Mupirocin resistance in coagulase-negative staphylococci, after topical prophylaxis for the reduction of colonization of central venous catheters

Topical mupirocin was routinely applied to insertion sites of central venous catheters (CVC) of neonates in a neonatal intensive care unit. After five years, mupirocin resistance was recorded in 42% of clinical isolates of coagulase-negative staphylococci (CNS). This decreased to 21% during a mupiro...

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Bibliographic Details
Published in:The Journal of hospital infection 1995-11, Vol.31 (3), p.189-193
Main Authors: Zakrzewska-Bode, A., Muytjens, H.L., Liem, K.D., Hoogkamp-Korstanje, J.A.A.
Format: Article
Language:English
Subjects:
Administration, Topical
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - pharmacology
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Catheterization, Central Venous
central venous catheters
Coagulase
Coagulase-negative staphylococci
Colony Count, Microbial
Drug Resistance, Microbial
Equipment Contamination
Female
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Male
Medical sciences
Mupirocin - administration & dosage
Mupirocin - pharmacology
mupirocin-resistance
neonates
Pharmacology. Drug treatments
Prospective Studies
Skin - microbiology
Staphylococcus
Staphylococcus - classification
Staphylococcus - drug effects
Staphylococcus - enzymology
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Summary:Topical mupirocin was routinely applied to insertion sites of central venous catheters (CVC) of neonates in a neonatal intensive care unit. After five years, mupirocin resistance was recorded in 42% of clinical isolates of coagulase-negative staphylococci (CNS). This decreased to 21% during a mupirocin-free interval of five months. We performed a prospective study on the significance of mupirocin use on the staphylococcal skin flora of 15 newly admitted neonates. During treatment, mupirocin-susceptible strains were replaced by highly resistant ones. After treatment, all but one neonate harboured at least one resistant strain; 29% of all strains were moderately resistant (mupirocin minimum inhibitory concentrations (MICs) 16 mg/L) and 55% were highly resistant (MICs > 1024 mg/L). One CVC (7%) became colonized with a resistant strain. One year after stopping routine mupirocin application the incidence of resistance had dropped to 13%; CVC colonization was recorded in 2–4%.
ISSN:0195-6701
1532-2939
DOI:10.1016/0195-6701(95)90065-9