Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia
The prevalence and spread of mupirocin and antiseptic resistance among colonizing and infectious Staphylococcus aureus were determined. S. aureus isolated from anterior nares and infection sites of patients hospitalized in the largest tertiary care referral hospital in Malaysia was investigated for...
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2014
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| Online Access: | http://psasir.upm.edu.my/id/eprint/34503/ http://psasir.upm.edu.my/id/eprint/34503/1/Methicillin-susceptible%20and%20-resistant%20Staphylococcus%20aureus%20with%20high-level%20antiseptic%20and%20low-level%20mupirocin%20resistance%20in%20Malaysia.pdf |
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| author | Moghaddam, Hamed Ghasemzadeh Belkum, Alex van Awang Hamat, Rukman Wamel, Willem van Neela, Vasanthakumari |
| author_facet | Moghaddam, Hamed Ghasemzadeh Belkum, Alex van Awang Hamat, Rukman Wamel, Willem van Neela, Vasanthakumari |
| author_sort | Moghaddam, Hamed Ghasemzadeh |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | The prevalence and spread of mupirocin and antiseptic resistance among colonizing and infectious Staphylococcus aureus were determined. S. aureus isolated from anterior nares and infection sites of patients hospitalized in the largest tertiary care referral hospital in Malaysia was investigated for mupirocin and antiseptic susceptibility testing, and for PCR detection of mupA, qacA/B, and smr genes. Twelve isolates showed resistance to mupirocin by disk diffusion, of which 10 (3.8%) harbored the mupA gene. Minimum inhibitory concentrations (MICs) ranged from 64 to 768 μg/ml for mupA positive and below 46 μg/ml for negative isolates. The mupA was more common among ST239 isolates (70%). The qacA/B was carried in 67 out of 95 methicillin-resistant Staphylococcus aureus (MRSA) (70.5%) and 3 out of 164 methicillin-susceptible Staphylococcus aureus (MSSA) (1.8%), while smr was carried in 6 out of 95 MRSA (6.3%) strains. MICs ranged from 3.9 to 15.6 μg/ml for benzethonium chloride (BTC) and benzalkonium chloride (BKC), and from 10.3 to 20.7 μg/ml for chlorhexidine digluconate (CHG). Isolates with qacA/B and smr or qacA/B alone showed higher MIC (20.7 μg/ml for CHG and 15.6 μg/ml for BTC and BKC) than the isolates that lacked antiseptic resistance genes (10.3 μg/ml for CHG and 3.9 μg/ml for BTC and BKC). In 16 cases, ST239 was isolated from the infection site and the nares simultaneously, and shared identical resistance patterns (qacAB or qacAB+smr), suggesting possible endogenous infection. Spread of low-level mupirocin resistance expressing ST239 MRSA and high-level resistance expressing emerging ST1, co-existing with antiseptic-resistant genes showing elevated MICs, should be monitored for effective infection control. |
| first_indexed | 2025-11-15T09:24:13Z |
| format | Article |
| id | upm-34503 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T09:24:13Z |
| publishDate | 2014 |
| publisher | Mary Ann Liebert |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-345032016-09-19T02:22:03Z http://psasir.upm.edu.my/id/eprint/34503/ Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia Moghaddam, Hamed Ghasemzadeh Belkum, Alex van Awang Hamat, Rukman Wamel, Willem van Neela, Vasanthakumari The prevalence and spread of mupirocin and antiseptic resistance among colonizing and infectious Staphylococcus aureus were determined. S. aureus isolated from anterior nares and infection sites of patients hospitalized in the largest tertiary care referral hospital in Malaysia was investigated for mupirocin and antiseptic susceptibility testing, and for PCR detection of mupA, qacA/B, and smr genes. Twelve isolates showed resistance to mupirocin by disk diffusion, of which 10 (3.8%) harbored the mupA gene. Minimum inhibitory concentrations (MICs) ranged from 64 to 768 μg/ml for mupA positive and below 46 μg/ml for negative isolates. The mupA was more common among ST239 isolates (70%). The qacA/B was carried in 67 out of 95 methicillin-resistant Staphylococcus aureus (MRSA) (70.5%) and 3 out of 164 methicillin-susceptible Staphylococcus aureus (MSSA) (1.8%), while smr was carried in 6 out of 95 MRSA (6.3%) strains. MICs ranged from 3.9 to 15.6 μg/ml for benzethonium chloride (BTC) and benzalkonium chloride (BKC), and from 10.3 to 20.7 μg/ml for chlorhexidine digluconate (CHG). Isolates with qacA/B and smr or qacA/B alone showed higher MIC (20.7 μg/ml for CHG and 15.6 μg/ml for BTC and BKC) than the isolates that lacked antiseptic resistance genes (10.3 μg/ml for CHG and 3.9 μg/ml for BTC and BKC). In 16 cases, ST239 was isolated from the infection site and the nares simultaneously, and shared identical resistance patterns (qacAB or qacAB+smr), suggesting possible endogenous infection. Spread of low-level mupirocin resistance expressing ST239 MRSA and high-level resistance expressing emerging ST1, co-existing with antiseptic-resistant genes showing elevated MICs, should be monitored for effective infection control. Mary Ann Liebert 2014 Article PeerReviewed application/pdf en http://psasir.upm.edu.my/id/eprint/34503/1/Methicillin-susceptible%20and%20-resistant%20Staphylococcus%20aureus%20with%20high-level%20antiseptic%20and%20low-level%20mupirocin%20resistance%20in%20Malaysia.pdf Moghaddam, Hamed Ghasemzadeh and Belkum, Alex van and Awang Hamat, Rukman and Wamel, Willem van and Neela, Vasanthakumari (2014) Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia. Microbial Drug Resistance, 20 (5). pp. 472-477. ISSN 1076-6294; ESSN: 1931-8448 http://online.liebertpub.com/doi/abs/10.1089/mdr.2013.0222 10.1089/mdr.2013.0222 |
| spellingShingle | Moghaddam, Hamed Ghasemzadeh Belkum, Alex van Awang Hamat, Rukman Wamel, Willem van Neela, Vasanthakumari Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia |
| title | Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia |
| title_full | Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia |
| title_fullStr | Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia |
| title_full_unstemmed | Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia |
| title_short | Methicillin-susceptible and -resistant Staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in Malaysia |
| title_sort | methicillin-susceptible and -resistant staphylococcus aureus with high-level antiseptic and low-level mupirocin resistance in malaysia |
| url | http://psasir.upm.edu.my/id/eprint/34503/ http://psasir.upm.edu.my/id/eprint/34503/ http://psasir.upm.edu.my/id/eprint/34503/ http://psasir.upm.edu.my/id/eprint/34503/1/Methicillin-susceptible%20and%20-resistant%20Staphylococcus%20aureus%20with%20high-level%20antiseptic%20and%20low-level%20mupirocin%20resistance%20in%20Malaysia.pdf |