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Staphylococcus aureus nasal carriage in children receiving long-term peritoneal dialysis

P Kingwatanakul1, B A Warady

  • 1Children's Mercy Hospital, Kansas City, Missouri, USA.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|January 1, 1997
PubMed

Insights

Staphylococcus aureus nasal carriage is common in children on peritoneal dialysis and linked to exit-site infections. Mupirocin treatment may minimize peritonitis risk, but carriage risk increases with dialysis duration.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Staphylococcus aureus (SA) nasal carriage prevalence and effects of antibiotic therapy are unclear in pediatric peritoneal dialysis (PD) patients.
  • Understanding these factors is crucial for managing infections in this vulnerable population.

Purpose of the Study:

  • To determine the frequency of SA nasal carriage in children undergoing long-term PD.
  • To assess the impact of SA nasal carriage and intranasal mupirocin treatment on exit-site infections (ESI) and peritonitis.

Main Methods:

  • Prospective study of 21 children on PD, with nasal cultures for SA every 4-12 weeks.
  • SA nasal carriage (NSA+) was treated with 7-day intranasal mupirocin.
  • Infection rates (ESI, peritonitis) were compared between SA-positive (NSA+) and SA-negative (NSA-) patients.

Main Results:

  • SA nasal carriage (NSA+) was detected in 61.9% of patients.
  • NSA+ patients had a higher incidence of SA exit-site infections (ESI) (0.42 infections/patient-year) compared to NSA- patients (0 infections/patient-year).
  • The incidence of non-SA infections did not differ between groups; SA peritonitis risk appeared minimal with mupirocin treatment.

Conclusions:

  • SA nasal carriage is associated with SA exit-site infections in children on PD.
  • Intranasal mupirocin may reduce the risk of SA peritonitis.
  • The likelihood of SA nasal carriage may increase with longer duration of PD treatment.

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