title: Intranasal mupirocin does not prevent exit-site infections in children receiving peritoneal dialysis.
abstract: OBJECTIVE
  Exit-site infections (ESI) in patients receiving peritoneal dialysis (PD) often progress to tunnel infections and peritonitis, sometimes requiring PD catheter removal. Staphylococcus aureus (SA) is the commonest cause of ESI. In this study, we evaluated the efficacy of mupirocin nasal ointment in preventing ESI in children receiving PD.
  
  
  METHODS
  A single-center study.
  
  
  METHODS
  Tokyo Metropolitan Kiyose Children's Hospital.
  
  
  METHODS
  47 outpatients [33 males; age 11.7 +/- 4.9 years (mean +/- SD)] participated in this study between April 1998 and March 1999 at Tokyo Metropolitan Kiyose Children's Hospital. The total study period comprised 399 patient-months. Nasal cultures were performed every month. Nasal carriers of SA applied intranasal mupirocin ointment twice per day for 7 days. We compared the incidence of ESI in the intervention group to 77 historical controls (48 males; age 7.6 +/- 5.1 years); the total control period comprised 2802 patient-months.
  
  
  RESULTS
  32 patients were identified as SA nasal carriers on one or two occasions (32/47 or 68%). The total period of SA nasal carriage was 95 patient-months (95/399 or 24%). The incidence of ESI caused by SA among all ESI cases was 20/28 (71%) in the study group and 115/151 (76%) in the control. There was no significant difference. The incidence of peritonitis caused by SA among all peritonitis cases was 3/6 (50%) in the study group and 17/42 (40%) in the control group, showing no significant difference. There was no significant difference in the overall incidence of ESI, peritonitis, or replacement of PD catheters between the study group and the control group.
  
  
  CONCLUSIONS
  Intranasal mupirocin ointment did not prevent ESI. Further study is needed to develop an effective method of preventing ESI in pediatric PD patients.
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Kiyose Children's Hospital, Tokyo, Japan. yaraki@jd6.so-net.ne.jp
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Araki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hataya
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ikeda
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishikura
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002353:Carrier State / Q000382:microbiology; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D016712:Mupirocin / Q000008:administration & dosage*; D009296:Nasal Cavity / Q000382:microbiology; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin