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Mupirocin resistance and methicillin-resistant Staphylococcus aureus (MRSA)
1Department of Medical Microbiology, St. Georges Hospital, Medical School, London, UK.
The Journal of Hospital Infection
|January 1, 1997
Summary
Mupirocin effectively eliminates methicillin-resistant Staphylococcus aureus (MRSA) carriage. However, increasing resistance, particularly high-level, poses challenges, necessitating careful antibiotic stewardship to preserve treatment efficacy.
Area of Science:
- Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Mupirocin is the primary topical treatment for eliminating methicillin-resistant Staphylococcus aureus (MRSA) carriage.
- Increased mupirocin use correlates with reported MRSA outbreaks exhibiting low- and high-level resistance.
Purpose of the Study:
- To review the implications of emerging mupirocin resistance in MRSA.
- To discuss the impact of low- and high-level resistance on clinical practice and outbreak management.
Main Methods:
- Literature review of studies on mupirocin resistance in MRSA.
- Analysis of clinical implications of low- and high-level resistance.
- Evaluation of alternative treatment options and their efficacy.
Main Results:
- Low-level mupirocin resistance is increasing but may not significantly alter current treatment protocols.
- High-level mupirocin resistance, though uncommon, is plasmid-mediated and can complicate MRSA elimination during outbreaks.
- Alternative treatments for MRSA carriage exist, but their effectiveness and safety profiles require further investigation.
Conclusions:
- Controlled antibiotic use is crucial for limiting the rise of mupirocin resistance in MRSA.
- Strategies should focus on judicious use of mupirocin and other antimicrobial agents to maintain treatment effectiveness.
- Further research into alternative MRSA eradication therapies is warranted.