The Influence of Calcium Mupirocin Nasal Ointment on the Incidence of Staphylococcus Aureus Infections in Haemodialysis Patients

Abstract

Mupirocin was used in haemodialysis patients in an attempt to eradicate nasal carriage of Staphylococcus aureus and to prevent infection caused by this microorganism. The effectiveness of calcium mupirocin as a 2% nasal ointment OB2 (16 patients for 104 patient-months) was compared to that of placebo (18 patients for 147 patient-months) in a double-blind study. Mupirocin or placebo were applied in both anterior nares thrice daily for 2 weeks and subsequently three times weekly for a total of 9 months. During therapy, S. aureus was recovered from only 6% of the nasal cultures in the mupirocin group compared to 58% in the placebo group (P less than or equal to 0.01). Only one S. aureus infection was documented in the mupirocin group compared to six in the placebo group (P less than or equal to 0.05). The S. aureus strain causing the single infection in the mupirocin group was of a different phage type to that of the original nasal strain. In contrast, at least four of the six strains causing infection in the placebo group were of similar phage type to the original nasal strain. All S. aureus isolates remained mupirocin sensitive (MIC less than or equal to 1 mg/l). In conclusion, mupirocin nasal ointment was effective in eradicating nasal carriage of S. aureus and in preventing S. aureus infections in patients on haemodialysis.

Prevention of catheter-related bacteremia in children on hemodialysis: time for action

“…Once-or thriceweekly maintenance regimens of mupirocin were equally efficacious. In addition, the incidence of bacteremia caused by other microorganisms was not significantly affected [56]. Unfortunately there is a relatively high recurrence rate of nasal colonization, and continuous treatment is necessary.…”

Determinants of Acquisition and Carriage ofStaphylococcus aureusin Infancy

“…The rising prevalence of antibiotic-resistant strains, such as methicillin-resistant S. aureus and S. aureus with reduced susceptibility to glycopeptides (15,17,22), increases the need to prevent disease through the identification and modification of risk factors. Three sets of observations indicate that nasal carriage of S. aureus is an important risk factor for sepsis with this organism: carriers have higher rates of infection than noncarriers (16,29,30,31); the strain causing infection is usually the carriage strain in a given individual (16,18,28,31); and eradication of carriage reduces nosocomial infection (2,10,20,31). Temporary eradication of S. aureus in those at high risk of sepsis is desirable but relies on the unlikely premise of sustained susceptibility to antibiotics such as mupirocin.…”

Are measures against MRSA transmission effective?

“…Veilederen kan lastes ned fra www.fhi.no. 64 Arbeidsgivers plikter i forhold til å verne arbeidstakerne mot biologiske faktorer fremgår av forskrift om vern mot eksponering for biologiske faktorer (bakterier, virus, sopp m.m.) på arbeidsplassen, jf.…”