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KMID : 0364820120480020093
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Korean Journal of Microbiology
2012 Volume.48 No. 2 p.93 ~ p.101
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Resistance Determinants and Antimicrobial Susceptibilities of Mupirocin-Resistant Staphylococci Isolated from a Korean Hospital
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Min Yu-Hong
Lee Jong-Seo
Kwon Ae-Ran
Shim Mi-Ja
Choi Eung-Chil
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Abstract
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We analyzed mupirocin resistance rates among staphylococcal isolates collected from a Korean hospital in 2003 (100
isolates), 2005 (195 isolates), 2006 (151 isolates), and 2009 (112 isolates). In Staphylococcus aureus, rates of
high-level mupirocin resistance (MIC, minimal inhibitory concentration ≥512 μg/ml) decreased and did not appear
since 2005. In contrast, low-level mupirocin resistance (MIC 8?256 μg/ml) was not detected in 2003 and 2005 but its
rates later increased to 6.9% in 2009. Total resistance rates of coagulase-negative staphylococci (CNS) were
significantly higher than those of S. aureus. The rates of high-level resistance of CNS increased from 16.0% in 2003
to 31.5% in 2009. The rate of low-level resistance of CNS was 8.0% in 2003 and around 11% later. In all high-level
resistant isolates, the ileS-2 gene was detected. All low-level resistant isolates contained the known V588F mutation
in ileS gene. Previously unknown mutations such as V458G in S. aureus and D172A, Y490H and I750V in CNS were
identified additionally. One S. aureus isolate with high-level resistance was resistant to oxacillin and several topical
antibiotics commonly used for the treatment of skin infection. Ten S. aureus isolates with low-level resistance were
also resistant to all of these antibiotics except fusidic acid. CNS isolates with high-level (61 isolates) and low-level
resistance (27 isolates) exhibited significantly higher resistance rates to these antibiotics than mupirocin-susceptible
CNS isolates (167 isolates). In conclusion, prevention of the emergence of mupirocin resistance is necessary for the
effective treatment of skin infection by staphylococci.
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KEYWORD
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Staphylococcus aureus, coagulase-negative staphylococci, mupirocin, resistance
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