Prevalence of mupirocin resistant (mupA) gene in S. aureus isolates from two tertiary care hospitals of Punjab

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Raza Mustafa
Muhammad Shaheen Iqbal
Farheen Ansari
Muhammad Sohail
Karam Rasool
Muhammad Omer

Abstract

Introduction: Mupirocin is a topical ointment and de-colonizing agent, used to reduce the burden of Staphylococcus aureus from nasal nares. Unjudiciary use of mupirocin has resulted in the emergence of resistance mediated by a gene mupA found to be associated with high-level mupirocin (HLMup R) resistance. The objectives of this study were to find out the prevalence of MRSA/MSSA, mupA gene, and antimicrobial resistance among burn patients and outdoor patients.


Material and Methods: A total of 238 non-repetitive specimens were collected from nasal nares and burn wounds of patients in two tertiary care hospitals. S. aureus was isolated by conventional biochemical and molecular methods. Prevalence of resistance gene and antimicrobial susceptibility were identified by PCR and Kirby Bauer disk diffusion method respectively.


Results: The prevalence of MRSA was 13% (32/238) and MSS 29% (70/238). We screened 102 isolates for the mupA gene and found 21 MRSA and 12 MSSA with a total of 33 isolates carrying this gene and the p-value was 0.0001. Most strains were found to be MDR.


Discussion and Conclusion: MRSA strains are prevailing in hospital environments whereas mupA gene carriage rate shows that antimicrobial use of mupirocin to decolonize bacteria needs to be minimized. Antimicrobial stewardship and closed surveillance may be regulated.

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