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Bactericidal efficacy of mupirocin in multi-antibiotic resistant Staphylococcus aureus burn wound infection
H Rode1, P M de Wet, A J Millar
1Department of Paediatric Surgery, University of Cape Town, South Africa.
Abstract:
Methicillin resistant Staphylococcus aureus strains (MRSA) have become increasingly prevalent as pathogenic organisms, especially in burn wounds, with an associated mortality of 20-40% among those clinically infected. Mupirocin ointment, a new topical antibiotic, has proved in vitro and in vivo to be highly effective in the treatment of MRSA infections. A modified Walker burn wound model was used to define the rate of trans-eschar penetration, biodynamic availability and bactericidal efficacy of 2% mupirocin ointment in established MRSA burn wound infection. In-vitro penetration trials confirmed the effective diffusion of mupirocin through 1.5 mm eschar within 2 h. A single topical application of mupirocin resulted in a 98.3% (5.67 x 10(8) cfu/g of tissue--1.0 x 10(7) cfu/g of tissue) reduction in intra-eschar viable organisms within 36 h post application. A second topical application of mupirocin at 24 h resulted in a total reduction of 99.6% in viable intra-eschar organisms (1.85 x 10(8) cfu/gram of tissue--6.76 x 10(5) cfu/g of tissue). It is concluded that mupirocin is highly effective in controlling MRSA burn wound infection and should be applied topically every 24 h.
Insights
Mupirocin ointment effectively treats Methicillin-resistant Staphylococcus aureus (MRSA) burn wound infections. Topical application every 24 hours significantly reduces bacterial load, demonstrating high efficacy in controlling MRSA.
Area of Science:
- Infectious Diseases
- Dermatology
- Pharmacology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is a growing threat in burn wound infections, causing significant mortality.
- Topical mupirocin ointment shows promise for treating MRSA infections.
Purpose of the Study:
- To evaluate the penetration, availability, and bactericidal efficacy of 2% mupirocin ointment in MRSA burn wound infections.
- To determine optimal application frequency for mupirocin in burn wound settings.
Main Methods:
- Utilized a modified Walker burn wound model.
- Conducted in-vitro penetration trials through eschar.
- Assessed bacterial reduction in established MRSA burn wound infections.
Main Results:
- Mupirocin effectively diffused through 1.5 mm eschar within 2 hours.
- A single application reduced MRSA by 98.3% within 36 hours.
- Two applications (24 hours apart) reduced MRSA by 99.6%.
Conclusions:
- Mupirocin ointment is highly effective for controlling MRSA burn wound infections.
- Topical application every 24 hours is recommended for optimal results.