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2008, Number 4

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Gac Med Mex 2008; 144 (4)

Colonización por Staphylococcus aureusy riesgo de desarrollar episodio de peritonitiscausado por cepa idéntica en pacientes pediátricosen diálisis peritoneal continua ambulatoria

Miranda-Novales G, Aburto y-Huesca R, Leaños-Miranda B, Mendoza-Guevara L, Paniagua R, Amato D

Language: Spanish
References: 35
Page: 297-302
PDF size: 124.35 Kb.


ABSTRACT

Objective: To determine the risk of pediatric end stage renal disease patients undergoing continuous ambulatory peritoneal dialysis to develop a subsecuent peritonitis episode caused by an identical Staphylococcus aureus (SA) strain.
Methods: Longitudinal survey carried out in a CAPD center at the nephrology department of a tertiary care (reference) pediatric hospital. At recruitment, swabs were collected from the nares, exit site, and hands, respectively from 29 patients who were followedup for a mean period of 369 ± 80 days (range 224-516 days), and from the nares and hands of their mothers. Isolated SA strains were kept in BHI glycerol at –20° C for subsequent analysis. Peritonitis episodes were monitored and registered. When a SA strain was isolated from the dialysate effluent it was compared with the preexisting strain by PFGE.
Results: We report 7 SA-mediated peritonitis episodes among 6 patients. Only one of these patients was a previous nasal carrier, and 2 were previous exit site carriers of the same SA strain. The relative risk of developing a peritonitis episode caused by a preexistent SA strain colonizing the exit site was 0.948. The relative risk of developing a peritonitis episode caused by a preexistent SA strain colonizing the nares was 0.525.
Conclusions: SA carriers do not appear to be at higher risk of developing peritonitis by an SA related strain than non-carriers. Our results do not lend support to the recommendation of monitoring nasal or exit site carrier status in CAPD patients. The need of attempting to eradicate SA from nose or exit site is also questioned.


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