TREATMENT OF STAPHYLOCOCCUS-AUREUS NASAL CARRIERS IN CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS WITH MUPIROCIN - LONG-TERM RESULTS
TREATMENT OF STAPHYLOCOCCUS-AUREUS NASAL CARRIERS IN CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS WITH MUPIROCIN - LONG-TERM RESULTS
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DOI：
10.1016/s0272-6386(12)80434-3
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发表时间：
1993-11-01
影响因子：
13.2
通讯作者：
MONCALIAN, J
中科院分区：
文献类型：
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作者：
PEREZFONTAN, M;GARCIAFALCON, T;MONCALIAN, J
我们介绍了在我们的连续非卧床腹膜透析装置中使用莫匹罗星（Bactroban，SmithKline Beecham Pharmaceuticals，费城，宾夕法尼亚州）治疗金黄色葡萄球菌鼻腔携带者（SANC）的前瞻性方案的临床结果。我们监测了腹膜炎和导管出口部位感染的发生率、感染相关的导管丢失率以及 SANC 状态与金黄色葡萄球菌感染之间的关联程度。研究组包括 94 名患者，随访时间为 1,097 患者月（B 期）。在研究期前 24 个月期间（随访 1,043 患者月）（A 期）对 74 名连续不卧床腹膜透析患者进行回顾性收集了相同的信息。在 47.5% 的患者中观察到金黄色葡萄球菌鼻携带。莫匹罗星对于根除鼻孔金黄色葡萄球菌非常有效，但大多数患者需要定期重新治疗。金黄色葡萄球菌腹膜炎的发生率从A期的1次/58患者月下降到B期的1次/548患者月，出口部位感染的发生率从A期的1次/55患者月下降到B期的1次/137患者月。然而，其他革兰氏阳性菌和阴性菌的感染发生率同时增加。腹膜炎（P = 不显着）或出口部位感染（P < 0.05）后导管丢失率从 A 期到 B 期呈下降趋势。77% 的腹膜炎感染和 74% 的金黄色葡萄球菌出口部位感染发生在 SANC 中。总之，SANC状态的治疗对连续门诊腹膜透析患者金黄色葡萄球菌腹膜炎和出口部位感染的发生率具有明显的有益作用。然而，由于其他革兰氏阳性菌和阴性菌感染的发生率同时增加，这些感染的全球发病率并没有明显改善。
We present the clinical results of a prospective protocol of the treatment ofStaphylococcus aureusnasal carriers (SANCs) in our continuous ambulatory peritoneal dialysis unit with mupirocin (Bactroban, SmithKline Beecham Pharmaceuticals, Philadelphia, PA). We monitored the incidence of peritonitis and catheter exit-site infection, the rate of infection-related catheter loss, and the degree of association between SANC state and S aureus infection. The study group included 94 patients with a follow-up of 1,097 patient-months (phase B). The same information was retrospectively collected among 74 continuous ambulatory peritoneal dialysis patients treated during the 24 months preceding the study period (follow-up of 1,043 patient-months) (phase A).S aureusnasal carriage was observed in 47.5% of the patients. Mupirocin was very effective in eradicating S aureus from the nares, but most patients required periodic retreatment. The incidence ofS aureusperitonitis decreased from 1 episode/58 patient-months in phase A to 1 episode/ 548 patient-months in phase B, and the incidence of exit-site infection decreased from one episode/55 patient-months in phase A to 1 episode/137 patient-months in phase B. However, there was a simultaneous increase in the incidence of infections by other gram-positive and -negative bacteria. The rate of catheter loss after peritonitis (P = not significant) or exit-site infection (P < 0.05) tended to decrease from phase A to phase B. Seventy-seven percent of the peritonitis infections and 74% of the exit-site infections byS aureusoccurred in SANCs. In conclusion, the treatment of the SANC state has a clear beneficial effect on the incidence of S aureus peritonitis and exit-site infections in patients undergoing continuous ambulatory peritoneal dialysis. However, the global incidence of these infections is not clearly improved, due to a simultaneous increase in the incidence of infections by other gram-positive and -negative bacteria.