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Journal of Clinical Microbiology, October 2001, p. 3775-3777, Vol. 39, No. 10
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.10.3775-3777.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Low Concentrations of Mupirocin in the Pharynx following Intranasal Application May Contribute to Mupirocin Resistance in Methicillin-Resistant Staphylococcus aureus

Hiroshi Watanabe,1,* Hironori Masaki,1 Norichika Asoh,1 Kiwao Watanabe,1 Kazunori Oishi,1 Shinobu Kobayashi,2 Akiyoshi Sato,3 Rinya Sugita,4 and Tsuyoshi Nagatake1

Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University,1 and Departments of Internal Medicine2 and Microbiology,3 Kyorin Hospital, Nagasaki, and Sugita Otorhinolaryngologic Clinic, Chiba,4 Japan

Received 21 May 2001/Returned for modification 11 July 2001/Accepted 24 July 2001

We describe a patient with methicillin-resistant Staphylococcus aureus (MRSA) colonizing the pharynx. The MIC of mupirocin was 0.25 µg/ml before treatment and increased after treatment to 8 µg/ml. Using pulsed-field gel electrophoresis, we confirmed that the genotypes of MRSA that colonized the pharynx before and after the use of mupirocin were identical. We measured the delivery of mupirocin to the pharynx in three normal volunteers and two patients. Low concentrations of mupirocin were present in the pharynx in all cases 10 min to 3 days after intranasal application. Our data suggested that low concentrations of the drug in the pharynx after intranasal application of mupirocin ointment might explain the selection of mupirocin resistance in MRSA.

* Corresponding author. Mailing address: Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan. Phone: 81 (95) 849-7842. Fax: 81 (95) 849-7843. E-mail: h-wata{at}net.nagasaki-u.ac.jp.

Journal of Clinical Microbiology, October 2001, p. 3775-3777, Vol. 39, No. 10
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.10.3775-3777.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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