Pignatari A, Pfaller M, Hollis R, Sesso R, Leme I, Herwaldt L
Department of Pathology, University of Iowa College of Medicine, Iowa City 52242.
J Clin Microbiol. 1990 Sep;28(9):1898-902. doi: 10.1128/jcm.28.9.1898-1902.1990.
Staphylococcus aureus is the most common cause of peritonitis in patients undergoing peritoneal dialysis in Brazil. Using restriction endonuclease analysis of plasmid DNA, we investigated the importance of chronic carriage of S. aureus in the development of peritonitis in patients on continuous ambulatory peritoneal dialysis at the Division of Nephrology, Escola Paulista de Medicina, Sao Paulo, Brazil. A total of 117 isolates (30 patients) of S. aureus were available for typing, including 51 isolates (22 patients) from the nares, 58 isolates (27 patients) from pericatheter skin, and 8 isolates (6 patients) from peritoneal fluid, from patients with peritonitis. Restriction endonuclease subtyping showed that although most patients harbored more than one subtype of S. aureus, in the majority of patients nasal and/or pericatheter skin isolates with identical restriction endonuclease digest patterns were recovered on more than one occasion. Furthermore, 95% of patients with both nasal and pericatheter colonization were colonized with the same subtypes at both sites. All of the patients with peritonitis were infected with a subtype which colonized the nares, pericatheter skin, or both. These results demonstrate the importance of an endogenous source of S. aureus in the development of continuous ambulatory peritoneal dialysis-associated peritonitis.
在巴西，金黄色葡萄球菌是接受腹膜透析患者发生腹膜炎最常见的病因。我们运用质粒DNA限制性内切酶分析方法，对巴西圣保罗保罗医科大学肾病科持续非卧床腹膜透析患者中金黄色葡萄球菌慢性携带情况在腹膜炎发生中的重要性进行了研究。共有117株金黄色葡萄球菌分离株（来自30例患者）可供分型，其中包括来自30例患者鼻腔的51株分离株、来自27例患者导管周围皮肤的58株分离株以及来自6例腹膜炎患者腹膜液的8株分离株。限制性内切酶亚型分析显示，虽然大多数患者携带不止一种金黄色葡萄球菌亚型，但在大多数患者中，不止一次从鼻腔和/或导管周围皮肤分离出具有相同限制性内切酶消化模式的菌株。此外，95%鼻腔和导管周围均有定植的患者在这两个部位定植的是相同亚型。所有腹膜炎患者均感染了一种在鼻腔、导管周围皮肤或两者均有定植的亚型。这些结果表明，内源性金黄色葡萄球菌来源在持续非卧床腹膜透析相关性腹膜炎的发生中具有重要作用。
