Study of mupirocin resistance in clinical isolates of methicillin resistant staphylococcus aureus causing wound infection in a tertiary care rural hospital

Dardi Charan Kaur

MRSA is one of the commonest causes of wound infections and is significant pathogen because of its multi-drug resistance nature. Mupirocin is an effective topical antibacterial agent that is used for the management of skin infections. There are two mupirocin resistance phenotypes; low level and high level. Mupirocin-resistant MRSA has also been associated with an increase in in-hospital mortality, compared to the level associated with mupirocin-susceptible MRSA. So the present study was undertaken with the aim to know the prevalence of the low-level and the high-level mupirocin resistances among MRSA causing Wound Infection

Materials & Methods: A total of 65 non-duplicate MRSA isolates were then tested for mupirocin resistance by the concomitant use of 5µg and 200µg mupirocin discs.

Discussion: Among 65 MRSA isolates, mupirocin resistance was found in 9 (13.85%) isolates. In our study, of 65 MRSA isolates, High-level Mupirocin resistance was observed in 2 (3.08%) and Low-level resistance in 7 (10.77%). The 7 low-level mupirocin resistance isolates were from Skin 1(1.54%); Medicine 2 (3.08%) and maximum were from obgy 4 (6.15%). Two High-level mupirocin resistances were from NICU (1.54%) & Medicine (1.54%). There is a strong association between previous mupirocin exposure and both low-level and high-level mupirocin resistance.

Conclusion: The prevalence of High-level & low-level mupirocin resistances among MRSA in the patients with wound infections is a matter of concern. High-level mupirocin resistance (mupA carriage) is also linked to MDR. Hence, we conclude that all MRSA isolates from wounds should be routinely screened for mupirocin resistance.

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