Upton A, Lang S, Heffernan H
Department of Infectious Diseases, Auckland Hospital, Private Bag 92024, Auckland, New Zealand.
J Antimicrob Chemother. 2003 Mar;51(3):613-7. doi: 10.1093/jac/dkg127.
To describe trends in mupirocin resistance among Staphylococcus aureus in New Zealand (NZ), following the availability of mupirocin in 1986.
Data from a variety of sources were used for this study: susceptibility data collected annually from diagnostic laboratories throughout NZ; a local survey of mupirocin-resistant S. aureus in the Auckland area in 1997; a national survey of S. aureus antimicrobial susceptibility in 1999; and the national methicillin-resistant S. aureus (MRSA) surveillance programme.
All data sources show that there was a steady increase in mupirocin resistance among S. aureus throughout the 1990s, and rates in NZ are now markedly higher than those reported in most other comparable countries. By 1999, resistance averaged 28%, with higher rates among community-acquired compared with hospital-acquired isolates, and with a wide geographical variation in resistance. Resistance was more common among S. aureus generally than MRSA.
We postulate that the steady rise in mupirocin resistance among S. aureus in NZ throughout the 1990s may be due, at least in part, to the over the counter availability of mupirocin from 1991 to 2000. The current patterns of mupirocin consumption need to be reviewed and its use rationalized to maximize the chances of this antibiotic retaining beneficial antistaphylococcal activity.
描述1986年莫匹罗星在新西兰上市后，金黄色葡萄球菌对莫匹罗星的耐药性趋势。
本研究使用了来自多种来源的数据：每年从新西兰各地诊断实验室收集的药敏数据；1997年对奥克兰地区耐莫匹罗星金黄色葡萄球菌的局部调查；1999年对金黄色葡萄球菌抗菌药敏的全国性调查；以及全国耐甲氧西林金黄色葡萄球菌（MRSA）监测计划。
所有数据来源均显示，在整个20世纪90年代，金黄色葡萄球菌对莫匹罗星的耐药性稳步上升，新西兰的耐药率现在明显高于大多数其他可比国家报告的耐药率。到1999年，耐药率平均为28%，社区获得性分离株的耐药率高于医院获得性分离株，且耐药性存在广泛的地域差异。金黄色葡萄球菌的耐药性一般比MRSA更常见。
我们推测，20世纪90年代新西兰金黄色葡萄球菌对莫匹罗星耐药性的稳步上升，至少部分原因可能是1991年至2000年莫匹罗星可在柜台购买。目前莫匹罗星的消费模式需要重新审视，其使用需要合理化，以最大限度地提高这种抗生素保持有益抗葡萄球菌活性的机会。
