Mupirocin resistance and methicillin-resistant Staphylococcus aureus (MRSA)

Eltringham, Ian

doi:10.1016/s0195-6701(97)90162-6

Cited by 108 publications

(63 citation statements)

References 37 publications

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“…The MET and MUP MICs were further confirmed by the E-test according to the manufacturer's instructions (AB Biodisk, Solna, Sweden). MUP sensitivity was defined as MICs of Յ4 g/ml, H-MuR was defined as MICs of Ն512 g/ml, and L-MuR was defined as MICs ranging from 8 to 256 g/ml in both S. aureus and CoNS (2,8,10). MET susceptibility and MET resistance were defined as oxacillin (OXA) E-test MICs of Յ2 and Ն4 g/ml, respectively, in S. aureus or MICs of Յ0.25 and Ն0.5 g/ml, respectively, in CoNS.…”

Section: Methodsmentioning

confidence: 99%

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New Quadriplex PCR Assay for Detection of Methicillin and Mupirocin Resistance and Simultaneous Discrimination ofStaphylococcus aureusfrom Coagulase-Negative Staphylococci

et al. 2004

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Major challenges in diagnostic molecular microbiology are to develop a simple assay to distinguish Staphylococcus aureus from the less virulent but clinically important coagulase-negative staphylococci (CoNS) and to simultaneously determine their antibiotic resistance profiles. Multiplex PCR assays have been developed for the detection of methicillin-and mupirocin-resistant S. aureus and CoNS but not for the simultaneous discrimination of S. aureus from CoNS. We designed a new set of Staphylococcus genus-specific primers and developed a novel quadriplex PCR assay targeting the 16S rRNA (Staphylococcus genus specific), nuc (S. aureus species specific), mecA (a determinant of methicillin resistance), and mupA (a determinant of mupirocin resistance) genes to identify most staphylococci, to discriminate S. aureus from CoNS and other bacteria, and to simultaneously detect methicillin and mupirocin resistance. Validation of the assay with 96 ATCC control strains and 323 previously characterized clinical isolates, including methicillin-and mupirocin-sensitive and -resistant S. aureus and CoNS isolates and other bacteria, demonstrated 100% sensitivity, specificity, and accuracy. This assay represents a simple, rapid, accurate, and reliable approach for the detection of methicillin-and mupirocin-resistant staphylococci and offers the hope of preventing their widespread dissemination through early and reliable detection.

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Section: Methodsmentioning

confidence: 99%

“…After centrifugation at 20,000 ϫ g for 1 min, 5 l of the supernatant was used as a template in a 25-l PCR mixture. (2,8,10).…”

Section: Methodsmentioning

confidence: 99%

New Quadriplex PCR Assay for Detection of Methicillin and Mupirocin Resistance and Simultaneous Discrimination ofStaphylococcus aureusfrom Coagulase-Negative Staphylococci

et al. 2004

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“…Mupirocin (pseudomonic acid A) has in vitro activity against most Gram-positive organisms and a few Gram-negative organisms (12). It is approved for decolonization of S. aureus nasal carriage in patients Ͼ12 years of age (16,29).…”

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confidence: 99%

Association of High-Level Mupirocin Resistance and Multidrug-Resistant Methicillin-Resistant Staphylococcus aureus at an Academic Center in the Midwestern United States

et al. 2011

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Mupirocin is a topical antimicrobial used to eradicate methicillin-resistant Staphylococcus aureus (MRSA) colonization, usually in the absence of susceptibility testing. We hypothesized that high-level (HL) mupirocin resistance was associated with multidrug resistance (MDR). To this end, unique patient isolates identified at our institution during 2008 were stratified into those resistant to >3 non-␤-lactam antimicrobial classes (MDR) and non-MDR MRSA. HL mupirocin resistance was screened by mupA PCR on all MDR isolates (n ‫؍‬ 191) and a 20% random sample (n ‫؍‬ 130) of non-MDR isolates; E-testing confirmed HL resistance. We found that among MDR isolates, 13 (6.8%) carried mupA, whereas none of the non-MDR isolates did (P ‫؍‬ 0.001). Thus, although the overall prevalence of HL mupirocin resistance is low among MRSA isolates at our institution, an association exists between mupA carriage and MDR. Using genotyping and antimicrobial susceptibility profiling, we identified nine HL mupirocin-resistant clones. Whereas the majority of mupAnegative MDR isolates had a health care-associated MRSA (HA-MRSA) genotype (multilocus sequence type 5 [ST5] or SCCmec type II), the majority of mupA-positive MDR isolates had a community-associated MRSA (CA-MRSA) genotype (ST8 or SCCmec type IV). However, CA-and HA-MRSA genotypes were more evenly distributed among mupA-positive isolates compared to mupA-negative MDR isolates. Thus, in Chicago, mupA is circulating among both CA-and HA-MRSA backgrounds.

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“…Mupirocin is an effective antibiotic for elimination of methicillin-resistant Staphylococcus aureus (MRSA) from nasal colonization and has been used to control the spread of these organisms among patients during outbreaks (Eltringham, 1997). Mupirocin-resistant strains can be found, and they are grouped in two distinct categories: low-level or intermediate resistance (Mup I ), with MICs of 4-256 ìg ml À1 , and high-level resistance (Mup R ), with MICs >512 ìg ml À1 (Eltringham, 1997).…”

Section: Introductionmentioning

confidence: 99%

“…Mupirocin-resistant strains can be found, and they are grouped in two distinct categories: low-level or intermediate resistance (Mup I ), with MICs of 4-256 ìg ml À1 , and high-level resistance (Mup R ), with MICs >512 ìg ml À1 (Eltringham, 1997). Mup R has been associated with the failure to clear the organism in patients.…”

Section: Introductionmentioning

confidence: 99%

Improvement of mupirocin E-test for susceptibility testing of Staphylococcus aureus

Mondino

Santos

Bastos

et al. 2003

Journal of Medical Microbiology

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Interpretation of the mupirocin E-test for low-level mupirocin-resistant Staphylococcus aureus strains has been improved by adding the indicator dye tetrazolium. E-tests were compared with agar dilution methods for assessing mupirocin susceptibility. MICs obtained by the agar dilution method and E-tests showed 89·3 % agreement within 2 log 2 dilution criteria. The agreement between MICs increased to 100 % in the 1 log 2 dilution definition when the indicator dye tetrazolium was added to the E-test. The use of the E-test with tetrazolium reduction is more accurate for determining mupirocin MICs for S. aureus strains.

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Mupirocin resistance and methicillin-resistant Staphylococcus aureus (MRSA)

Cited by 108 publications

References 37 publications

New Quadriplex PCR Assay for Detection of Methicillin and Mupirocin Resistance and Simultaneous Discrimination ofStaphylococcus aureusfrom Coagulase-Negative Staphylococci

New Quadriplex PCR Assay for Detection of Methicillin and Mupirocin Resistance and Simultaneous Discrimination ofStaphylococcus aureusfrom Coagulase-Negative Staphylococci

Association of High-Level Mupirocin Resistance and Multidrug-Resistant Methicillin-Resistant Staphylococcus aureus at an Academic Center in the Midwestern United States

Improvement of mupirocin E-test for susceptibility testing of Staphylococcus aureus

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