Lye W C, Leong S O, van der Straaten J, Lee E J
Department of Medicine, National University Hospital, Singapore.
Adv Perit Dial. 1994;10:163-5.
Staphylococcus aureus nasal carriage has been shown to be associated with an increased risk of S. aureus exit-site infections, but its association with peritonitis is less well established. We performed a four-year prospective study to determine the relationship between S. aureus continuous ambulatory peritoneal dialysis (CAPD)-related infections and nasal carriage. All patients who had been started on CAPD from 1989 to 1992 had regular nose cultures. S. aureus nasal carriage was defined as two of three positive nose cultures. A total of 41 carriers and 105 noncarriers were studied. The rates of S. aureus exit-site infection (0.23 vs 0.09 episode/patient/year, p < 0.005), peritonitis (0.33 vs 0.10 episode/patient/year, p < 0.005), and catheter loss (0.12 vs 0.05, p < 0.01) were significantly higher among the carriers. Life-table analysis showed a significant risk of S. aureus exit-site infection and peritonitis for carriers (p < 0.01). Logistic regression analysis showed that S. aureus nasal carriage was the most important predictive factor for S. aureus peritonitis. In conclusion, our study showed that S. aureus nasal carriage is related to an increased incidence of S. aureus CAPD-related infections.
金黄色葡萄球菌鼻腔定植已被证明与金黄色葡萄球菌出口部位感染风险增加有关，但其与腹膜炎的关联尚未完全明确。我们进行了一项为期四年的前瞻性研究，以确定金黄色葡萄球菌持续性非卧床腹膜透析（CAPD）相关感染与鼻腔定植之间的关系。所有在1989年至1992年开始进行CAPD的患者均定期进行鼻腔培养。金黄色葡萄球菌鼻腔定植定义为三次鼻腔培养中有两次阳性。共研究了41名定植者和105名非定植者。定植者中金黄色葡萄球菌出口部位感染率（0.23比0.09次/患者/年，p<0.005）、腹膜炎发生率（0.33比0.10次/患者/年，p<0.005）和导管丢失率（0.12比0.05，p<0.01）显著更高。生存分析显示定植者发生金黄色葡萄球菌出口部位感染和腹膜炎的风险显著增加（p<0.01）。逻辑回归分析表明，金黄色葡萄球菌鼻腔定植是金黄色葡萄球菌腹膜炎最重要的预测因素。总之，我们的研究表明，金黄色葡萄球菌鼻腔定植与金黄色葡萄球菌CAPD相关感染的发生率增加有关。
