Routine use of mupirocin at the peritoneal catheter exit site and mupirocin resistance

Still low after 7 years

Thierry Lobbedez, Michael Gardam, Helen Dedier, Dorothy Burdzy, Maggie Chu, Sharon Izatt, Joanne M. Bargman, Sarbjit V. Jassal, S. Vas, James Brunton, Dimitrios G. Oreopoulos

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective. The purpose of this study (the third in a series of similar studies) is to evaluate the prevalence of Staphylococcus aureus (SA), methicillin-resistant SA (MRSA) and mupirocin-resistant SA (MuRSA) carriers in a peritoneal dialysis centre where patients have been instructed to use prophylactic mupirocin ointment at the catheter exit site over the last 7 years. Methods. Swabs were taken from catheter exit site, nares, axillae and groin in 147 chronic peritoneal dialysis out-patients between November 2003 and January 2004. Axillae/groin and nasal samples were pooled and cultured in the same medium, whereas exit site swabs were cultured separately. All SA isolated were tested for methicillin and mupirocin resistance using oxacillin screening plates and E-test strips. Results. Sixteen of 147 patients (10.9%) were found to be SA carriers: of these 13 (8.8%) had a positive nasal/axillae/groin culture; two (1.4%) had both nasal/axillae/groin- and exit site-positive culture; and one (0.7%) had only exit site-positive culture. In these 16 SA carriers, we found mupirocin-resistant strains (MuRSA) in four patients (25%) and MRSA in two patients (12.5%). Among the four MuRSA carriers, one had both nasal/axillae/groin- and exit site-positive culture and three had only nasal/axillae/groin-positive culture. Three high-level resistance and one low-level resistance MuRSA carriers were isolated. One MuRSA strain was also methicillin resistant. All MRSA strains were sensitive to vancomycin and rifampicin. Conclusion. After 7 years' routine use of prophylactic mupirocin ointment at the catheter exit site in non-selected chronic peritoneal dialysis patients, MuRSA was found in 25% of SA strains isolated or in 2.7% of the patients. Compared with our previous study, 3 years earlier, there is no significant increase in the MuRSA prevalence in peritoneal dialysis patients who routinely apply mupirocin ointment at the catheter exit site.

Original languageEnglish
Pages (from-to)3140-3143
Number of pages4
JournalNephrology Dialysis Transplantation
Volume19
Issue number12
DOIs
Publication statusPublished - Dec 2004

Fingerprint

Mupirocin
Catheters
Axilla
Groin
Staphylococcus aureus
Nose
Methicillin Resistance
Peritoneal Dialysis
Ointments
Oxacillin
Vancomycin
Rifampin
Methicillin-Resistant Staphylococcus aureus
Outpatients

Keywords

  • Catheter exit site
  • Mupirocin
  • Peritoneal dialysis
  • Resistance
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Lobbedez, T., Gardam, M., Dedier, H., Burdzy, D., Chu, M., Izatt, S., ... Oreopoulos, D. G. (2004). Routine use of mupirocin at the peritoneal catheter exit site and mupirocin resistance: Still low after 7 years. Nephrology Dialysis Transplantation, 19(12), 3140-3143. https://doi.org/10.1093/ndt/gfh494

Routine use of mupirocin at the peritoneal catheter exit site and mupirocin resistance : Still low after 7 years. / Lobbedez, Thierry; Gardam, Michael; Dedier, Helen; Burdzy, Dorothy; Chu, Maggie; Izatt, Sharon; Bargman, Joanne M.; Jassal, Sarbjit V.; Vas, S.; Brunton, James; Oreopoulos, Dimitrios G.

In: Nephrology Dialysis Transplantation, Vol. 19, No. 12, 12.2004, p. 3140-3143.

Research output: Contribution to journalArticle

Lobbedez, T, Gardam, M, Dedier, H, Burdzy, D, Chu, M, Izatt, S, Bargman, JM, Jassal, SV, Vas, S, Brunton, J & Oreopoulos, DG 2004, 'Routine use of mupirocin at the peritoneal catheter exit site and mupirocin resistance: Still low after 7 years', Nephrology Dialysis Transplantation, vol. 19, no. 12, pp. 3140-3143. https://doi.org/10.1093/ndt/gfh494
Lobbedez, Thierry ; Gardam, Michael ; Dedier, Helen ; Burdzy, Dorothy ; Chu, Maggie ; Izatt, Sharon ; Bargman, Joanne M. ; Jassal, Sarbjit V. ; Vas, S. ; Brunton, James ; Oreopoulos, Dimitrios G. / Routine use of mupirocin at the peritoneal catheter exit site and mupirocin resistance : Still low after 7 years. In: Nephrology Dialysis Transplantation. 2004 ; Vol. 19, No. 12. pp. 3140-3143.
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abstract = "Objective. The purpose of this study (the third in a series of similar studies) is to evaluate the prevalence of Staphylococcus aureus (SA), methicillin-resistant SA (MRSA) and mupirocin-resistant SA (MuRSA) carriers in a peritoneal dialysis centre where patients have been instructed to use prophylactic mupirocin ointment at the catheter exit site over the last 7 years. Methods. Swabs were taken from catheter exit site, nares, axillae and groin in 147 chronic peritoneal dialysis out-patients between November 2003 and January 2004. Axillae/groin and nasal samples were pooled and cultured in the same medium, whereas exit site swabs were cultured separately. All SA isolated were tested for methicillin and mupirocin resistance using oxacillin screening plates and E-test strips. Results. Sixteen of 147 patients (10.9{\%}) were found to be SA carriers: of these 13 (8.8{\%}) had a positive nasal/axillae/groin culture; two (1.4{\%}) had both nasal/axillae/groin- and exit site-positive culture; and one (0.7{\%}) had only exit site-positive culture. In these 16 SA carriers, we found mupirocin-resistant strains (MuRSA) in four patients (25{\%}) and MRSA in two patients (12.5{\%}). Among the four MuRSA carriers, one had both nasal/axillae/groin- and exit site-positive culture and three had only nasal/axillae/groin-positive culture. Three high-level resistance and one low-level resistance MuRSA carriers were isolated. One MuRSA strain was also methicillin resistant. All MRSA strains were sensitive to vancomycin and rifampicin. Conclusion. After 7 years' routine use of prophylactic mupirocin ointment at the catheter exit site in non-selected chronic peritoneal dialysis patients, MuRSA was found in 25{\%} of SA strains isolated or in 2.7{\%} of the patients. Compared with our previous study, 3 years earlier, there is no significant increase in the MuRSA prevalence in peritoneal dialysis patients who routinely apply mupirocin ointment at the catheter exit site.",
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AU - Lobbedez, Thierry

AU - Gardam, Michael

AU - Dedier, Helen

AU - Burdzy, Dorothy

AU - Chu, Maggie

AU - Izatt, Sharon

AU - Bargman, Joanne M.

AU - Jassal, Sarbjit V.

AU - Vas, S.

AU - Brunton, James

AU - Oreopoulos, Dimitrios G.

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N2 - Objective. The purpose of this study (the third in a series of similar studies) is to evaluate the prevalence of Staphylococcus aureus (SA), methicillin-resistant SA (MRSA) and mupirocin-resistant SA (MuRSA) carriers in a peritoneal dialysis centre where patients have been instructed to use prophylactic mupirocin ointment at the catheter exit site over the last 7 years. Methods. Swabs were taken from catheter exit site, nares, axillae and groin in 147 chronic peritoneal dialysis out-patients between November 2003 and January 2004. Axillae/groin and nasal samples were pooled and cultured in the same medium, whereas exit site swabs were cultured separately. All SA isolated were tested for methicillin and mupirocin resistance using oxacillin screening plates and E-test strips. Results. Sixteen of 147 patients (10.9%) were found to be SA carriers: of these 13 (8.8%) had a positive nasal/axillae/groin culture; two (1.4%) had both nasal/axillae/groin- and exit site-positive culture; and one (0.7%) had only exit site-positive culture. In these 16 SA carriers, we found mupirocin-resistant strains (MuRSA) in four patients (25%) and MRSA in two patients (12.5%). Among the four MuRSA carriers, one had both nasal/axillae/groin- and exit site-positive culture and three had only nasal/axillae/groin-positive culture. Three high-level resistance and one low-level resistance MuRSA carriers were isolated. One MuRSA strain was also methicillin resistant. All MRSA strains were sensitive to vancomycin and rifampicin. Conclusion. After 7 years' routine use of prophylactic mupirocin ointment at the catheter exit site in non-selected chronic peritoneal dialysis patients, MuRSA was found in 25% of SA strains isolated or in 2.7% of the patients. Compared with our previous study, 3 years earlier, there is no significant increase in the MuRSA prevalence in peritoneal dialysis patients who routinely apply mupirocin ointment at the catheter exit site.

AB - Objective. The purpose of this study (the third in a series of similar studies) is to evaluate the prevalence of Staphylococcus aureus (SA), methicillin-resistant SA (MRSA) and mupirocin-resistant SA (MuRSA) carriers in a peritoneal dialysis centre where patients have been instructed to use prophylactic mupirocin ointment at the catheter exit site over the last 7 years. Methods. Swabs were taken from catheter exit site, nares, axillae and groin in 147 chronic peritoneal dialysis out-patients between November 2003 and January 2004. Axillae/groin and nasal samples were pooled and cultured in the same medium, whereas exit site swabs were cultured separately. All SA isolated were tested for methicillin and mupirocin resistance using oxacillin screening plates and E-test strips. Results. Sixteen of 147 patients (10.9%) were found to be SA carriers: of these 13 (8.8%) had a positive nasal/axillae/groin culture; two (1.4%) had both nasal/axillae/groin- and exit site-positive culture; and one (0.7%) had only exit site-positive culture. In these 16 SA carriers, we found mupirocin-resistant strains (MuRSA) in four patients (25%) and MRSA in two patients (12.5%). Among the four MuRSA carriers, one had both nasal/axillae/groin- and exit site-positive culture and three had only nasal/axillae/groin-positive culture. Three high-level resistance and one low-level resistance MuRSA carriers were isolated. One MuRSA strain was also methicillin resistant. All MRSA strains were sensitive to vancomycin and rifampicin. Conclusion. After 7 years' routine use of prophylactic mupirocin ointment at the catheter exit site in non-selected chronic peritoneal dialysis patients, MuRSA was found in 25% of SA strains isolated or in 2.7% of the patients. Compared with our previous study, 3 years earlier, there is no significant increase in the MuRSA prevalence in peritoneal dialysis patients who routinely apply mupirocin ointment at the catheter exit site.

KW - Catheter exit site

KW - Mupirocin

KW - Peritoneal dialysis

KW - Resistance

KW - Staphylococcus aureus

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