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Response of chronic renal failure mice to peritoneal Staphylococcus epidermidis challenge: impact of repeated
B Gallimore1, R F Gagnon, G K Richards
1Department of Medicine, Montreal General Hospital, Quebec, Canada.
Abstract:
The effect of repeated instillation of peritoneal dialysis (PD) solution on the peritoneal clearance of a Staphylococcus epidermidis challenge was investigated in a mouse model of surgically induced chronic renal failure. For periods of up to 2 weeks, mice bearing peritoneal catheter implants underwent daily (3 mL) or twice daily (1.5 mL) peritoneal instillation of PD solution (4.25% dextrose) by transcutaneous injection into the catheter lumen. Peritoneal instillation of PD solution did not have a significant influence on the microbiological status of peritoneal structures of renal failure or sham-operated mice following experimental intracatheter S epidermidis inoculation with 10(6) colony-forming units (CFU) (assessment 48 hours after inoculation) or 10(8) CFU (assessment 1 week after inoculation). Microbiological and scanning electron microscopy (SEM) assessments of recovered peritoneal catheters demonstrated that S epidermidis remained associated with the catheter site after other peritoneal structures had become culture negative. SEM of the parietal peritoneum revealed striking morphologic alterations of the mesothelial surface as a consequence of daily PD solution infusion. In the absence of S epidermidis inoculation, repeated instillation of PD solution caused a marked acute peritoneal inflammation without evidence of a concomitant systemic inflammatory response. Furthermore, peritoneal inflammatory response to S epidermidis challenge was augmented by the infusion procedure. Concurrent assessments of inflammatory response and microbiological status revealed that, in spite of heightened peritoneal inflammatory response with peritoneal infusion, bacterial clearance from the catheter site was not improved. Although the animal preparation was limited to peritoneal infusion without drainage, the influence of repeated peritoneal instillation of hyperosmolar, acidic PD solution on the response of mice to S epidermidis challenge was successfully addressed.
Insights
Repeated peritoneal dialysis (PD) solution instillation did not improve Staphylococcus epidermidis clearance from peritoneal dialysis catheters in mice. PD solution caused inflammation and altered mesothelial surfaces, but did not enhance bacterial removal.
Area of Science:
- Nephrology
- Microbiology
- Pathology
Background:
- Peritoneal dialysis (PD) is a life-sustaining treatment for chronic renal failure.
- Catheter-related infections, particularly Staphylococcus epidermidis, are a significant complication in PD patients.
- The impact of PD solution instillation on the peritoneal environment and infection dynamics requires further investigation.
Purpose of the Study:
- To investigate the effect of repeated peritoneal dialysis solution instillation on Staphylococcus epidermidis clearance in a mouse model.
- To assess the influence of PD solution on peritoneal inflammation and mesothelial morphology.
- To determine if PD solution infusion impacts bacterial load at the catheter site.
Main Methods:
- A mouse model of surgically induced chronic renal failure was used.
- Mice received daily or twice-daily instillations of PD solution (4.25% dextrose) via peritoneal catheter.
- Infection was induced with Staphylococcus epidermidis (10^6 or 10^8 CFU).
- Microbiological cultures, scanning electron microscopy (SEM), and inflammatory markers were assessed.
Main Results:
- PD solution instillation did not significantly affect Staphylococcus epidermidis clearance from peritoneal structures.
- Staphylococcus epidermidis remained associated with the catheter site even when other peritoneal areas were culture-negative.
- SEM revealed significant morphologic alterations of the mesothelial surface due to PD solution infusion.
- Repeated PD solution instillation induced acute peritoneal inflammation, augmenting the response to S. epidermidis challenge.
- Despite heightened inflammation, bacterial clearance from the catheter site was not improved.
Conclusions:
- Repeated peritoneal dialysis solution instillation does not enhance bacterial clearance from PD catheters in this model.
- PD solution instillation causes peritoneal inflammation and mesothelial damage, potentially complicating infection management.
- Further research is needed to understand the long-term effects and optimize PD protocols to minimize infectious complications.