Emergence of mupirocin-resistant Staphylococcus aureus in chronic peritoneal dialysis patients using mupirocin prophylaxis to prevent exit-site infection

Rajeev Annigeri, John Conly, S. Vas, Helen Dedier, Kannam P. Prakashan, Joanne M. Bargman, Vanita Jassal, Dimitrios Oreopoulos

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

◆ Objective: To determine the prevalence of the carriage of Staphylococcus aureus (SA), methicillin-resistant Staphylococcus aureus (MRSA), and mupirocin-resistant Staphylococcus aureus (MuRSA) in chronic peritoneal dialysis (CPD) patients after 4 years of prophylactic mupirocin application to the exit site, in a peritoneal dialysis unit. ◆ Methods: Three swabs were collected from the nares, axillae/groin, and exit site, respectively, from 149 patients on CPD between May and July 2001. All swabs were cultured on solid selective agar (mannitol salt agar) and in mannitol salt broth. Staphylococcus aureus isolates were tested for methicillin resistance using oxacillin screening plates, and mupirocin resistance using E-test strips. Low-level MuRSA was defined as minimum inhibitory concentration (MIC) of 4 mg/mL or more, and high-level MuRSA as MIC of 256 mg/mL or more. ◆ Results: Staphylococcus aureus was isolated from 26 (17%) patients (25 from nares/axilla/groin, and 1 from the exit site). High-level MuRSA was isolated from 4 patients (3% of the total study population; 15% of total SA isolates). No MRSA was detected. One patient with high-level MuRSA had peritonitis due to SA, resulting in treatment failure and catheter loss, soon after the swabs were collected for the study. ◆ Conclusion: We report the emergence of high-level MuRSA in CPD patients after a 4-year practice of continuous use of mupirocin in a small number of patients in our unit. Our results may have significant implications for the future practice of prophylactic use of mupirocin by CPD patients to prevent exit-site infection.

Original languageEnglish
Pages (from-to)554-559
Number of pages6
JournalPeritoneal Dialysis International
Volume21
Issue number6
Publication statusPublished - 2001

Fingerprint

Mupirocin
Peritoneal Dialysis
Staphylococcus aureus
Infection
Axilla
Groin
Microbial Sensitivity Tests
Mannitol
Methicillin-Resistant Staphylococcus aureus
Agar
Salts
Oxacillin
Methicillin Resistance
Peritonitis
Treatment Failure

Keywords

  • Chronic peritoneal dialysis
  • Mupirocin prophylaxis
  • Mupirocin-resistant Staphylococcus aureus

ASJC Scopus subject areas

  • Nephrology

Cite this

Emergence of mupirocin-resistant Staphylococcus aureus in chronic peritoneal dialysis patients using mupirocin prophylaxis to prevent exit-site infection. / Annigeri, Rajeev; Conly, John; Vas, S.; Dedier, Helen; Prakashan, Kannam P.; Bargman, Joanne M.; Jassal, Vanita; Oreopoulos, Dimitrios.

In: Peritoneal Dialysis International, Vol. 21, No. 6, 2001, p. 554-559.

Research output: Contribution to journalArticle

Annigeri, Rajeev ; Conly, John ; Vas, S. ; Dedier, Helen ; Prakashan, Kannam P. ; Bargman, Joanne M. ; Jassal, Vanita ; Oreopoulos, Dimitrios. / Emergence of mupirocin-resistant Staphylococcus aureus in chronic peritoneal dialysis patients using mupirocin prophylaxis to prevent exit-site infection. In: Peritoneal Dialysis International. 2001 ; Vol. 21, No. 6. pp. 554-559.
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T1 - Emergence of mupirocin-resistant Staphylococcus aureus in chronic peritoneal dialysis patients using mupirocin prophylaxis to prevent exit-site infection

AU - Annigeri, Rajeev

AU - Conly, John

AU - Vas, S.

AU - Dedier, Helen

AU - Prakashan, Kannam P.

AU - Bargman, Joanne M.

AU - Jassal, Vanita

AU - Oreopoulos, Dimitrios

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N2 - ◆ Objective: To determine the prevalence of the carriage of Staphylococcus aureus (SA), methicillin-resistant Staphylococcus aureus (MRSA), and mupirocin-resistant Staphylococcus aureus (MuRSA) in chronic peritoneal dialysis (CPD) patients after 4 years of prophylactic mupirocin application to the exit site, in a peritoneal dialysis unit. ◆ Methods: Three swabs were collected from the nares, axillae/groin, and exit site, respectively, from 149 patients on CPD between May and July 2001. All swabs were cultured on solid selective agar (mannitol salt agar) and in mannitol salt broth. Staphylococcus aureus isolates were tested for methicillin resistance using oxacillin screening plates, and mupirocin resistance using E-test strips. Low-level MuRSA was defined as minimum inhibitory concentration (MIC) of 4 mg/mL or more, and high-level MuRSA as MIC of 256 mg/mL or more. ◆ Results: Staphylococcus aureus was isolated from 26 (17%) patients (25 from nares/axilla/groin, and 1 from the exit site). High-level MuRSA was isolated from 4 patients (3% of the total study population; 15% of total SA isolates). No MRSA was detected. One patient with high-level MuRSA had peritonitis due to SA, resulting in treatment failure and catheter loss, soon after the swabs were collected for the study. ◆ Conclusion: We report the emergence of high-level MuRSA in CPD patients after a 4-year practice of continuous use of mupirocin in a small number of patients in our unit. Our results may have significant implications for the future practice of prophylactic use of mupirocin by CPD patients to prevent exit-site infection.

AB - ◆ Objective: To determine the prevalence of the carriage of Staphylococcus aureus (SA), methicillin-resistant Staphylococcus aureus (MRSA), and mupirocin-resistant Staphylococcus aureus (MuRSA) in chronic peritoneal dialysis (CPD) patients after 4 years of prophylactic mupirocin application to the exit site, in a peritoneal dialysis unit. ◆ Methods: Three swabs were collected from the nares, axillae/groin, and exit site, respectively, from 149 patients on CPD between May and July 2001. All swabs were cultured on solid selective agar (mannitol salt agar) and in mannitol salt broth. Staphylococcus aureus isolates were tested for methicillin resistance using oxacillin screening plates, and mupirocin resistance using E-test strips. Low-level MuRSA was defined as minimum inhibitory concentration (MIC) of 4 mg/mL or more, and high-level MuRSA as MIC of 256 mg/mL or more. ◆ Results: Staphylococcus aureus was isolated from 26 (17%) patients (25 from nares/axilla/groin, and 1 from the exit site). High-level MuRSA was isolated from 4 patients (3% of the total study population; 15% of total SA isolates). No MRSA was detected. One patient with high-level MuRSA had peritonitis due to SA, resulting in treatment failure and catheter loss, soon after the swabs were collected for the study. ◆ Conclusion: We report the emergence of high-level MuRSA in CPD patients after a 4-year practice of continuous use of mupirocin in a small number of patients in our unit. Our results may have significant implications for the future practice of prophylactic use of mupirocin by CPD patients to prevent exit-site infection.

KW - Chronic peritoneal dialysis

KW - Mupirocin prophylaxis

KW - Mupirocin-resistant Staphylococcus aureus

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