Mupirocin resistance in coagulase-negative staphylococci

Connolly, Stuart; Noble, W. C.; Phillips, Ian

doi:10.1099/00222615-39-6-450

Cited by 22 publications

(9 citation statements)

References 10 publications

(1 reference statement)

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“…Plasmid-mediated resistance to high-level mupirocin has been reported in S. aureus [17][18][19][20] and CNS [18,25] with resistance reported after prolonged use of mupirocin in a few institutions [6,14]. The results presented here have demonstrated that 94% of the staphylococci isolated in a burns unit were fully susceptible to mupirocin after 2 years of continuous use of mupirocin for treatment of staphylococcal infections and the eradication of colonization.…”

Section: Discussionsupporting

confidence: 49%

“…No staphylococcal isolates from the burns unit were tested for resistance to mupirocin prior to mupirocin use. Nevertheless, high-level mupirocin resistance has been reported in some staphylococci isolated prior to the production and clinical use of mupirocin [18,25]. Notwithstanding the original source of the mupirocin resistance determinant in the S. haemolyticus, its detection was timely because it helped to raise the awareness of staff to the presence of a potential problem.…”

Section: Discussionmentioning

confidence: 99%

“…However, the majority of the CNS isolates were from blood cultures, an indication of the growing importance of these organisms in bloodstream infections. Although mupirocin has not been used specifically to eradicate colonization by CNS, the CNS isolates were tested for resistance to mupirocin because CNS has been found to express high-level resistance to mupirocin which are borne on conjugative plasmids [18,25]. All of the 395 isolates were tested for susceptibility to mupirocin and other antimicrobial agents.…”

Section: Resultsmentioning

confidence: 99%

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Susceptibility of Staphylococci Isolated from a Burns Unit to Mupirocin and Other Antimicrobial Agents

et al. 1998

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The activity of mupirocin (Bactroban) against coagulase-positive and coagulase-negative staphylococci isolated in a burns unit was tested to ascertain its effectiveness, and to detect any resistant isolates after continuous use of mupirocin for 2.5 years. A total of 395 staphylococci, consisting of 330 Staphylococcus aureus and 65 coagulase-negative staphylococci, were tested for resistance to mupirocin and other antimicrobial agents. The results showed that 94.5% of the isolates were fully susceptible to mupirocin (MIC ≤4 mg/l), and 5.3% expressed low-level resistance (MIC 8–128 mg/l). One Staphylococcus haemolyticus isolate expressed high-level resistance (MIC >1,024 mg/l). It transferred high-level mupirocin resistance to other staphylococci in conjugation experiments, which indicated a capacity to transmit mupirocin resistance between species. The results demonstrated that mupirocin was still highly effective against staphylococci in the burns unit. However, the demonstration that the resistant S. haemolyticus isolate could transfer high-level mupirocin resistance to other staphylococci was of concern. There is a compelling need to test staphylococci from clinical materials for mupirocin resistance. Early detection of resistance can prevent the establishment and spread of the mupirocin-resistant strains in the unit.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Susceptibility of Staphylococci Isolated from a Burns Unit to Mupirocin and Other Antimicrobial Agents

et al. 1998

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“…Colonization and infection with Staphylococcus aureus are common in older people in long-term-care facilities (LTCFs) (1,2,4). The prevalence of S. aureus colonization and infection, which result primarily from methicillin-resistant strains, has recently been reported by chronic care facilities worldwide (1,3,6,7).…”

mentioning

confidence: 99%

Clonal Dissemination and mupA Gene Polymorphism of Mupirocin-Resistant Staphylococcus aureus Isolates from Long-Term-Care Facilities in South Korea

Yoo¹,

Shin²,

Ok³

et al. 2006

Antimicrob Agents Chemother

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We identified 25 high-level mupirocin-resistant (MuH) and 21 low-level mupirocin-resistant (MuL) Staphylococcus aureus isolates from eight long-term-care facilities (LTCFs). The pulsed-field gel electrophoresis patterns of 19 MuH and 19 MuL isolates from two facilities were identical for 18 and 15 isolates, respectively. The most predominant mupA restriction fragment length polymorphism type was found in 21 MuH isolates. We conclude that clonal transmission of MuH and MuL S. aureus strains occurred in these LTCFs. This is the first report of clonal transfer of mupirocin resistance in LTCFs.Colonization and infection with Staphylococcus aureus are common in older people in long-term-care facilities (LTCFs) (1, 2, 4). The prevalence of S. aureus colonization and infection, which result primarily from methicillin-resistant strains, has recently been reported by chronic care facilities worldwide (1,3,6,7). Mupirocin calcium ointment is a topical antibiotic indicated for the eradication of nasal carriage of staphylococci, including methicillin-resistant strains. Mupirocin alone or in combination with other antimicrobial agents decreases S. aureus colonization among residents of LTCFs (3,7,8,20). Several outbreaks of methicillin-resistant S. aureus colonization and infection in LTCFs have been reported, and until now, it was thought that the application of mupirocin ointment might help break the chain of transmission. However, the extensive use of this agent has led to the rapid emergence of mupirocinresistant strains in different parts of the world (9,16,11,13,18,19). To our knowledge, there are no reports on the prevalence and outbreak of mupirocin-resistant S. aureus in LTCFs. In South Korea, mupirocin ointment has been used since 1994 to eradicate staphylococcal infection in hospitals, and the prevalence and mechanisms of mupirocin-resistant staphylococci were first reported in 2003 (23).We investigated the clonal transmission of high-level mupirocin-resistant (MuH) and low-level mupirocin-resistant (MuL) S. aureus and the mupA gene polymorphisms of MuH S. aureus strains in LTCFs. Seven hundred forty-nine swab specimens were obtained from patients of eight LTCFs from July to August 2002. Nasal swab specimens were obtained from 632 patients (one isolate per patient), and 117 infection swab samples were obtained from infected sites (e.g., sore, wound, or trachea) present in these patients. Swab specimens were cultured on staphylococcal broth (Trypticase soy broth [TSB]) medium for 24 h at 35°C. Mannitol salt agar and mannitol salt oxacillin agar supplemented with 6 g/ml oxacillin were used to isolate S. aureus and methicillin-resistant S. aureus, respectively. Initial identification was based on colony morphology, Gram staining, the coagulase test using the Staphaureux latex agglutination kit (Murex Biotech Ltd., Dartford, United Kingdom), and thermonuclease production with DNase medium (Becton Dickinson, Franklin Lakes, NJ). When necessary, further confirmatory tests were performed using a Vitek system (bioMerieux,...

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“…High‐degree mupirocin resistance in coagulase‐negative staphylococci isolates from the nares and catheter exit site in PD patients was documented many years ago (74). In contrast, HDR to mupirocin among S. aureus isolates has been uncommon in dialysis patients (59,64,75,76).…”

Section: Mupirocin Resistance In Staphylococci In Dialysis Patientsmentioning

confidence: 99%

Infection with Antimicrobial‐resistant Microorganisms in Dialysis Patients

Berns

2003

Seminars in Dialysis

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The prevalence of antimicrobial-resistant microorganisms in various health care settings, including outpatient dialysis facilities, has increased dramatically in the last decade. Antimicrobial use and patient-to-patient transmission of resistant strains are the two main factors that have contributed to this rapid increase. Methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative staphylococci are commonly isolated as a cause of hemodialysis (HD) catheter-related bacteremia and peritoneal dialysis (PD)-related catheter infection and peritonitis. The widespread use of vancomycin in dialysis patients is of concern because of an increase in the prevalence of vancomycin-resistant enterococci (VRE) in dialysis patients. Staphylococci with reduced sensitivity to vancomycin have also appeared in dialysis patients. A more recent problem is the appearance of S. aureus isolates with a high degree of resistance to the topical antimicrobial agent mupirocin. This has been seen in PD patients who have received prophylactic application of mupirocin at the peritoneal catheter exit site. Appropriate antimicrobial use will help protect the efficacy of currently used antibiotics, such as vancomycin. Published guidelines for use of vancomycin should be followed. New antimicrobials such as linezolid and quinupristin/dalfopristin have activity against VRE and MRSA, but resistance to these agents has already occurred. Preventing transmission of antimicrobial-resistant microorganisms in health care settings, including outpatient dialysis facilities, is important in limiting the spread of these resistant organisms.

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Mupirocin resistance in coagulase-negative staphylococci

Cited by 22 publications

References 10 publications

Susceptibility of Staphylococci Isolated from a Burns Unit to Mupirocin and Other Antimicrobial Agents

Susceptibility of Staphylococci Isolated from a Burns Unit to Mupirocin and Other Antimicrobial Agents

Clonal Dissemination and mupA Gene Polymorphism of Mupirocin-Resistant Staphylococcus aureus Isolates from Long-Term-Care Facilities in South Korea

Infection with Antimicrobial‐resistant Microorganisms in Dialysis Patients

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