Abstract
As an increasingly common cause of skin infections worldwide, the prevalence of antibiotic-resistant Staphylococcus aureus (S. aureus) across China has not been well documented. This literature aims to study the resistance profile to commonly used antibiotics, including macrolides, fusidic acid (FA) and mupirocin, and its relationship to the genetic typing in 34 S. aureus strains, including 6 methicillin-resistant S. aureus (MRSA), isolated from a Chinese hospital. The MIC results showed 27 (79.4%), 1 (2.9%) and 6 (17.6%) isolates were resistant to macrolides, FA and mupirocin, respectively. Among 27 macrolide-resistant S. aureus isolates, 5 (18.5%) were also resistant to mupirocin and 1 (3.7%) to FA. A total of 13 available resistant genes were analyzed in 28 antibiotic-resistant strains using polymerase chain reaction (PCR). The positive rates of macrolide-resistant ermA, ermB, ermC, erm33 and low level mupirocin-resistant ileS mutations were 11.1%, 25.9%, 51.9%, 7.4% and 100%, respectively. Other determinants for FA- and high level mupirocin-resistance were not found. The results of multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) revealed 13 sequence types (STs) and 18 clusters in 23 resistant gene positive S. aureus isolates. Among these STs, ST5 was most prevalent, accounting for 18.2%. Notably, various clusters were found with similar resistance phenotype and genotype, exhibiting a weak genetic relatedness and high genetic heterogeneities. In conclusion, macrolides, especially erythromycin, are not appropriate to treat skin infections caused by S. aureus, and more effective measures are required to reduce the dissemination of macrolides, FA and mupirocin resistance of the pathogen.
Highlights
As one of the most common pathogens, S. aureus usually caused systemic and pyogenic local infections in both community settings and hospitals
Macrolides, especially erythromycin, are not appropriate to treat skin infections caused by S. aureus, and more effective measures are required to reduce the dissemination of macrolides, fusidic acid (FA) and mupirocin resistance of the pathogen
The topical antimicrobial agents, especially macrolide antibiotic erythromycin, fusidic acid (FA), mupirocin, are commonly used to treat skin infections caused by S. aureus
Summary
As one of the most common pathogens, S. aureus usually caused systemic and pyogenic local infections in both community settings and hospitals. Due to the existence of virulence factors of S. aureus, it tends to cause more widespread infections, such as meningitis, endocarditis and blood stream infections [1]. The topical antimicrobial agents, especially macrolide antibiotic erythromycin, fusidic acid (FA), mupirocin, are commonly used to treat skin infections caused by S. aureus. Macrolides are widely used to treat acute upper and lower respiratory tract infections, sexually transmitted diseases and chronic pulmonary infections. They applied to skin and soft tissue infections [2]. As the first macrolide antibiotic discovered in 1952, www.impactjournals.com/oncotarget
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