The efficacy of mupirocin ointment and chlorhexidine body scrubs in the eradication of nasal carriage of Staphylococcus aureus among patients undergoing long-term hemodialysis.
BACKGROUND
Patients undergoing long-term hemodialysis have a high prevalence of Staphylococcus aureus nasal carriage, which may lead to serious infections. Mupirocin ointment has been used intranasally to eradicate S. aureus carriage in health human volunteers and health care workers. Chlorhexidine, an antiseptic with excellent antistaphylococcal activity, is widely used for handwashing and skin cleansing.


METHODS
Anterior nares cultures were obtained from patients older than 18 years who were undergoing long-term hemodialysis. Patients with S. aureus nasal carriage were enrolled in the study. Axillae and groins were cultured. Patients were given mupirocin ointment intranasally twice per day for 7 days and chlorhexidine body scrubs daily for the first 3 days. Follow-up cultures were obtained from anterior nares, axillae, and groins at 1 day, and 1, 4, 8 and 12 weeks after treatment.


RESULTS
One day after completion of treatment nasal carriage was eradicated in 83% of patients (15/18). After 12 weeks, 69% of patients (11/16) were free of nasal carriage.


CONCLUSIONS
Success rates of eradication were excellent compared with those in other published reports. This simple and effective regimen had no major side effects.
Watanakunakorn
C
C
Infectious Disease Section, St. Elizabeth Hospital Medical Center, Youngstown, Ohio 44501-1790.
Brandt
J
J
Durkin
P
P
Santore
S
S
Bota
B
B
Stahl
C J
CJ
D000281:Administration, Intranasal; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D001365:Axilla / Q000382:microbiology; D002353:Carrier State / Q000382:microbiology*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000494:pharmacology*; D006119:Groin / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D016712:Mupirocin / Q000008:administration & dosage / Q000494:pharmacology*; D009666:Nose / Q000382:microbiology*; D009824:Ointments; D006435:Renal Dialysis; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D013997:Time Factors
D009824:Ointments; D016712:Mupirocin; D002710:Chlorhexidine