STAPHYLOCOCCUS-AUREUS SEPTIC ARTHRITIS IN PATIENTS ON HEMODIALYSIS-TREATMENT

We retrospectively reviewed hospital discharge diagnoses of septic art hritis over an 11-year period (1982 through 1992) at 3 medical centers ; 11 episodes of septic arthritis were identified in patients on hemod ialysis treatment. Of the 11 episodes, 9 were caused by Staphylococcus aureus; in 8 of 9, the blood cultures were positive for the organism and the infection was monoarticular. Concurrent infection of the dialy sis access site occurred in 4 cases, Two patients died (22%), We postu late that repeated skin trauma and contact with health care personnel and facilities result in a high rate of nasal carriage of 5 aureus and , hence, an increased risk of bacteremia with its attendant complicati ons such as septic arthritis, The use of mupirocin nasal ointment is r eported to eradicate or suppress carriage in a high percentage of pati ents; some studies report that long-term suppressive therapy reduces t he frequency of 5 aureus bacteremia.