title: Prevalence of Mupirocin Resistance Among Staphylococci, its Clinical Significance and Relationship to Clinical Use.
abstract: BACKGROUND
  Mupirocin competitively inhibits bacterial isoleucyl transfer-RNA synthetase and inhibit bacterial protein synthesis. Widespread usage and over the counter availability of the drug has resulted in resistance among Staphylococcus species.
  
  
  OBJECTIVE
  This study aimed to determine the overall prevalence of mupirocin resistance among staphylococci. Correlate clinical significance of mupirocin resistance and its relationship to clinical use.
  
  
  METHODS
  Consecutive, nonrepetitive, clinical isolates of Staphylococcus aureus (n = 98), and coagulase-negative staphylococci (CoNS) (n = 45) from skin and soft-tissue infections between January 2014 and June 2014 were studied. Antibiotic susceptibility testing was done according to Clinical and Laboratory Standards Institute guidelines. Low- and high-level mupirocin resistance was screened by using 5 µg and 200 µg discs respectively and confirmed by agar dilution. Annual consumption of mupirocin was studied and correlated with resistance.
  
  
  RESULTS
  High-level mupirocin resistance was found in 8.2% S. aureus and 15.6% of CoNS, while low-level mupirocin resistance was found in 17% S. aureus and 8.9% CoNS. High-level mupirocin resistance was more common in methicillin-sensitive S. aureus isolates when compared with methicillin-resistant S. aureus isolates (P < 0.05). Mupirocin resistant S. epidermidis were associated with methicillin resistance and constitutive clindamycin resistance.
  
  
  CONCLUSIONS
  High prevalence of mupirocin resistance was found in the present study. Increased prevalence of mupirocin resistance among community-acquired staphylococci demands the judicious use of the drug in the community.
authors.affiliation: Department of Microbiology, ESIC MC and PGIMSR, Rajajinagar, Bengaluru, Karnataka, India.
authors.forename: Manohar Shoorashetty
authors.initials: MS
authors.lastname: Rudresh
authors.affiliation: Department of Microbiology, ESIC MC and PGIMSR, Rajajinagar, Bengaluru, Karnataka, India.
authors.forename: Giriyapur Siddappa
authors.initials: GS
authors.lastname: Ravi
authors.affiliation: Department of Microbiology, ESIC MH, Indore, Madhya Pradesh, India.
authors.forename: Aravind
authors.initials: A
authors.lastname: Motagi
authors.affiliation: Department of Microbiology, ESIC MC and PGIMSR, Rajajinagar, Bengaluru, Karnataka, India.
authors.forename: Ann Mary
authors.initials: AM
authors.lastname: Alex
authors.affiliation: Department of Microbiology, ESIC MC and PGIMSR, Rajajinagar, Bengaluru, Karnataka, India.
authors.forename: Parthasarathi
authors.initials: P
authors.lastname: Sandhya
authors.affiliation: Department of Microbiology, ESIC MC and PGIMSR, Rajajinagar, Bengaluru, Karnataka, India.
authors.forename: Bangalore Viswanath
authors.initials: BV
authors.lastname: Navaneeth
keywords: Coagulase-negative staphylococci; Staphylococus aureus; methicillin resistant Staphylococcus aureus; methicillin sensitive Staphylococcus aureus; mupirocin resistance