51. Topical Antibiotic Use Coselects for the Carriage of Mobile Genetic Elements Conferring Resistance to Unrelated Antimicrobials in Staphylococcus aureus.
- Author
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Carter GP, Schultz MB, Baines SL, Gonçalves da Silva A, Heffernan H, Tiong A, Pham PH, Monk IR, Stinear TP, Howden BP, and Williamson DA
- Subjects
- Administration, Topical, Bayes Theorem, Drug Resistance, Multiple, Bacterial genetics, Fusidic Acid pharmacology, Genome, Bacterial drug effects, Genome, Bacterial genetics, Humans, Microbial Sensitivity Tests methods, Mupirocin pharmacology, New Zealand, Staphylococcal Skin Infections drug therapy, Staphylococcal Skin Infections microbiology, Staphylococcus aureus genetics, Anti-Bacterial Agents pharmacology, Drug Resistance, Multiple, Bacterial drug effects, Staphylococcal Infections drug therapy, Staphylococcus aureus drug effects
- Abstract
Topical antibiotics, such as mupirocin and fusidic acid, are commonly used in the prevention and treatment of skin infections, particularly those caused by staphylococci. However, the widespread use of these agents is associated with increased resistance to these agents, potentially limiting their efficacy. Of particular concern is the observation that resistance to topical antibiotics is often associated with multidrug resistance, suggesting that topical antibiotics may play a role in the emergence of multidrug-resistant (MDR) strains. New Zealand (NZ) has some of the highest globally recorded rates of topical antibiotic usage and resistance. Using a combination of Pacific Biosciences single-molecule real-time (SMRT) whole-genome sequencing, Illumina short-read sequencing, and Bayesian phylogenomic modeling on 118 new multilocus sequence type 1 (ST1) community Staphylococcus aureus isolates from New Zealand and 61 publically available international ST1 genome sequences, we demonstrate a strong correlation between the clinical introduction of topical antibiotics and the emergence of MDR ST1 S. aureus We also provide in vitro experimental evidence showing that exposure to topical antibiotics can lead to the rapid selection of MDR S. aureus isolates carrying plasmids that confer resistance to multiple unrelated antibiotics, from within a mixed population of competitor strains. These findings have important implications regarding the impact of the indiscriminate use of topical antibiotics., (Copyright © 2018 Carter et al.)
- Published
- 2018
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