Detection of high and low level mupirocin resistance among clinical isolates of Staphylococcus aureus

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Original Article

Author Details : Arularasu P, Alice Peace R, Priyadarshini Shanmugam

Volume : 3, Issue : 4, Year : 2016

Article Page : 468-471

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Abstract

Introduction: Staphylococcus aureus infections have become more difficult to treat due to multidrug resistance. Therefore removal of nasal carriage of Staphylococci plays a major role in infection control. Mupirocin is an effective topical agent for nasal decolonization. Existence of high level mupirocin resistance (HLMR) excludes its use and low level resistance (LLMR) need higher dosage recommendations. Hence screening of HLMR and LLMR in a hospital is essential.
Materials and Methods: A total of 100 isolates obtained from skin and soft tissue infections and blood were used and the study was carried out at Chettinad hospital and Research Institute, Kelambakkam, Chennai, India. HLMR and LLMR were detected using 200 µg and 5µg mupirocin discs respectively. The MIC for mupirocin resistant isolates was determined by agar dilution method.
Results: Among the 100 strains tested 79 were MSSA (Methicillin sensitive) and 21 were MRSA (Methicillin Resistant). Out of 100 strains 7 (7%) were mupirocin resistant. Out of the seven resistant isolates, one isolate (MSSA) was resistant to 5µg mupirocin and six (2 MRSA and 4 MSSA) isolates were resistant to 200 µg mupirocin. MIC for LLMR and HLMR isolates was 8µg/ml and ?1024µg/ml respectively.
Conclusion: Emergence of LLMR and HLMR isolates has become more common because of its repeated use. Hence continual monitoring for its prevalence is very much needed and also can guide the clinician to select appropriate empirical therapy.

Keywords: Staphylococcus aureus; Low level Mupirocin resistance; High level Mupirocin resistance; Methicillin Resistance

How to cite : Arularasu P, Alice Peace R, Shanmugam P, Detection of high and low level mupirocin resistance among clinical isolates of Staphylococcus aureus. Indian J Microbiol Res 2016;3(4):468-471

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