Prevalence of High and Low-Level Mupirocin Resistance in Clinical Isolates of Staphylococcus Aureus from Skin and Soft Tissue Infection
Life Sciences -Microbiology
DOI:
https://doi.org/10.22376/ijlpr.2023.13.5.L42-L49Keywords:
Skin and Soft Tissue Infection, Staphylococcus aureus, MRSA, High-level Mupirocin resistance, Low-level Mupirocin resistanceAbstract
The skin has an extremely diverse ecology of organisms that may produce infection. The clinical manifestations of skin and soft tissue infection(SSTIs) culminate in a two-step process involving invasion and the interaction of bacteria with host defenses. Approximately 7% to 10% of hospitalized patientsare affected by SSTIs. Mupirocin has been used to treat skin infections and eradicate the nasal carriage of MRSA. Our aim is to estimate the prevalence of lowand high-level Mupirocin resistance among the clinical isolates of Staphylococcus aureus from skin and soft tissue infection. The study was conducted in theDepartment of Microbiology, Krishna Institute of Medical Sciences, Krishna Hospital and Medical Research Centre, Karad, District- Satara. Specimen collectionand processing of samples were performed as per standards. The Kirby -Bauer disc diffusion method was used for the sensitivity to common antibioticsrecommended Clinical and Laboratory Standard Institute (CLSI 2021). Mupirocin resistance was detected using 5μg and 200μg Mupirocin discs to determineLow and High -level resistance. 135 Staphylococcus aureus isolates were obtained from patients admitted to various medical, surgical, and intensive care unitsand patients attending outpatient departments. Out of 415 clinically suspected cases of skin and soft tissue infection, 91.33% were culture positive, and 8.67%were culture negative. Out of 379 microorganisms, 44.06% were Gram-positive cocci, 27.44% were Gram negative bacilli, 24.27% were Gram negative cocci,and 14.22% were Gram-positive bacilli. Out of 167 Gram positive cocci, 135 (80.84%) were Staphylococcus aureus, 22 (13.17%) were Coagulase NegativeStaphylococcus and 10 (5.99%) were Micrococcus. We conclude that the prevalence of Staphylococcus aureus was 32.53%, among which Mupirocin high and lowlevelresistance was 5.92% and 7.41%, respectively.
References
Shinde RV, Pawar SK, Mohite RV, Shinde AR, Duggu P. Study of nasal carriage of Staphylococcus aureus with. Arch Clin Microbiol. 2016;7(1):1.
Leigh DA, Joy G. Treatment of familial Staphylococcal infection—comparison of Mupirocin nasal ointment and chlorhexidine/neomycin (naseptin) cream in eradication of nasal carriage. J Antimicrob Chemother. 1993;31(6):909-17. doi: 10.1093/jac/31.6.909, PMID 8360128.
Poovelikunnel T, Gethin G, Humphreys H. Mupirocin resistance: clinical implications and potential alternatives for the eradication of MRSA. J Antimicrob Chemother. 2015;70(10):2681-92. doi: 10.1093/jac/dkv169, PMID 26142407.
Khan A, Tewari R, Shree N. Mupirocin-resistant methicillin-resistant Staphylococcus aureus–Are these strains wrongly reported and treated? Int J Med Sci Public Health. 2020;9(6):363-7. doi: 10.5455/ijmsph.2020.06092202029062020.
Shinde RV, Patil SR, Mohite ST, Shinde AR, Patil SS. Study of nasal carriage of Staphylococcus aureus among hospital staff with special reference to methicillin resistance and bacteriophage type. Int J Health Sci Res. 2012;2(5):42-50.
Dardi CK. Mupirocin resistance in clinical isolates of methicillin-resistant Staphylococcus aureus from a tertiary care rural hospital. Int J Adv Med Health Res. 2014;1(2):52. doi: 10.4103/2349-4220.148000.
Clinical and Laboratory Standards Institute performance standards for antimicrobial Susceptibility testing, CLSI document M100;E31:E2021.
Moreira de Oliveira NE, Cardozo AP, Marques ED, Netto dos Santos KR. demarval MG. Interpretive criteria to differentiate low- and high-level Mupirocin resistance in Staphylococcus aureus. J Med Microbiol. 2007;56(7):937-9.
Chaturvedi P, Singh AK, Singh AK, Shukla S, Agarwal L. Prevalence of Mupirocin resistant Staphylococcus aureus isolates among patients admitted to a tertiary care hospital. North Am J Med Sci. 2014;6(8):403-7. doi: 10.4103/1947-2714.139293, PMID 25210674.
Perumal PG, Kannan S, Appalaraju B. Detection and Distribution of Low Level and High-Level Mupirocin Resistance among Clinical methicillin resistant Staphylococcus aureus Isolates. J Clin Diagn Res. 2022;16(5):16. doi: 10.7860/JCDR/2022/55943.16298.
Fritz SA, Hogan PG, Camins BC, Ainsworth AJ, Patrick C, Martin MS et al. Mupirocin and chlorhexidine resistance in Staphylococcus aureus in patients with community-onset skin and soft tissue infections. Antimicrob Agents Chemother. 2013;57(1):559-68. doi: 10.1128/AAC.01633-12, PMID 23147738.
Oommen SK, Appalaraju B, Jinsha K. Mupirocin resistance in clinical isolates of Staphylococci in a tertiary care centre in south India. Indian J Med Microbiol. 2010;28(4):372-5. doi: 10.4103/0255-0857.71825, PMID 20966573.
Debnath a, chikkaswamy bk. Antibiogram and susceptibility pattern of methicillin resistant Staphylococcus aureus collected from various clinical samples in Bengaluru. Asian J Pharm Clin Res. 2015;8(6):260-4.
Bhavana MV, Joshi S, Adhikary R, Beena HB. Mupirocin resistance in Staphylococcus aureus in a tertiary care hospital of South India A prospective study. Asian J Pharm Clin Res. 2019;12(9):98-100.
Rudresh MS, Ravi GS, Motagi A, Alex AM, Sandhya P, Navaneeth BV. Prevalence of Mupirocin resistance among Staphylococci, its clinical significance and relationship to clinical use. J Lab Physicians. 2015;7(2):103-7. doi: 10.4103/0974-2727.163127, PMID 26417160.
Abdulgader SM, Lentswe T, Whitelaw A, Newton-Foot M. The prevalence and molecular mechanisms of Mupirocin resistance in Staphylococcus aureus isolates from a Hospital in Cape Town, South Africa. Antimicrob Resist Infect Control. 2020;9(1):47. doi: 10.1186/s13756-020-00707-8, PMID 32169102.
Prakash R, Garg A, Arya R. Chronicity of high and low level Mupirocin resistance in Staphylococcus aureus from 30 Indian hospitals; 2022. doi: 10.21203/rs.3.rs-2242108/v1.
Gadepalli R, Dhawan B, Mohanty S, Kapil A, Das BK, Chaudhry R, et al. Mupirocin resistance in Staphylococcus aureus in an Indian hospital. Diagn Microbiol Infect Dis. 2007;58(1):125-7. doi: 10.1016/j.diagmicrobio.2006.10.012, PMID 17240103.
Schmitz FJ, Lindenlauf E, Hofmann B, Fluit AC, Verhoef J, Heinz HP et al. Franz- Josef. J Antimicrob Chemother. 1998;42(4):489-95. doi: 10.1093/jac/42.4.489, PMID 9818748.
Kumar D, Bisht D, Faujdar SS. Incidence of Mupirocin resistance in Staphylococcus aureus isolated from rural population: A new emerging challenge. Int J Curr Res Rev. 2020;12(22):82-5. doi: 10.31782/IJCRR.2020.12225.
Shivanna V, Dasegowda V. Comparison of disk diffusion and agar dilution method for the detection of Mupirocin resistance in staphylococcal isolates from skin and soft tissue infections. J Lab Physicians. 2023 Jan 18. doi: 10.1055/s-0042-1760672.
Yun H-J, Lee SW, Yoon GM, Kim SY, Choi S, Lee YS et al. Prevalence and mechanisms of low- and high-level Mupirocin resistance in staphylococci isolated from a Korean hospital. J Antimicrob Chemother. 2003;51(3):619-23. doi: 10.1093/jac/dkg140.
Nicholson AM, Thorns C, Wint H, Didier M, Willis R, McMorris N et al. The detection of Mupirocin resistance and the distribution of methicillin-resistant Staphylococcus aureus at the University Hospital of the West Indies, Jamaica. West Indian Med J. 2010;59(5):509-13. PMID 21473397.
Madhumati B, Rajendran V, Ashwin K. Prevalence of Mupirocin Resistance in methicillin resistant Staphylococcus aureus Strains isolated from a Tertiary Care Hospital. Int J Curr Microbiol App Sci. 2018;7(5):329-36. doi: 10.20546/ijcmas.2018.705.042.
Simor AE, Stuart TL, Louie L, Watt C, Ofner-Agostini M, Gravel D et al. Mupirocin-resistant, methicillin-resistant Staphylococcus aureus strains in Canadian hospitals. Antimicrob Agents Chemother. 2007;51(11):3880-6. doi: 10.1128/AAC.00846-07, PMID 17724154.
Sanju AJ, Kopula SS, Palraj KK. Screening for Mupirocin resistance in Staphylococcus. J Clin Diagn Res. 2015;9(10):DC09-10. doi: 10.7860/JCDR/2015/15230.6678, PMID 26557517.
Published
How to Cite
Issue
Section
Copyright (c) 2023 Miss. Aishwarya Subhash Mohite, Dr. Ravindra V. Shinde, Dr. Deepak S. Patil, Dr. Shivaji T. Mohite, Dr. Satish R. Patil, Dr. Anjali R. Shinde, Dr. Sandeep B. Shinde
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.