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Mupirocin resistance in Staphylococcus aureus causing recurrent skin and soft tissue infections in children

J Chase McNeil1, Kristina G Hulten, Sheldon L Kaplan

  • 1Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Feigin Center, Suite 1150, 1102 Bates St., Houston, TX 77030, USA.

Antimicrobial Agents and Chemotherapy
|February 2, 2011
PubMed

Insights

Staphylococcus aureus mupirocin resistance, often due to the mupA gene, was found in 14.7% of pediatric isolates. The mupA gene was more prevalent in methicillin-susceptible S. aureus strains.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Mupirocin is a topical antibiotic used to treat Staphylococcus aureus infections.
  • Resistance to mupirocin in S. aureus is frequently mediated by the acquisition of the mupA gene, which encodes a novel isoleucyl-tRNA synthetase.
  • Recurrent skin and soft tissue infections can be challenging to treat, especially with emerging antibiotic resistance.

Purpose of the Study:

  • To determine the prevalence of mupirocin resistance and the presence of the mupA gene in Staphylococcus aureus isolates from children with recurrent skin infections.
  • To compare the frequency of the mupA gene in methicillin-susceptible S. aureus (MSSA) versus methicillin-resistant S. aureus (MRSA).
  • To assess the co-occurrence of mupirocin resistance with clindamycin resistance in these isolates.

Main Methods:

  • Collection of Staphylococcus aureus isolates from pediatric patients with recurrent skin and soft tissue infections at Texas Children's Hospital.
  • Phenotypic testing for mupirocin resistance using standard antimicrobial susceptibility testing methods.
  • Molecular detection of the mupA gene using appropriate genetic assays.
  • Subtyping of isolates into methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA).
  • Testing for clindamycin resistance in mupirocin-resistant isolates.

Main Results:

  • Out of 136 S. aureus isolates tested, 20 (14.7%) exhibited resistance to mupirocin.
  • The mupA gene was detected in 15 isolates (11% of total).
  • The mupA gene was significantly more common in MSSA (21.4%) compared to MRSA (8.3%; P=0.03).
  • Seven of the 20 mupirocin-resistant isolates (35%) also displayed resistance to clindamycin.

Conclusions:

  • Mupirocin resistance is a notable issue in pediatric S. aureus isolates causing recurrent skin infections.
  • The mupA gene is a key determinant of mupirocin resistance and is more frequently found in MSSA.
  • Co-resistance to clindamycin among mupirocin-resistant isolates suggests potential challenges in treatment options for these infections.

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