MINIMUM INHIBITORY CONCENTRATION LEVELS OF MUPIROCIN BY E-TEST AMONG STAPHYLOCOCCUS AUREUS ISOLATES AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN

Authors

  • UMAMAHESWARI JAGADEESAN Department of Microbiology, Indira Gandhi Medical College and Research Institute, Puducherry, India https://orcid.org/0000-0001-6387-2832
  • JAYAVARTHINNI MANAVALAN Department of Microbiology, Indira Gandhi Medical College and Research Institute, Puducherry, India https://orcid.org/0000-0002-2766-6422
  • ROOBHINI SRI NSK Department of Microbiology, Indira Gandhi Medical College and Research Institute, Puducherry, India https://orcid.org/0000-0003-2551-8749
  • NANDITA BANAJI Department of Microbiology, Indira Gandhi Medical College and Research Institute, Puducherry, India https://orcid.org/0000-0001-5528-4985

DOI:

https://doi.org/10.22159/ijpps.2023v15i5.47638

Keywords:

Staphylococcus aureus, Methicillin resistant Staphylococcus aureus (MRSA), Mupirocin resistance, Minimum inhibitory concentration (MIC), Low-level mupirocin resistance (MupRL), High-level mupirocin resistance (MupRH)

Abstract

Objective: This study was done to evaluate the susceptibility of Staphylococcus aureus to mupirocin and to determine the antimicrobial susceptibility pattern of Staphylococcus aureus among various clinical isolates.

Methods: All the consecutive, non-duplicative Staphylococcus aureus isolates collected during the year 2020 were subjected to the disk diffusion method to evaluate the antimicrobial susceptibility pattern and were stocked. Mupirocin susceptibility for all stocked Staphylococcus aureus was detected by Minimal inhibitory concentration (MIC) determination by Epsilometer test (E-test).

Results: The total number of Staphylococcus aureus was 52. The maximum number of Staphylococcus aureus was isolated from pus sample 40 (76.9%). Among the 52 isolates, 26 (50%) were found to be methicillin-resistant Staphylococcus aureus (MRSA). All the isolates were susceptible to tetracycline (100%), vancomycin (100%), teicoplanin (100%), and linezolid (100%). By E-test, the overall prevalence of mupirocin resistance was 63.5%. Low-level Mupirocin resistance (MupRL) of 8-256 µg/ml was 59.6% and high-level mupirocin resistance (MupRH) of ≥512 µg/ml was 3.9%.

Conclusion: The present study shows a high prevalence of mupirocin resistance (63.5%) which is a serious concern. Therefore, indiscriminate use of topical mupirocin in carriers is not advisable. It may be recommended only in case of an outbreak of skin and soft tissue infection attributed to Staphylococcus aureus.

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References

Procop GW, Chruch DL, Hall GS, Janda WM, Koneman EW, Schreckenberger PC. Koneman’s color atlas and textbook of diagnostic microbiology. 7th ed. Philadelphia: Wolters Kluwer Health; 2017.

Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015 Jul;28(3):603-61. doi: 10.1128/CMR.00134-14, PMID 26016486, PMCID PMC4451395.

Ansari S, Jha RK, Mishra SK, Tiwari BR, Asaad AM. Recent advances in Staphylococcus aureus infection: focus on vaccine development. Infect Drug Resist. 2019 May 13;12:1243-55. doi: 10.2147/IDR.S175014. PMID 31190912, PMCID PMC6526327.

Mukhopadyay C, Devi ES, Nayak BS. Methicillin-resistant Staphylococcus aureus carriage among health-care professionals of a tertiary care hospital. TL Bhat AK, H MH. Asian J Pharm Clin Res. 2018 Mar 1;11(3):346-9. doi: 10.22159/ajpcr.2018. v11i3.23151.

Khoshnood S, Heidary M, Asadi A, Soleimani S, Motahar M, Savari M. A review on the mechanism of action, resistance, synergism, and clinical implications of mupirocin against Staphylococcus aureus. Biomed Pharmacother. 2019 Jan;109:1809-18. doi: 10.1016/j.biopha.2018.10.131. PMID 30551435.

Tiewsoh JBA, Dias M. Screening of methicillin-resistant Staphylococcus aureus in healthcare workers and students and its susceptibility to mupirocin in a tertiary care teaching hospital in South India. J Lab Physicians. 2017 Oct-Dec;9(4):239-42. doi: 10.4103/0974-2727.214262, PMID 28966483, PMCID PMC5607750.

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 Jan 7;98-100. doi: 10.22159/ajpcr.2018. v12i1.21183.

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 Nov;12(22):82-5, doi: 10.31782/IJCRR.2020.12225.

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 Jul-Dec;7(2):103-7. doi: 10.4103/0974-2727.163127, PMID 26417160, PMCID PMC4559621.

Rajkumar S, Sistla S, Manoharan M, Sugumar M, Nagasundaram N, Parija SC. Prevalence and genetic mechanisms of antimicrobial resistance in Staphylococcus species: a multicentre report of the Indian Council of Medical Research antimicrobial resistance surveillance network. Indian J Med Microbiol. 2017 Jan-Mar;35(1):53-60. doi: 10.4103/ ijmm.IJMM_16_427. PMID 28303819.

Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA. Manual of clinical microbiology. 9th ed. Washington DC: ASM Press; 2007.

Performance standards for antimicrobial susceptibility testing; 30th Informational Supplement, Clinical and Laboratory Standards Institute [CLSI] M100-S30. Vol. 40, No.1. Wayne, PA: Clinical and Laboratory Standards Institute; 2020.

Performance standards for antimicrobial susceptibility testing; 28th Informational Supplement, Clinical and Laboratory Standards Institute [CLSI] M100-S28. Vol. 38, No.3. Wayne, PA: Clinical and Laboratory Standards Institute; 2018.

Mohanty S, Behera B, Sahu S, Praharaj AK. Recent pattern of antibiotic resistance in Staphylococcus aureus clinical isolates in Eastern India and the emergence of reduced susceptibility to vancomycin. J Lab Physicians. 2019 Oct-Dec;11(4):340-5. doi: 10.4103/JLP.JLP_39_19. PMID 31929701, PMCID PMC6943858.

Chavadi M, Narasanna R, Chavan A, Oli AK, Kelmani RC. Prevalence of methicillin-resistant and virulence determinants in clinical isolates of Staphylococcus aureus. Open Infect Dis J. 2018 Aug 13;10(1):108-15. doi: 10.2174/ 1874279301810010108.

Indian council of medical research, division of epidemiology and communicable diseases, antimicrobial resistance research and surveillance network. Annual report; Jan 2021. Available from: https://main.icmr.nic;in/sites/default/files/ upload_documents/AMR_Annual_Report_2021.pdf. [Last accessed on 10 Dec 2021].

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. N Am J Med Sci. 2014 Aug;6(8):403-7. doi: 10.4103/1947-2714.139293, PMID 25210674, PMCID PMC4158649.

Rajaduraipandi K, Mani KR, Panneerselvam K, Mani M, Bhaskar M, Manikandan P. Prevalence and antimicrobial susceptibility pattern of methicillin-resistant staphylococcus aureus: a multicentre study. Indian J Med Microbiol. 2006 Jan;24(1):34-8. doi: 10.4103/0255-0857.19892, PMID 16505553.

Shukla S, Pant H, Singh AK, Singh RP. Prevalence of mupirocin resistance in clinical isolates of Staphylococcus aureus in a tertiary care Hospital. East Afr Scholars J Sci. 2019 Dec;2(12):727-9. doi: 10.36349/EASMS.2019.v02i12.011.

Published

01-05-2023

How to Cite

JAGADEESAN, U., J. MANAVALAN, R. SRI NSK, and N. BANAJI. “MINIMUM INHIBITORY CONCENTRATION LEVELS OF MUPIROCIN BY E-TEST AMONG STAPHYLOCOCCUS AUREUS ISOLATES AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 15, no. 5, May 2023, pp. 24-27, doi:10.22159/ijpps.2023v15i5.47638.

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