RESUMEN
Sixty coagulase-negative staphylococcus (CNS) isolates were recovered from the blood cultures or peritoneal dialysate effluent of 43 patients on renal dialysis. The patients had either renal dialysis catheter-related sepsis (CRS) or continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis. Isolates were characterized by biotyping, and genotyped by pulsed-field gel electrophoresis (PFGE). Phenotypic properties of the strains were also investigated. Several genotypes were identified with no one specific strain of CNS being associated with CRS. However, closely related strains were isolated from several patients within the units studied, suggesting horizontal transfer of micro-organisms. Genotypic macro-restriction profiles did not concur with phenotypic profiles or biotypes, confirming that genotyping is required for epidemiological studies. All staphylococcal strains were investigated for the production of phenotypic characteristics. Significant differences were predominantly seen in the production of lipase, esterase and elastase in strains isolated from the renal patients with CRS and CAPD-associated peritonitis, compared with a non-septic control group. These phenotypic characteristics may therefore have a role in the maintenance of CRS in renal patients.
Asunto(s)
Catéteres de Permanencia/efectos adversos , Infección Hospitalaria/microbiología , Diálisis Peritoneal/efectos adversos , Infecciones Estafilocócicas/microbiología , Staphylococcus epidermidis/genética , Staphylococcus hominis/genética , Adulto , Anciano , Anciano de 80 o más Años , Técnicas de Tipificación Bacteriana , Estudios de Casos y Controles , Coagulasa , Infección Hospitalaria/epidemiología , Infección Hospitalaria/etiología , ADN Bacteriano/análisis , ADN Bacteriano/genética , Electroforesis en Gel de Campo Pulsado , Esterasas/metabolismo , Femenino , Genotipo , Humanos , Control de Infecciones , Lipasa/metabolismo , Masculino , Persona de Mediana Edad , Elastasa Pancreática/metabolismo , Diálisis Peritoneal/instrumentación , Peritonitis/microbiología , Fenotipo , Sepsis/microbiología , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/etiología , Staphylococcus epidermidis/enzimología , Staphylococcus hominis/enzimologíaRESUMEN
OBJECTIVES: To determine the sensitivity and specificity of a novel antibody test for the diagnosis of intravascular catheter-related infections due to coagulase-negative staphylococci. METHODS: Sixty-seven patients diagnosed as having central venous catheter (CVC)-associated sepsis based on strict clinical criteria, including positive blood cultures, were compared to 67 patients with a CVC in situ who exhibited no evidence of sepsis. An ELISA serological test based on a novel short-chain lipoteichoic acid antigen isolated from coagulase-negative staphylococci (CNS) was used to determine the patient's serological response (IgG and IgM) to CVC sepsis caused by CNS. The specificity and sensitivity of the test was determined. RESULTS: There was a significant increase in the antibody levels (IgG and IgM) to the short-chain lipoteichoic acid in patients with CVC-associated staphylococcal sepsis as compared to the control patients. CONCLUSIONS: This new serological method may offer a useful diagnostic test for intravascular catheter infections caused by staphylococci.