Molecular fingerprinting of fusidic acid- and rifampicin-resistant strains of methicillin-resistant Staphylococcus aureus (MRSA) from Malaysian hospitals

Abstract

The emergence and spread of multiresistant methicillin-resistant Staphylococcus aureus (MRSA) strains, especially those resistant to fusidic acid and rifampicin, in Malaysian hospitals is of concern. In this study DNA fingerprinting by PFGE was performed on fusidic acid-and rifampicin-resistant isolates from Malaysian hospitals to determine the genetic relatedness of these isolates and their relationship with the endemic MRSA strains. In all, 32 of 640 MRSA isolates from 9 Malaysian hospitals were resistant to fusidic acid and rifampicin. Seven PFGE types (A, ZC, ZI, ZJ, ZK, ZL and ZM) were observed. The commonest type was type ZC, seen in 72% of isolates followed by type A, seen in 13%. Each of the other types (ZI, ZJ, ZK, ZL and ZM) was observed in a single isolate. Each type, even the commonest, was found in only one hospital. This suggests that the resistant strains had arisen from individual MRSA strains in each hospital and not as a result of the transmission of a common clone.

Emergence of Rifampicin Resistance in Methicillin-ResistantStaphylococcus aureusIsolated at a Turkish University Hospital

“…They all expressed high-level rifampicin resistance (MIC, Ͼ256 g/ml), which is higher than the rifampicin MIC of Ͼ4 mg/L and Ͼ16 mg/L reported by Norazah et al 14 …”

“…9,10 Besides vancomycin, rifampicin has been used in combination with other antibiotics to treat MRSA infections because of its excellent tissue penetration and potent antistaphylococcal properties, 1,7,20 and, until recently, the majority of MRSA isolates remained susceptible. 1,7,21 However, recent reports of rifampicin resistance in MRSA from different countries 3,8,14 suggest that rifampicin resistance in MRSA may be increasing.…”

Detection of Methicillin-Resistant Staphylococcus aureus Using mecA/nuc Genes and Antibiotic Susceptibility Profile of Malaysian Clinical Isolates

“…A report has shown that resistance towards fusidic acid may develop if the drug is used alone (Chambers 1997). In Malaysia, a fusidic acid-rifampicin combination is used as an alternative oral regimen for the treatment of bacteraemia, musculoskeletal and cardiovascular infections caused by MRSA (Norazah et al 2002). Fortunately all of the MSSA used in this study are still susceptible to rifampicin.…”

Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampin‐based regimen

“…However, literature is having quite a number of reports reporting primary MRSA resistance to rifampin as well as following combination therapy (Yourassowksy et al 1981, Gottlieb et al 1998, Aucken et al 2002, Norazah et al 2002, Srinivasan et al 2006. A study has shown emergence of rifampin resistance to MRSA in tuberculosis wards.…”