This is from the NEJM. This may not be a solution for you but it may help someone else.
Use of a Staphylococcus aureus Conjugate Vaccine in Patients Receiving Hemodialysis "...Staphylococcus aureus is a major cause of nosocomial and community-acquired infections, including bacteremia, metastatic abscesses, septic arthritis, endocarditis, osteomyelitis, and wound infections.1,2,3 A study of hospitalized patients in 1995 found that the death rate, the length of stay, and the medical costs were twice as high for S. aureus–associated hospitalizations as for other hospitalizations.4 Among patients receiving hemodialysis, S. aureus bacteremia is a prominent cause of complications and death, with an annual incidence of 3 to 4 percent.5 An increasing percentage of isolates are resistant to methicillin6 and show relative resistance to vancomycin.7 Hence, immunoprophylaxis against S. aureus is a worthwhile objective. ..."
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Background In patients with decreased resistance to infection, Staphylococcus aureus is a major cause of bacteremia and its complications. The capsular polysaccharides are essential for the pathogenesis of and immunity to S. aureus infection and are targets for vaccines.
Methods In a double-blind trial involving patients with end-stage renal disease who were receiving hemodialysis, we evaluated the safety, immunogenicity, and efficacy of a vaccine with S. aureus type 5 and 8 capsular polysaccharides conjugated to nontoxic recombinant Pseudomonas aeruginosa exotoxin A. Between April 1998 and August 1999, 1804 adult patients at 73 hemodialysis centers were randomly assigned to receive a single intramuscular injection of either vaccine or saline. IgG antibodies to S. aureus type 5 and 8 capsular polysaccharides were measured for up to two years, and episodes of S. aureus bacteremia were recorded. Efficacy was estimated by comparing the incidence of S. aureus bacteremia in the patients who received the vaccine with the incidence in the control patients.
Results Reactions to the vaccine were generally mild to moderate, and most resolved within two days. The capsular polysaccharides elicited an antibody response of at least 80 µg per milliliter (the estimated minimal level conferring protection) in 80 percent of patients for type 5 and in 75 percent of patients for type 8. The efficacy during weeks 3 to 54 was only 26 percent (P=0.23). However, between weeks 3 and 40 after vaccination, S. aureus bacteremia developed in 11 of 892 patients in the vaccine group who could be evaluated for bacteremia, as compared with 26 of 906 patients in the control group (estimate of efficacy, 57 percent; 95 percent confidence interval, 10 to 81 percent; nominal P=0.02).
Conclusions In patients receiving hemodialysis, a conjugate vaccine can confer partial immunity against S. aureus bacteremia for approximately 40 weeks, after which protection wanes as antibody levels decrease. ..."
http://content.nejm.org/cgi/content/full/346/7/491?andorexacttitleabs=and&SEARCHID=1&search_tab=articles&search_tab=articles&sortspec=Score%2Bdesc%2BPUBDATE_SORTDATE%2Bdesc&excludeflag=TWEEK_element&hits=20&where=fulltext&FIRSTINDEX=20&andorexactfulltext=and&resourcetype=HWCIT&fulltext=hemodialysis&searchterm=hemodialysis&searchid=1&FIRSTINDEX=20&resourcetype=HWCITSorry about the long address but that's what you get when you search the NEJM.
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