PMID- 22760047
OWN - NLM
STAT- MEDLINE
DCOM- 20130103
LR  - 20220331
IS  - 1098-660X (Electronic)
IS  - 0095-1137 (Print)
IS  - 0095-1137 (Linking)
VI  - 50
IP  - 9
DP  - 2012 Sep
TI  - Emergence of high-level mupirocin resistance in coagulase-negative staphylococci 
      associated with increased short-term mupirocin use.
PG  - 2947-50
LID - 10.1128/JCM.00302-12 [doi]
AB  - In our hospital, mupirocin has increasingly been used for peri-operative 
      decolonization of Staphylococcus aureus. The target for mupirocin is isoleucyl 
      tRNA synthetase (ileS). High-level resistance to mupirocin is conferred by 
      acquisition of plasmids expressing a distinct ileS gene (ileS2). Here we 
      evaluated the longitudinal trends in high-level mupirocin resistance in 
      coagulase-negative staphylococci (CoNS) and linked this to the presence of ileS2 
      genes and mupirocin use. We assessed mupirocin resistance in CoNS bloodstream 
      isolates from 2006 to 2011 tested by Phoenix automated testing (PAT). We 
      evaluated the reliability of PAT results using Etest. PAT species determination 
      was confirmed by MALDI-TOF (matrix-assisted laser desorption ionization-time of 
      flight) mass spectrometry. We investigated the presence of ileS2 in the first 100 
      consecutive CoNS bloodstream isolates of each year using RT-PCR. Mupirocin use 
      increased from 3.6 kg/year in 2006 to 13.3 kg/year in 2010 and correlated with 
      the increase in the percentage of CoNS isolates carrying ileS2 (8% in 2006 to 22% 
      in 2011; Spearman's rho, 0.137; P = 0.01). The sensitivity and specificity of PAT 
      for detecting high-level mupirocin resistance were 0.97 and 0.97, respectively. 
      ileS2 was detected in 81 of 82 phenotypically highly mupirocin-resistant strains 
      and associated with resistance to ciprofloxacin, erythromycin, and clindamycin. 
      In conclusion, we found a rapid increase in high-level resistance to mupirocin 
      and resistance to other antibiotics in CoNS associated with an increase in 
      mupirocin use. The associated resistance to other antibiotics may result in a 
      reduction of oral antibiotic options for prolonged treatment of prosthetic 
      infections with CoNS.
FAU - Bathoorn, Erik
AU  - Bathoorn E
AD  - Department of Clinical Microbiology, University Medical Center, Utrecht, the 
      Netherlands. d.bathoorn@umcutrecht.nl
FAU - Hetem, David J
AU  - Hetem DJ
FAU - Alphenaar, Jeriela
AU  - Alphenaar J
FAU - Kusters, Johannes G
AU  - Kusters JG
FAU - Bonten, Marc J M
AU  - Bonten MJ
LA  - eng
PT  - Journal Article
DEP - 20120703
PL  - United States
TA  - J Clin Microbiol
JT  - Journal of clinical microbiology
JID - 7505564
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Coagulase)
RN  - D0GX863OA5 (Mupirocin)
RN  - EC 6.1.1.5 (Isoleucine-tRNA Ligase)
SB  - IM
MH  - Anti-Bacterial Agents/*pharmacology/therapeutic use
MH  - Bacteremia/microbiology
MH  - Blood/microbiology
MH  - Coagulase/*metabolism
MH  - *Drug Resistance, Bacterial
MH  - Humans
MH  - Isoleucine-tRNA Ligase/genetics
MH  - Microbial Sensitivity Tests/methods
MH  - Mupirocin/*pharmacology/therapeutic use
MH  - Plasmids
MH  - Sensitivity and Specificity
MH  - Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods
MH  - Staphylococcal Infections/microbiology
MH  - Staphylococcus/*drug effects/enzymology/isolation & purification
PMC - PMC3421826
EDAT- 2012/07/05 06:00
MHDA- 2013/01/04 06:00
PMCR- 2013/03/01
CRDT- 2012/07/05 06:00
PHST- 2012/07/05 06:00 [entrez]
PHST- 2012/07/05 06:00 [pubmed]
PHST- 2013/01/04 06:00 [medline]
PHST- 2013/03/01 00:00 [pmc-release]
AID - JCM.00302-12 [pii]
AID - 00302-12 [pii]
AID - 10.1128/JCM.00302-12 [doi]
PST - ppublish
SO  - J Clin Microbiol. 2012 Sep;50(9):2947-50. doi: 10.1128/JCM.00302-12. Epub 2012 
      Jul 3.