CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(03): 372-376
DOI: 10.1055/s-0042-1760672
Original Article

Comparison of Disk Diffusion and Agar Dilution Method for the Detection of Mupirocin Resistance in Staphylococcal Isolates from Skin and Soft Tissue Infections

1   Department of Microbiology, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India
,
Venkatesha Dasegowda
1   Department of Microbiology, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India
› Author Affiliations
Funding None.

Abstract

Aims and Objectives Mupirocin is a widely used topical antibiotic for the treatment of skin and soft tissue infections. This has resulted in resistance leading to treatment failure. Hence, the present study aimed to determine the prevalence of mupirocin resistance among staphylococcal isolates obtained from the skin and soft tissue infections. Also, comparison of disc diffusion and agar dilution method in detecting mupirocin resistance was done.

Materials and Methods This cross-sectional study was conducted in the Department of Microbiology of a tertiary health care center in Karnataka from January to December, 2018. Clinical samples such as wound swabs, tissues, and pus were included in the study. All staphylococcal isolates were screened for mupirocin resistance using 5 µg and 200 µg discs for low-level (MuL) and high-level mupirocin resistance (MuH), respectively. Minimum inhibitory concentration (MIC) was determined using the agar dilution method.

Results Out of 100 staphylococcal isolates, 68 were Staphylococcus aureus and 32 were CoNS. MuH was detected in 11 isolates. MuH was more common in CoNS (10/11) compared with S. aureus (1/11). MuL was not found in the study.

Discussion In our study, 10 out of 11 mupirocin-resistant isolates were methicillin resistant, which is statistically significant (p < 0.05). The correlation between results of disc diffusion and MIC were appropriate in this study.

Conclusion Judicial prescription of mupirocin after knowing the susceptibility report should become the standard practice. Screening for mupirocin resistance can be done by disc diffusion in resource-limited settings.



Publication History

Article published online:
18 January 2023

© 2023. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Oorett FA. The emergence of mupirocin resistance among clinical isolates of Methillin resistant Staphylococcus aureus in Trinidad: a first report. J Infect Dis 2008; 6 (12) 107-110
  • 2 Sutherland R, Boon RJ, Griffin KE, Masters PJ, Slocombe B, White AR. Antibacterial activity of mupirocin (pseudomonic acid), a new antibiotic for topical use. Antimicrob Agents Chemother 1985; 27 (04) 495-498
  • 3 Patel JB, Gorwitz RJ, Jernigan JA. Mupirocin resistance. Clin Infect Dis 2009; 49 (06) 935-941
  • 4 Moreira de Oliveira NE, Cardozo APCM, Marques EA, Netto Dos Santos KR, deMarval MG. Interpretive criteria to differentiate low- and high-level mupirocin resistance in Staphylococcus aureus. J Med Microbiol 2007; 56 (Pt 7): 937-939
  • 5 Collee JG, Marr W. Culture of bacteria. In: Collee JG, Fraser AG, Marmion BP, Simmons A. eds. Mackie and McCartney Practical Medical Microbiology, 14th ed. New York: Churchill Livingstone; 2006: 113-129
  • 6 Clinical and Laboratory Standards Institute [CLSI] M100–S28. Performance standards for antimicrobial susceptibility testing: 28th Informational Supplement; Wayne, PA: CLSI;2018
  • 7 Clinical and Laboratory Standards Institute [CLSI] M100–S28. Screening test for detection of high-level mupirocin resistance in Staphylococcus aureus: 28th Informational Supplement; Wayne, PA: CLSI; 2018
  • 8 Clinical and Laboratory Standards Institute [CLSI] M7–A9. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; 9th ed Wayne, PA: CLSI; 2018
  • 9 Rudresh MS, Ravi GS, Motagi A, Alex AM, Sandhya P, Navaneeth BV. Prevalence of mupirocin resistance among Staphylococci, its clinical significance and relationship to clinical use. J Lab Physicians 2015; 7 (02) 103-107
  • 10 Shivanna V, Kumar RN, Venkatesha D. The emergence of mupirocin resistance among the clinical isolates of Staphylococci in a rural tertiary health-care centre of South India. J Acad Clin Microbiol 2018; 20 (01) 14-18
  • 11 Gadepalli R, Dhawan B, Mohanty S. et al. Mupirocin resistance in Staphylococcus aureus in an Indian hospital. Diagn Microbiol Infect Dis 2007; 58 (01) 125-127
  • 12 Sanju AJ, Kopula SS, Palraj KK. Screening for mupirocin resistance in Staphylococcus . J Clin Diagn Res 2015; 9 (10) DC09-DC10
  • 13 Rajkumari N, Mathur P, Bhardwaj N. et al. Resistance pattern of mupirocin in methicillin-resistant Staphylococcus aureus in trauma patients and comparison between disc diffusion and E-test for better detection of resistance in low resource countries. J Lab Physicians 2014; 6 (02) 91-95
  • 14 S. J, M. M, AS SB, Mathew R, M. K, Lal BY. prevalence of high and low level mupirocin resistance among Staphylococcal isolates from skin infection in a tertiary care hospital. J Clin Diagn Res 2013; 7 (02) 238-242
  • 15 Finlay JE, Miller LA, Poupard JA. Interpretive criteria for testing susceptibility of staphylococci to mupirocin. Antimicrob Agents Chemother 1997; 41 (05) 1137-1139