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journal article May 01, 2003

Mupirocin-Resistant, Methicillin-ResistantStaphylococcus aureus: Does Mupirocin Remain Effective?

Elaine S. Walker Jose E. Vasquez Roy Dula Hollie Bullock Felix A. Sarubbi
Infection Control & Hospital Epidemiology Vol. 24 No. 5 pp. 342-346 · Cambridge University Press (CUP)
View at Publisher Save 10.1086/502218
Abstract
AbstractObjective:To determine the efficacy of mupirocin ointment in reducing nasal colonization with mupirocin-susceptible, methicillin-resistantStaphylococcus aureus(MS MRSA) as well as mupirocin-resistant MRSA (MR MRSA).Design:Prospective evaluation in which patients colonized with MRSA were treated twice daily with 2% topical mupirocin ointment for 5 days.Setting:James H. Quillen Veterans' Affairs Medical Center.Patients:Forty hospitalized patients with two anterior nares cultures positive for MRSA within a 7-day period.Methods:Treated patients had post-treatment cultures at day 3 and weeks 1,2, and 4. Isolates underwent mupirocin-susceptibility testing and DNA typing. MRSA clearance and type turnover were assessed for isolates that were mupirocin-susceptible, low-level (LL) MR MRSA and high-level (HL) MR MRSA.Results:Post-treatment nares cultures on day 3 were negative for 78.5%, 80%, and 27.7% of patients with MS MRSA, LL-MR MRSA, and HL-MR MRSA, respectively. Sustained culture negativity at 1 to 4 weeks was more common in the MS MRSA group (91%) than in the LL-MR MRSA group (25%) or the HL-MR MRSA group (25%). Positive post-treatment cultures usually showed the same DNA pattern relative to baseline. Plasmid curing of 18 HL-MR MRSA resulted in 15 MS MRSA and 3 LL-MR MRSA.Conclusions:Mupirocin was effective in eradicating MS MRSA, but strains of MR MRSA often persisted after treatment. This appeared to reflect treatment failure rather than exogenous recolonization. MR MRSA is now more prevalent and it is appropriate to sample MRSA populations for mupirocin susceptibility prior to incorporating mupirocin into infection control programs.
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References
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Journal of Hospital Infection
Metrics
117
Citations
36
References
Details
Published
May 01, 2003
Vol/Issue
24(5)
Pages
342-346
License
View
Authors
E
Elaine S. Walker
J
Jose E. Vasquez
R
Roy Dula
H
Hollie Bullock
F
Felix A. Sarubbi
Cite This Article
Elaine S. Walker, Jose E. Vasquez, Roy Dula, et al. (2003). Mupirocin-Resistant, Methicillin-ResistantStaphylococcus aureus: Does Mupirocin Remain Effective?. Infection Control & Hospital Epidemiology, 24(5), 342-346. https://doi.org/10.1086/502218
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