Mupirocin for preventing exit-site infection and peritonitis in patients undergoing peritoneal dialysis

Xu, Gaosi; Tu, Wei; Xu, Chengyun

doi:10.1093/ndt/gfp411

Cited by 84 publications

(87 citation statements)

References 21 publications

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“…S. aureus carriage was also more frequent among poorly controlled patients, in agreement with previous reports (3). Interestingly, the latter condition was not associated an increased risk of peritonitis or TESI, probably because carriers were systematically scrutinized and treated with nasal or pericatheter mupirocin (or both) as needed (25). The association between glycemic control and TESI should not be unexpected, given the correlation between DM and skin and soft-tissue infections, particularly in a surgical setting.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Glycemic Control and the Incidence of Peritoneal and Catheter Tunnel and Exit-Site Infections in Diabetic Patients Undergoing Peritoneal Dialysis

et al. 2014

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♦ Background: Diabetes mellitus, especially if complicated by poor glycemic control, portends an increased risk of infection. The significance of this association in the case of diabetic patients undergoing peritoneal dialysis (PD) has not been assessed. ♦ Methods: Using a retrospective observational design, we analyzed the association between glycemic control at the start of PD (estimated from glycosylated hemoglobin levels) and the risk of peritoneal and catheter tunnel and exit-site infections during follow-up in 183 incident patients on PD. We used the median value of glycosylated hemoglobin to classify patients into good (group A) or poor (group B) glycemic control groups. We applied multivariate strategies of analysis to control for other potential predictors of PD-related infection. ♦ Results: Groups A and B differed significantly in age, dialysis vintage, use of insulin, and rate of Staphylococcus aureus carriage. Neither the incidence (0.60 episodes in group A vs 0.56 episodes in group B per patient-year) nor the time to a first peritoneal infection (median: 42 months vs 38 months) differed significantly between the study groups. In contrast, group B had a significantly higher incidence of catheter tunnel and exit-site infections (0.23 episodes vs 0.12 episodes per patient-year) and shorter time to a first infection episode (64 months vs 76 months, p = 0.004). The difference persisted in multivariate analysis (adjusted hazard ratio: 2.65; 95% confidence interval: 1.13 to 6.05; p = 0.013). We observed no differences between the study groups in the spectrum of causative organisms or in the outcomes of PD-related infections. ♦ Conclusions: Poor glycemic control is a consistent predictor of subsequent risk of catheter tunnel and exit-site infection, but not of peritoneal infection, among diabetic patients starting PD therapy.

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Section: Discussionmentioning

confidence: 99%

Correlation between Glycemic Control and the Incidence of Peritoneal and Catheter Tunnel and Exit-Site Infections in Diabetic Patients Undergoing Peritoneal Dialysis

et al. 2014

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“…Antibiotic protocols against S. aureus are effective in reducing the risk of S. aureus catheter infections (66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81) Routine exit-site care by the patient begins when the exit site is well healed; such care is part of the patient's training. Water and antibacterial soap are recommended by many centers.…”

Section: Exit-site Care To Prevent Peritonitismentioning

confidence: 99%

ISPD Position Statement on Reducing the Risks of Peritoneal Dialysis–Related Infections

et al. 2011

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“…3 As it was shown in the previous studies, the use of prophylactic antibiotics at the exit site or orally (neomycin sulfate, mupirocin, rifampin, TMP-SMX, ciprofloxacin) reduce S. aureus colonization and catheter-related infection rate. [4][5][6][7] In the recent studies, it has been shown that application of mupirocin to the exit site considerably reduces ESI and peritonitis rate. 8,9 Currently, the most popular regimen for mupirocin is to apply it at the exit site once a day, 3-5 times a week.…”

Section: Introductionmentioning

confidence: 99%

Mupirocin application at the exit site in peritoneal dialysis patients: five years of experience

et al. 2010

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Introduction: In this study, we aimed to analyze the effects of once-or thrice-weekly mupirocin application on peritonitis, exit-site infection (ESI), and antibiotic resistance with mupirocin. Patients and methods: By 2000 mupirocin began to be applied once a week to 33 patients who previously did not use mupirocin at the exit site. By the beginning of 2002, the patients were assigned to two groups. In group I patients continued to apply mupirocin once a week. In group II patients began to apply mupirocin to the exit site three times weekly and we began to obtain cultures from the nares, inguinal area, axillae, and the exit site. Results: A total of 28 episodes of ESI and 41 episodes of peritonitis were seen in 33 patients prior to mupirocin treatment, while a total of 14 episodes of ESI and 34 episodes of peritonitis were observed in all groups of patients who used mupirocin. In a subgroup analysis, 13 episodes of peritonitis and 7 episodes of ESI were determined in group I, while 6 episodes of peritonitis and 1 episode of ESI were determined in group II. Staphylococcus aureus reproduction rate and mupirocin resistance were 2.11 and 0.2%, respectively. Coagulase-negative staphylococcus reproduction rate was 70.56% (MuR: 59.87% and MeR: 33.7%) and 72.6% (MuR: 64.7% and MeR: 33.3%) in groups I and II, respectively. Conclusion: Mupirocin application at the exit sites reduces peritonitis and ESI to a considerable amount, and thrice-weekly application of mupirocin seems to be more efficient compared to once-weekly application.

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Mupirocin for preventing exit-site infection and peritonitis in patients undergoing peritoneal dialysis

Abstract: Mupirocin prophylaxis was effective on preventing ESI and peritonitis due to S. aureus and other organisms in PD patients.

Cited by 84 publications

References 21 publications

Correlation between Glycemic Control and the Incidence of Peritoneal and Catheter Tunnel and Exit-Site Infections in Diabetic Patients Undergoing Peritoneal Dialysis

Correlation between Glycemic Control and the Incidence of Peritoneal and Catheter Tunnel and Exit-Site Infections in Diabetic Patients Undergoing Peritoneal Dialysis

ISPD Position Statement on Reducing the Risks of Peritoneal Dialysis–Related Infections

Mupirocin application at the exit site in peritoneal dialysis patients: five years of experience

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