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Effect of rifampin on Staphylococcus aureus colonization in children on chronic peritoneal dialysis
C D Hanevold1, M C Fisher, R Waltz
1Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA.
Insights
Rifampin effectively cleared Staphylococcus aureus nasal colonization in pediatric dialysis patients, but rapid recolonization occurred in most. Eradicating exit site colonization also proved challenging, limiting rifampin
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Clinical Microbiology
Background:
- Staphylococcus aureus colonization is a significant risk factor for infections in pediatric patients undergoing peritoneal dialysis.
- Effective strategies for eradicating S. aureus carriage are crucial to prevent serious complications.
Purpose of the Study:
- To evaluate the efficacy of rifampin, in combination with cloxacillin, for eliminating Staphylococcus aureus nasal and exit site colonization in pediatric peritoneal dialysis patients.
Main Methods:
- A cohort of six pediatric patients with documented nasal S. aureus colonization received a 7-day course of rifampin and cloxacillin.
- Nasal and exit site cultures were obtained to assess the eradication of S. aureus carriage before and after treatment.
Main Results:
- Antimicrobial therapy successfully eliminated nasal S. aureus carriage in all treated patients.
- However, rapid recolonization of the nasal passages occurred in 66% of patients within the study period.
- Eradication of S. aureus from the exit site was challenging, with only 3 out of 5 patients achieving negative cultures post-treatment.
Conclusions:
- While rifampin and cloxacillin can transiently eliminate S. aureus nasal carriage, high rates of recolonization limit its long-term effectiveness.
- The combination therapy showed limited success in eradicating S. aureus exit site colonization, suggesting further research is needed for effective strategies in this vulnerable population.
Abstract:
The efficacy of rifampin in eliminating Staphylococcus aureus colonization was evaluated in a pediatric peritoneal dialysis population. Six children with documented nasal colonization were treated for 7 days with rifampin and cloxacillin. Although antimicrobial therapy eliminated nasal carriage in all patients, recolonization occurred in 66%. Exit site colonization proved difficult to eradicate with negative cultures documented in only 3 of 5 children after rifampin/cloxacillin therapy. Although S. aureus carriage is a risk factor for S. aureus infections, efforts to eradicate carriage with rifampin are hindered by rapid recolonization.