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A decline in mupirocin resistance in methicillin-resistant Staphylococcus aureus accompanied administrative control

Elaine S Walker1, Foster Levy, Mahmoud Shorman

  • 1James H. Quillen VAMC (11C), Mountain Home, TN 37684, USA. walkeres@etsu.edu

Journal of Clinical Microbiology
|June 9, 2004
PubMed

Insights

Implementing judicious use policies for mupirocin significantly reduced resistance in methicillin-resistant Staphylococcus aureus (MRSA) isolates. This demonstrates the effectiveness of antimicrobial stewardship in combating antibiotic resistance.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant clinical challenge.
  • Mupirocin is a crucial topical antibiotic for treating MRSA infections.
  • Antimicrobial resistance to mupirocin is a growing concern.

Purpose of the Study:

  • To evaluate the impact of varying mupirocin usage rates and prescription policies on mupirocin resistance in MRSA isolates.
  • To assess the relationship between antimicrobial stewardship interventions and the prevalence of mupirocin resistance.

Main Methods:

  • Retrospective analysis of MRSA isolates from different eras at a Veterans Affairs medical center.
  • Correlation of isolate susceptibility data with mupirocin prescription data and policy changes.
  • Assessment of both high-level and low-level mupirocin resistance.

Main Results:

  • Mupirocin prescriptions decreased dramatically from 3.0 to 0.1 per 1,000 patient days following policy implementation.
  • High-level mupirocin resistance in MRSA isolates declined sharply from 31% to 4%.
  • Low-level mupirocin resistance also decreased significantly, from 26% to 10%.

Conclusions:

  • Stringent administrative control and judicious use policies for mupirocin are effective in reducing antimicrobial resistance.
  • Antimicrobial stewardship programs can successfully mitigate the development of resistance in MRSA.
  • Prescription control is a viable strategy to preserve the efficacy of topical antibiotics like mupirocin.

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