Virgillio Ariana M, Felton Emily A, Jackson Jessica K, Kennedy Sarah J, Becker Deanna N, Lima Amorce, Atrubin Kimberly, Cella Eleonora, Azarian Taj, Silbert Suzane, Shaw Lindsey N, Kim Kami
Division of Infectious Disease and International Medicine, University of South Florida, Tampa, Florida, USA.
Center for Antimicrobial Resistance, University of South Florida, Tampa, Florida, USA.
Open Forum Infect Dis. 2025 Jul 15;12(7):ofaf374. doi: 10.1093/ofid/ofaf374. eCollection 2025 Jul.
Colonization with is a risk factor for subsequent infection. Decolonization with the topical antibiotic mupirocin is effective and reduces the risk of subsequent infection for both methicillin-sensitive and methicillin-resistant (MRSA) strains but may select for mupirocin-resistant isolates.
We characterized oxacillin and mupirocin susceptibility amongst 384 strains isolated from clinical samples isolated in 2017-2023 in Tampa, Florida, spanning strains collected before and after the onset of the coronavirus disease 2019 (COVID-19) pandemic. Whole genome sequencing of bacterial isolates was conducted in parallel and correlated with drug susceptibility profiles.
Mupirocin resistance (MupR) was nearly exclusively present in MRSA strains (103/106, 97.1% of MupR; 103/299, 34.4% of MRSA). Although our hospital protocol for decolonization shifted to povidone iodine in the post-COVID period, the overall prevalence of MupR did not change in pre-COVID and post-COVID samples (28.9% vs 26%). Genotype correlated with antibiotic susceptibility with low-level MupR, linked to mutations in and high-level MupR, linked to the presence of . Genome analysis revealed that most MupR strains fell into 3 sequence types (ST) falling into 2 major clonal complexes (CC): CC8 ST8 (including community-associated MRSA strains USA300 and USA500), CC5 ST5 (associated with healthcare-associated MRSA such as USA100), and CC5 ST3390. ST3390 isolates had the highest prevalence of MupR (30/36 83%; high-level MupR 20/36 55.6%; low-level MupR 10/36 27.8%).
Mupirocin resistance was prevalent in our hospital MRSA strains. We also found evidence for emergence and persistence of ST3390 MRSA-MupR strains in Florida.
金黄色葡萄球菌定植是后续感染的一个风险因素。使用外用抗生素莫匹罗星进行去定植是有效的，可降低甲氧西林敏感和耐甲氧西林（MRSA）菌株后续感染的风险，但可能会选择出耐莫匹罗星的分离株。
我们对2017年至2023年在佛罗里达州坦帕市从临床样本中分离出的384株金黄色葡萄球菌菌株的苯唑西林和莫匹罗星敏感性进行了表征，这些菌株跨越了2019冠状病毒病（COVID-19）大流行开始前后收集的菌株。对细菌分离株进行了全基因组测序，并与药敏谱相关联。
耐莫匹罗星（MupR）几乎仅存在于MRSA菌株中（103/106，占MupR的97.1%；103/299，占MRSA的34.4%）。尽管我们医院在COVID后时期的去定植方案改为聚维酮碘，但耐莫匹罗星在COVID前和COVID后样本中的总体患病率没有变化（28.9%对26%）。基因型与抗生素敏感性相关，低水平MupR与 中的突变有关，高水平MupR与 的存在有关。基因组分析显示，大多数耐莫匹罗星菌株属于3种序列类型（ST），分为2个主要克隆复合体（CC）：CC8 ST8（包括社区相关MRSA菌株USA300和USA500）、CC5 ST5（与医疗保健相关MRSA如USA100相关）和CC5 ST3390。ST3390分离株的耐莫匹罗星患病率最高（30/36，83%；高水平MupR 20/36，55.6%；低水平MupR 10/36，27.8%）。
耐莫匹罗星在我们医院的MRSA菌株中很普遍。我们还发现了佛罗里达州ST3390 MRSA-MupR菌株出现和持续存在的证据。
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