title: Prevalence of High and Low Level Mupirocin Resistance among Staphylococcal Isolates from Skin Infection in a Tertiary Care Hospital.
abstract: BACKGROUND
  Mupirocin has been used for the treatment of skin infections and for the eradication of the nasal carriage of Methicillin -resistant Staphylococcus aureus (MRSA). The increased use of this antibiotic has been accompanied by its resistance, resulting in treatment failures.
  
  
  OBJECTIVE
  This study was aimed at determining the prevalences of low and high level Mupirocin resistance among the clinical isolates of Staphylococcus species which were obtained from pyogenic infections.
  
  
  METHODS
  Clinical samples such as wound swabs, tissues and pus which were submitted to the microbiology laboratory during a period of six months were screened for the growth of Staphylococcus species, which were identified as Staphylococcus aureus and Coagulase negative Staphylococcus species by the routine microbiological procedures. All the isolates were tested for their Mupirocin susceptibilities by using 5 and 200 μg discs and their resistance was confirmed from their Minimum Inhibitory Concentrations (MICs).
  
  
  RESULTS
  Out of 400 samples, 150 samples grew Staphylococcus species, of which 113 were Staphylococcus aureus and 37 were Coagulase negative Staphylococcus (CoNS). Only 5(3.3%) mupirocin resistant Staphylococcus species: three high level and two low level strains were detected. The MICs for the two low level and three high level Mupirocin resistant strains were 256 mg/L and ≥512mg/L each respectively.
  
  
  CONCLUSIONS
  We conclude that the screening for mupirocin resistance, in terms of high-level and low-level resistance among the Staphylococcus species from patients with skin and soft tissue infections is warranted and that it is important for the clinicians in selecting the appropriate, empirical, topical, antimicrobial therapy. It also provides useful information about the prevalence of these resistant pathogens.
authors.affiliation: Department of Microbiology, Saveetha Medical College & Hospital, Saveetha University , Thandalam, Kancheepuram District-602 105, Tamilnadu, India .
authors.forename: Jayakumar
authors.initials: J
authors.lastname: S
authors.forename: Meerabai
authors.initials: M
authors.lastname: M
authors.forename: Shameem Banu
authors.initials: SB
authors.lastname: A S
authors.forename: Renu
authors.initials: R
authors.lastname: Mathew
authors.forename: Kalyani
authors.initials: K
authors.lastname: M
authors.forename: Binesh
authors.initials: B
authors.lastname: Lal Y
keywords: Coagulase negative Staphylococcus (CoNS); High and Low level mupirocin resistance; Methicillin-resistant Staphylococcus aureus (MRSA)
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