LOK C, STANLEY K, HUX J, RICHARDSON R, TOBE S, DEDIER H, CONLY JM; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. K-669.
Univ of Toronto, Toronto, ON, Canada.
BACKGROUND: Staphylococci are the primary cause of blood stream (BSIs) and exit site infections (ESIs) in HDCRIs. Given the broad spectrum of activity of PO (bacitracin 500U/g, polymyxin B 10,000 U/g, gramicidin 0.25 mg/g) we conducted a clinical trial to assess the impact of PO on the incidence and microbiology of HDCRIs. METHODS: The study was designed as a double blinded placebo controlled randomized trial in renal patients receiving HD. Standard protocols and definitions of outcomes of BSIs and ESIs were used in each of the 2 groups. Blood and exit site culture isolates were identified by standard methods and strain similarity was assessed by antibiogram and pulsed field gel electrophoresis (PFGE). RESULTS: There were 2.5 vs 0.6 bacteremias (p<0.0004) and 4.1 vs 1.0 (p<0.001) total HDCRIs in the PO and placebo groups, respectively. No significant differences existed in the patient populations to explain the findings. No differences in the proportion of HDCRIs due to coagulase negative staphylococci and S aureus were noted between the 2 groups, each accounting for 69% of the total infections. Of 27 BSIs, concordant organisms were identified at the exit site in 10 (37%). Of 4 yeast BSIs, all were due to Candida parapsilosis. PFGE of these isolates revealed different clonal types.To date, no PO resistant bacteria have been identified. CONCLUSIONS: PO has a significant benefit in preventing HDCRIs, with a similar reduction in both BSIs and ESIs. There appeared to be a general decrease in both gram positive and gram negative bacteria causing HDCRIs with the use of PO.
Publication Types:
Keywords:
- Bacteremia
- Electrophoresis, Gel, Pulsed-Field
- Humans
- Ointments
- Renal Dialysis
- Staphylococcus
- microbiology
- organization & administration
Other ID:
UI: 102268391
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