scholarly journals Mupirocin-Resistant, Methicillin-Resistant Staphylococcus aureus Strains in Canadian Hospitals

2007 ◽  
Vol 51 (11) ◽  
pp. 3880-3886 ◽  
Author(s):  
Andrew E. Simor ◽  
Tammy L. Stuart ◽  
Lisa Louie ◽  
Christine Watt ◽  
Marianne Ofner-Agostini ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Blot Hybridization ◽  
Southern Blot Hybridization ◽  
Methicillin Resistant ◽  
Pfge Typing ◽  
Laboratory Characterization ◽  
Mupirocin Resistance ◽  
Mrsa Strains ◽  
High Level ◽  
Epidemiologic Characteristics

ABSTRACT Mupirocin resistance in Staphylococcus aureus is increasingly being reported in many parts of the world. This study describes the epidemiology and laboratory characterization of mupirocin-resistant methicillin-resistant S. aureus (MRSA) strains in Canadian hospitals. Broth microdilution susceptibility testing of 4,980 MRSA isolates obtained between 1995 and 2004 from 32 Canadian hospitals was done in accordance with CLSI guidelines. The clinical and epidemiologic characteristics of strains with high-level mupirocin resistance (HLMupr) were compared with those of mupirocin-susceptible (Mups) strains. MRSA strains were characterized by pulsed-field gel electrophoresis (PFGE) and typing of the staphylococcal chromosomal cassette mec. PCR was done to detect the presence of the mupA gene. For strains with mupA, plasmid DNA was extracted and subjected to Southern blot hybridization. A total of 198 (4.0%) HLMupr MRSA isolates were identified. The proportion of MRSA strains with HLMupr increased from 1.6% in the first 5 years of surveillance (1995 to 1999) to 7.0% from 2000 to 2004 (P < 0.001). Patients with HLMupr MRSA strains were more likely to have been aboriginal (odds ratio [OR], 3.7; 95% confidence interval [CI], 1.5 to 9.4; P = 0.006), to have had community-associated MRSA (OR, 2.2; 95% CI, 1.0 to 5.0; P = 0.05), and to have been colonized with MRSA (OR, 1.7; 95% CI, 1.0 to 3.0; P = 0.04). HLMupr MRSA strains were also more likely to be resistant to fusidic acid (21% versus 4% for mupirocin-susceptible strains; P < 0.001). All HLMupr MRSA strains had a plasmid-associated mupA gene, most often associated with a 9-kb HindIII fragment. PFGE typing and analysis of the plasmid profiles indicate that both plasmid transmission and the clonal spread of HLMupr MRSA have occurred in Canadian hospitals. These results indicate that the incidence of HLMupr is increasing among Canadian strains of MRSA and that HLMupr MRSA is recovered from patients with distinct clinical and epidemiologic characteristics compared to the characteristics of patents with Mups MRSA strains.

Emergence of High-Level Mupirocin Resistance in Methicillin-ResistantStaphylococcus aureusIsolated From Brazilian University Hospitals

1996 ◽  
Vol 17 (12) ◽  
pp. 813-816 ◽  
Author(s):  
Kátia Regina Netto dos Santos ◽  
Leila de Souza Fonseca ◽  
Paulo Pinto Gontijo Filho
Keyword(s):  
Staphylococcus Aureus ◽  
Rio De Janeiro ◽  
University Hospitals ◽  
Methicillin Resistant ◽  
Mupirocin Resistance ◽  
Mrsa Strains ◽  
High Level

AbstractSurveillance for methicillin-resistantStaphylococcus aureus(MRSA) was implemented in Rio de Janeiro and Uberlândia University Hospitals, which had different policies on use of mupirocin. One hundred fourteen multiresistant MRSA strains were isolated from 62 patients. Mupirocin resistance was observed in 63% of strains in Rio de Janeiro, where there was extensive use of topical mupirocin, and 6.1% in Uberlândia, where its use was rare.

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.

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

scholarly journals Genotyping of methicillin resistant Staphylococcus aureus from the United Arab Emirates

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Abiola Senok ◽  
Rania Nassar ◽  
Handan Celiloglu ◽  
Anju Nabi ◽  
Mubarak Alfaresi ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
United Arab Emirates ◽  
Arabian Gulf ◽  
Acid Resistance ◽  
Methicillin Resistant ◽  
Gulf Countries ◽  
Gentamicin Resistance ◽  
Mupirocin Resistance ◽  
Mrsa Strains

Abstract Reports from Arabian Gulf countries have demonstrated emergence of novel methicillin resistant Staphylococcus aureus (MRSA) strains. To address the lack of data from the United Arab Emirates (UAE), genetic characterisation of MRSA identified between December 2017 and August 2019 was conducted using DNA microarray-based assays. The 625 MRSA isolates studied were grouped into 23 clonal complexes (CCs) and assigned to 103 strains. CC5, CC6, CC22 and CC30 represented 54.2% (n/N = 339/625) of isolates with other common CCs being CC1, CC8, CC772, CC361, CC80, CC88. Emergence of CC398 MRSA, CC5-MRSA-IV Sri Lanka Clone and ST5/ST225-MRSA-II, Rhine-Hesse EMRSA/New York-Japan Clone in our setting was detected. Variants of pandemic CC8-MRSA-[IVa + ACME I] (PVL+) USA300 were detected and majority of CC772 strains were CC772-MRSA-V (PVL+), “Bengal- Bay Clone”. Novel MRSA strains identified include CC5-MRSA-V (edinA+), CC5-MRSA-[VT + fusC], CC5-MRSA-IVa (tst1+), CC5-MRSA-[V/VT + cas + fusC + ccrA/B-1], CC8-MRSA-V/VT, CC22-MRSA-[IV + fusC + ccrAA/(C)], CC45-MRSA-[IV + fusC + tir], CC80-MRSA-IVa, CC121-MRSA-V/VT, CC152-MRSA-[V + fusC] (PVL+). Although several strains harboured SCC-borne fusidic acid resistance (fusC) (n = 181), erythromycin/clindamycin resistance (ermC) (n = 132) and gentamicin resistance (aacA-aphD) (n = 179) genes, none harboured vancomycin resistance genes while mupirocin resistance gene mupR (n = 2) and cfr gene (n = 1) were rare. An extensive MRSA repertoire including CCs previously unreported in the region and novel strains which probably arose locally suggest an evolving MRSA landscape.

scholarly journals Chlorhexidine and Mupirocin Susceptibility of Methicillin-Resistant Staphylococcus aureus Isolates in the REDUCE-MRSA Trial

2016 ◽  
Vol 54 (11) ◽  
pp. 2735-2742 ◽  
Author(s):  
Mary K. Hayden ◽  
Karen Lolans ◽  
Katherine Haffenreffer ◽  
Taliser R. Avery ◽  
Ken Kleinman ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Cluster Randomized Trial ◽  
Confidence Limits ◽  
Methicillin Resistant ◽  
Content Type ◽  
Mrsa Infection ◽  
Mupirocin Resistance ◽  
Cluster Randomized ◽  
High Level

Whether targeted or universal decolonization strategies for the control of methicillin-resistant Staphylococcus aureus (MRSA) select for resistance to decolonizing agents is unresolved. The REDUCE-MRSA trial (ClinicalTrials registration no. NCT00980980) provided an opportunity to investigate this question. REDUCE-MRSA was a 3-arm, cluster-randomized trial of either screening and isolation without decolonization, targeted decolonization with chlorhexidine and mupirocin, or universal decolonization without screening to prevent MRSA infection in intensive-care unit (ICU) patients. Isolates from the baseline and intervention periods were collected and tested for susceptibility to chlorhexidine gluconate (CHG) by microtiter dilution; mupirocin susceptibility was tested by Etest. The presence of the qacA or qacB gene was determined by PCR and DNA sequence analysis. A total of 3,173 isolates were analyzed; 2 were nonsusceptible to CHG (MICs, 8 μg/ml), and 5/814 (0.6%) carried qacA or qacB . At baseline, 7.1% of MRSA isolates expressed low-level mupirocin resistance, and 7.5% expressed high-level mupirocin resistance. In a mixed-effects generalized logistic regression model, the odds of mupirocin resistance among clinical MRSA isolates or MRSA isolates acquired in an ICU in intervention versus baseline periods did not differ across arms, although estimates were imprecise due to small numbers. Reduced susceptibility to chlorhexidine and carriage of qacA or qacB were rare among MRSA isolates in the REDUCE-MRSA trial. The odds of mupirocin resistance were no different in the intervention versus baseline periods across arms, but the confidence limits were broad, and the results should be interpreted with caution.

The prevalence of methicillin resistant Staphylococcus aureus (MRSA) isolates with high-level mupirocin resistance from patients and personnel in a burn center

Burns ◽  
2013 ◽  
Vol 39 (4) ◽  
pp. 650-654 ◽  
Author(s):  
Effat Abbasi-Montazeri ◽  
Azar Dokht Khosravi ◽  
Mohammad Mehdi Feizabadi ◽  
Hamed Goodarzi ◽  
Seyed Sajjad Khoramrooz ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Burn Center ◽  
Mupirocin Resistance ◽  
High Level

Vancomycin-gentamicin synergism revisited: effect of gentamicin susceptibility of methicillin-resistant Staphylococcus aureus.

1996 ◽  
Vol 40 (6) ◽  
pp. 1534-1535 ◽  
Author(s):  
L Mulazimoglu ◽  
S D Drenning ◽  
R R Muder
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Staphylococcal Infection ◽  
Bacteriological Response ◽  
Methicillin Resistant ◽  
Gentamicin Resistance ◽  
Agar Dilution ◽  
Mrsa Strains ◽  
High Level ◽  
Time Kill

Vancomycin monotherapy of deep-seated staphylococcal infection may be associated with poor bacteriological response. We evaluated 24 unique patient isolates of methicillin-resistant Staphylococcus aureus (MRSA) for vancomycin-gentamicin synergism by determining time-kill curves for vancomycin at 10 micrograms/ml and gentamicin at 1 microgram/ml. Nine MRSA strains showed high-level gentamicin resistance (HLGR) (MIC, > 500 micrograms/ml), and 15 did not. Vancomycin-gentamicin demonstrated synergism against none of the HLGR strains. For the non-HLGR strains, gentamicin agar dilution MICs ranged from 0.5 to > 128 micrograms/ml. Vancomycin-gentamicin demonstrated synergism against six of these strains and indifference against nine of them. There was no relationship between the agar dilution MIC of gentamicin and the occurrence of synergism against non-HLGR strains. We conclude that a gentamicin MIC of > 500 micrograms/ml predicts a lack of vancomycin-gentamicin synergism for strains of MRSA. For non-HLGR strains, synergism is not predictable from the gentamicin MIC.

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