Sources of Staphylococcus Aureus for Patients on Continuous Ambulatory Peritoneal Dialysis

Abstract

← Objective This study was designed to determine whether family members and health care workers are a source of Staphylococcus aureus for patients on peritoneal dialysis. ← Design Over 36 months, cultures were obtained from the nares of patients, family members that cared for the patients’ catheters, and health care workers in a dialysis unit. Pulsed-field gel electrophoresis was performed on all S. aureus isolates. ← Setting A university-based peritoneal dialysis program. ← Participants 74 patients, 32 family members, and 17 health care workers. ← Interventions None. ← Main Outcome Measures The number of patients that acquired S. aureusstrains during the study period. ← Results Of the 48 patients whose initial nares cultures were negative, 7 (15%) acquired S. aureus strains. Overall, 24 of 53 (45%) patients that had 2 or more cultures obtained during the study gained strains. Potential sources were not identified for strains gained by 11 (46%) patients. Five patients appeared to acquire their strains from family members; however, other patients also shared related strains; 8 patients acquired strains shared by other patients. ← Conclusions Family members and other patients appeared to be important sources of S. aureus for patients on peritoneal dialysis. Health care workers that carry S. aureus transiently may be important intermediaries. Good hand hygiene is essential to prevent transmission of S. aureus to these susceptible patients.