{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T06:40:09Z","timestamp":1759992009547},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The association between mupirocin use and plasmid-based high-level resistance development mediated through mupA in CoNS has not been quantified. We determined acquisition of mupirocin resistance in Staphylococcus aureus and CoNS in surgery patients treated peri-operatively with mupirocin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>Patients admitted for surgery were treated with nasal mupirocin ointment and chlorhexidine soap for 5 days, irrespective of S. aureus carrier status. Nasal swabs were obtained before decolonization (T1) and 4 days after surgery (T2) and were inoculated onto agars containing 8 mg\/L mupirocin. Staphylococci were identified by MALDI-TOF MS and mupirocin resistance was confirmed by Etest.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1578 surgical patients, 936 (59%) had nasal swabs obtained at T1 and T2; 192 (21%) patients carried mupirocin-resistant CoNS at T1 and 406 (43%) at T2 (P\u200a&amp;lt;\u200a0.001). Of 744 patients not colonized at T1, 277 acquired resistance (37%), corresponding to an acquisition rate of 7.4\/100 patient days at risk. In all, 588 (97%) of 607 mupirocin-resistant CoNS had an MIC &amp;gt;256 mg\/L (high level) and 381 of 383 (99.5%) were mupA positive. No acquisition of mupirocin resistance was observed in S. aureus.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Acquisition of mupirocin resistance following decolonization was widespread in CoNS and absent in S. aureus. As almost all isolates harboured the mupA gene, monitoring resistance development in S. aureus when decolonization strategies containing mupirocin are used is recommended.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dku522","type":"journal-article","created":{"date-parts":[[2014,12,24]],"date-time":"2014-12-24T03:27:05Z","timestamp":1419391625000},"page":"1182-1184","source":"Crossref","is-referenced-by-count":15,"title":["Acquisition of high-level mupirocin resistance in CoNS following nasal decolonization with mupirocin"],"prefix":"10.1093","volume":"70","author":[{"given":"David J.","family":"Hetem","sequence":"first","affiliation":[{"name":"1 \u00a0Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Charles","family":"Vogely","sequence":"additional","affiliation":[{"name":"2 \u00a0Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim T.","family":"Severs","sequence":"additional","affiliation":[{"name":"1 \u00a0Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annet","family":"Troelstra","sequence":"additional","affiliation":[{"name":"1 \u00a0Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes G.","family":"Kusters","sequence":"additional","affiliation":[{"name":"1 \u00a0Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc J. M.","family":"Bonten","sequence":"additional","affiliation":[{"name":"1 \u00a0Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands"},{"name":"3 \u00a0Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2014,12,23]]},"reference":[{"key":"2022020120574822400_DKU522C1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1056\/NEJMoa0808939","article-title":"Preventing surgical-site infections in nasal carriers of Staphylococcus aureus","volume":"362","author":"Bode","year":"2010","journal-title":"N Engl J Med"},{"key":"2022020120574822400_DKU522C2","doi-asserted-by":"crossref","first-page":"e14815","DOI":"10.1371\/journal.pone.0014815","article-title":"Cost-effectiveness of preoperative screening and eradication of Staphylococcus aureus carriage","volume":"6","author":"Wassenberg","year":"2011","journal-title":"PLoS One"},{"key":"2022020120574822400_DKU522C3","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1128\/JCM.44.1.260-265.2006","article-title":"Multiple-locus variable-number tandem repeat analysis for typing of Staphylococcus epidermidis","volume":"44","author":"Johansson","year":"2006","journal-title":"J Clin Microbiol"},{"key":"2022020120574822400_DKU522C4","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1093\/jac\/dki387","article-title":"In vivo transfer of high-level mupirocin resistance from Staphylococcus epidermidis to methicillin-resistant Staphylococcus aureus associated with failure of mupirocin prophylaxis","volume":"56","author":"Hurdle","year":"2005","journal-title":"J Antimicrob Chemother"},{"key":"2022020120574822400_DKU522C5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0195-6701(97)90162-6","article-title":"Mupirocin resistance and methicillin-resistant Staphylococcus aureus (MRSA)","volume":"35","author":"Eltringham","year":"1997","journal-title":"J Hosp Infect"},{"key":"2022020120574822400_DKU522C6","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1128\/AAC.05325-11","article-title":"MupB, a new high-level mupirocin resistance mechanism in Staphylococcus aureus","volume":"56","author":"Seah","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"key":"2022020120574822400_DKU522C7","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1093\/cid\/cir233","article-title":"Impact of combined low-level mupirocin and genotypic chlorhexidine resistance on persistent methicillin-resistant Staphylococcus aureus carriage after decolonization therapy: a case\u2013control study","volume":"52","author":"Lee","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2022020120574822400_DKU522C8","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1093\/jac\/dkh028","article-title":"Clonal dissemination of mupirocin-resistant staphylococci in Greek hospitals","volume":"53","author":"Petinaki","year":"2004","journal-title":"J Antimicrob Chemother"},{"key":"2022020120574822400_DKU522C9","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.jhin.2013.09.006","article-title":"Clinical relevance of mupirocin resistance in Staphylococcus aureus","volume":"85","author":"Hetem","year":"2013","journal-title":"J Hosp Infect"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/70\/4\/1182\/42354933\/jac_70_4_1182.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/70\/4\/1182\/42354933\/jac_70_4_1182.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T21:02:03Z","timestamp":1643749323000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/70\/4\/1182\/807278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,12,23]]},"references-count":9,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2014,12,23]]},"published-print":{"date-parts":[[2015,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dku522","relation":{},"ISSN":["1460-2091","0305-7453"],"issn-type":[{"value":"1460-2091","type":"electronic"},{"value":"0305-7453","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,4]]},"published":{"date-parts":[[2014,12,23]]}}}