Mupirocin and Staphylococcus aureus: a recent paradigm of emerging antibiotic resistance

Abstract

We postulate that the steady rise in mupirocin resistance among S. aureus in NZ throughout the 1990s may be due, at least in part, to the over the counter availability of mupirocin from 1991 to 2000. The current patterns of mupirocin consumption need to be reviewed and its use rationalized to maximize the chances of this antibiotic retaining beneficial antistaphylococcal activity.

A Preoperative Decolonization Protocol for Staphylococcus aureus Prevents Orthopaedic Infections

“…One obvious concern about widespread mupirocin use is the potential for increased drug resistance and subsequent failure [8,15,18,28]. However, selective use of short courses of mupirocin for nasal decolonization is thought not to cause widespread resistance [20].…”

Mupirocin Resistance Related to Increasing Mupirocin Use in Clinical Isolates of Methicillin-Resistant Staphylococcus aureus in a Pediatric Population

“…Mupirocin Etest (AB Biodisk; MIC range, 0.064 to 1,024 g/ml) was used according to the manufacturer's instructions on Mueller-Hinton agar. The MIC breakpoints were chosen to correlate with previous studies of mupirocin resistance (3,9,14,16,19). Mupirocin susceptibility was defined as an MIC of Ͻ8 g/ml, intermediate resistance as an MIC of 8 to 256 g/ml, and high-level resistance as an MIC of Ն512 g/ml.…”

Control of Methicillin-Resistant Staphylococcus aureus in a Tertiary Hospital with Low Background Endemicity: Evidence That Interventions Do Work

“…It is not our routine practice to decolonize patients who are colonized with MRSA, because there is a moderately high rate of mupirocin resistance among S. aureus isolates in New Zealand 6 and there is a lack of evidence for persistent clearance among patients with MRSA colonization at more than 1 site. 7 Until recently, HCWs have been screened for MRSA colonization prior to commencing employment, and those found to be colonized were decolonized before starting work in a clinical care area.…”