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The prevalence of low- and high-level mupirocin resistance in staphylococci from 19 European hospitals
F J Schmitz1, E Lindenlauf, B Hofmann
1Institute for Medical Microbiology and Virology, Heinrich-Heine University Düsseldorf, Germany.
Abstract:
The topical agent mupirocin plays a crucial role in strategies designed to control outbreaks of methicillin-resistant Staphylococcus aureus. The extent of high- or low-level mupirocin resistance amongst S. aureus from European hospitals is not known. Six hundred and ninety-nine S. aureus and 249 coagulase-negative staphylococci (CNS) derived from blood, hospital-acquired pneumonia or skin and soft tissue infections from 19 European hospitals were tested for susceptibility to mupirocin and oxacillin. Methicillin sensitivity was found in 72% and 32% of S. aureus and CNS, respectively. High-level mupirocin resistance was detected in 1.6% of S. aureus and 5.6% of CNS isolates, while low-level mupirocin resistance was detected in 2.3% of S. aureus and 7.2% of CNS isolates. Amongst S. aureus, methicillin-resistant isolates were twice as likely to have high- or low-level mupirocin resistance. This difference was less pronounced in CNS. No relationship was found between the site of infection and prevalence of mupirocin resistance. High- and low-level mupirocin resistance was detected amongst staphylococci from 10 and 16 of the hospitals studied, respectively. To maintain the relatively low prevalence of mupirocin resistance in Europe amongst both S. aureus and CNS, the prudent use of mupirocin restricted to defined infection control strategies should be emphasized.
Insights
Mupirocin resistance in Staphylococcus aureus and coagulase-negative staphylococci (CNS) is present in European hospitals. Prudent use of mupirocin is essential to maintain its effectiveness against these resistant bacteria.
Area of Science:
- * Clinical microbiology and infectious diseases.
- * Antimicrobial resistance surveillance.
Background:
- * Mupirocin is vital for controlling methicillin-resistant Staphylococcus aureus (MRSA) outbreaks.
- * The prevalence of mupirocin resistance in European hospitals was previously unknown.
Purpose of the Study:
- * To determine the extent of high- and low-level mupirocin resistance in Staphylococcus aureus and coagulase-negative staphylococci (CNS) from European hospitals.
- * To investigate the relationship between mupirocin resistance and methicillin resistance or infection site.
Main Methods:
- * Susceptibility testing to mupirocin and oxacillin was performed on 699 S. aureus and 249 CNS isolates from 19 European hospitals.
- * Isolates were sourced from blood, hospital-acquired pneumonia, and skin/soft tissue infections.
Main Results:
- * Methicillin sensitivity was observed in 72% of S. aureus and 32% of CNS.
- * High-level mupirocin resistance was found in 1.6% of S. aureus and 5.6% of CNS; low-level resistance in 2.3% of S. aureus and 7.2% of CNS.
- * Methicillin-resistant S. aureus isolates were twice as likely to exhibit mupirocin resistance; this trend was less pronounced in CNS. No link was found between infection site and resistance prevalence.
Conclusions:
- * Mupirocin resistance is present in staphylococci across multiple European hospitals.
- * Methicillin resistance is associated with higher rates of mupirocin resistance in S. aureus.
- * Emphasizing prudent mupirocin use within defined infection control strategies is crucial for preserving its efficacy.