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三级护理医院皮肤感染葡萄球菌分离株中莫匹罗星高、低水平耐药的患病率

Prevalence of High and Low Level Mupirocin Resistance among Staphylococcal Isolates from Skin Infection in a Tertiary Care Hospital.

作者信息

S Jayakumar, M Meerabai, A S Shameem Banu, Mathew Renu, M Kalyani, Lal Y Binesh

机构信息

Department of Microbiology, Saveetha Medical College & Hospital, Saveetha University , Thandalam, Kancheepuram District-602 105, Tamilnadu, India .

出版信息

J Clin Diagn Res. 2013 Feb;7(2):238-42. doi: 10.7860/JCDR/2013/4694.2736. Epub 2013 Feb 1.

Abstract

BACKGROUND

Mupirocin has been used for the treatment of skin infections and for the eradication of the nasal carriage of Methicillin -resistant Staphylococcus aureus (MRSA). The increased use of this antibiotic has been accompanied by its resistance, resulting in treatment failures.

OBJECTIVE

This study was aimed at determining the prevalences of low and high level Mupirocin resistance among the clinical isolates of Staphylococcus species which were obtained from pyogenic infections.

MATERIAL AND METHOD

Clinical samples such as wound swabs, tissues and pus which were submitted to the microbiology laboratory during a period of six months were screened for the growth of Staphylococcus species, which were identified as Staphylococcus aureus and Coagulase negative Staphylococcus species by the routine microbiological procedures. All the isolates were tested for their Mupirocin susceptibilities by using 5 and 200 μg discs and their resistance was confirmed from their Minimum Inhibitory Concentrations (MICs).

RESULT

Out of 400 samples, 150 samples grew Staphylococcus species, of which 113 were Staphylococcus aureus and 37 were Coagulase negative Staphylococcus (CoNS). Only 5(3.3%) mupirocin resistant Staphylococcus species: three high level and two low level strains were detected. The MICs for the two low level and three high level Mupirocin resistant strains were 256 mg/L and ≥512mg/L each respectively.

CONCLUSION

We conclude that the screening for mupirocin resistance, in terms of high-level and low-level resistance among the Staphylococcus species from patients with skin and soft tissue infections is warranted and that it is important for the clinicians in selecting the appropriate, empirical, topical, antimicrobial therapy. It also provides useful information about the prevalence of these resistant pathogens.

摘要

背景

莫匹罗星已被用于治疗皮肤感染以及根除耐甲氧西林金黄色葡萄球菌(MRSA)的鼻腔携带菌。这种抗生素使用的增加伴随着耐药性的产生,导致治疗失败。

目的

本研究旨在确定从化脓性感染中分离出的葡萄球菌临床菌株中低水平和高水平莫匹罗星耐药的发生率。

材料与方法

对六个月期间提交至微生物实验室的伤口拭子、组织和脓液等临床样本进行葡萄球菌生长情况筛查,通过常规微生物学程序将其鉴定为金黄色葡萄球菌和凝固酶阴性葡萄球菌。使用5μg和200μg的药敏纸片对所有分离株进行莫匹罗星敏感性测试,并通过其最低抑菌浓度(MIC)确认耐药情况。

结果

在400份样本中,150份样本培养出葡萄球菌,其中113份为金黄色葡萄球菌,37份为凝固酶阴性葡萄球菌(CoNS)。仅检测到5株(3.3%)对莫匹罗星耐药的葡萄球菌:3株高水平耐药和2株低水平耐药菌株。两株低水平和三株高水平莫匹罗星耐药菌株的MIC分别为256mg/L和≥512mg/L。

结论

我们得出结论,对皮肤和软组织感染患者的葡萄球菌进行莫匹罗星耐药性筛查,包括高水平和低水平耐药,是有必要的,这对于临床医生选择合适的经验性局部抗菌治疗非常重要。它还提供了有关这些耐药病原体流行情况的有用信息。

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