Nephrol Dial Transplant (1993) 8: 235-239
© 1993 European Renal Association-European Dialysis and Transplant Association
research-article
Nasal mupirocin ointment decreases the incidence of Staphylococcus aureus bacteraemias in haemodialysis patients
1Unit for Renal and Infectious Diseases, Algemeen Ziekenhuis Sint Jan Brugge, Belgium 2Department of Microbiology, Algemeen Ziekenhuis Sint Jan Brugge, Belgium 3Institut Pasteur du Brabant Bruxelles, Belgium 4Division of General Medicine, Clinical Epidemiology and Health Services Research, University of Iowa Hospitals and Clinics Iowa City, Iowa, USA
Correspondence and offprint requests to: Correspondence and offprint requests to: Dr J. R. Boelaert, Unit for Renal and Infectious Diseases, Algemeen Ziekenhuis Sint-Jan, B-8000 Brugge, Belgium
The incidence of S. aureus bacteraemia in a haemodialysis unit was studied over 2 years (167.75 patient-years of follow-up) during which nasal calcium mupirocin was used to eradicate nasal S. aureus carriage; this incidence was compared to that previously observed in the same unit before the use of nasal mupirocin (185.8 patient-years). Nasal mupirocin led to eradication of nasal S. aureus carriage in 96.3% of surveillance cultures and to a fourfold reduction in the incidence of S. aureus bacteraemia per patient-year, from 0.097 before mupirocin to 0.024 with mupirocin use (P=0.008). Once or thrice weekly maintenance regimens of mupirocin were equally efficacious. The incidence of bacteraemia caused by other microorganisms was not significantly affected. One single mupirocin-resistant isolate was identified in a nasal surveillance culture. Eradication of S. aureus from the nares did not lead to overgrowth by other microorganisms. Chemoprophylaxis with nasal mupirocin in haemodialysis patients is cost-effective.
Keywords: bacteraemia; haemodialysis; infection; mupirocin; nasal carriage; Staphylococcus aureus
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