Prevalence of clinical meticillin-resistant Staphylococcus aureus (MRSA) with high-level mupirocin resistance in Shanghai and Wenzhou, China

Li, Qingzhong; Wu, Qiong; Zhang, Yibo; Liu, Meina; Hu, Fupin; Xu, Xiaogang; Zhu, Demei; Ni, Yizhao

doi:10.1016/j.ijantimicag.2009.09.018

Cited by 46 publications

(41 citation statements)

References 31 publications

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“…Two studies exhibited a high degree of relationship (Ho et al, 2012;Sheng et al, 2009), but another report revealed no correlation (Longtin et al, 2011). In this context, the findings displayed that the positive rate of qacA/B was observed to be high in MuH MRSA isolates with a higher MIC of chlorhexidine (100%, 85.7%, and 50.0% in isolates with MICs of ≥8 μg/ml, 4 μg/ml and 2 μg/ml, respectively) ( Table 1) (Liu et al, 2010). All isolates were susceptible to vancomycin, teicoplanin, linezolid and fusidic acid (Liu et al, 2010).…”

Section: Accepted Manuscriptmentioning

confidence: 94%

“…This may be owing to the differences in number and types of isolates collected for each investigation or types of disinfectants for general use, providing different selective pressures on MRSA isolates in different regions. Nineteen PFGE-SCCmec-spa-MLST types were identified for the isolates studied, as described previously (Liu et al, 2010. Twenty eight isolates containing qacA/B+smr, 6…”

Section: However In the Previous Study Of A Collection Of 56 Qac-tolmentioning

confidence: 99%

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Frequency of biocide-resistant genes and susceptibility to chlorhexidine in high-level mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MuH MRSA)

Zhao

Han

et al. 2015

Diagnostic Microbiology and Infectious Disease

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Section: Accepted Manuscriptmentioning

confidence: 94%

Section: However In the Previous Study Of A Collection Of 56 Qac-tolmentioning

confidence: 99%

Frequency of biocide-resistant genes and susceptibility to chlorhexidine in high-level mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MuH MRSA)

Zhao

Han

et al. 2015

Diagnostic Microbiology and Infectious Disease

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“…High-level mupirocin-resistant S. aureus isolates were detected using primers mupA-F (59-TATATTATGCGATGGAAG-GTTGG-39) and mupA-R (59-AATAAAATCAGCTGGAAAGTGT TG-39) amplifying the mupA gene (Liu et al, 2010). The mupA gene amplicon of each isolate was sequenced and compared with sequences available in BLAST (http://blast.ncbi.nlm.nih.gov/Blast.cgi).…”

Section: Methodsmentioning

confidence: 99%

Multidrug-resistant clones of community-associated meticillin-resistant Staphylococcus aureus isolated from Chinese children and the resistance genes to clindamycin and mupirocin

Wang

Liu

Yang

et al. 2012

Journal of Medical Microbiology

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This study aimed to correlate the multidrug resistance (MDR) and sequence type (ST) clones of community-associated (CA) meticillin-resistant Staphylococcus aureus (MRSA) to identify the genes responsible for clindamycin and mupirocin resistance in S. aureus isolates from paediatric hospitals in mainland China. A total of 435 S. aureus isolates were collected. Compared with CA meticillinsusceptible S. aureus (MSSA), the resistance rates of CA-MRSA to ciprofloxacin, chloramphenicol, gentamicin and tetracycline were higher (19.0 vs 2.6 %, P,0.001; 14.7 vs 3.1 %, P,0.001; 14.7 vs 3.1 %, P,0.01; and 46.0 vs 13.3 %, P,0.001, respectively). Compared with hospital-associated (HA)-MRSA, the resistance rates of CA-MRSA to ciprofloxacin, gentamicin, rifampicin, tetracycline and trimethoprim-sulfamethoxazole were lower (19 vs 94.8 %, P,0.001; 14.7 vs 84.4 %, P,0.001; 5.5 vs 88.3 %, P,0.001; 46 vs 94.8 %, P,0.001; and 1.8 vs 9.1 %, P,0.01, respectively). The resistance rates of CA-MRSA, HA-MRSA and CA-MSSA to clindamycin (92.0, 77.9 and 64.1 %, respectively) and erythromycin (85.9, 77.9 and 63.1 %, respectively) were high. The MDR rates (resistance to three or more non-b-lactams) were 49.6, 100 and 14 % in the CA-MRSA, HA-MRSA and CA-MSSA isolates, respectively. Five of seven ST clones in the CA-MRSA isolates, namely ST59, ST338, ST45, ST910 and ST965, had MDR rates of .50 % (67.9, 87.5, 100, 50 and 83.3 %, respectively). The constitutive phenotype of macrolide-lincosamide-streptogramin B (MLS B ) resistance (69 %) and the ermB gene (38.1 %) predominated among the MLS B -resistant CA S. aureus strains. The resistance rate to mupirocin was 2.3 % and plasmids carrying the mupA gene varied in size between 23 and 54.2 kb in six strains with high-level resistance as determined by Southern blot analysis. The present study showed that resistance to non-b-lactams, especially to clindamycin, is high in CA-MRSA isolates from Chinese children and that the profile of resistance is related to clonal type. This study revealed distinctive patterns of MLS B -resistant genes among CA S. aureus isolates.

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“…There are also recent data suggesting that failure of MRSA decolonization is more likely when qacA and/or qacB is present in conjunction with low-level mupirocin resistance (LLMR) (18). High-level mupirocin resistance (HLMR) is emerging in various hospitals around the world (19)(20)(21)(22). In addition to mupA, mupB has been identified recently in isolates with HLMR (14,23).…”

mentioning

confidence: 99%

Chlorhexidine and Mupirocin Susceptibilities of Methicillin-Resistant Staphylococcus aureus from Colonized Nursing Home Residents

McDanel

Murphy

Diekema

et al. 2013

Antimicrob Agents Chemother

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f Chlorhexidine and mupirocin are used in health care facilities to eradicate methicillin-resistant Staphylococcus aureus (MRSA) carriage. The objective of this study was to assess the frequency of chlorhexidine and mupirocin resistance in isolates from nares carriers in multiple nursing homes and to examine characteristics associated with resistance. Nasal swab samples were collected from approximately 100 new admissions and 100 current residents in 26 nursing homes in Orange County, CA, from October 2008 to May 2011. MRSA isolates were tested for susceptibility by using broth microdilution, disk diffusion, and Etest; for genetic relatedness using pulsed-field gel electrophoresis; and for qac gene carriage by PCR. Characteristics of the nursing homes and their residents were collected from the Medicare Minimum Data Set and Long-Term Care Focus. A total of 829 MRSA isolates were obtained from swabbing 3,806 residents in 26 nursing homes. All isolates had a chlorhexidine MIC of <4 g/ml. Five (0.6%) isolates harbored the qacA and/or qacB gene loci. Mupirocin resistance was identified in 101 (12%) isolates, with 78 (9%) isolates exhibiting high-level mupirocin resistance (HLMR). HLMR rates per facility ranged from 0 to 31%. None of the isolates with HLMR displayed qacA or qacB, while two isolates carried qacA and exhibited low-level mupirocin resistance. Detection of HLMR was associated with having a multidrug-resistant MRSA isolate (odds ratio [OR], 2.69; P ‫؍‬ 0.004), a history of MRSA (OR, 2.34; P < 0.001), and dependency in activities of daily living (OR, 1.25; P ‫؍‬ 0.004). In some facilities, HLMR was found in nearly one-third of MRSA isolates. These findings may have implications for the increasingly widespread practice of MRSA decolonization using intranasal mupirocin.

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Prevalence of clinical meticillin-resistant Staphylococcus aureus (MRSA) with high-level mupirocin resistance in Shanghai and Wenzhou, China

Cited by 46 publications

References 31 publications

Frequency of biocide-resistant genes and susceptibility to chlorhexidine in high-level mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MuH MRSA)

Frequency of biocide-resistant genes and susceptibility to chlorhexidine in high-level mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MuH MRSA)

Multidrug-resistant clones of community-associated meticillin-resistant Staphylococcus aureus isolated from Chinese children and the resistance genes to clindamycin and mupirocin

Chlorhexidine and Mupirocin Susceptibilities of Methicillin-Resistant Staphylococcus aureus from Colonized Nursing Home Residents

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