Journal article
Chlorhexidine and mupirocin susceptibilities of methicillin-resistant staphylococcus aureus from colonized nursing home residents
Antimicrobial agents and chemotherapy, Vol.57(1), pp.552-558
01/2013
DOI: 10.1128/AAC.01623-12
PMCID: PMC3535956
PMID: 23147721
Abstract
Chlorhexidine and mupirocin are used in health care facilities to eradicate methicillin-resistant Staphylococcus aureus (MRSA) carriage. The objective of this study was to assess the frequency of chlorhexidine and mupirocin resistance in isolates from nares carriers in multiple nursing homes and to examine characteristics associated with resistance. Nasal swab samples were collected from approximately 100 new admissions and 100 current residents in 26 nursing homes in Orange County, CA, from October 2008 to May 2011. MRSA isolates were tested for susceptibility by using broth microdilution, disk diffusion, and Etest; for genetic relatedness using pulsed-field gel electrophoresis; and for qac gene carriage by PCR. Characteristics of the nursing homes and their residents were collected from the Medicare Minimum Data Set and Long-Term Care Focus. A total of 829 MRSA isolates were obtained from swabbing 3,806 residents in 26 nursing homes. All isolates had a chlorhexidine MIC of ≤4 μg/ml. Five (0.6%) isolates harbored the qacA and/or qacB gene loci. Mupirocin resistance was identified in 101 (12%) isolates, with 78 (9%) isolates exhibiting high-level mupirocin resistance (HLMR). HLMR rates per facility ranged from 0 to 31%. None of the isolates with HLMR displayed qacA or qacB, while two isolates carried qacA and exhibited low-level mupirocin resistance. Detection of HLMR was associated with having a multidrug-resistant MRSA isolate (odds ratio [OR], 2.69; P = 0.004), a history of MRSA (OR, 2.34; P < 0.001), and dependency in activities of daily living (OR, 1.25; P = 0.004). In some facilities, HLMR was found in nearly one-third of MRSA isolates. These findings may have implications for the increasingly widespread practice of MRSA decolonization using intranasal mupirocin.
Details
- Title: Subtitle
- Chlorhexidine and mupirocin susceptibilities of methicillin-resistant staphylococcus aureus from colonized nursing home residents
- Creators
- Jennifer S McDanel - Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA. jennifer-kroeger@uiowa.eduCourtney R MurphyDaniel J DiekemaVictor QuanDiane S KimEllena M PetersonKaye D EvansGrace L TanMary K HaydenSusan S Huang - University of California, Irvine
- Resource Type
- Journal article
- Publication Details
- Antimicrobial agents and chemotherapy, Vol.57(1), pp.552-558
- Publisher
- United States
- DOI
- 10.1128/AAC.01623-12
- PMID
- 23147721
- PMCID
- PMC3535956
- ISSN
- 1098-6596
- eISSN
- 1098-6596
- Language
- English
- Date published
- 01/2013
- Academic Unit
- Infectious Diseases; Epidemiology; Pathology; Internal Medicine
- Record Identifier
- 9983986268102771
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