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Decrease in infections with the introduction of mupirocin cream at the peritoneal dialysis catheter exit site

Linda Uttley1, Anand Vardhan, Sundeep Mahajan

  • 1Department of Renal Medicine, Manchester Royal Infirmary, Manchester, UK. ram.gokal@cmmc.nhs.uk

Journal of Nephrology
|August 6, 2004
PubMed
Abstract

Insights

Mupirocin cream significantly reduced Staphylococcus aureus exit site infections (ESI) and related peritonitis in peritoneal dialysis patients. This intervention offers a safe and effective strategy to prevent these common complications, improving patient outcomes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Staphylococcus aureus infections, including peritonitis and catheter exit site infections (ESI), are major causes of hospitalization and catheter loss in patients undergoing chronic peritoneal dialysis (PD).
  • Effective prevention strategies are crucial to improve patient outcomes and reduce healthcare burden associated with PD-related infections.

Purpose of the Study:

  • To evaluate the effectiveness of mupirocin cream applied to the catheter exit site in preventing ESI and peritonitis in PD patients.
  • To assess the impact of mupirocin on Staphylococcus aureus-related infections specifically.

Main Methods:

  • A prospective, historically controlled study involving 86 patients initiating a PD program.
  • Patients applied mupirocin cream 2% to the exit site daily or every other day.
  • A historical control group of 113 PD patients predating the intervention was used for comparison over a 22-month follow-up period.

Main Results:

  • Mupirocin application led to a significant reduction in overall ESI incidence (79% relative reduction) and Staphylococcus aureus ESI (85% relative reduction).
  • While overall peritonitis rates did not change, Staphylococcus aureus peritonitis significantly decreased (from 0.07 to 0 incidence).
  • Catheter removal rates were lower in the mupirocin group (1 vs. 5), though not statistically significant.

Conclusions:

  • Topical mupirocin application at the exit site is effective in significantly reducing the incidence of Staphylococcus aureus-related ESI and peritonitis in PD patients.
  • The intervention demonstrated a favorable safety profile with no significant side effects reported.

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