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.

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.

scholarly journals Staphylococcus aureus Clinical Isolate with High-Level Methicillin Resistance with an lytH Mutation Caused by IS1182 Insertion

2007 ◽  
Vol 52 (2) ◽  
pp. 643-647 ◽  
Author(s):  
Takaji Fujimura ◽  
Kazuhisa Murakami
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Isolate ◽  
Methicillin Resistance ◽  
Clinical Isolates ◽  
Lytic Enzymes ◽  
Resistance Level ◽  
Low Level ◽  
Mrsa Strains ◽  
High Level ◽  
Level Resistance

ABSTRACT We previously reported that deficiency of the lytH gene, whose product is homologous to lytic enzymes, caused the elevation of methicillin resistance in Staphylococcus aureus strain SR17238, a strain of S. aureus with a low level of resistance to methicillin (low-level MRSA) (J. Bacteriol. 179:6294-6301, 1997). In this study, we demonstrated that deficiency of lytH caused the same phenomenon in four other clinical isolates of low-level MRSA, suggesting this deficiency to exist in clinical isolates. We therefore searched the region including lytH in 127 clinical isolates of MRSA by PCR and found one strain, SR17164 (methicillin MIC, 1,600 μg/ml), in which the lytH gene was inactivated by insertion sequence IS1182. lytH::IS1182 was replaced with intact lytH in this strain by integration and excision of the plasmid carrying the lytH region. Recombinants with intact lytH genes showed methicillin MICs of 800 μg/ml, twofold lower than those of the recombinants with lytH::IS1182 and the parent. In addition, S. aureus SR17164, which has a high level of methicillin resistance, had properties similar to those caused by lytH deficiency; that is, the resistance levels of strain SR17164 and lytH-deficient variants from strain SR17238 were not significantly affected by llm inactivation, which greatly lowered resistance levels in most other high-level MRSA strains. These findings suggest that lytH inactivation contributed, to some extent, to the resistance level of S. aureus SR17164. To the best of our knowledge, this strain is the first clinical isolate of MRSA for which the genetic base for high-level resistance has been clarified.

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 Screening of methicillin-resistant Staphylococcus aureus in healthcare workers and students and its susceptibility to mupirocin in a tertiary care teaching hospital in South India

2017 ◽  
Vol 9 (04) ◽  
pp. 239-242 ◽  
Author(s):  
Jutang Babat Ain Tiewsoh ◽  
Meena Dias
Keyword(s):  
Staphylococcus Aureus ◽  
Healthcare Workers ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Carrier State ◽  
Coagulase Negative Staphylococcus ◽  
Methicillin Resistant ◽  
Mupirocin Resistance ◽  
High Level ◽  
Level Resistance

Abstract BACKGROUND: Staphylococcus is the most common pathogen causing infection in hospitals. They also colonize the healthcare workers who serve as reservoir of infection. Emergence of methicillin-resistant Staphylococcus aureus (MRSA) is a burning issue throughout the world contributing to significant morbidity and mortality. Use of mupirocin to eradicate the carrier state is the need of the hour. OBJECTIVES: To screen healthcare workers (HCWs) and medical students for MRSA and to know the susceptibility of mupirocin in this group. MATERIALS AND METHODS: A total of 432 students, nursing staff, doctors and house-keeping staff were screened for MRSA for 4 months. The MRSA and methicillin-resistant coagulase-negative Staphylococcus (MRCoNS) isolates were then tested for mupirocin resistance. RESULTS: Out of 432 samples, 24 (5.55%) were MRSA and 104 (24.07%) were MRCoNS. Only 4.16% (n = 1) showed high-level resistance to mupirocin among the MRSA isolates, while resistance among MRCoNS was higher at 6.7% (n = 7) for low-level resistance and 17.30% (n = 18) for high-level resistance. CONCLUSION: MRSA colonization of HCWs may serve as a source of infection and mupirocin resistance should be screened for all whether working in Intensive Care Units or not and if detected, alternative treatment should be used which will result in appropriate use of this antibiotic for decolonization.

scholarly journals Prevalence and molecular characterization of methicillin-resistant Staphylococcus aureus with mupirocin, fusidic acid and/or retapamulin resistance

2020 ◽  
Author(s):  
Wenjing Chen ◽  
Chunyan He ◽  
Han Yang ◽  
Wen Shu ◽  
Zelin Cui ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Fusidic Acid ◽  
Resistance Mechanisms ◽  
Antibiotics Resistance ◽  
Genetic Characteristics ◽  
Methicillin Resistant ◽  
Low Level ◽  
High Level ◽  
Level Resistance

Abstract Data on the prevalence of resistance to mupirocin (MUP), fusidic acid (FA) and retapamulin (RET) in methicillin-resistant Staphylococcus aureus (MRSA) from China are still limited. In this study we examined these three antibiotics resistance pheno and geno-typically in 1206 MRSA clinical isolates. Phenotypic MUP, FA and RET resistance was determined by MICs, and genotypically by PCR and DNA sequencing examining genes mupA / B , fusB - D , cfr and vgaA / Av , and mutations in ileS , fusA / E , rplC , and 23S RNA V domain. The genetic characteristics of resistance isolates were conducted by PFGE and MLST. Overall MRSA MUP, FA and RET resistance was low (5.1%, 1.0% and 0.3%, respectively). The mupA was the mechanism of high-level MUP resistance. All low-level MUP resistance isolates possessed an equivocal mutation N213D in IleS, and 2 of them additionally had the reported V588F mutation impacting the Rossman fold. FusA mutations, such as L461K, H457Q, H457Y and V90I, were the primary FA resistance mechanisms among high-level resistance isolates, most of which contained fusC ; however, all low-level resistance strains carried fusB . No resistance mechanisms detected were found among RET resistance isolates. Genetic analysis demonstrated clone spread for MUP resistance isolates. In conclusion, MUP, FA and RET exhibited highly activity against MRSA isolates. Acquired genes and chromosome-borne genes mutations were responsible for MUP and FA resistance, and further investigation is needed to uncover the RET resistance mechanisms. Moreover, the surveillance to MUP in MRSA should be strengthened to prevent resistance increase due to the expansion of clones.

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.

scholarly journals Fluconazole tolerance in clinical isolates of Cryptococcus neoformans.

1997 ◽  
Vol 41 (4) ◽  
pp. 748-751 ◽  
Author(s):  
K Venkateswarlu ◽  
M Taylor ◽  
N J Manning ◽  
M G Rinaldi ◽  
S L Kelly
Keyword(s):  
Cryptococcus Neoformans ◽  
Amphotericin B ◽  
Clinical Isolates ◽  
Biochemical Basis ◽  
Low Level ◽  
Cellular Content ◽  
Low Levels ◽  
High Level ◽  
Level Resistance ◽  
Target Enzyme

Eleven isolates of Cryptococcus neoformans were investigated to determine the biochemical basis of their tolerance to fluconazole. The MICs of fluconazole for three isolates with low-level resistance were 3- to 6-fold higher than those for sensitive isolates, while the MICs for four isolates with high-level resistance were 100- to 200-fold higher than those for sensitive isolates. The level of ergosterol present in the isolates varied, and those which had relatively low levels of ergosterol were resistant to amphotericin B. Changes in the affinity of the target enzyme (sterol 14alpha-demethylase) and decreases in the cellular content of fluconazole seemed to be responsible for the resistance in isolates with low-level and high-level resistance, respectively.

scholarly journals Ceftobiprole- and Ceftaroline-Resistant Methicillin-Resistant Staphylococcus aureus

2015 ◽  
Vol 59 (5) ◽  
pp. 2960-2963 ◽  
Author(s):  
Liana C. Chan ◽  
Li Basuino ◽  
Binh Diep ◽  
Stephanie Hamilton ◽  
Som S. Chatterjee ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Content Type ◽  
Low Level ◽  
Mrsa Strains ◽  
High Level ◽  
Level Resistance

ABSTRACTThe role ofmecAmutations in conferring resistance to ceftobiprole and ceftaroline, cephalosporins with anti-methicillin-resistantStaphylococcus aureus(MRSA) activity, was determined with MRSA strains COL and SF8300. The SF8300 ceftaroline-passaged mutant carried a singlemecAmutation, E447K (E-to-K change at position 447), and expressed low-level resistance. This mutation in COL conferred high-level resistance to ceftobiprole but only low-level resistance to ceftaroline. The COL ceftaroline-passaged mutant, which expressed high-level resistance to ceftobiprole and ceftaroline, had mutations inpbp2,pbp4, andgdpPbut notmecA.

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.

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