Bistrup C, Jensen K T, Kabel B, Pedersen R S
Department of Nephrology and Endocrinology, Ribe County Hospital, Esbjerg, Denmark.
Perit Dial Int. 1997 Sep-Oct;17(5):480-5.
We hypothesized that carriage of Staphylococcus aureus among continuous ambulatory peritoneal dialysis (CAPD) patients was influenced by their spouses. Furthermore, this carrier status was compared to previous Staph. aureus peritonitis episodes in order to identify the influence of Staph. aureus carriage on peritonitis rate.
A combined prospective surveillance study (Staph. aureus carriage) and retrospective chart review (Staph. aureus peritonitis).
A single peritoneal dialysis unit in a county hospital.
Cultures from patients (n = 32) and spouses (n = 16) were obtained twice, with a 1-month interval, from the anterior nares, the umbilical, and one groin area. All positive cultures were phage typed. Retrospective chart review of all episodes of Staph. aureus peritonitis among the patients was carried out.
Twelve of 32 patients (37.5%) and 5 of 16 spouses (31%) evaluated were carriers. Half of the spouses of patients who were Staph. aureus carriers, were also carriers, as opposed to 20% of spouses of noncarrier patients (p = 0.30). Patients and spouses always shared the same phage type. Among patients, Staph. aureus was found in the nose only (n = 9), in all three regions (n = 2), and extranasally only (n = 1). If only one nasal culture was used to establish carriage, the sensitivity and negative predictive value would be 92% and 95%, respectively. A trend toward a higher incidence (p = 0.062) of Staph. aureus peritonitis was found among carriers (patients), 0.37 versus 0.28 peritonitis episode/dialysis-year.
Only one positive nasal culture was necessary when carriage of Staph. aureus was to be established. Staph. aureus carriage was found more often in patients who had previously suffered from Staph. aureus peritonitis. The phage types isolated remained fairly constant, and the patients and spouses often had the same carrier state and shared the same phage types, although transmission does not always take place.
我们假设持续性非卧床腹膜透析（CAPD）患者中金黄色葡萄球菌的携带情况受其配偶的影响。此外，将这种携带状态与既往金黄色葡萄球菌腹膜炎发作情况进行比较，以确定金黄色葡萄球菌携带对腹膜炎发生率的影响。
一项前瞻性监测研究（金黄色葡萄球菌携带情况）与回顾性病历审查（金黄色葡萄球菌腹膜炎）相结合的研究。
一家县医院的单个腹膜透析单元。
对32例患者和16例配偶，从前鼻孔、脐部和一个腹股沟区每隔1个月采集两次培养样本。所有阳性培养物均进行噬菌体分型。对患者中所有金黄色葡萄球菌腹膜炎发作情况进行回顾性病历审查。
在接受评估的32例患者中有12例（37.5%）、16例配偶中有5例（31%）为携带者。金黄色葡萄球菌携带者患者的配偶中有一半也是携带者，而非携带者患者的配偶中这一比例为20%（p = 0.30）。患者及其配偶的噬菌体分型始终相同。在患者中，金黄色葡萄球菌仅在鼻部检出（n = 9）、在所有三个区域均检出（n = 2）以及仅在鼻外检出（n = 1）。若仅使用一次鼻培养来确定携带情况，其敏感性和阴性预测值分别为92%和95%。在携带者（患者）中发现金黄色葡萄球菌腹膜炎的发生率有升高趋势（p = 0.062），分别为每透析年0.37次和0.28次腹膜炎发作。
确定金黄色葡萄球菌携带情况时仅需一次鼻培养阳性。既往有金黄色葡萄球菌腹膜炎的患者中金黄色葡萄球菌携带情况更为常见。分离出的噬菌体分型保持相对稳定，患者及其配偶通常具有相同的携带状态且噬菌体分型相同，尽管传播并非总是发生。
