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Decrease in the incidence of mupirocin resistance among methicillin-resistant Staphylococcus aureus in carriers from
Juliana Caierão1, Laura Berquó, Cícero Dias
1Fundação Faculdade Federal de Ciências Médicas de Porto Alegre.
American Journal of Infection Control
|January 31, 2006
Summary
High-level mupirocin resistance in Methicillin-resistant Staphylococcus aureus (MRSA) carriers decreased significantly over three years in an ICU. This decline in mupirocin resistance may be linked to plasmid-located resistance genes and patient outcomes.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant global healthcare challenge.
- Mupirocin is a key agent for MRSA decolonization and infection control.
Purpose of the Study:
- To investigate the incidence of mupirocin resistance among MRSA carriers within an intensive care unit (ICU).
Main Methods:
- Analysis of 2723 nasal swabs collected over three years.
- Verification of methicillin and mupirocin resistance using agar diffusion, E test, and PCR (mecA, ileS-2, mupA).
- Plasmid-curing and pulsed-field gel electrophoresis (PFGE) were performed on high-resistance isolates.
Main Results:
- Overall high-level mupirocin resistance (HR-Mup) incidence was 4.84% among MRSA carriers.
- HR-Mup incidence significantly decreased from 13.04% in year 1 to 0% in year 3 (P = .02).
- Low-level mupirocin resistance (LR-Mup) showed a significant increase (P = .01).
Conclusions:
- Genes conferring HR-Mup (ileS-2/mupA) are located on plasmids.
- Most MRSA isolates, including HR-Mup strains, were genetically related.
- The observed decline in HR-Mup is likely due to plasmid-mediated resistance and rapid patient turnover.