TY - JOUR
T1 - Mupirocin ointment application at the exit site of temporary central line hemodialysis catheters markedly reduces S. aureus bloodstream infections
AU - Silverberg, D.
AU - Stozenko, F.
AU - Blum, M.
AU - Tzion, S. Ben
AU - Schwartz, D.
AU - Yachnin, T.
AU - Baruch, R.
AU - Shaked, M.
AU - Iaina, A.
AU - Siegman-Igra, Y.
PY - 2003/8/1
Y1 - 2003/8/1
N2 - Purpose. Sepsis is a serious complication of temporary central line hemodialysis catheters placed in subclavian, jugular, or femoral veins. The purpose of this study was to compare the incidence of catheter-related bloodstream infections (CRBSIs) in our hemodialysis unit when the exit sites of these catheters were disinfected by 2 different methods. Methods. At the onset of every dialysis, the exit sites of the temporary hemodialysis catheters were cleaned with a solution of 0.5% chlorhexidine gluconate and 70% isopropyl alcohol, followed by the local application of either of the following: 10% povidoneiodine solution (Period I) of 2% mupirocin ointment (Period II). The two periods of time were then compared. Period I extended from January 1996 to December 1998 (3 years), during which time 867 catheters were inserted. Period II extended from January 1999 to December 2000 (2 years), during which time 1, 138 catheters were inserted. In all cases where positive blood cultures were found, the patients were carefully assessed by the Infectious Disease Service. Results. From Period I to Period II, episodes of Staphylococcus aureus CRBSI fell by a factor of 6.9 - from 21/867 (2.42%) to 4/1, 138 (0.35%) (p < 0.001). Episodes of CRBSI caused by Staphylococcus epidermidis, Enterococcus, and Gram-negative bacteria did not change significantly from Period I to Period II - from 2 (0.2%) to 5 (0.4%) for S. epidermidis, 3 (0.3%) to 0 for Enterococcus, and 9 (1.0%) to 10 (0.9%) for Gram-negative CRBSI episodes, respectively. Total temporary catheter-related bloodstream infection episodes fell from 35 (4.0%) to 19 (1.7%) from Period I to Period II (p < 0.01). Conclusion. We conclude that the routine use of mupirocin ointment at the exit site in hemodialysis patients with temporary central line catheters is associated with a marked reduction in the incidence of catheter-related S. aureus bloodstream infections.
AB - Purpose. Sepsis is a serious complication of temporary central line hemodialysis catheters placed in subclavian, jugular, or femoral veins. The purpose of this study was to compare the incidence of catheter-related bloodstream infections (CRBSIs) in our hemodialysis unit when the exit sites of these catheters were disinfected by 2 different methods. Methods. At the onset of every dialysis, the exit sites of the temporary hemodialysis catheters were cleaned with a solution of 0.5% chlorhexidine gluconate and 70% isopropyl alcohol, followed by the local application of either of the following: 10% povidoneiodine solution (Period I) of 2% mupirocin ointment (Period II). The two periods of time were then compared. Period I extended from January 1996 to December 1998 (3 years), during which time 867 catheters were inserted. Period II extended from January 1999 to December 2000 (2 years), during which time 1, 138 catheters were inserted. In all cases where positive blood cultures were found, the patients were carefully assessed by the Infectious Disease Service. Results. From Period I to Period II, episodes of Staphylococcus aureus CRBSI fell by a factor of 6.9 - from 21/867 (2.42%) to 4/1, 138 (0.35%) (p < 0.001). Episodes of CRBSI caused by Staphylococcus epidermidis, Enterococcus, and Gram-negative bacteria did not change significantly from Period I to Period II - from 2 (0.2%) to 5 (0.4%) for S. epidermidis, 3 (0.3%) to 0 for Enterococcus, and 9 (1.0%) to 10 (0.9%) for Gram-negative CRBSI episodes, respectively. Total temporary catheter-related bloodstream infection episodes fell from 35 (4.0%) to 19 (1.7%) from Period I to Period II (p < 0.01). Conclusion. We conclude that the routine use of mupirocin ointment at the exit site in hemodialysis patients with temporary central line catheters is associated with a marked reduction in the incidence of catheter-related S. aureus bloodstream infections.
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AN - SCOPUS:0042575273
SN - 0090-2934
VL - 32
SP - 484-489+513
JO - Dialysis and Transplantation
JF - Dialysis and Transplantation
IS - 8
ER -