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The emergence of mupirocin resistance: a challenge to infection control and antibiotic prescribing practice

B D Cookson1

  • 1Laboratory of Hospital Infection, PHLS Central Public Health Laboratory, London, UK.

The Journal of Antimicrobial Chemotherapy
|March 25, 1998
PubMed

Insights

Mupirocin is a highly effective topical antibiotic for skin infections and nasal Staphylococcus aureus. However, antibiotic resistance emerged shortly after its introduction, necessitating a review of its use and resistance mechanisms.

Area of Science:

  • Microbiology
  • Dermatology
  • Infectious Diseases

Background:

  • Mupirocin, a topical antibiotic, has been widely used since 1985 for skin infections and nasal Staphylococcus aureus (SA) clearance.
  • It is registered in over 90 countries and effective against methicillin-resistant SA (MRSA).
  • Antibiotic resistance to mupirocin was reported soon after its clinical introduction.

Purpose of the Study:

  • To review the clinical use of mupirocin.
  • To discuss the mechanisms, genetics, surveillance, and epidemiology of mupirocin resistance in staphylococci.
  • To identify factors contributing to resistance and propose control strategies.

Main Methods:

  • Literature review of mupirocin use and resistance.
  • Analysis of resistance mechanisms and genetic elements.
  • Epidemiological surveillance data examination.
  • Discussion of factors influencing resistance development.

Main Results:

  • Mupirocin remains a successful topical antibiotic despite early resistance.
  • Resistance mechanisms include target modification (plasmid-mediated or chromosomal) and efflux pumps.
  • Epidemiological data highlight the increasing prevalence of mupirocin resistance in Staphylococci.
  • Factors such as overuse, misuse, and poor infection control contribute to resistance.

Conclusions:

  • Mupirocin's efficacy is threatened by emerging resistance.
  • Understanding resistance mechanisms and epidemiology is crucial for preserving its clinical utility.
  • Strategies to control resistance, including judicious use and enhanced surveillance, are necessary.

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