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

• 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
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/0195-6701(95)90065-9

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%.