ABSTRACT
OBJECTIVE: The purpose of this study (the third in a series of similar studies) is to evaluate the prevalence of Staphylococcus aureus (SA), methicillin-resistant SA (MRSA) and mupirocin-resistant SA (MuRSA) carriers in a peritoneal dialysis centre where patients have been instructed to use prophylactic mupirocin ointment at the catheter exit site over the last 7 years. METHODS: Swabs were taken from catheter exit site, nares, axillae and groin in 147 chronic peritoneal dialysis out-patients between November 2003 and January 2004. Axillae/groin and nasal samples were pooled and cultured in the same medium, whereas exit site swabs were cultured separately. All SA isolated were tested for methicillin and mupirocin resistance using oxacillin screening plates and E-test strips. RESULTS: Sixteen of 147 patients (10.9%) were found to be SA carriers: of these 13 (8.8%) had a positive nasal/axillae/groin culture; two (1.4%) had both nasal/axillae/groin- and exit site-positive culture; and one (0.7%) had only exit site-positive culture. In these 16 SA carriers, we found mupirocin-resistant strains (MuRSA) in four patients (25%) and MRSA in two patients (12.5%). Among the four MuRSA carriers, one had both nasal/axillae/groin- and exit site-positive culture and three had only nasal/axillae/groin-positive culture. Three high-level resistance and one low-level resistance MuRSA carriers were isolated. One MuRSA strain was also methicillin resistant. All MRSA strains were sensitive to vancomycin and rifampicin. CONCLUSION: After 7 years' routine use of prophylactic mupirocin ointment at the catheter exit site in non-selected chronic peritoneal dialysis patients, MuRSA was found in 25% of SA strains isolated or in 2.7% of the patients. Compared with our previous study, 3 years earlier, there is no significant increase in the MuRSA prevalence in peritoneal dialysis patients who routinely apply mupirocin ointment at the catheter exit site.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Mupirocin/therapeutic use , Peritoneal Dialysis , Staphylococcal Infections/prevention & control , Adult , Aged , Aged, 80 and over , Catheters, Indwelling/adverse effects , Drug Resistance, Bacterial , Female , Follow-Up Studies , Humans , Male , Methicillin Resistance , Middle Aged , Mupirocin/pharmacology , Retrospective Studies , Staphylococcus aureus/drug effects , Time FactorsABSTRACT
BACKGROUND: Sexual dysfunction including erectile dysfunction (ED) is common in patients with end stage renal disease on peritoneal dialysis (PD). Prevalence and determinants of ED in these patients has not been well characterized. PATIENTS AND METHODS: Prevalence of ED in 44 patients on chronic PD was assessed using the International Index of Erectile Function (IIEF-5) commonly called Sexual Health Inventory for Men (SHIM) score. The associations between ED and other medical conditions was also assessed. RESULTS: Prevalence of ED was high at 88%. Mean age of all patients was 61.8 +/- 13.9 years. Thirty-two patients were hypertensive, 19 of them had coronary artery disease and 13 patients were diabetics. All patients with diabetes had ED. Age and diabetes were found to be significantly associated with ED. CONCLUSION: ED is highly prevalent in patients on chronic PD. Increasing age and diabetes were associated with higher percentage of ED.
