10.26091/ESRNZ.8062865.v1
Glen P. Carter
Glen P.
Carter
Mark Schultz
Mark
Schultz
Sarah L. Baines
Sarah L.
Baines
Anders Gonçalves da Silva
Anders Gonçalves
da Silva
Helen Heffernan
Helen
Heffernan
Audrey Tiong
Audrey
Tiong
Peter H. Pham
Peter H.
Pham
Ian R. Monk
Ian R.
Monk
Timothy P. Stinear
Timothy P.
Stinear
Benjamin P. Howden
Benjamin P.
Howden
Deborah A. Williamson
Deborah A.
Williamson
Topical antibiotic use coselects for the carriage of mobile genetic elements conferring resistance to unrelated antimicrobials in Staphylococcus aureus
Institute of Environmental Science and Research
2019
Fusidic acid
mupirocin
Staphylococcus aureus
Topical antibiotics
Coselection
Multidrug resistance
Plasmids
Mupirocin Resistance
Evolution
Chlorhexidine
Bacteremia
Emergence
New Zealand
Microbiology
Microbial Genetics
2019-05-02 04:24:57
Journal contribution
https://research.esr.cri.nz/articles/journal_contribution/Topical_antibiotic_use_coselects_for_the_carriage_of_mobile_genetic_elements_conferring_resistance_to_unrelated_antimicrobials_in_Staphylococcus_aureus/8062865
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.