MRSA resisting antibiotics
A study by Dr Brian O’Connell, director of the National MRSA Reference Laboratory, and consultant microbiologist at St James’s Hospital, and Dr Angela Rossney, chief medical scientist, has recorded an emerging high-level resistance to the antibiotic mupirocin in a rising number of MRSA isolates examined in the lab.
Dr O’Connell said mupirocin was “an agent quite useful to eradicate MRSA carriage”.
“However, if mupirocin resistance was to become stable among MRSA strains in Ireland, it would make eradication of carriage more difficult,” he said.
The doctors warn that if high-level resistance to mupirocin was to become prevalent, effectively rendering the antibiotic useless, then the medical community will have lost a valuable drug in the battle to control the spread of the superbug.
“It would be prudent, therefore, that institutions monitor the use of mupirocin to ensure that misuse, including inappropriate, prolonged or repeated use be avoided, especially among long-term patients so that this most valuable antimicrobial drug is not lost to therapeutic practice,” the study says.
The National MRSA Reference Laboratory monitors rates of resistance to clinically useful antibiotics among MRSA isolates recovered from blood of patients in hospitals.
Last year at a conference organised by MRSA victims and their families, Dr Rossney said the laboratory was in “dire straits” due to a lack of resources. Yesterday Dr O’Connell said the situation had not changed.
Mupirocin is mainly used as an ointment and is very effective in eliminating MRSA from colonised nasal passages when used in conjunction with other MRSA decolonisation regimens.
Guidelines from the Strategy for the control of Antimicrobial Resistance in Ireland warn that the dosage (three times a day for five days) should not be repeated more than once to avoid emergence of resistance.
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