Mupirocin resistance in clinical isolates of methicillin sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India

JMS SKIMS ◽  
2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Nargis Bali ◽  
Maroof Peer ◽  
Roseleen Kour ◽  
Suhail Ahmad ◽  
Parvaiz Koul
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
North India ◽  
Clinical Samples ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Low Level ◽  
Mupirocin Resistance ◽  
Level Resistance

Background: Staphylococcus aureus continues to be major healthcare problem worldwide as therapeutic options for its management are limited. Decolonisation regimes using mupiroicin are aimed at reducing the burden of infection due to this microorganism. However resistance to mupirocin poses a threat to the current standard eradication protocols.Aims: To find out the type and extent of mupirocin resistance in clinical isolates of S. aureus. Material and methods: This cross-sectional study was carried out at a tertiary care centre of North India for a period of 6 months. S. aureus recovered by standard microbiological procedures form various clinical samples such as blood, urine, pus and other body fluids was subjected to antimicrobial susceptibility testing along with detection of mupirocin resistance using 5 and 200µg discs. Minimum inhibitory concentration (MIC) of mupirocin was determined using E -test strips. Fisher’s exact test was done to determine the statistical significance. A P-value of <0.05 was considered as statistically significant.Results: A total of 247 S. aureus isolates were recovered of which 81 (32.8%) were resistant to methicillin (MRSA) whereas 166 (67.2%) were sensitive to this antibiotic (MSSA). Low level resistance to mupirocin was seen in 7 (8.6%) MRSA and 3 (1.8%) MSSA isolates. Prior use of this topical antibiotic and previous hospitalisation were found to be the risk factors associated with mupirocin resistance. Conclusion: Low level mupirocin resistance was seen in S. aureus isolates which if left unchecked could in future pave way for high level resistance and subsequent treatment failures.

Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 48-49
Author(s):  
Javaid Ahmad Bhat ◽  
Shariq Rashid Masoodi
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
Resistance Mechanisms ◽  
North India ◽  
Global Public Health ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Effective Prevention ◽  
Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

scholarly journals MUPIROCIN RESISTANCE IN STAPHYLOCOCCUS AUREUS IN A TERTIARY CARE HOSPITAL OF SOUTH INDIA – A PROSPECTIVE STUDY

2019 ◽  
Vol 12 (1) ◽  
pp. 98
Author(s):  
Malavalli Venkatesh Bhavana ◽  
Sangeeta Joshi ◽  
Ranjeeta Adhikary ◽  
Hosdurg Bhaskar Beena
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Resistant Strains ◽  
Mupirocin Resistance ◽  
High Level ◽  
A Prospective Study ◽  
Level Resistance

Objective: Mupirocin is a topical antibiotic used for the treatment of skin and soft tissue infections caused by Staphylococcus aureus and for the nasal decolonization of methicillin-resistant S. aureus (MRSA). The increasing reports of resistance to mupirocin are a matter of concern. We undertook this study to detect and differentiate the mupirocin resistance pattern and to analyze the susceptibility pattern among S. aureus isolates of our hospital.Methods: This is a prospective laboratory-based study conducted during the period May–September 2014. Clinical samples that grew S. aureus during the study period were tested for mupirocin resistance using the 5 μg and 200 μg discs. Minimum inhibitory concentration (MIC) detection of resistant strains was performed using the E-test.Results: Mupirocin resistance was seen in 4.81% of our S. aureus isolates; all of which exhibited high-level resistance with MIC ≥1024 μg/ml.Conclusions: The resistance is bound to rise with the increased usage of mupirocin; regular testing will help in tackling this upcoming problem and in preserving this important antibiotic against MRSA.

scholarly journals MUPIROCIN RESISTANCE IN STAPHYLOCOCCUS AUREUS IN A TERTIARY CARE HOSPITAL OF SOUTH INDIA – A PROSPECTIVE STUDY

2019 ◽  
Vol 12 (1) ◽  
pp. 98
Author(s):  
Malavalli Venkatesh Bhavana ◽  
Sangeeta Joshi ◽  
Ranjeeta Adhikary ◽  
Hosdurg Bhaskar Beena
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Resistant Strains ◽  
Mupirocin Resistance ◽  
High Level ◽  
A Prospective Study ◽  
Level Resistance

Objective: Mupirocin is a topical antibiotic used for the treatment of skin and soft tissue infections caused by Staphylococcus aureus and for the nasal decolonization of methicillin-resistant S. aureus (MRSA). The increasing reports of resistance to mupirocin are a matter of concern. We undertook this study to detect and differentiate the mupirocin resistance pattern and to analyze the susceptibility pattern among S. aureus isolates of our hospital.Methods: This is a prospective laboratory-based study conducted during the period May–September 2014. Clinical samples that grew S. aureus during the study period were tested for mupirocin resistance using the 5 μg and 200 μg discs. Minimum inhibitory concentration (MIC) detection of resistant strains was performed using the E-test.Results: Mupirocin resistance was seen in 4.81% of our S. aureus isolates; all of which exhibited high-level resistance with MIC ≥1024 μg/ml.Conclusions: The resistance is bound to rise with the increased usage of mupirocin; regular testing will help in tackling this upcoming problem and in preserving this important antibiotic against MRSA.

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.

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