Nasal mupirocin ointment decreases the incidence of Staphylococcus aureus bacteraemias in haemodialysis patients

• Published in: Nephrology, dialysis, transplantation Vol. 8; no. 3; p. 235
• Main Authors: Boelaert, J R, Van Landuyt, H W, Godard, C A, Daneels, R F, Schurgers, M L, Matthys, E G, De Baere, Y A, Gheyle, D W, Gordts, B Z, Herwaldt, L A
• Format: Journal Article
• Language: English
• Published: England 1993
• Subjects: Administration, Intranasal; Adult; Aged; Bacteremia - prevention & control; Carrier State - drug therapy; Cost-Benefit Analysis; Humans; Middle Aged; Mupirocin - administration & dosage; Mupirocin - therapeutic use; Nose - microbiology; Ointments; Renal Dialysis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - prevention & control; Staphylococcus aureus - drug effects
• ISSN: 0931-0509
• DOI: 10.1093/oxfordjournals.ndt.a092438

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 micro-organisms 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 micro-organisms. Chemoprophylaxis with nasal mupirocin in haemodialysis patients is cost-effective.