Glucose-based dialysis fluids inhibit innate defense against Staphylococcus aureus.

摘要: Abstract Background Staphylococcus aureus peritonitis is a serious complication of Chronic Peritoneal Dialysis (CPD) and associated with higher risk for severe recurrent infections compared other bacteria. We have previously shown that complement-mediated effectors essential optimal opsonophagocytosis S. are inhibited by high glucose concentrations. Since most commonly used peritoneal dialysis (PD) fluids glucose-based, we hypothesized glucose-based PD likely inhibit complement host defenses against aureus. Methods Commercially available were tested: (Dianeal), Dianeal supplemented amino acids, icodextrin-based (Extraneal) acid-based (Nutrineal). Control fluid was generated to simulate excluding the glucose. Three commercially concentrations 1.5% (15gm/1000 ml), 2.5% (25 gm/1000 ml) 4.25% (42.5 gm/1000 ml). Complement analyzed including opsonization C3-fragments, anaphylatoxin generation, phagocytosis efficiency. also evaluated clinical strains, MRSA specific activation pathways. Results Glucose-based (≥7-fold reduction) aureus-induced generation anaphylatoxins C3a C5a (>10-fold non-glucose based fluids. 1.5%, 4.25%, all similarly C3-mediated opsonization. showed ≥4-fold reduction in strains S.aureus, strains. Decreased S.aureus correlated decreased neutrophils. Conclusion Complement-mediated severely non-glucose-based By inhibiting defenses, may increase severity CPD patients using these