An investigation of the skin flora of dialysis and transplant patients

Noble, W. C.; Rebel, M.; Smith, Ingrid

doi:10.1111/j.1365-2133.1974.tb15866.x

Cited by 20 publications

(6 citation statements)

References 15 publications

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“…ESRD is a long-standing and chronic disease. In addition, ESRD patients could have retention of urea on the skin and experience drying of the skin due to water withdrawal [27]. Such changes may bring about a shift in skin colonizers.…”

Section: Discussionmentioning

confidence: 99%

Lower Education Level Is a Risk Factor for Peritonitis and Technique Failure but Not a Risk for Overall Mortality in Peritoneal Dialysis under Comprehensive Training System

Kim¹,

Lee²,

Park³

et al. 2017

PLoS ONE

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BackgroundLower education level could be a risk factor for higher peritoneal dialysis (PD)-associated peritonitis, potentially resulting in technique failure. This study evaluated the influence of lower education level on the development of peritonitis, technique failure, and overall mortality.MethodsPatients over 18 years of age who started PD at Seoul National University Hospital between 2000 and 2012 with information on the academic background were enrolled. Patients were divided into three groups: middle school or lower (academic year≤9, n = 102), high school (912, n = 324). Outcomes were analyzed using Cox proportional hazards models and competing risk regression.ResultsA total of 655 incident PD patients (60.9% male, age 48.4±14.1 years) were analyzed. During follow-up for 41 (interquartile range, 20–65) months, 255 patients (38.9%) experienced more than one episode of peritonitis, 138 patients (21.1%) underwent technique failure, and 78 patients (11.9%) died. After adjustment, middle school or lower education group was an independent risk factor for peritonitis (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.10–2.36; P = 0.015) and technique failure (adjusted HR, 1.87; 95% CI, 1.10–3.18; P = 0.038), compared with higher than high school education group. However, lower education was not associated with increased mortality either by as-treated (adjusted HR, 1.11; 95% CI, 0.53–2.33; P = 0.788) or intent-to-treat analysis (P = 0.726).ConclusionsAlthough lower education was a significant risk factor for peritonitis and technique failure, it was not associated with increased mortality in PD patients. Comprehensive training and multidisciplinary education may overcome the lower education level in PD.

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Section: Discussionmentioning

confidence: 99%

Lower Education Level Is a Risk Factor for Peritonitis and Technique Failure but Not a Risk for Overall Mortality in Peritoneal Dialysis under Comprehensive Training System

Kim¹,

Lee²,

Park³

et al. 2017

PLoS ONE

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“…Few studies of the microbial flora in the nose and on the skin of hemodialysis patients have examined the presence or absence of gram-negative bacilli. Noble and associates (11) recovered multiple species of gram-negative bacilli from the nose and skin of hemodialysis patients and renal transplant patients, but they did not study the relationship between nose and skin colonization. In the first of two studies published by Goldblum and co-workers (2), they recovered very few gram-negative bacilli from the skin of either hemodialysis patients or normal controls and suggested that failure to culture gram-negative rods from skin in their patients might have been due to the arid climate of New Mexico where the studies were performed.…”

Section: Discussionmentioning

confidence: 99%

Prospective study of microbial colonization of the nose and skin and infection of the vascular access site in hemodialysis patients

et al. 1988

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We conducted a prospective study of nasal and skin floras in 71 patients receiving chronic hemodialysis. We wished to determine whether a sterile skin preparation technique was more effective than a clean technique in removing microorganisms from the skin of the vascular access site. We also examined the effect of administration of antibiotics and status of patient hygiene on microbial flora. The presence of Staphylococcus aureus in the nose had a low predictive value for the simultaneous presence of the microorganism on the skin. The status of skin colonization can be accurately assessed only by culture of the skin. Sterile technique was no more effective at removing microorganisms from skin than was clean technique. Antibiotics significantly affected nasal flora but not skin flora. S. aureus was significantly more likely to remain on the skin after application of an antiseptic in patients with poor hygiene than in patients with good hygiene (P = 0.002). Patients with poor hygiene also had a significantly higher concentration of S. aureus on the skin of the vascular access site after application of antiseptic than patients with good hygiene (P = 0.005). We found no evidence to support a change from clean to sterile technique for skin preparation, but improvement in personal hygiene may be an effective strategy for prevention of vascular access infections.

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“…This conclusion is supported by other studies that showed that S. aureus carriage rates vary between different ethnic groups, with higher rates in white individuals, in men, and lower rates in elderly individuals (Williams, 1963; Armstrong‐Esther, 1976; Riewerts Eriksen et al , 1995; Parnaby et al , 1996; Cole et al , 2001; Peacock et al , 2003; Herwaldt et al , 2004). Increased carriage rates are found in hospitalized patients (Goslings & Buchli, 1958; Shooter et al , 1958; Williams et al , 1959; Noble et al , 1974; Paul et al , 1982; Kluytmans et al , 1997; Nouwen et al , 2001). Another recently discovered nasal determinant is smoking status: current smoking was negatively associated with nasal S. aureus carriage (van Belkum et al , 2009).…”

Section: Staphylococcus Aureusmentioning

confidence: 99%

The role of nasal carriage inStaphylococcus aureusburn wound colonization

Kooistra-Smid¹,

Nieuwenhuis²,

Belkum³

et al. 2009

FEMS Immunology &Amp; Medical Microbiology

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Thermal injury destroys the physical skin barrier that normally prevents invasion of microorganisms. This and concomitant depression of local and systemic host cellular and humoral immune responses are important factors that contribute to colonization and infection of the burn wound. One of the most common burn wound pathogens is Staphylococcus aureus. Staphylococcus aureus is both a human commensal and a frequent cause of infections leading to mild to life-threatening diseases. Despite a variety of infection control measures, for example patient cohorting and contact precaution at burn centres, S. aureus is still frequently encountered in burn wounds. Colonization with S. aureus has been associated with delayed wound healing, increased need for surgical interventions, and prolonged length of stay at burn centres. In this minireview, we focus on S. aureus nasal carriage in relation to S. aureus burn wound colonization and subsequent infection, and its impact on strategies for infection control.

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An investigation of the skin flora of dialysis and transplant patients

Cited by 20 publications

References 15 publications

Lower Education Level Is a Risk Factor for Peritonitis and Technique Failure but Not a Risk for Overall Mortality in Peritoneal Dialysis under Comprehensive Training System

Lower Education Level Is a Risk Factor for Peritonitis and Technique Failure but Not a Risk for Overall Mortality in Peritoneal Dialysis under Comprehensive Training System

Prospective study of microbial colonization of the nose and skin and infection of the vascular access site in hemodialysis patients

The role of nasal carriage inStaphylococcus aureusburn wound colonization

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