title: Mupirocin resistance in coagulase-negative staphylococci, after topical prophylaxis for the reduction of colonization of central venous catheters.
abstract: Topical mupirocin was routinely applied to insertion sites of central venous catheters (CVC) of neonates in a neonatal intensive care unit. After five years, mupirocin resistance was recorded in 42% of clinical isolates of coagulase-negative staphylococci (CNS). This decreased to 21% during a mupirocin-free interval of five months. We performed a prospective study on the significance of mupirocin use on the staphylococcal skin flora of 15 newly admitted neonates. During treatment, mupirocin-susceptible strains were replaced by highly resistant ones. After treatment, all but one neonate harboured at least one resistant strain; 29% of all strains were moderately resistant (mupirocin minimum inhibitory concentrations (MICs) 16 mg/L) and 55% were highly resistant (MICs > 1024 mg/L). One CVC (7%) became colonized with a resistant strain. One year after stopping routine mupirocin application the incidence of resistance had dropped to 13%; CVC colonization was recorded in 2.4%.
authors.affiliation: Department of Medical Microbiology, University Hospital Nijmegen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Zakrzewska-Bode
authors.forename: H L
authors.initials: HL
authors.lastname: Muytjens
authors.forename: K D
authors.initials: KD
authors.lastname: Liem
authors.forename: J A
authors.initials: JA
authors.lastname: Hoogkamp-Korstanje
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002405:Catheterization, Central Venous; D003030:Coagulase; D015169:Colony Count, Microbial; D004352:Drug Resistance, Microbial; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D016712:Mupirocin / Q000008:administration & dosage / Q000494:pharmacology*; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology; D013210:Staphylococcus / Q000145:classification / Q000187:drug effects* / Q000201:enzymology
chemical_list: D000900:Anti-Bacterial Agents; D003030:Coagulase; D016712:Mupirocin