Kluytmans J A, Manders M J, van Bommel E, Verbrugh H
Department of Clinical Microbiology, University Hospital Rotterdam, The Netherlands.
Infect Control Hosp Epidemiol. 1996 Dec;17(12):793-7. doi: 10.1086/647238.
To study the efficacy of mupirocin for the elimination of nasal carriage of Staphylococcus aureus in hemodialysis patients.
The efficacy of mupirocin was studied in a prospectively followed cohort. The effect of this intervention on the rate of S aureus bacteremia was evaluated using a historic control group.
Patients on the hemodialysis unit of the University Hospital Rotterdam, a tertiary referral center.
The study group consisted of consecutive patients on hemodialysis from February 1, 1992, until November 1, 1993. They were screened by taking nasal cultures monthly during their time on hemodialysis. If S aureus was isolated, treatment with mupirocin nasal ointment was initiated. The control group consisted of patients treated on the same hemodialysis unit from January 1, 1990, until January 1, 1992.
The study group consisted of 226 patients, of whom 172 were evaluated to determine the efficacy of mupirocin. Sixty-seven (39%) were identified as nasal carriers. Following the initial treatment, 66 nasal cultures (98.5%) became negative. After 3 months and 6 months, respectively, 63 (94%) and 61 (91%) of the treated carriers had negative cultures. The rate of bacteremia (defined as the number of episodes of S aureus bacteremia per patient-year on hemodialysis) was significantly lower among the 226 patients in the study group (0.04 per patient-year) than among the 273 patients in the control group (0.25 per patient year, P < .001). Development of resistance and adverse effects were not observed.
Mupirocin nasal ointment effectively eliminates nasal carriage of S aureus in patients on hemodialysis. This was associated with a significant reduction of the incidence of S aureus bacteremia, as compared to historic controls.
研究莫匹罗星清除血液透析患者鼻腔金黄色葡萄球菌定植的疗效。
在一个前瞻性随访队列中研究莫匹罗星的疗效。使用一个历史对照组评估该干预措施对金黄色葡萄球菌菌血症发生率的影响。
鹿特丹大学医学中心血液透析科，一家三级转诊中心。
研究组由1992年2月1日至1993年11月1日期间连续进行血液透析的患者组成。在血液透析期间，每月采集鼻腔培养物对他们进行筛查。如果分离出金黄色葡萄球菌，即开始使用莫匹罗星鼻软膏治疗。对照组由1990年1月1日至1992年1月1日在同一血液透析科接受治疗的患者组成。
研究组有226例患者，其中172例接受评估以确定莫匹罗星的疗效。67例（39%）被确定为鼻腔定植者。初始治疗后，66份鼻腔培养物（98.5%）转为阴性。分别在3个月和6个月后，63例（94%）和61例（91%）接受治疗的定植者培养物为阴性。研究组的226例患者中菌血症发生率（定义为每位血液透析患者每年金黄色葡萄球菌菌血症发作次数）显著低于对照组的273例患者（分别为0.04次/患者年和0.25次/患者年，P<0.001）。未观察到耐药性的产生和不良反应。
莫匹罗星鼻软膏可有效清除血液透析患者鼻腔中的金黄色葡萄球菌定植。与历史对照组相比，这与金黄色葡萄球菌菌血症发生率的显著降低相关。
