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Species identification and antibiotic sensitivity of coagulase-negative staphylococci from CAPD peritonitis
Abstract:
Forty-three strains of coagulase-negative staphylococci were obtained from dialysis effluent during 41 episodes of CAPD peritonitis. Eighty per cent of these were found to be Staphylococcus epidermidis but several other species also occurred. A recurrent infection lasting 15 weeks was caused by Staph. haemolyticus. Multiple antibiotic resistance was found to be common. Of 13 antibiotics tested, only vancomycin was active against all strains although most strains were also sensitive to rifampicin, netilmicin and cefamandole. Vancomycin was chosen for the initial treatment of CAPD peritonitis caused by coagulase-negative staphylococci and eradicated the organism in 29 of 30 episodes.
Insights
Coagulase-negative staphylococci, common in CAPD peritonitis, often show antibiotic resistance. Vancomycin effectively treated most infections, highlighting its role in managing these challenging dialysis-related infections.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Nephrology
Background:
- Coagulase-negative staphylococci (CoNS) are significant pathogens in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
- CAPD peritonitis presents a substantial risk for patients with end-stage renal disease, potentially leading to technique failure.
- Understanding the antimicrobial susceptibility patterns of CoNS is crucial for effective treatment strategies.
Purpose of the Study:
- To characterize the species distribution of CoNS isolated from CAPD peritonitis episodes.
- To determine the antibiotic resistance profiles of these CoNS isolates.
- To evaluate the efficacy of vancomycin in treating CAPD peritonitis caused by CoNS.
Main Methods:
- Isolation and identification of 43 CoNS strains from dialysis effluent during 41 CAPD peritonitis episodes.
- Antimicrobial susceptibility testing against 13 different antibiotics.
- Clinical data review for treatment outcomes, focusing on vancomycin efficacy.
Main Results:
- Staphylococcus epidermidis accounted for 80% of CoNS isolates; other species, including Staphylococcus haemolyticus causing recurrent peritonitis, were also identified.
- A high prevalence of multidrug resistance was observed among the CoNS strains.
- Vancomycin demonstrated activity against all tested strains and was successful in eradicating the infection in 29 out of 30 treated episodes.
Conclusions:
- CoNS, particularly S. epidermidis, are common causative agents of CAPD peritonitis, frequently exhibiting multidrug resistance.
- Vancomycin is a highly effective agent for the initial treatment of CAPD peritonitis due to CoNS.
- Rifampicin, netilmicin, and cefamandole may serve as alternative or adjunctive therapies for susceptible strains.