Targeted mupirocin-based decolonization for Staphylococcus aureus carriers and the subsequent risk of mupirocin resistance in haemodialysis patients - a longitudinal study over 20 years

N Hassoun-Kheir; N Buetti; V Olivier; M Perez; J Frossard; G Renzi; J Schrenzel; P Saudan; S Harbarth

doi:10.1016/j.jhin.2023.01.019

Targeted mupirocin-based decolonization for Staphylococcus aureus carriers and the subsequent risk of mupirocin resistance in haemodialysis patients - a longitudinal study over 20 years

J Hosp Infect. 2023 May:135:55-58. doi: 10.1016/j.jhin.2023.01.019. Epub 2023 Feb 16.

Authors

N Hassoun-Kheir¹, N Buetti², V Olivier³, M Perez⁴, J Frossard⁴, G Renzi⁵, J Schrenzel⁶, P Saudan³, S Harbarth⁴

Affiliations

¹ Infection Control Program, Geneva University Hospitals and Faculty of Medicine, WHO Collaborating Center, Geneva, Switzerland. Electronic address: Nasreen20@gmail.com.
² Infection Control Program, Geneva University Hospitals and Faculty of Medicine, WHO Collaborating Center, Geneva, Switzerland; INSERM, IAME, Université Paris-Cité, Paris, France.
³ Nephrology Service, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
⁴ Infection Control Program, Geneva University Hospitals and Faculty of Medicine, WHO Collaborating Center, Geneva, Switzerland.
⁵ Bacteriology Laboratory, Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland.
⁶ Bacteriology Laboratory, Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals, Geneva, Switzerland; Genomic Research Laboratory, Division of Infectious Diseases, Department of Medicine, University Hospitals and University of Geneva, Geneva, Switzerland.

PMID: 36805086
DOI: 10.1016/j.jhin.2023.01.019

Abstract

Mupirocin-based decolonization of Staphylococcus aureus carriers undergoing haemodialysis is not widely implemented due to concerns of mupirocin resistance. In our haemodialysis unit, a strategy combining universal S. aureus screening with targeted mupirocin-based decolonization was introduced two decades ago. In this study of haemodialysis patients, mupirocin resistance was assessed in blood and colonizing S. aureus isolates during two periods. Mupirocin resistance in S. aureus was infrequent in both blood and colonizing isolates. Furthermore, in the years 2003-2021, a decreasing trend in the annual rate of S. aureus bloodstream infections was observed. Targeted mupirocin-based decolonization of S. aureus carriers undergoing haemodialysis is a sustainable measure for preventing healthcare-associated infections.

Keywords: Bloodstream infections; Haemodialysis; Mupirocin resistance; Staphylococcal carriage.

MeSH terms

Anti-Bacterial Agents / therapeutic use
Carrier State / drug therapy
Chlorhexidine
Humans
Longitudinal Studies
Mupirocin* / therapeutic use
Renal Dialysis / adverse effects
Staphylococcal Infections* / drug therapy
Staphylococcal Infections* / prevention & control
Staphylococcus aureus

Substances

Mupirocin
Chlorhexidine
Anti-Bacterial Agents