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Epidemiology of Staphylococcus Aureus Infections in Patients on Hemodialysis

Published online by Cambridge University Press:  02 January 2015

J. Ena ,
J.R. Boelaert ,
L.D. Boyken ,
H.W. Van Landuyt ,
C.A. Godard  and
LA. Herwaldt
J. Ena
Affiliation:
Division of General Medicine, Clinical Epidemiology and Health Services Research, Department of Internal Medicine C41, GH, University of Iowa, Iowa City, Iowa
J.R. Boelaert
Affiliation:
Unit of Renal and Infectious Disease, and Department of Microbiology, Algemeen Ziekenhuis St. Jan, Brugge, Belgium
L.D. Boyken
Affiliation:
Division of General Medicine, Clinical Epidemiology and Health Services Research, Department of Internal Medicine C41, GH, University of Iowa, Iowa City, Iowa Veterans Administration Medical Center, Iowa City, Iowa
H.W. Van Landuyt
Affiliation:
Unit of Renal and Infectious Disease, and Department of Microbiology, Algemeen Ziekenhuis St. Jan, Brugge, Belgium
C.A. Godard
Affiliation:
Institut Pasteur du Brabant, Bruxelles, Belgium
LA. Herwaldt*
Affiliation:
Division of General Medicine, Clinical Epidemiology and Health Services Research, Department of Internal Medicine C41, GH, University of Iowa, Iowa City, Iowa Veterans Administration Medical Center, Iowa City, Iowa
*
Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242-1081
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Abstract

Objective:

To determine the epidemiology of Staphylococcus aureus infections in hemodialysis patients.

Method:

S aureus isolates from surveillance cultures and from sites of infection were evaluated by both bacteriophage typing and restriction endonuclease digestion of plasmid DNA.

Setting:

A hemodialysis unit in Brugge, Belgium.

Organisms:

S aureus isolates from 11 chronic hemodialysis patients who had participated in the placebo arm of a previously reported placebo-mupirocin comparative study.

Results:

Of 75 S aureus isolates evaluated, 63 were from cultures of nares and 12 from infections (three arteriovenous fistula infections, four wound infections, and five bacteremias). All isolates were typed by bacteriophages and 56 (75%) had plasmids. Three patients developed 12 infections. Eleven infections were caused by isolates previously identified in surveillance cultures. Only one infection was caused by a strain not identified previously in surveillance cultures.

Conclusion:

These results support the hypothesis that S aureus isolates causing infections in hemodialysis patients are of endogenous origin.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 2 , February 1994 , pp. 78 - 81
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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References

1.Kirmani, N, Tuazon, CU, Murray, HW, Parrish, AE, Sheagren, JN. Staphylococcus aureus carriage rate of patients receiving long-term hemodialysis. Arch Intern Med 1978;138:1657–1659.Google Scholar
2.Cheesbrough, JS, Finch, RG, Burden, RP. A prospective study of the mechanisms of infection associated with hemodialysis catheters. J Infect Dis 1986;154:579–589.Google Scholar
3.Goldblum, SE, Reed, WP, Ulrich, JA, Goldman, RS. Staphylococcal carriage and infections in hemodialysis patients. Dialysis and Transplant 1978;7:1140–1148.Google Scholar
4.Yu, VL, Goetz, A, Wagener, M, et al. Staphylococcus aureus nasal carriage and infections in patients on hemodialysis. Efficacy of antibiotic prophylaxis. N Engl J Med 1986;315:91–96.Google Scholar
5.Boelaert, JR, De Smedt, RA, De Baere, YA, et al. The influence of calcium mupirocin nasal ointment on the incidence of Staphylococcus aureus infections in haemodialysis patients. Nephrol Dial Transplant 1989;4:278–281.Google Scholar
6.Martin, AM, Clunie, GJA. Tonkin, RW, Robson, JS. The aetiology and management of shunt infections in patients on intermittent haemodialysis. Proceedings of the European Dialysis and Transplant Association 1967;4:67–72.Google Scholar
7.Archer, GL, Mayhall, CG. Comparison of epidemiological markers used in the investigation of an outbreak of methicillin-resistant Staphylococcus aureus infections. J Clin Microbiol 1983;18:395–399.Google Scholar
8.Collins, JK, Smith, JS, Kelly, MTComparison of phage typing, plasmid mapping and antibiotic resistance patterns as epidemiologic markers in a nosocomial outbreak of methicillin-resistant Staphylococcus aureus infections. Diagn Microbial Infect Dis 1984;2:233–245.Google Scholar
9.Hartstein, AI, Morthland, VH, Eng, S, Schoenknecht, FD, Rashad, AL. Restriction enzyme analysis of plasmid DNA and bacteriophage typing of paired Staphylococcus aureus blood culture isolates. J Clin Microbiol 1989;27:1874–1879.Google Scholar
10.Rhinehart, E, Shales, DM, Keys, TFet al. Nosocomial clonal dissemination of methicillin-resistant Staphylococcus aureus. Elucidation by plasmid analysis. Arch Intern Med 1987;147:521–524.Google Scholar
11.Nahaie, MR, Goodfellow, M, Hat-wood, CR. A rapid screening procedure for staphylococcal plasmids. J Microbiol Methods 1984;2:73–81.Google Scholar
12.Sader, HS, Pignatari, AC, Leme, IL, et al. Epidemiologic typing of multiply drug-resistant Pseudomonas aeruginosa isolated from an outbreak in an intensive care unit. Diag Microbiol Infect Dis 1993;17:13–18.Google Scholar
13.Pignatari, A, Boyken, L, Herwaldt, LA, et al. Application of restriction endonuclease analysis of chromosomal DNA in the study of Staphylococcus aureus colonization in continuous ambulatory peritoneal dialysis (CAPD) patients. Diag Microbiol Infect Dis 1992;15:195–199.Google Scholar
14.Pignatari, A, Pfaller, M, Hollis, R, Sesso, R, Leme, I, Herwaldt, LA. Staphylococcus aureus colonization and infection in patients on continuous ambulatory peritoneal dialysis. J Clin Microbiol 1990;28:1898–1902.Google Scholar
15.Boelaert, JR, De Baere, Y, Godard, C, Van Landuyt, HW. Eradication of Staphylococcus aureus in dialysis by mupirocin. Presented at the 29th Interscience Conference on Antimicrobial Agents and Chemotherapy; September 17-20, 1989; Houston, Texas. Abstract 1262.Google Scholar
16.Cookson, BD. Mupirocin resistance in staphylococci. J Antimicrob Chemother 1990;25:497–503.Google Scholar