[Epidemiology and prevention of Staphylococcus aureus infections during hemodialysis].
Staphylococcus aureus is the pathogen most often isolated from blood during bacteraemic episodes in haemodialysis patients (42%). The pathophysiology of these infections is discussed and a prophylactic strategy is proposed. Nasal carriage of S. aureus, found in 42% of haemodialysis patients, plays a major role in its cutaneous dissemination and hence in the risk of infection by this microorganism. Long-term use of nasal mupirocin in haemodialysis patients with nasal carriage of S. aureus (t.i.d. for 3 to 5 days, followed by once a week) led to a decrease in the yearly incidence of S. aureus bacteraemia from 0.097 to 0.024 (p < 0.01). Tolerance was excellent. This chemoprophylaxis results in substantial savings. When applied as proposed (only nasal application), the long-term use of mupirocin only very rarely leads to the emergence of mupirocin-resistance in S. aureus (1 case in 165 patient-years).
Boelaert
J R
JR
Unité de Néphrologie et de Maladies infectieuses, Algemeen Ziekenhuis St Jan, Bruges.
Van Landuyt
H W
HW
De Baere
Y A
YA
Gheyle
D W
DW
Daneels
R F
RF
Schurgers
M L
ML
Matthys
E G
EG
Gordts
B Z
BZ
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D002353:Carrier State / Q000188:drug therapy* / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D016712:Mupirocin / Q000627:therapeutic use*; D009296:Nasal Cavity / Q000382:microbiology; D006435:Renal Dialysis; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D012867:Skin / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification
D016712:Mupirocin
Epidémiologie et prévention des infections à Staphylococcus aureus en hémodialyse.