Abstract | BACKGROUND:
Peritonitis and exit-site infections (ESI) are major causes of technique failure and morbidity in peritoneal dialysis (PD) patients. Topical mupirocin on the exit-site has been shown to reduce such complications and prolong life in PD. Since the year 2000, such an approach has been adopted for our new incident PD population. We now report the results of this new protocol. We also studied the effect of co-morbidity on peritonitis occurrence. METHODS: RESULTS: Topical mupirocin at the exit-site has led to a significant reduction in peritonitis rate (0.443 vs 0.339 episodes/patient-year; P<0.0005) and ESI (0.168 vs 0.156 episodes/patient-year; P<0.005) attributed primarily to the significant reduction in Staphylococcus aureus infections. There was an unexpected finding of lower Pseudomonas aeruginosa peritonitis in the mupirocin group (P<0.005). Stepwise multiple logistic regression analysis revealed that only mupirocin application and serum albumin were significant predictors of peritonitis. CONCLUSIONS: Our study, although limited by its retrospective nature, demonstrated that topical mupirocin was associated with a significant reduction in ESI and peritonitis with unexpected findings of lower Pseudomonas peritonitis. Serum albumin prior to the initiation of PD was a strong predictor of subsequent peritonitis. Mupirocin, with its low toxicity, ease of application and demonstrable beneficial effect in reducing ESI and peritonitis is now used on all incident PD patients.
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Authors | Christopher Thiam-Seong Lim, Kok-Seng Wong, Marjorie Wai-Yin Foo |
Journal | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
(Nephrol Dial Transplant)
Vol. 20
Issue 8
Pg. 1702-6
(Aug 2005)
ISSN: 0931-0509 [Print] England |
PMID | 15855200
(Publication Type: Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Ointments
- Mupirocin
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Topics |
- Administration, Topical
- Anti-Bacterial Agents
(therapeutic use)
- Cardiovascular Diseases
(drug therapy, etiology)
- Catheters, Indwelling
(adverse effects)
- Cohort Studies
- Diabetes Mellitus
(drug therapy, etiology)
- Humans
- Incidence
- Middle Aged
- Mupirocin
(therapeutic use)
- Ointments
- Peritoneal Dialysis, Continuous Ambulatory
(adverse effects, instrumentation)
- Peritonitis
(epidemiology, etiology, prevention & control)
- Retrospective Studies
- Singapore
(epidemiology)
- Staphylococcal Infections
(epidemiology, etiology, prevention & control)
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