Brown A L, Stephenson J R, Baker L R, Tabaqchali S
Department of Nephrology, St Bartholomew's Hospital, London, UK.
Nephrol Dial Transplant. 1991;6(9):643-8. doi: 10.1093/ndt/6.9.643.
We identified twenty patients maintained on continuous ambulatory peritoneal dialysis who suffered repeated episodes of peritonitis caused by coagulase-negative staphylococci. We documented hand and exist-site coagulase-negative staphylococcus-associated peritonitis over a total period of 32 months, and compared hand and exit-site strains with strains isolated from dialysate fluid using three typing methods: biotyping using the API Staph kit plus antibiograms, immunoblotting using sera raised in rabbits to three standard strains of coagulase-negative staphylococci, and 35S-methionine-labelled coagulase-negative staphylococcal profiles separated on sodium dodecylsulphate polyacrylamide gel electrophoresis and visualised by autoradiography (radioPAGE). In 5 of 84 episodes, strains isolated from skin were indistinguishable by all three typing methods from the dialysate strain. In a further two episodes, hand or exit-site isolates were indistinguishable by all three typing methods from the dialysate strain isolated in the subsequent, but not the same, episode. Thus in the majority of episodes, no inference of hand or exit-site origin of dialysate infection could be drawn.
我们确定了20名维持持续性非卧床腹膜透析的患者，他们反复发生由凝固酶阴性葡萄球菌引起的腹膜炎。我们记录了在32个月的总时间里手部及出口部位与凝固酶阴性葡萄球菌相关的腹膜炎情况，并使用三种分型方法将手部和出口部位的菌株与从透析液中分离出的菌株进行比较：使用API葡萄球菌试剂盒进行生物分型并结合抗菌谱、使用兔抗三种凝固酶阴性葡萄球菌标准菌株产生的血清进行免疫印迹，以及在十二烷基硫酸钠聚丙烯酰胺凝胶电泳上分离并用放射自显影法（放射性聚丙烯酰胺凝胶电泳）可视化的35S-甲硫氨酸标记的凝固酶阴性葡萄球菌图谱。在84次发作中的5次中，从皮肤分离出的菌株通过所有三种分型方法与透析液菌株无法区分。在另外两次发作中，手部或出口部位的分离株通过所有三种分型方法与后续（但不是同一）发作中分离出的透析液菌株无法区分。因此，在大多数发作中，无法推断透析液感染源自手部或出口部位。
