Response to intraperitoneal Staphylococcus epidermidis challenge in renal failure mice.

The role of renal failure in the pathogenesis of the Staphylococcus epidermidis (S. epidermidis) peritonitis presented by end-stage renal disease patients treated with continuous ambulatory peritoneal dialysis was investigated in a mouse model of surgically-induced renal failure. Six weeks after the surgery, an i.p. inoculum of 10(6) colony forming units S. epidermidis was administered to renal failure mice and their sham-operated and normal controls, and assessment of bacterial clearance and inflammatory response was conducted over the next 72 hours. Peritoneal clearance of S. epidermidis was complete in most animals; however, the process was significantly delayed in renal failure mice compared to sham-operated controls. Viable bacteria invariably remained associated with the peritoneum after peritoneal washings had become culture negative. Peritoneal inflammatory response was markedly diminished in renal failure mice, the early polymorphonuclear cell response being particularly affected. Peripheral response consisted of a prompt and short-lived polymorph increase which was similar in renal failure and sham-operated mice. The factors responsible for the observed impairment of local inflammatory response in association with delayed bacterial clearance in renal failure mice following i.p. challenge with S. epidermidis remain to be defined.