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Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia

The prevalence and spread of mupirocin and antiseptic resistance among colonizing and infectious Staphylococcus aureus were determined. S. aureus isolated from anterior nares and infection sites of patients hospitalized in the largest tertiary care referral hospital in Malaysia was investigated for...

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Main Authors: Moghaddam, Hamed Ghasemzadeh, Belkum, Alex van, Awang Hamat, Rukman, Wamel, Willem van, Neela, Vasanthakumari
Format: Article
Language:English
Published: Mary Ann Liebert 2014
Online Access:http://psasir.upm.edu.my/id/eprint/34503/1/Methicillin-susceptible%20and%20-resistant%20Staphylococcus%20aureus%20with%20high-level%20antiseptic%20and%20low-level%20mupirocin%20resistance%20in%20Malaysia.pdf
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spelling oai:psasir.upm.edu.my:34503 http://psasir.upm.edu.my/id/eprint/34503/ Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia Moghaddam, Hamed Ghasemzadeh Belkum, Alex van Awang Hamat, Rukman Wamel, Willem van Neela, Vasanthakumari The prevalence and spread of mupirocin and antiseptic resistance among colonizing and infectious Staphylococcus aureus were determined. S. aureus isolated from anterior nares and infection sites of patients hospitalized in the largest tertiary care referral hospital in Malaysia was investigated for mupirocin and antiseptic susceptibility testing, and for PCR detection of mupA, qacA/B, and smr genes. Twelve isolates showed resistance to mupirocin by disk diffusion, of which 10 (3.8%) harbored the mupA gene. Minimum inhibitory concentrations (MICs) ranged from 64 to 768 μg/ml for mupA positive and below 46 μg/ml for negative isolates. The mupA was more common among ST239 isolates (70%). The qacA/B was carried in 67 out of 95 methicillin-resistant Staphylococcus aureus (MRSA) (70.5%) and 3 out of 164 methicillin-susceptible Staphylococcus aureus (MSSA) (1.8%), while smr was carried in 6 out of 95 MRSA (6.3%) strains. MICs ranged from 3.9 to 15.6 μg/ml for benzethonium chloride (BTC) and benzalkonium chloride (BKC), and from 10.3 to 20.7 μg/ml for chlorhexidine digluconate (CHG). Isolates with qacA/B and smr or qacA/B alone showed higher MIC (20.7 μg/ml for CHG and 15.6 μg/ml for BTC and BKC) than the isolates that lacked antiseptic resistance genes (10.3 μg/ml for CHG and 3.9 μg/ml for BTC and BKC). In 16 cases, ST239 was isolated from the infection site and the nares simultaneously, and shared identical resistance patterns (qacAB or qacAB+smr), suggesting possible endogenous infection. Spread of low-level mupirocin resistance expressing ST239 MRSA and high-level resistance expressing emerging ST1, co-existing with antiseptic-resistant genes showing elevated MICs, should be monitored for effective infection control. Mary Ann Liebert 2014 Article PeerReviewed application/pdf en http://psasir.upm.edu.my/id/eprint/34503/1/Methicillin-susceptible%20and%20-resistant%20Staphylococcus%20aureus%20with%20high-level%20antiseptic%20and%20low-level%20mupirocin%20resistance%20in%20Malaysia.pdf Moghaddam, Hamed Ghasemzadeh and Belkum, Alex van and Awang Hamat, Rukman and Wamel, Willem van and Neela, Vasanthakumari (2014) Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia. Microbial Drug Resistance, 20 (5). pp. 472-477. ISSN 1076-6294; ESSN: 1931-8448 http://online.liebertpub.com/doi/abs/10.1089/mdr.2013.0222 10.1089/mdr.2013.0222
institution UPM IR
collection UPM IR
language English
description The prevalence and spread of mupirocin and antiseptic resistance among colonizing and infectious Staphylococcus aureus were determined. S. aureus isolated from anterior nares and infection sites of patients hospitalized in the largest tertiary care referral hospital in Malaysia was investigated for mupirocin and antiseptic susceptibility testing, and for PCR detection of mupA, qacA/B, and smr genes. Twelve isolates showed resistance to mupirocin by disk diffusion, of which 10 (3.8%) harbored the mupA gene. Minimum inhibitory concentrations (MICs) ranged from 64 to 768 μg/ml for mupA positive and below 46 μg/ml for negative isolates. The mupA was more common among ST239 isolates (70%). The qacA/B was carried in 67 out of 95 methicillin-resistant Staphylococcus aureus (MRSA) (70.5%) and 3 out of 164 methicillin-susceptible Staphylococcus aureus (MSSA) (1.8%), while smr was carried in 6 out of 95 MRSA (6.3%) strains. MICs ranged from 3.9 to 15.6 μg/ml for benzethonium chloride (BTC) and benzalkonium chloride (BKC), and from 10.3 to 20.7 μg/ml for chlorhexidine digluconate (CHG). Isolates with qacA/B and smr or qacA/B alone showed higher MIC (20.7 μg/ml for CHG and 15.6 μg/ml for BTC and BKC) than the isolates that lacked antiseptic resistance genes (10.3 μg/ml for CHG and 3.9 μg/ml for BTC and BKC). In 16 cases, ST239 was isolated from the infection site and the nares simultaneously, and shared identical resistance patterns (qacAB or qacAB+smr), suggesting possible endogenous infection. Spread of low-level mupirocin resistance expressing ST239 MRSA and high-level resistance expressing emerging ST1, co-existing with antiseptic-resistant genes showing elevated MICs, should be monitored for effective infection control.
format Article
author Moghaddam, Hamed Ghasemzadeh
Belkum, Alex van
Awang Hamat, Rukman
Wamel, Willem van
Neela, Vasanthakumari
spellingShingle Moghaddam, Hamed Ghasemzadeh
Belkum, Alex van
Awang Hamat, Rukman
Wamel, Willem van
Neela, Vasanthakumari
Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia
author_facet Moghaddam, Hamed Ghasemzadeh
Belkum, Alex van
Awang Hamat, Rukman
Wamel, Willem van
Neela, Vasanthakumari
author_sort Moghaddam, Hamed Ghasemzadeh
title Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia
title_short Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia
title_full Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia
title_fullStr Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia
title_full_unstemmed Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia
title_sort methicillin-susceptible and -resistant staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in malaysia
publisher Mary Ann Liebert
publishDate 2014
url http://psasir.upm.edu.my/id/eprint/34503/1/Methicillin-susceptible%20and%20-resistant%20Staphylococcus%20aureus%20with%20high-level%20antiseptic%20and%20low-level%20mupirocin%20resistance%20in%20Malaysia.pdf
_version_ 1819295694039547904
score 13.4562235

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