[Epidemiology and prevention of Staphylococcus aureus infections during hemodialysis]

Nephrologie. 1994;15(2):157-61.
[Article in French]

Abstract

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).

Publication types

  • English Abstract
  • Review

MeSH terms

  • Arteriovenous Shunt, Surgical / adverse effects
  • Carrier State / drug therapy*
  • Carrier State / epidemiology
  • Catheterization, Central Venous / adverse effects
  • Catheters, Indwelling / adverse effects
  • Humans
  • Incidence
  • Mupirocin / therapeutic use*
  • Nasal Cavity / microbiology
  • Renal Dialysis*
  • Sepsis / epidemiology
  • Sepsis / etiology
  • Sepsis / microbiology
  • Sepsis / prevention & control
  • Skin / microbiology
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / prevention & control*
  • Staphylococcus aureus / isolation & purification

Substances

  • Mupirocin