Piraino B, Perlmutter J A, Holley J L, Bernardini J
Department of Medicine, University of Pittsburgh, Pennsylvania.
Perit Dial Int. 1993;13 Suppl 2:S332-4.
Although the definition of S. aureus nasal carriage in peritoneal dialysis patients is variable, carriage is often defined as 2 or more positive cultures for S. aureus. We investigated the relationship between S. aureus infections and nasal carriage (defined as 1 or more positive nose cultures) in 138 patients on peritoneal dialysis. By this definition, approximately 50% of the patients were carriers. The rates of S. aureus exit-site infection (0.28/year vs 0.43/year, p < 0.001) and peritonitis (0.08/year vs 0.20/year, p < 0.001) were lower in the noncarriers (patients with no positive nose cultures) than in those patients who had 1 or more positive nose cultures. Patients with only 1 positive nose culture had a similar S. aureus exit-site infection rate (0.31/year vs 0.28/year), but a higher peritonitis rate (0.24/year vs 0.08/year, p < 0.001) compared to those patients with no positive nose cultures. However, patients with 2 or more positive nose cultures were at increased risk for both S. aureus exit-site infections and peritonitis. This relationship held even when only patients with frequent nose cultures were included in the analysis. Thus patients with even 1 positive nose culture for S. aureus are at risk for S. aureus peritonitis and should not be classified as noncarriers.
尽管腹膜透析患者金黄色葡萄球菌鼻腔定植的定义各不相同，但定植通常被定义为金黄色葡萄球菌培养2次或更多次呈阳性。我们调查了138例腹膜透析患者金黄色葡萄球菌感染与鼻腔定植（定义为鼻腔培养1次或更多次呈阳性）之间的关系。按照这个定义，约50%的患者为定植者。非定植者（鼻腔培养无阳性结果的患者）的金黄色葡萄球菌出口部位感染率（0.28/年 vs 0.43/年，p<0.001）和腹膜炎发生率（0.08/年 vs 0.20/年，p<0.001）低于鼻腔培养1次或更多次呈阳性的患者。仅有1次鼻腔培养呈阳性的患者的金黄色葡萄球菌出口部位感染率与非定植者相似（0.31/年 vs 0.28/年），但腹膜炎发生率更高（0.24/年 vs 0.08/年，p<0.001）。然而，鼻腔培养2次或更多次呈阳性的患者发生金黄色葡萄球菌出口部位感染和腹膜炎的风险增加。即使分析中仅纳入鼻腔培养频繁的患者，这种关系依然成立。因此，即使仅有1次金黄色葡萄球菌鼻腔培养呈阳性的患者也有发生金黄色葡萄球菌腹膜炎的风险，不应归类为非定植者。
