Emergence and spread of low-level mupirocin resistance in methicillin-resistant Staphylococcus aureus isolated from a community hospital in Japan
Emergence and spread of low-level mupirocin resistance in methicillin-resistant Staphylococcus aureus isolated from a community hospital in Japan
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DOI：
10.1053/jhin.2000.0931
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发表时间：
2001-04-01
影响因子：
6.9
通讯作者：
Nagatake, T
中科院分区：
文献类型：
--
作者：
Watanabe, H;Masaki, H;Nagatake, T
本研究的目的是调查日本一家社区医院耐甲氧西林金黄色葡萄球菌(MRSA)对莫匹罗星的耐药性。从日本引进莫匹罗星前的56例患者(第一组，1990年6月~1996年8月)的呼吸道分离出90株MRSA，并与应用莫匹罗星后的48例患者(第二组，1996年9月~1998年1月)的168株和85例患者(第三组，1999年2月~1999年12月)的146株进行比较。通过测定9种抗生素的最低抑菌浓度(MIC)进行比较。应用莫匹罗星后，27例患者的55株MRSA对莫匹罗星呈低水平耐药(MIC为6.25~50µg/ml)，对莫匹罗星敏感(MIC<3.13µg/ml)。大多数低水平耐莫匹罗星MRSA的患者是老年人(大于或等于65岁)，接受完全胃肠外营养或鼻饲，并有其他潜在疾病。经脉冲场凝胶电泳法(PFGE)分子分型，II组13株MRSA均为A、B、C三种模式，以A为主，而III组13株MRSA为A、C、C三种模式，以A、D为主。然而，我们应该意识到，未来可能会出现对莫匹罗星高度耐药的MRSA。(C)2001年医院感染学会。
The objective of this study was to investigate the state of mupirocin resistance in methicillin-resistant Staphylococcus aureus (MRSA) in a community hospital in Japan. Ninety strains of MRSA were isolated from the respiratory tract of 56 patients (group I, Jun 1990-Aug 1996) before introduction of mupirocin in Japan, which were compared with 168 strains from 48 patients (group II, Sept 1996-Jan 1998) and 146 strains from 85 patients (group III, Feb 1999-Dec 1999) isolated after introduction of mupirocin. Comparisons were made by determining the minimum inhibitory concentrations (MIC) against nine antibiotics. Fifty-five MRSA isolates from 27 patients [13 (27.1%) of 48 in group II and 14 (16.5%) of 85 in group III] after introduction of mupirocin showed low-level resistance to mupirocin (MIC, 6.25 to 50 mug/ml) but the remaining isolates were sensitive to mupirocin (MIC less than or equal to 3.13 mug/ml). Most patients colonized with low-level mupirocin-resistant MRSA were elderly(greater than or equal to 65 years of age), on total parenteral nutrition or nasal feeding and had other underlying diseases. The proportion of patients colonized with low-level mupirocin-resistant MRSA following repeated use of mupirocin was higher in patients of group II than those of group III. Molecular typing by pulsed-field gel electrophoresis (PFGE) demonstrated that the pattern of 13 MRSA isolates from 13 patients of group II consisted of three patterns (A, B, C) with predominance of pattern A, while the pattern of 13 MRSA isolates from 13 patients of group III consisted of three patterns (A, C, D) with predominance of patterns A and D. Our results indicated that resistance of MRSA to mupirocin remains at a low level at present in Japan. However, we should be aware of the possible emergence of MRSA highly resistant to mupirocin in the future. (C) 2001 The Hospital Infection Society.