Background: Mupirocin resistance of methicillin-resistant Staphylococcus aureus (MRSA) was frequently reported, but heterogeneous mupirocin resistance in Staphylococcus aureus (S. aureus) was rarely recognized. This study aims to investigate the prevalence of mupirocin heteroresistance among clinical S. aureus isolates and its possible molecular mechanism.
Methods: Disk diffusion and agar dilution were used to detect the resistance features of mupirocin resistant S. aureus isolates collected form a tertiary teaching hospital in China. Population analysis profiling was used to identify the mupirocin heteroresistant isolates. Multi locus sequence typing and Staphylococcus protein A gene molecular typing were used to discriminate the genetic features of the heteroresistant isolates. Mutations in the isoleucyl tRNA synthetase (ileS) gene of S. aureus isolates were detected by gene sequencing technique.
Results: Mupirocin heteroresistant isolates were identified in 27.67% (83/300) strains. The dominant clones with mupirocin heteroresistance were ST239-t030 MRSAs (25.30%, 21/83). Mutations of G1762T and A637G in ileS gene could be detected in the mupirocin resistant and heteroresistant isolates. The resistance of resistant subpopulations with mutation of G1762T in ileS gene could stabilize for at least 25 passages.
Conclusions: This study first revealed a higher prevalence of mupirocin heteroresistance in S. aureus. The mutation of G1762T in ileS gene is closely correlated with both mupirocin resistant and heteroresistant S. aureus isolates, supportingo ileS as a potential marker for fast identification of mupirocin resistant S. aureus.
Keywords: Heteroresistance; Staphylococcus aureus; mupirocin resistance.
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