THE PREVALENCE OF LOW-LEVEL AND HIGH-LEVEL MUPIROCIN RESISTANCE IN STAPHYLOCOCCI FROM 19 EUROPEAN HOSPITALS

The topical agent mupirocin plays a crucial role in strategies designe d to control outbreaks of methicillin-resistant Staphylococcus aureus. The extent of high- or low-level mupirocin resistance amongst S. aure us from European hospitals is not known. Six hundred and ninety-nine S . aureus and 249 coagulase-negative staphylococci (CNS) derived from b lood, hospital-acquired pneumonia or skin and soft tissue infections f rom 19 European hospitals were tested for susceptibility to mupirocin and oxacillin. Methicillin sensitivity was found in 72% and 32% of S. aureus and CNS, respectively. High-level mupirocin resistance was dete cted in 1.6% of S. aureus and 5.6% of CNS isolates, while low-level mu pirocin resistance was detected in 2.3% of S. aureus and 7.2% of CNS i solates. Amongst S. aureus, methicillin-resistant isolates were twice as likely to have high- or low-level mupirocin resistance. This differ ence was less pronounced in CNS. No relationship was found between the site of infection and prevalence of mupirocin resistance. High- and l ow-level mupirocin resistance was detected amongst staphylococci from 10 and 16 of the hospitals studied, respectively. To maintain the rela tively low prevalence of mupirocin resistance in Europe amongst both S . aureus and CNS, the prudent use of mupirocin restricted to defined i nfection control strategies should be emphasized.