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Trends in mupirocin resistance in Europe and USA among 13,087 staphylococcal and S pyogenes isolates



Trends in mupirocin resistance in Europe and USA among 13,087 staphylococcal and S pyogenes isolates



Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 43: 144



Background: Resistance (R) to the topical agent mupirocin (MUP) has been described as increasing in various geographic areas where clinical use is high. Two levels of R (low, MIC >8-256; high, MIC >256 mug/ml) occur, but routine susceptibility (S) testing has rarely been applied. Methods: The SENTRY Antimicrobial Surveillance Program monitored for MUP-R from 2000-2002 (>60 medical centers) in Europe (EU) and North America (NA). All S testing was by reference NCCLS methods and results for S. aureus (SA; 9,808), coag.-neg. staphylococci (CoNS; 3,006) and S. pyogenes (SPYO; 273) were analyzed by region, year and community-acquired (CA) versus nosocomial (NOS) origin. R strains were screened for high-level patterns by Etest (AB BIODISK) strips. Results: MUP activity against nosocomial isolates (6,484 strains). MUP-R rates among CA isolates (6,303 strains) were: for EU (CoNS, 16.3%; SA, 2.5%) and for USA (CoNS, 31.2%; SA, 4.7%). MUP-R in SA and CoNS increased in the EU, variable in USA. All SPYO strains were MUP-S. High-level MUP-R was noted in approximately half of all R isolates. Conclusions: Significant MUP-R was detected in EU and USA in CoNS (16.3-40.7%) and SA (2.5-8.8%) varying by geography (USA>EU), infection origin (NOS>CA) and year (increasing in EU). A continued stepwise increase in R of staphylococci, especially SA, to MUP may eventually limit its effectiveness as a topical agent. Continued surveillance (SENTRY Program) of topically applied agents should guide selection of those most active.

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Accession: 035985439

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