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Chanchaithong P, Chueahiran S, Pinpimai K, Sroithongkham P, Leelapsawas C, Indra R, Yindee J, Chuanchuen R. Chromosomal and plasmid localization of ileS2 in high-level mupirocin-resistant Staphylococcus pseudintermedius and Staphylococcus aureus isolated from canine and feline origins. J Antimicrob Chemother 2024; 79:1856-1864. [PMID: 38863334 DOI: 10.1093/jac/dkae172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/11/2024] [Indexed: 06/13/2024] Open
Abstract
OBJECTIVES To characterize the mobile genetic elements and genetic localization of ileS2 in high-level mupirocin-resistant (Hi-MupR) methicillin-resistant Staphylococcus pseudintermedius (MRSP) and MRSA isolates recovered from canine and feline clinical samples. METHODS The identification of bacterial species and presence of mecA and ileS2 genes in MRSP and MRSA isolates were performed using MALDI-TOF MS and PCR, respectively. Antimicrobial resistance (AMR) phenotypes were determined by broth microdilution assays. The genome characteristics, ileS2-containing elements and staphylococcal cassette chromosome mec (SCCmec) were illustrated using complete circular genomes obtained from hybrid assembly of Illumina short-reads and Oxford Nanopore Technologies long-reads. These were analysed through phylogenetic and bioinformatics approaches. RESULTS A total of 18 MRSP clinical isolates and four MRSA clinical isolates exhibited the Hi-MupR phenotype and carried multiple AMR genes, including mecA and ileS2 genes. MRSP ST182-SCCmec V (n = 6) and ST282-ΨSCCmec57395-t10 (n = 4) contained the ileS2 transposable unit associated with IS257 on the chromosome. Three MRSA ST398-SCCmec V-t034/t4652 isolates carried ∼42 kb pSK41-like ileS2 plasmids, whereas similar ileS2 plasmids lacking tra genes were found in MRSP ST282-ΨSCCmec57395-t72/t21 isolates. Furthermore, a new group of ileS2 plasmids, carried by MRSP ST45-ΨSCCmec57395, ST433-ΨSCCmecKW21-t05 and ST2165-SCCmec IV-t06, and by one MRSA ST398-SCCmec V-t034 strain, shared the plasmid backbone with the cfr/fexA-carrying plasmid pM084526_1 in MRSA ST398. CONCLUSIONS This study provides the first evidence of ileS2 integration into the S. pseudintermedius chromosome, which is a rare occurrence in staphylococcal species, and plasmids played a pivotal role in dissemination of ileS2 in both staphylococcal species.
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Affiliation(s)
- Pattrarat Chanchaithong
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Surawit Chueahiran
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Komkiew Pinpimai
- Aquatic Resources Research Institute, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Parinya Sroithongkham
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chavin Leelapsawas
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Rusmin Indra
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Jitrapa Yindee
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Rungtip Chuanchuen
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Chulalongkorn University, Bangkok, 10330, Thailand
- Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
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Shivanna V, Dasegowda V. Comparison of Disk Diffusion and Agar Dilution Method for the Detection of Mupirocin Resistance in Staphylococcal Isolates from Skin and Soft Tissue Infections. J Lab Physicians 2023; 15:372-376. [PMID: 37564234 PMCID: PMC10411145 DOI: 10.1055/s-0042-1760672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Aims and Objectives Mupirocin is a widely used topical antibiotic for the treatment of skin and soft tissue infections. This has resulted in resistance leading to treatment failure. Hence, the present study aimed to determine the prevalence of mupirocin resistance among staphylococcal isolates obtained from the skin and soft tissue infections. Also, comparison of disc diffusion and agar dilution method in detecting mupirocin resistance was done. Materials and Methods This cross-sectional study was conducted in the Department of Microbiology of a tertiary health care center in Karnataka from January to December, 2018. Clinical samples such as wound swabs, tissues, and pus were included in the study. All staphylococcal isolates were screened for mupirocin resistance using 5 µg and 200 µg discs for low-level (MuL) and high-level mupirocin resistance (MuH), respectively. Minimum inhibitory concentration (MIC) was determined using the agar dilution method. Results Out of 100 staphylococcal isolates, 68 were Staphylococcus aureus and 32 were CoNS. MuH was detected in 11 isolates. MuH was more common in CoNS (10/11) compared with S. aureus (1/11). MuL was not found in the study. Discussion In our study, 10 out of 11 mupirocin-resistant isolates were methicillin resistant, which is statistically significant ( p < 0.05). The correlation between results of disc diffusion and MIC were appropriate in this study. Conclusion Judicial prescription of mupirocin after knowing the susceptibility report should become the standard practice. Screening for mupirocin resistance can be done by disc diffusion in resource-limited settings.
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Affiliation(s)
- Vijaya Shivanna
- Department of Microbiology, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India
| | - Venkatesha Dasegowda
- Department of Microbiology, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India
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Chueahiran S, Yindee J, Boonkham P, Suanpairintr N, Chanchaithong P. Methicillin-Resistant Staphylococcus aureus Clonal Complex 398 as a Major MRSA Lineage in Dogs and Cats in Thailand. Antibiotics (Basel) 2021; 10:antibiotics10030243. [PMID: 33671008 PMCID: PMC7997496 DOI: 10.3390/antibiotics10030243] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to present molecular and antimicrobial resistance characteristics of methicillin-resistant Staphylococcus aureus (MRSA) clonal complex (CC) 398 isolated from diseased dogs and cats in Thailand. A total of 20 MRSA isolates of 134 Staphylococcus aureus isolated from canine and feline clinical samples during 2017-2020 were CC398, consisting of sequence type (ST) 398 (18 isolates), ST5926 (1 isolate), and ST6563 (1 isolate) by multilocus sequence typing. spa t034 and staphylococcal cassette chromosome mec (SCCmec) V were predominantly associated with ST398. Intraclonal differentiation was present by additional spa (t1255, t4653), non-detectable spa, composite SCCmec with a hybrid of ccrA1B1+ccrC and class A mec complex, and DNA fingerprints by pulsed-field gel electrophoresis. The isolates essentially carried antimicrobial resistance genes, mediating multiple resistance to β-lactams (mecA, blaZ), tetracyclines [tet(M)], aminoglycosides [aac(6')-Ie-aph(2')-Ia], and trimethoprim (dfr). Livestock-associated MRSA ST398 resistance genes including lnu(B), lsa(E), spw, fexA, and tet(L) were heterogeneously found and lost in subpopulation, with the absence or presence of additional erm(A), erm(B), and ileS2 genes that corresponded to resistance phenotypes. As only a single CC398 was detected with the presence of intraclonal variation, CC398 seems to be the successful MRSA clone colonizing in small animals as a pet-associated MRSA in Thailand.
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Affiliation(s)
- Surawit Chueahiran
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (S.C.); (J.Y.)
| | - Jitrapa Yindee
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (S.C.); (J.Y.)
| | - Pongthai Boonkham
- Veterinary Diagnostic Laboratory, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Nipattra Suanpairintr
- Department of Pharmacology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Pattrarat Chanchaithong
- Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (S.C.); (J.Y.)
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
- Correspondence:
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Prevalence of biocide resistance genes and chlorhexidine and mupirocin non-susceptibility in Portuguese hospitals during a 31-year period (1985-2016). J Glob Antimicrob Resist 2020; 24:169-174. [PMID: 33373736 DOI: 10.1016/j.jgar.2020.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/15/2020] [Accepted: 12/09/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Methicillin-resistantStaphylococcus aureus (MRSA) remains a major human pathogen. MRSA decolonisation strategies frequently combine chlorhexidine baths and mupirocin nasal ointment. Although MRSA remains widespread in Portuguese hospitals, information regarding resistance to biocides and mupirocin is scarce. We evaluated the prevalence of biocide resistance genes and chlorhexidine and mupirocin non-susceptibility in a representative and well-characterised collection of MRSA isolated in Portuguese hospitals during a 31-year period (1985-2016). METHODS Prevalence of five biocide resistance genes (lmrS, mepA, sepA, qacAB and smr) was determined by PCR. Antibiotic susceptibility was assessed by disk diffusion and by MIC determination using broth microdilution (chlorhexidine) and Etest (mupirocin). RESULTS Chromosomal genessepA and mepA were detected in all isolates, while lmrS was found in 87.1%. The prevalence of plasmid-borne genes was significant for qacAB (22.4%), associated with the Iberian (ST247-I/IA) clone (P < 0.0001), and low for smr (1.0%) detected among isolates belonging to the ST239-III/IIIvariant clone. Chlorhexidine non-susceptibility (MIC ≥ 4 mg/L) was observed in two isolates belonging to the EMRSA-15 clone (ST22-IV). Non-susceptibility to mupirocin (MIC > 1 mg/L) was significant (15.4%; n = 31) and mainly found among isolates of the EMRSA-15 clone (P < 0.0001; n = 29). One isolate presented low-level mupirocin resistance (MIC = 32 mg/L), and two missense mutations N213D (A637G) and V588F (G1762T) were identified in the ileS gene. CONCLUSION Concerningly, we detected a high prevalence of biocide resistance genes and an association of mupirocin and chlorhexidine non-susceptibility with the dominant EMRSA-15 clone in Portuguese hospitals.
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Muthuswamy S, Viswanathan A, Yegappan R, Selvaprithiviraj V, Vasudevan AK, Biswas R, Jayakumar R. Antistaphylococcal and Neutrophil Chemotactic Injectable κ-Carrageenan Hydrogel for Infectious Wound Healing. ACS APPLIED BIO MATERIALS 2018; 2:378-387. [DOI: 10.1021/acsabm.8b00625] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Shiva Muthuswamy
- Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Aparna Viswanathan
- Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Ramanathan Yegappan
- Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Vignesh Selvaprithiviraj
- Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Anil Kumar Vasudevan
- Department of Microbiology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Raja Biswas
- Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, India
| | - Rangasamy Jayakumar
- Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi 682041, India
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Goudarzi M, Fazeli M, Eslami G, Pouriran R. Genetic Diversity Analysis of Mupirocin-Resistant Staphylococcus aureus Clinical Isolates in Tehran Hospitals, Iran. Microb Drug Resist 2018; 25:558-566. [PMID: 30499764 DOI: 10.1089/mdr.2018.0146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Few studies describe the molecular characterization of mupirocin resistance in Staphylococcus aureus strains. In this study, we evaluated the characteristics of mupirocin resistance in S. aureus isolates for 1-year period in Tehran, Iran. In a cross-sectional study, we collected 51 unique mupirocin-resistant strains obtained from 648 S. aureus isolates. High- and low-level resistance were determined by minimum inhibitory concentration with broth microdilution method. Presence of the genes for resistance to antibiotics and toxins was detected by polymerase chain reaction assays. Genotyping was performed by S. aureus protein A (spa) and staphylococcal cassette chromosome mec (SCCmec) typing, whereas clones were determined by multilocus sequence typing. Among mupirocin-resistant isolates, methicillin-resistant S. aureus (MRSA) 23 (45.1%) and 28 (54.9%) isolates were classified as high- and low-level mupirocin resistance, respectively. Among the 51 tested strains 25 (49%) isolates were positive for mupA genes. Seven different clones were detected in this study. High-level mupirocin-resistant (HLMUPR) strains belonged to ST8-SCCmec IV/t064 (n = 10, 19.6%), ST5-SCCmec IV/t002 (n = 5, 9.8%), ST8-SCCmec IV/t008 (n = 4, 7.8%), and ST239-SCCmec III/t631 (n = 4, 7.8%) clones, while low-level mupirocin-resistant (LLMUPR) strains belonged to ST22-SCCmec IV/t790 (n = 11, 21.6%), ST239-SCCmec III/t860 (n = 9, 17.7%), and ST15-SCCmec IV/t084 (n = 8, 15.7%) clones. Two strains belonged to ST22-SCCmec IV/t790 clone, despite carrying mupA gene, and demonstrated LLMUPR phenotype. One ST8-SCCmecIV/t008 strain with HLMUPR was confirmed as Vancomycin-intermediate S. aureus strain. Our data demonstrated the need for thorough epidemiological monitoring and a routine mupirocin testing program to prevent and detect mupirocin resistance in MRSA.
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Affiliation(s)
- Mehdi Goudarzi
- 1 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Fazeli
- 2 Department of Virology, Pasteur Institute of Iran, Tehran, Iran
| | - Gita Eslami
- 1 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ramin Pouriran
- 3 School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Park JH, Kang JH, Hyun JE, Hwang CY. Low prevalence of mupirocin resistance inStaphylococcus pseudintermediusisolates from canine pyoderma in Korea. Vet Dermatol 2018; 29:95-e37. [DOI: 10.1111/vde.12518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Ji-Hyung Park
- Laboratory of Veterinary Dermatology; College of Veterinary Medicine; Seoul National University; Seoul 08826 Korea
| | - Jung-Hun Kang
- Laboratory of Veterinary Dermatology; College of Veterinary Medicine; Seoul National University; Seoul 08826 Korea
| | - Jae-Eun Hyun
- Laboratory of Veterinary Dermatology; College of Veterinary Medicine; Seoul National University; Seoul 08826 Korea
| | - Cheol-Yong Hwang
- Laboratory of Veterinary Dermatology; College of Veterinary Medicine; Seoul National University; Seoul 08826 Korea
- Research Institute for Veterinary Science; College of Veterinary Medicine; Seoul National University; Seoul 08826 Korea
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Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns. Clin Microbiol Rev 2017; 30:827-860. [PMID: 28592405 DOI: 10.1128/cmr.00112-16] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Bacterial skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic (such as mupirocin or fusidic acid) or an antiseptic (such as chlorhexidine or alcohol). However, there is limited evidence to support the widespread prophylactic or therapeutic use of topical agents. Challenges involved in the use of topical antimicrobials include increasing rates of bacterial resistance, local hypersensitivity reactions (particularly to older agents, such as bacitracin), and concerns about the indiscriminate use of antiseptics potentially coselecting for antibiotic resistance. We review the evidence for the major clinical uses of topical antibiotics and antiseptics. In addition, we review the mechanisms of action of common topical agents and define the clinical and molecular epidemiology of antimicrobial resistance in these agents. Moreover, we review the potential use of newer and emerging agents, such as retapamulin and ebselen, and discuss the role of antiseptic agents in preventing bacterial skin infections. A comprehensive understanding of the clinical efficacy and drivers of resistance to topical agents will inform the optimal use of these agents to preserve their activity in the future.
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Rossi CC, da Silva Dias I, Muniz IM, Lilenbaum W, Giambiagi-deMarval M. The oral microbiota of domestic cats harbors a wide variety of Staphylococcus species with zoonotic potential. Vet Microbiol 2017; 201:136-140. [DOI: 10.1016/j.vetmic.2017.01.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 12/16/2022]
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Conceição T, de Lencastre H, Aires-de-Sousa M. Efficacy of octenidine against antibiotic-resistant Staphylococcus aureus epidemic clones. J Antimicrob Chemother 2016; 71:2991-4. [PMID: 27334666 DOI: 10.1093/jac/dkw241] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Teresa Conceição
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Hermínia de Lencastre
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal Laboratory of Microbiology and Infectious Diseases, The Rockefeller University, New York, NY, USA
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Rossi CC, Ferreira NC, Coelho MLV, Schuenck RP, Bastos MDCDF, Giambiagi-deMarval M. Transfer of mupirocin resistance from Staphylococcus haemolyticus clinical strains to Staphylococcus aureus through conjugative and mobilizable plasmids. FEMS Microbiol Lett 2016; 363:fnw121. [PMID: 27190144 DOI: 10.1093/femsle/fnw121] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2016] [Indexed: 12/15/2022] Open
Abstract
Coagulase-negative staphylococci are thought to act as reservoirs of antibiotic resistance genes that can be transferred to Staphylococcus aureus, thus hindering the combat of this bacterium. In this work, we analyzed the presence of plasmids conferring resistance to the antibiotic mupirocin-widely used to treat and prevent S. aureus infections in hospital environments-in nosocomial S. haemolyticus strains. About 12% of the 75 strains tested were resistant to mupirocin, and this phenotype was correlated with the presence of plasmids. These plasmids were shown to be diverse, being either conjugative or mobilizable, and capable of transferring mupirocin resistance to S. aureus Our findings reinforce that S. haemolyticus, historically and mistakenly considered as a less important pathogen, is a reservoir of resistance genes which can be transferred to other bacteria, such as S. aureus, emphasizing the necessity of more effective strategies to detect and combat this emergent opportunistic pathogen.
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Affiliation(s)
- Ciro C Rossi
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21491-590, Brazil
| | - Natália C Ferreira
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21491-590, Brazil Departamento de Biotecnologia Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-170, Brazil
| | - Marcus L V Coelho
- Divisão de Biologia Molecular e Correlatos (DIMOL), Instituto Nacional da Propriedade Industrial, Rio de Janeiro, Rio de Janeiro 20090-910, Brazil
| | - Ricardo P Schuenck
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21491-590, Brazil Departamento de Patologia, Universidade Federal do Espirito Santo, Centro Biomédico, Vitoria, ES 23043-900, Brazil
| | - Maria do Carmo de F Bastos
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21491-590, Brazil
| | - Marcia Giambiagi-deMarval
- Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21491-590, Brazil
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Rudresh MS, Ravi GS, Motagi A, Alex AM, Sandhya P, Navaneeth BV. Prevalence of Mupirocin Resistance Among Staphylococci, its Clinical Significance and Relationship to Clinical Use. J Lab Physicians 2015; 7:103-7. [PMID: 26417160 PMCID: PMC4559621 DOI: 10.4103/0974-2727.163127] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: Mupirocin competitively inhibits bacterial isoleucyl transfer-RNA synthetase and inhibit bacterial protein synthesis. Widespread usage and over the counter availability of the drug has resulted in resistance among Staphylococcus species. Objectives: This study aimed to determine the overall prevalence of mupirocin resistance among staphylococci. Correlate clinical significance of mupirocin resistance and its relationship to clinical use. Methods: Consecutive, nonrepetitive, clinical isolates of Staphylococcus aureus (n = 98), and coagulase-negative staphylococci (CoNS) (n = 45) from skin and soft-tissue infections between January 2014 and June 2014 were studied. Antibiotic susceptibility testing was done according to Clinical and Laboratory Standards Institute guidelines. Low- and high-level mupirocin resistance was screened by using 5 µg and 200 µg discs respectively and confirmed by agar dilution. Annual consumption of mupirocin was studied and correlated with resistance. Results: High-level mupirocin resistance was found in 8.2% S. aureus and 15.6% of CoNS, while low-level mupirocin resistance was found in 17% S. aureus and 8.9% CoNS. High-level mupirocin resistance was more common in methicillin-sensitive S. aureus isolates when compared with methicillin-resistant S. aureus isolates (P < 0.05). Mupirocin resistant S. epidermidis were associated with methicillin resistance and constitutive clindamycin resistance. Conclusion: High prevalence of mupirocin resistance was found in the present study. Increased prevalence of mupirocin resistance among community-acquired staphylococci demands the judicious use of the drug in the community.
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Affiliation(s)
| | | | - Aravind Motagi
- Department of Microbiology, ESIC MH, Indore, Madhya Pradesh, India
| | - Ann Mary Alex
- Department of Microbiology, ESIC MC and PGIMSR, Rajajinagar, Bengaluru, Karnataka, India
| | - Parthasarathi Sandhya
- Department of Microbiology, ESIC MC and PGIMSR, Rajajinagar, Bengaluru, Karnataka, India
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Brown PD. Multiple-locus VNTR Analyses of Methicillin-resistant Staphylococcus aureus from Jamaica. Infect Dis (Lond) 2015; 8:31-8. [PMID: 26448687 PMCID: PMC4583095 DOI: 10.4137/idrt.s31084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 08/23/2015] [Accepted: 08/31/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND This study assessed the antimicrobial susceptibilities and the presence of inducible macrolide–lincosamide–streptogramin B (iMLSB) resistance in methicillin-resistant Staphylococcus aureus (MRSA) of Jamaica as well as the relatedness using polymerase chain reaction-based staphylococcal cassette chromosome mec (SCCmec) and multiple-locus variable numbers of tandem repeat analyses (MLVAs). MATERIALS AND METHODS Antimicrobial susceptibility, the presence of MLSB resistance, and SCCmec and MLVA patterns were assessed for 61 nonduplicate isolates of MRSA from hospitalized patients. RESULTS While no isolate was resistant to vancomycin, 53 (86.9%) isolates were resistant to ciprofloxacin, 52 (85.3%) to erythromycin, 49 (80%) to lincomycin, and 45 (74%) to clindamycin. Of the 52 erythromycin-resistant isolates, 48% exhibited constitutive resistance and 8% showed inducible MLSB (iMLSB) resistance. Most (85%) of typable isolates were SCCmec type IV, and among these, 16 MLVA patterns were identified. CONCLUSION Multidrug resistance continues to characterize MRSA. Among the erythromycin-resistant isolates, constitutive resistance and iMLSB resistance are common. These facts will complicate the treatment of MRSA infections and warrant continued surveillance and judicial use of antimicrobial agents.
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Affiliation(s)
- Paul D Brown
- Department of Basic Medical Sciences, The University of the West Indies at Mona, Jamaica
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Mongkolrattanothai K, Mankin P, Raju V, Gray B. Surveillance for Mupirocin Resistance Among Methicillin-Resistant Staphylococcus aureus Clinical Isolates. Infect Control Hosp Epidemiol 2015; 29:993-4. [DOI: 10.1086/590536] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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15
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Wattal C, Oberoi JK. Mupirocin resistant staphylococcus aureus nasal colonization among healthcare workers. Indian J Crit Care Med 2014; 18:709-10. [PMID: 25425836 PMCID: PMC4238086 DOI: 10.4103/0972-5229.144009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Chand Wattal
- From: Department of Clinical Microbiology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India
| | - Jaswinder Kaur Oberoi
- From: Department of Clinical Microbiology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India
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Chaturvedi P, Singh AK, Singh AK, Shukla S, Agarwal L. Prevalence of Mupirocin Resistant Staphylococcus aureus Isolates Among Patients Admitted to a Tertiary Care Hospital. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2014; 6:403-7. [PMID: 25210674 PMCID: PMC4158649 DOI: 10.4103/1947-2714.139293] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: For the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections and decolonization of MRSA carriers, the use of mupirocin a topical antibiotic is increasing day by day. Aim: The present study was carried out to determine the prevalence rate of high-level and low-level mupirocin resistant MRSA isolates among patients admitted to a tertiary care hospital. Materials and Methods: This is a prospective study carried out on MRSA isolated from the various clinical specimens from outpatient and inpatient departments during period of one year. A total of 82 MRSA isolates were recovered from 6468 different clinical specimens. Mupirocin resistant MRSA was detected by two different methods: Epsilometer test (E-test) and agar dilution method. D-shaped zone test (D-zone test) was also performed for determination of inducible clindamycin resistance in MRSA isolates. Results: Out of 82 non-duplicate MRSA isolates mupirocin resistance were found in 15 (18.3%) isolates by both E-test and agar dilution method. Of these 15 mupirocin resistant, 8 (53.3%) isolates were high-level resistant (MuH) and 7 (46.7%) isolates were low-level resistant (MuL). Four isolates were D-zone test positive showing simultaneous inducible clindamycin resistance among mupirocin resistant MRSA isolates. Conclusion: Higher prevalence of both high-level and low-level of mupirocin resistant MRSA was observed in patient from the population. It is advisable to perform routine test to detect MRSA colonization among health care workers and nasal decolonization to prevent spread of MRSA infections among hospitalized patients.
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Affiliation(s)
- Parul Chaturvedi
- Department of Microbiology, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
| | - Amit Kumar Singh
- Department of Microbiology, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
| | - Amit Kumar Singh
- Department of Microbiology, Major SD Singh Medical College and Hospital, Farrukhabad, Uttar Pradesh, India
| | - Snehanshu Shukla
- Department of Microbiology, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
| | - Loveleena Agarwal
- Department of Microbiology, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
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Hetem D, Bonten M. Clinical relevance of mupirocin resistance in Staphylococcus aureus. J Hosp Infect 2013; 85:249-56. [DOI: 10.1016/j.jhin.2013.09.006] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 09/01/2013] [Indexed: 10/26/2022]
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S. J, M. M, A.S. SB, Mathew R, M. K, Lal Y. B. Prevalence of High and Low Level Mupirocin Resistance among Staphylococcal Isolates from Skin Infection in a Tertiary Care Hospital. J Clin Diagn Res 2013; 7:238-42. [PMID: 23543635 PMCID: PMC3592282 DOI: 10.7860/jcdr/2013/4694.2736] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 10/27/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND Mupirocin has been used for the treatment of skin infections and for the eradication of the nasal carriage of Methicillin -resistant Staphylococcus aureus (MRSA). The increased use of this antibiotic has been accompanied by its resistance, resulting in treatment failures. OBJECTIVE This study was aimed at determining the prevalences of low and high level Mupirocin resistance among the clinical isolates of Staphylococcus species which were obtained from pyogenic infections. MATERIAL AND METHOD Clinical samples such as wound swabs, tissues and pus which were submitted to the microbiology laboratory during a period of six months were screened for the growth of Staphylococcus species, which were identified as Staphylococcus aureus and Coagulase negative Staphylococcus species by the routine microbiological procedures. All the isolates were tested for their Mupirocin susceptibilities by using 5 and 200 μg discs and their resistance was confirmed from their Minimum Inhibitory Concentrations (MICs). RESULT Out of 400 samples, 150 samples grew Staphylococcus species, of which 113 were Staphylococcus aureus and 37 were Coagulase negative Staphylococcus (CoNS). Only 5(3.3%) mupirocin resistant Staphylococcus species: three high level and two low level strains were detected. The MICs for the two low level and three high level Mupirocin resistant strains were 256 mg/L and ≥512mg/L each respectively. CONCLUSION We conclude that the screening for mupirocin resistance, in terms of high-level and low-level resistance among the Staphylococcus species from patients with skin and soft tissue infections is warranted and that it is important for the clinicians in selecting the appropriate, empirical, topical, antimicrobial therapy. It also provides useful information about the prevalence of these resistant pathogens.
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Affiliation(s)
- Jayakumar S.
- Department of Microbiology, Saveetha Medical College & Hospital, Saveetha University, Thandalam, Kancheepuram District-602 105, Tamilnadu, India
| | - Meerabai M.
- Department of Microbiology, Saveetha Medical College & Hospital, Saveetha University, Thandalam, Kancheepuram District-602 105, Tamilnadu, India
| | - Shameem Banu A.S.
- Department of Microbiology, Saveetha Medical College & Hospital, Saveetha University, Thandalam, Kancheepuram District-602 105, Tamilnadu, India
| | - Renu Mathew
- Department of Microbiology, Saveetha Medical College & Hospital, Saveetha University, Thandalam, Kancheepuram District-602 105, Tamilnadu, India
| | - Kalyani M.
- Department of Microbiology, Saveetha Medical College & Hospital, Saveetha University, Thandalam, Kancheepuram District-602 105, Tamilnadu, India
| | - Binesh Lal Y.
- Department of Microbiology, Saveetha Medical College & Hospital, Saveetha University, Thandalam, Kancheepuram District-602 105, Tamilnadu, India
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Choudhury S, Krishnan PU, Ang B. Prevalence of high-level mupirocin resistance among meticillin-resistant Staphylococcus aureus isolates in a tertiary care hospital in Singapore. J Hosp Infect 2012; 82:56-7. [PMID: 22854355 DOI: 10.1016/j.jhin.2012.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 07/02/2012] [Indexed: 11/18/2022]
Abstract
High-level resistance to mupirocin in meticillin-resistant Staphylococcus aureus (MRSA) jeopardizes its role in nasal decolonization protocols. We carried out a study in 2010 to determine the prevalence of high-level mupirocin resistance in our tertiary-care hospital. The prevalence of high-level resistance to mupirocin in MRSA in this hospital was 11%. There was also complete agreement between the genotypic and phenotypic methods of detection of high-level mupirocin resistance in 24 of the screening isolates.
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Affiliation(s)
- S Choudhury
- Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore.
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20
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Aqel A, Ibrahim A, Shehabi A. Rare occurrence of mupirocin resistance among clinical Staphylococcus isolates in Jordan. Acta Microbiol Immunol Hung 2012; 59:239-47. [PMID: 22750783 DOI: 10.1556/amicr.59.2012.2.8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Staphylococcal infections have high occurrence in Jordanian patients. This study was carried out to determine the rates of high- and low-level mupirocin resistance (MupH and MupL) among staphylococci with the molecular characterization. Two hundred and thirty-two non-duplicate Staphylococcus spp. isolated from different clinical specimens were tested for mupirocin susceptibility using disk diffusion method and minimum inhibitory concentration (MIC). Resistance genes and clone relatedness was studied using polymerase chain reaction (PCR) and enterobacterial repetitive intergenic consensus primers (Eric-PCR) for the latter. Plasmid curing was performed to determine the genetic location of MupA gene. Among the 232 strains, 144 (62%) were methicillin-resistant Staphylococcus aureus (MRSA), 33 (14.2%) methicillin-susceptible Staphylococcus aureus (MSSA) and 55 (23.7%) were of other coagulase-negative Staphylococcus spp. (CoNS). Of all strains tested, only 6 (2.6%) were mupirocin resistant. MecA gene was detected in both MupL and MupH strains but MupA gene was only detected in MupH. Plasmid curing improved the plasmidic location of MupA gene. Molecular typing by Eric-PCR method revealed heterogenicity of the genetic make up of our MupL and MupH strains. Staphylococci with MupA-carrying genes are present in Jordanian hospitals, but thank to the limited use of mupirocin, they remain rare.
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Affiliation(s)
- Amin Aqel
- 1 Mu’tah University Faculty of Medicine Al-Karak Jordan
| | - Abdallah Ibrahim
- 2 Zarqa University Faculty of Allied Medical Sciences Zarqa Jordan
| | - Asem Shehabi
- 3 Jordan University Faculty of Medicine Amman Jordan
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21
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Jervis-Bardy J, Wormald PJ. Microbiological outcomes following mupirocin nasal washes for symptomatic, Staphylococcus aureus-positive chronic rhinosinusitis following endoscopic sinus surgery. Int Forum Allergy Rhinol 2011; 2:111-5. [DOI: 10.1002/alr.20106] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 09/20/2011] [Accepted: 10/09/2011] [Indexed: 11/11/2022]
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Staphylococcus haemolyticus as an important hospital pathogen and carrier of methicillin resistance genes. J Clin Microbiol 2011; 50:166-8. [PMID: 21976766 DOI: 10.1128/jcm.05563-11] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Phenotypic and molecular methods were used to characterize the antibiotic resistance of 64 clinical isolates of Staphylococcus haemolyticus. By PCR of the mecA gene, 87% were found to be methicillin resistant. Approximately 55% harbored staphylococcal cassette chromosome mec element (SCCmec) type V, and only one SCCmec type IV. Many isolates (75%) displayed multiresistance, and pulsotype analysis showed a high diversity.
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Antibiotic resistance of canine Staphylococcus intermedius group (SIG)--practical implications. Pol J Vet Sci 2011; 14:213-8. [PMID: 21721404 DOI: 10.2478/v10181-011-0032-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A total of 221 SIG strains were isolated from clinical samples of canine origin submitted to the Diagnostic Laboratory of the Division of Bacteriology and Molecular Biology at the Warsaw University of Life Sciences in Warsaw during the period 2006-2010. The aim of the study was to investigate the frequency of prevalence of methicillin-resistant SIG strains and to determine the MIC values of cephalotin, amoxicillin/clavulanic acid, ciprofloxacin, clindamycin, gentamicin, chloramphenicol, mupirocin for a collection of randomly selected 79 strains belonging to Staphylococcus intermedius group (SIG), including 23 mecA-positive and 56 mecA-negative strains. All isolates were identified as belonging to SIG based on their phenotypic properties and PCR amplification of S. intermedius-specific fragment of the 16S rRNA gene. The mecA gene was detected in 26 (12%) of 221 SIG strains. All tested mecA-negative SIG strains were susceptible to amoxicillin/clavulanic acid and cephalotin. One of the 56 mecA-negative SIG strains was resistant to ciprofloxacin, six (11%) to gentamicin. It was found that sixteen (29%) of 56 mecA-negative SIG strains were resistant to clindamycin. Most of the mecA-positive SIG strains were resistant to ciprofloxacin (96%), clindamycin (96%), and gentamicin (96%). Only one MRSIG strain was resistant to chloramphenicol. All examined mecA-positive SIG strains were found to be susceptible to mupirocin. Our results imply that staphylococcal multidrug resistance has become more prevalent, which could lead to difficulties in effective treatment. With some resistant strains the only therapeutic possibility are antimicrobial agents important in human medicine. New regulations for veterinary medicine concerning appropriate therapy of infections caused by multidrug-resistat staphylococci are needed.
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Lee AS, Macedo-Vinas M, François P, Renzi G, Schrenzel J, Vernaz N, Pittet D, Harbarth S. Impact of Combined Low-Level Mupirocin and Genotypic Chlorhexidine Resistance on Persistent Methicillin-Resistant Staphylococcus aureus Carriage After Decolonization Therapy: A Case-control Study. Clin Infect Dis 2011; 52:1422-30. [DOI: 10.1093/cid/cir233] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lozano C, Aspiroz C, Ara M, Gómez-Sanz E, Zarazaga M, Torres C. Methicillin-resistant Staphylococcus aureus (MRSA) ST398 in a farmer with skin lesions and in pigs of his farm: clonal relationship and detection of lnu(A) gene. Clin Microbiol Infect 2011. [DOI: 10.1111/j.l469-0691.2010.03437.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Lee AS, Macedo-Vinas M, François P, Renzi G, Vernaz N, Schrenzel J, Pittet D, Harbarth S. Trends in mupirocin resistance in meticillin-resistant Staphylococcus aureus and mupirocin consumption at a tertiary care hospital. J Hosp Infect 2011; 77:360-2. [PMID: 21276638 DOI: 10.1016/j.jhin.2010.11.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 11/17/2010] [Indexed: 11/19/2022]
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27
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Lozano C, Aspiroz C, Ara M, Gómez-Sanz E, Zarazaga M, Torres C. Methicillin-resistant Staphylococcus aureus (MRSA) ST398 in a farmer with skin lesions and in pigs of his farm: clonal relationship and detection of lnu(A) gene. Clin Microbiol Infect 2011; 17:923-7. [PMID: 21682806 DOI: 10.1111/j.1469-0691.2010.03437.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Skin infection associated with methicillin-resistant Staphylococcus aureus (MRSA)-ST398 was detected in a pig-farmer, and MRSA-ST398 isolates were also detected in nasal samples of the patient and of 11/12 pigs on his farm. Twelve MRSA isolates were obtained from skin lesions (n = 6) and nasal samples (n = 6) of the patient in two sampling moments and 11 MRSA isolates from nasal samples of pigs. They were typed as t011-SCCmecIVa-agrI and t108-SCCmecV-agrI (patient and pigs) and t588-SCCmecV-agrI (patient). The following resistance genes were detected (number isolates): tet(K) (1), tet(L) (23), tet(M) (13), erm(A) (13), erm(C) (13), msr(A) (11), lnu(A) (21), aph(2'')-acc(6') (3), ant(4') (13), aph(3') (12), dfrS1 (15) and dfrK (22). Seventeen human and animal MRSA-ST398 isolates showed indistinguishable PFGE patterns (A1-spa-t011 or B2-spa-t108) and similar phenotypic-genotypic characteristics, including the presence of the lnu(A) gene, associated with lincomycin resistance. Potential pig-to-human transference of ST398 is suggested in this study. The first detection of the lnu(A) gene in MRSA-ST398 is reported.
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Affiliation(s)
- C Lozano
- Área Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
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28
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Fulham KS, Lemarie SL, Hosgood G, Dick HLN. In vitro susceptibility testing of meticillin-resistant and meticillin-susceptible staphylococci to mupirocin and novobiocin. Vet Dermatol 2010; 22:88-94. [DOI: 10.1111/j.1365-3164.2010.00921.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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29
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Oommen SK, Appalaraju B, Jinsha K. Mupirocin resistance in clinical isolates of staphylococci in a tertiary care centre in south India. Indian J Med Microbiol 2010; 28:372-5. [DOI: 10.4103/0255-0857.71825] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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30
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Multicenter study to determine disk diffusion and broth microdilution criteria for prediction of high- and low-level mupirocin resistance in Staphylococcus aureus. J Clin Microbiol 2010; 48:2469-75. [PMID: 20444971 DOI: 10.1128/jcm.00340-10] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mupirocin susceptibility testing of Staphylococcus aureus has become more important as mupirocin is used more widely to suppress or eliminate S. aureus colonization and prevent subsequent health care- and community-associated infections. The present multicenter study evaluated two susceptibility testing screening methods to detect mupirocin high-level resistance (HLR), broth microdilution (BMD) MICs of >or=512 microg/ml, and a 6-mm zone diameter for a disk diffusion (DD) test with a 200-microg disk. Initial testing indicated that with Clinical and Laboratory Standards Institute methods for BMD and DD testing, the optimal conditions for the detection of mupirocin HLR were 24 h of incubation and reading of the DD zone diameters with transmitted light. Using the presence or absence of mupA as the "gold standard" for HLR, the sensitivity and specificity of a single-well 256 microg/ml BMD test were 97 and 99%, respectively, and those for the 200-microg disk test were 98 and 99%, respectively. Testing with two disks, 200 microg and 5 microg, was evaluated for its ability to distinguish HLR isolates (MICs >or= 512 microg/ml), low-level-resistant (LLR) isolates (MICs = 8 to 256 microg/ml), and susceptible isolates (MICs <or= 4 microg/ml). Using no zone with both disks as an indication of HLR and no zone with the 5-microg disk plus any zone with the 200-microg disk as LLR, only 3 of the 340 isolates were misclassified, with 3 susceptible isolates being classified as LLR. Use of standardized MIC or disk tests could enable the detection of emerging high- and low-level mupirocin resistance in S. aureus.
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Evaluation of disc diffusion methods and Vitek 2 automated system for testing susceptibility to mupirocin in Staphylococcus aureus. J Antimicrob Chemother 2008; 62:1018-23. [DOI: 10.1093/jac/dkn345] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Frequency of Mupirocin Resistant Staphylococcus aureus Strains Isolated From Nasal Carriers in Hospital Patients in Kermanshah. Jundishapur J Microbiol 1970. [DOI: 10.5812/jjm.4199] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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