Infectious Diseases
- Microbiology
Background:
- Peritonitis is a serious complication of continuous ambulatory peritoneal dialysis (CAPD).
- Coagulase-negative staphylococci (CoNS) are common causes of CAPD peritonitis.
- Understanding the source and transmission of CoNS is crucial for prevention.
Purpose of the Study:
- To investigate the epidemiology of CAPD peritonitis episodes caused by CoNS.
- To determine the likely source and timing of acquisition of the infecting CoNS strains.
- To identify potential predictive characteristics of infecting CoNS strains.
Main Methods:
- Prospective collection of skin swabs from CAPD patients.
- Microbiological analysis of swabs to identify and quantify CoNS.
- Typing of infecting CoNS strains and comparison with non-infecting strains.
- Correlation of swab findings with peritonitis episodes.
Main Results:
- CoNS were detected in prospective skin swabs in 6 out of 10 peritonitis episodes.
- Infecting strains were widely distributed on the skin and often predominant.
- The infecting organism was not detected in swabs taken more than 12 weeks prior to peritonitis.
- No specific adherence or slime production characteristics differentiated infecting from non-infecting strains.
Conclusions:
- The findings suggest recent acquisition of CoNS from the skin preceding CAPD peritonitis.
- Current typing methods and pre-episode surveillance of skin carriage are insufficient for predicting peritonitis.
- Further research into early detection markers for CoNS peritonitis is warranted.