scholarly journals 591. Mupirocin and Chlorhexidine Resistance in Staphylococcus aureus Isolated from Children in South Korea

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S279-S279
Author(s):  
Bi Na Kim ◽  
Hyun Mi Kang ◽  
Sun Hee Park ◽  
Joonhong Park ◽  
Jin Han Kang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Preterm Infants ◽  
Quaternary Ammonium ◽  
Sccmec Type ◽  
Toxin Gene ◽  
Low Level ◽  
Chlorhexidine Bathing ◽  
Nasal Mupirocin ◽  
Mupirocin Resistance ◽  
High Level

Abstract Background Increasing prevalence of mupirocin-resistant Staphylococcus aureus have been reported, and chlorhexidine resistance has become an issue. This study aimed to investigate the prevalence of mupirocin and chlorhexidine resistance in both colonized and infection causing Staphylococcus aureus in children, and find factors associated with increased virulence. Methods Staphylococcus aureus, isolated from children <18 years old admitted at a single center, were collected prospectively from August 2017 to July 2018. The isolates underwent multilocus sequence typing and were screened for genes causing chlorhexidine resistance (qac A/B), quaternary ammonium resistance (smr), mupirocin resistance (ileS mutation, Mup A, MupB), and Pantone Valentine Leucocidin (pvl) toxin. Results During the study period, a total of 49 non-duplicate isolates were included, of which 69.4% (n = 34) were Methicillin-resistant Staphylococcus aureus (MRSA). Of the colonizers (n = 25), the most common sequence type was ST 72 (68.0%), whereas among pathogens (n = 24), ST 72 (29.2%) and ST 89 (29.2%) were most prevalent. Pathogens in this study caused abscess formation (n = 3), sepsis (n = 4), and skin infections such as cellulitis and omphalitis (n = 17). Mupirocin resistance was found in 16.0% among colonizers vs. 45.8% among pathogens (P = 0.023). High-level mupirocin resistance was more common (n = 3/25, 12.0%) than low-level mupirocin resistance (n = 1/25, 4.0%) in colonizers, whereas, pathogens had similar rates of low-level (25.0%) and high-level (n = 20.8%) mupirocin resistance. PVL toxin gene was more frequently found in colonizers than pathogens (64.0% vs. 33.3%, P = 0.032), and all isolates had quaternary ammonium resistance genes. Chlorhexidine resistance gene was found in only 3 MRSA isolates colonized in the nares of preterm infants. All were SCCmec type 4, however, two were ST 72, spa type t1054, which had high -level mupirocin resistance and PVL toxin gene. Conclusion A PVL toxin gene-positive MRSA which had genes causing mupirocin and chlorhexidine resistance were found in the nasal carriages of preterm infants. These stains may cause failure of MRSA eradication in hospital settings, using conventional methods of nasal mupirocin application and chlorhexidine bathing. Disclosures All authors: No reported disclosures.

Localization and Characterization of MupA Gene in High and Low-Level Mupirocin Resistant Methicillin Resistant Staphylococcus Aureus

2020 ◽  
Vol 29 (3) ◽  
pp. 171-177
Author(s):  
Marwa S. Mostaf ◽  
Alaa R. Awad
Keyword(s):  
Staphylococcus Aureus ◽  
Plasmid Dna ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Gene Location ◽  
Chromosomal Dna ◽  
Methicillin Resistant ◽  
Low Level ◽  
Mupirocin Resistance ◽  
High Level

Background: Two types of mupirocin resistance among methicillin resistant Staphylococcus aureus (MRSA) have been reported; low-level mupirocin resistance (LL-MR), and high-level mupirocin resistance (HL-MR). The mupA gene is typically located on mobile genetic elements which facilitate the resistance dissemination. Objective: The aim of this work was to identify the mupA gene location, as well as the restriction fragment length polymorphism (RFLP) patterns in high and low-level mupirocin resistant MRSA. Methodology: This study was conducted on 100 MRSA isolates; seven of them were mupirocin resistant. The E test was used to identify high and low level mupirocin resistance. Amplification of mupA gene in total and plasmid DNA was performed. We also detected the spacer region (trsLM–IS257-like–mupA) in the 7 isolates by PCR then we investigated its RFLP patterns. Results: Four MR MRSA isolates had low level resistance, their MupA gene was located on chromosomal DNA, whereas, three isolates showed high level MR, their MupA gene was located on plasmid DNA. Four types of different RFLP patterns of the spacer region were identified; type-1 included two LL-MR isolates, each of type-2 and 3 included both HL-MR and LL-MR isolates, and type-4 included one HL-MR isolate. Conclusions: Staphylococcus aureus mupA gene responsible for LL-MR is located on the chromosome while that responsible for HL-MR is plasmid-mediated. The spacer region variations appear to occur in both chromosomal and plasmid-located mupA gene regardless the type of mupirocin resistance.

scholarly journals Mupirocin Resistance of Staphylococcus aureus in Clinical Isolates of National Hospital and in the Nasal Carriage of Healthy Undergraduates in Colombo, Sri Lanka

2021 ◽  
pp. 64-71
Author(s):  
G. A. Achintha ◽  
D. S. S. D. Rupasena ◽  
S. M. D. I. Pathum ◽  
C. P. Gunasekara ◽  
D. M. B. T Dissanayake ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Sri Lanka ◽  
Nasal Carriage ◽  
Inhibition Zone ◽  
Clinical Isolates ◽  
National Hospital ◽  
Low Level ◽  
Mupirocin Resistance ◽  
High Level ◽  
Level Resistance

Introduction and Objectives : Mupirocin resistance in Staphylococcus aureus is increasingly reported in many parts of the world. This study was conducted with the objective of describing high-level and low-level mupirocin resistance of S. aureus in clinical isolates and nasal carriage. Materials and Methods : A descriptive study was conducted including 45 nasal isolates of S. aureus collected from healthy university students in Colombo and 249 clinical isolates of S. aureus from the patient specimens in National Hospital of Sri Lanka. All of the confirmed S. aureus strains were tested for methicillin resistance using cefoxitin disc (30μg). S. aureus isolates were considered methicillin-resistant if the diameter of zone of inhibition was 21mm or less (CLSI, 2017). The S. aureus isolates were then tested for mupirocin resistance. Disk diffusion method was utilized with 5μg and 200μg mupirocin discs to determine low-level and high-level resistances respectively. The criterion employed for interpretation of mupirocin resistance was a combination of the widely accepted criterion described by Finlay, Miller, and Poupard (1997) for low-level mupirocin resistance and CLSI (2017) criterion for high-level mupirocin resistance. If both inhibition zone diameters for 5μg disk and 200μg were ≥14mm, the isolate was considered mupirocin sensitive. If 5μg disc displays <14mm and 200 μg disk displayed ≥14mm inhibition zone diameter, the isolate was considered to be mupirocin low level resistant. If there is no inhibition zone in 200μg disk, the isolate was considered as mupirocin high level resistant. Results : From the 45 nasal carriage isolates, 33 (73%) were Methicillin sensitive Staphylococcus aureus (MSSA) and 12 (27%) were Methicillin Resistant Staphylococcus aureus (MRSA). Among the clinical isolates, majority (n=158, 63%) were MRSA while only 91 (37%) MSSA. An overall mupirocin resistance rate of 4.4% among S. aureus was observed. Low-level mupirocin resistance was observed in 3.7% Staphylococcus aureus isolates and high-level mupirocin resistance was observed in 0.7% isolates. Mupirocin low-level and high-level resistance in MRSA isolates were 5.3% and 0.6% respectively. MSSA isolates demonstrated 1.6% (n=2) and 0.8% (n=1) mupirocin low-level and high-level resistances respectively. None of the nasal isolates were resistant to mupirocin while 6% (n=15) mupirocin low-level resistance and 0.8% (n=2) mupirocin high-level resistance was observed in clinical isolates. Conclusion : This initial survey of mupirocin resistance among S. aureus in a country with fairly high usage of mupirocin emphasizes that although the overall mupirocin resistance is relatively low in this population, regular surveillance of mupirocin resistance remains a necessity.

scholarly journals Prevalence of Chlorhexidine-Resistant Methicillin-Resistant Staphylococcus aureus following Prolonged Exposure

2014 ◽  
Vol 58 (8) ◽  
pp. 4404-4410 ◽  
Author(s):  
Carey D. Schlett ◽  
Eugene V. Millar ◽  
Katrina B. Crawford ◽  
Tianyuan Cui ◽  
Jeffrey B. Lanier ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Molecular Analysis ◽  
Prolonged Exposure ◽  
Controlled Trial ◽  
Epidemiological Data ◽  
Methicillin Resistant ◽  
Content Type ◽  
Mupirocin Resistance ◽  
High Level ◽  
Study Participants

ABSTRACTChlorhexidine has been increasingly utilized in outpatient settings to control methicillin-resistantStaphylococcus aureus(MRSA) outbreaks and as a component of programs for MRSA decolonization and prevention of skin and soft-tissue infections (SSTIs). The objective of this study was to determine the prevalence of chlorhexidine resistance in clinical and colonizing MRSA isolates obtained in the context of a community-based cluster-randomized controlled trial for SSTI prevention, during which 10,030 soldiers were issued chlorhexidine for body washing. We obtained epidemiological data on study participants and performed molecular analysis of MRSA isolates, including PCR assays for determinants of chlorhexidine resistance and high-level mupirocin resistance and pulsed-field gel electrophoresis (PFGE). During the study period, May 2010 to January 2012, we identified 720 MRSA isolates, of which 615 (85.4%) were available for molecular analysis, i.e., 341 clinical and 274 colonizing isolates. Overall, only 10 (1.6%) of 615 isolates were chlorhexidine resistant, including three from the chlorhexidine group and seven from nonchlorhexidine groups (P> 0.99). Five (1.5%) of the 341 clinical isolates and five (1.8%) of the 274 colonizing isolates harbored chlorhexidine resistance genes, and four (40%) of the 10 possessed genetic determinants for mupirocin resistance. All chlorhexidine-resistant isolates were USA300. The overall prevalence of chlorhexidine resistance in MRSA isolates obtained from our study participants was low. We found no association between extended chlorhexidine use and the prevalence of chlorhexidine-resistant MRSA isolates; however, continued surveillance is warranted, as this agent continues to be utilized for infection control and prevention efforts.

scholarly journals Emerging high-level mupirocin resistance among MRSA isolates in Ireland

2008 ◽  
Vol 13 (14) ◽  
pp. 1-2
Author(s):  
Angela Rossney ◽  
S O'Connell
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Blood Stream ◽  
Reference Laboratory ◽  
Methicillin Resistant ◽  
Mupirocin Resistance ◽  
High Level

High-level mupirocin resistance was detected among 37 of 2,586 (1.4%) methicillin-resistant Staphylococcus aureus (MRSA) blood-stream isolates sent to the Ireland's National MRSA Reference Laboratory between 1 January 1999 and 31 December 2005, compared with 29 of 997 isolates (2.9%) sent between 1 January 2006 and 31 December 2007.

scholarly journals Evaluation of mupA EVIGENE Assay for Determination of High-Level Mupirocin Resistance in Staphylococcus aureus

2010 ◽  
Vol 48 (11) ◽  
pp. 4253-4255 ◽  
Author(s):  
A. K. I. Rasmussen ◽  
R. L. Skov ◽  
R. A. Venezia ◽  
J. K. Johnson ◽  
H. Stender
Keyword(s):  
Staphylococcus Aureus ◽  
Mupirocin Resistance ◽  
High Level

Assessment of Mupirocin Resistance among Clinical Isolates of Methicillin Resistant Staphylococcus aureus

2021 ◽  
Vol 30 (1) ◽  
pp. 109-114
Author(s):  
Nancy M. Attia ◽  
Abeer Abd El Rahim Ghazal ◽  
Omnia M. Khaleel ◽  
Ahmed Gaballah
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Mupirocin Resistance ◽  
High Level ◽  
Research Institute Hospital ◽  
Low Prevalence ◽  
Mrsa Colonization

Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization is considered a major risk factor for nosocomial infections and its decolonization has reduced these infections. Mupirocin (MUP) is the topical antibiotic of choice for decolonization. MUP decolonization failure is attributed to MUP resistance. Objective: The aim of the current study is to assess MUP resistance among MRSA isolates phenotypically and genotypically. Methodology: Fifty MRSA isolates were identified in Microbiology Department in the Medical Research Institute hospital, Alexandria University. Antibiotic susceptibility to different classes of antibiotics by disk diffusion method was done. MUP minimum inhibitory concentration (MIC) was determined phenotypically by MUP Ezy MIC™ Strips. MUP resistance was determined genetically by multiplex PCR detection of mupA and mupB. Results: Of all MRSA isolates, 6% exhibited high level and none showed low level MUP resistance. Only mupA was detected in all resistant isolates. Conclusion: Despite low prevalence of MUP resistance, it is appropriate to test MUP resistance prior nasal decolonization

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