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Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Research Article

Mupirocin Resistance Among Methicillin Resistant Staphylococcus Isolates in a Tertiary Health Care Center

Author(s): Seema Mittal*, Pallavi Sayal, Priyanka Yadav, Ashok Kumar and Manisha Rajian

Volume 19, Issue 2, 2019

Page: [128 - 132] Pages: 5

DOI: 10.2174/1871526518666180501104525

Price: $65

Abstract

Introduction: The evolution of antibiotics in the last century has revolutionized the field of medicine and led this field to higher level of success in treating mild to severe infections, but the inappropriate use of these life saving drugs has been accompanied with the appearance of resistant strains to these agents.

Aims & Objectives: The aim of the study was to determine the prevalence rate of high and low-level mupirocin resistance in methicillin resistant staphylococcus,and to find out resistance to other antibiotics.

Materials & Methods: This study was conducted on 100 Staphylococcus isolates recovered from pus samples. Conventional disc diffusion tests were used for the detection of high and low level mupirocin resistance (mupirocin 5µg and 200µg discs) and for various other antimicrobials for example cephalexin, erythromycin, doxycycline, oxacillin, linezolid etc.

Results: Outof 100 Staphylococcus isolates processed during the study period in the department of microbiology, 74 were Staphylococcus aureus (S.aureus) and 26 were Coagulase negative Staphylococcus (CoNS). Among S.aureus 43.4% were Methicillin resistant Staphylococcus aureus (MRSA) and 56.6% were Methicillin sensitive Staphylococcus aureus (MSSA), whereas among CoNS 42% were methicillin resistant and 58% were methicillin sensitive. We observed 6.75% of high level mupirocin resistance among Staphylococcus aureus and 19.23% among Coagulase negative staphylococcus.

Conclusion: It was concluded that an inappropriate excessive use of mupirocin leads to a rapid increase in high-level resistance to mupirocin and other antibiotics in CoNS, affecting the treatment lines and success rate of infection control in hospital settings.

Keywords: MRSA, Mupirocin, Methicillin resistant CONS, antibiotic resistance, high level mupirocin resistance, low level mupirocin resistance.

Graphical Abstract

[1]
Davies, J.; Davies, D. Origins and evolution of antibiotic resistance. Microbiol. Mol. Biol. Rev., 2010, 74(3), 417-433.
[2]
Chambers, H.F.; Deleo, F.R. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat. Rev. Microbiol., 2009, 7(9), 629-641.
[3]
Cookson, B.D. The emergence of mupirocin resistance: a challenge to infection control and antibiotic prescribing practice. J. Antimicrob. Chemother., 1998, 41(1), 11-18.
[4]
Yun, H.J.; Lee, S.W.; Yoon, G.M.; Kim, S.Y.; Choi, S.; Lee, Y.S.; Choi, E.C.; Kim, S. Prevalence and mechanisms of low- and high-level mupirocin resistance in staphylococci isolated from a Korean hospital. J. Antimicrob. Chemother., 2003, 51(3), 619-623.
[5]
Laupland, K.B.; Conly, J.M. Treatment of Staphylococcus aureus colonization and prophylaxis for infection with topical intranasal mupirocin: an evidence-based review. Clin. Infect. Dis., 2003, 37(7), 933-938.
[6]
Udo, E.E.; Jacob, L.E.; Mathew, B. Genetic analysis of methicillin-resistant Staphylococcus aureus expressing high- and low-level mupirocin resistance. J. Med. Microbiol., 2001, 50(10), 909-915.
[7]
Seah, C.; Alexander, D.C.; Louie, L.; Simor, A.; Low, D.E.; Longtin, J.; Melano, R.G. MupB, a new high-level mupirocin resistance mechanism in Staphylococcus aureus. Antimicrob. Agents Chemother., 2012, 56(4), 1916-1920.
[8]
Colle, J.G.; Milrs, R.S.; Watt, B. Tests for identification of bacteria. In: Mackie & McCartney Practical Medical Microbiology, 14th edi-tion, edited by Collee JG, Fraser AG, Marmion BP andSimmons A (New Delhi: Elsevier), a division of Reed Elsevier India Pvt. Ltd.131-49.. , 2006.
[9]
Winn, W.C.; Allen, S.D.; Janda, W.M.; Koneman, E.W.; Procop, G.W. Schrecken, berger PC Woods G. Color atlas and text-book of diagnostic microbiology. 6th edition. Chapter 12 Gram Positive Cocci. Part I: Staphylococci and Related Gram Positive Cocci., 623-671, Philadelphia, Lippincott Williams and Wilkins. 2006.
[10]
Performance Standards for Antimicrobial Susceptibil-ity Testing: 20th Informational Supplement, : Clinical and Laboratory Standards Institute (CLSI) M100-S20Vol. 30, No1. Wayne, PA: Clinical and Labora-tory Standards Institute . , 2010.
[11]
Lowy, F.D. Antimicrobial resistance: the example of Staphylococcus aureus. J. Clin. Invest., 2003, 111(9), 1265-1273.
[12]
Oommen, S.K.; Appalaraju, B.; Jinsha, K. Mupirocin resistance in clinical isolates of Staphylococci in a tertiary care centre in south India. Ind.J. med. Microbial., 2011, 28(4), 372-375.
[13]
S, J.; M, M.; A S, S.B.; Mathew, R.; M, K.; Lal Y, B. ShameenBanu, A.S.; Mathew, R.; Kalayni, M.; Binesh, Lal. Y. 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(2), 238-242.
[14]
Simor, A.E.; Stuart, T.L.; Louie, L.; Watt, C.; Ofner-Agostini, M.; Gravel, D.; Mulvey, M.; Loeb, M.; McGeer, A.; Bryce, E.; Matlow, A. Mupirocin-resistant, methicillin-resistant Staphylococcus aureus strains in Canadian hospitals. Antimicrob. Agents Chemother., 2007, 51(11), 3880-3886.
[15]
Schmitz, F.J.; Lindenlauf, E.; Hofmann, B.; Fluit, A.C.; Verhoef, J.; Heinz, H.P.; Jones, M.E. The prevalence of low- and high-level mupirocin resistance in staphylococci from 19 European hospitals. J. Antimicrob. Chemother., 1998, 42(4), 489-495.
[16]
Hurdle, J.G.; O’Neill, A.J.; Mody, L.; Chopra, I.; Bradley, S.F. In vivo transfer of high-level mupirocin resistance from Staphylococcus epidermidis to methicillin-resistant Staphylococcus aureus associated with failure of mupirocin prophylaxis. J. Antimicrob. Chemother., 2005, 56(6), 1166-1168.
[17]
Bathoorn, E.; Hetem, D.J.; Alphenaar, J.; Kusters, J.G.; Bonten, M.J.M. Emergence of high-level mupirocin resistance in coagulase-negative staphylococci associated with increased short-term mupirocin use. J. Clin. Microbiol., 2012, 50(9), 2947-2950.
[18]
Diep, B.A.; Chambers, H.F.; Graber, C.J.; Szumowski, J.D.; Miller, L.G.; Han, L.L.; Chen, J.H.; Lin, F.; Lin, J.; Phan, T.H.; Carleton, H.A.; McDougal, L.K.; Tenover, F.C.; Cohen, D.E.; Mayer, K.H.; Sensabaugh, G.F.; Perdreau-Remington, F. Emergence of multidrug-resistant, community-associated, methicillin-resistant Staphylococcus aureus clone USA300 in men who have sex with men. Ann. Intern. Med., 2008, 148(4), 249-257.
[19]
McDanel, J.S.; Murphy, C.R.; Diekema, D.J.; Quan, V.; Kim, D.S.; Peterson, E.M.; Evans, K.D.; Tan, G.L.; Hayden, M.K.; Huang, S.S. Chlorhexidine and mupirocin susceptibilities of methicillin-resistant staphylococcus aureus from colonized nursing home residents. Antimicrob. Agents Chemother., 2013, 57(1), 552-558.
[20]
Unal, S.; Hoskins, J.; Flokowitsch, J.E.; Wu, C.Y.; Preston, D.A.; Skatrud, P.L. Detection of methicillin-resistant staphylococci by using the polymerase chain reaction. J. Clin. Microbiol., 1992, 30(7), 1685-1691.

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