Proceedings: Effects of cloxacillin on the flora of the skin and anterior nares.
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Biomedical subjects
Publications and source records attributed to R Bayston.
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The isolation of two coagulase-negative strains of Staphylococcus pyogenes is reported, and their biochemical characteristics are given. The reliability of coagulase tests alone in the identification of Staph. pyogenes is discussed, and the deoxyribonuclease test is recommended as a useful confirmatory test.
It has been found that children with hydrocephalus, whose Spitz-Holter valves are colonized with Staph. albus, have an antibody to this organism in their serum. Children without colonized shunts have little or no such antibody. A test for this antibody is described, and its use in such cases is discussed.
OBJECTIVE: To elucidate the factors leading to catheter loss from recurrent infection in patients on continuous ambulatory peritoneal dialysis (CAPD). DESIGN: All catheters removed from patients were prospectively examined for infection. SETTING: CAPD unit in large tertiary-care general hospital. PATIENTS: Sixty-five consecutive patients undergoing catheter removal for whatever cause; 20 catheters rejected because of desiccation or contamination in transit. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Micro-organisms linked to catheter removal; their locations on removed catheters. RESULTS: Of 45 catheters removed between January 1994 and August 1995, 26 were infected: 13/26 infections were caused by Staphylococcus aureus and 7/26 by Pseudomonas aeruginosa. In only one case was S. epidermidis associated with catheter removal. The most striking finding was that the inner cuff harbored large numbers of the infecting organisms, even when antibiotics had eradicated them from the peritoneal cavity and exit site, where present, and the catheter lumen. CONCLUSION: The importance of S. aureus and Ps. aeruginosa rather than S. epidermidis in catheter loss due to relapsing infection is confirmed. Persistence of the causative organisms in the inner cuff is a likely explanation for relapse after treatment, and might be due to the predominantly intraperitoneal administration of antibiotics. A clinical trial of the effect on catheter retention of empirical use of systemic or oral agents that give high tissue levels and are active against intracellular micro-organisms, along with recommended intraperitoneal regimens, is indicated.