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Table 3 Prevalence of mupirocin-resistant S. aureus from various sources in Africa based on phenotypic and molecular methods

From: Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis

Mupirocin resistance

Country

Source

Number positive/Total tested (%)

Phenotypic

Molecular

Guidelines or reports

Reference

Agar Dilution

Broth microdilution

Disk diffusion

E-test

Microscan system

VITEK

PCR

Micro array

BSAC

CLSI

EUCAST

Other reports

MupA-positive S. aureus

Egypt

Human

5/86 (5.8)

–

–

–

√

–

–

√

–

–

–

–

√a

[30]

Egypt

Human

6/73 (8.2)

√

–

–

–

–

–

√

–

–

√

–

–

[52]

Nigeria

Human

1/200 (0.5)

–

–

√

–

–

–

√

–

–

–

–

√b

[53]

South Africa

Human

2/227 (0.9)

–

–

√

–

–

–

√

–

–

–

–

√b

[50]

South Africa

Human

NA

–

–

√

–

–

√

√

–

–

√

–

–

[33]

LmupR S. aureus

Egypt

Human

25/86 (29.1)

–

–

–

√

–

–

√

–

–

–

–

√a

[30]

Egypt

Human

5/73 (6.8)

√

–

–

–

–

–

√

–

–

√

–

–

[52]

Ghana

Human

4/30 (13.3)

–

√

–

–

–

–

–

√

–

–

√

–

[55]

Libya

Human

4/109 (3.7)

√

–

√

–

–

–

–

–

√

–

–

–

[57]

South Africa

Human

14/227 (6.2)

–

–

√

–

–

–

–

–

–

–

–

√b

[50]

South Africa

Human

117/248 (47.2)

–

–

√

√

–

–

–

–

–

–

–

√c

[32]

South Africa

Human

43/997 (4.3)

–

–

√

–

–

√

–

–

–

√

–

–

[33]

South Africa

Human & Environment

4/13 (30.8)

–

–

–

–

–

√

–

–

–

–

–

–

[34]

HmupR S. aureus

Egypt

Human

5/86 (5.8)

–

–

–

√

–

–

√

–

–

–

–

√a

[30]

Egypt

Human

8/73 (11)

√

–

–

–

–

–

√

–

–

√

–

–

[52]

Ghana

Human

1/105 (1.0)

–

–

√

–

–

–

–

–

–

–

√

–

[54]

Libya

Human

1/109 (0.9)

√

–

√

–

–

–

–

–

√

–

–

–

[57]

Nigeria

Human

1/200 (0.5)

–

–

√

–

–

–

√

–

–

–

–

√b

[53]

Nigeria

Human

12/101 (11.9)

–

–

√

–

–

–

–

–

–

√

–

–

[44]

Nigeria

Human & Animal

33/87 (37.9)

–

–

√

–

–

–

–

–

–

√

–

–

[36]

South Africa

Human

2/227 (0.9)

–

–

√

–

–

–

√

–

–

–

–

√b

[50]

South Africa

Human

6/248 (2.4)

–

–

√

√

–

–

–

–

–

–

–

√c

[32]

South Africa

Human

234/997 (23.5)

–

–

√

–

–

√

–

–

–

√

–

–

[33]

mupR-MRSA

Egypt

Human

30/86 (34.9)

–

–

–

√

–

–

√

–

–

–

–

√a

[30]

Egypt

Human

3/39 (7.7)

–

–

√

–

–

–

–

–

–

√

–

–

[31]

Egypt

Human

13/73 (17.8)

√

–

–

–

–

–

√

–

–

√

–

–

[52]

Ghana

Human

4/30 (13.3)

–

√

–

–

–

–

–

√

–

–

√

–

[55]

Libya

Human

13/86 (15.1)

–

–

√

–

–

–

–

–

√

–

–

–

[56]

Libya

Human

5/109 (4.6)

√

–

√

–

–

–

–

–

√

–

–

–

[57]

Nigeria

Human & Animal

33/87 (37.9)

–

–

√

–

–

–

–

–

–

√

–

–

[36]

South Africa

Human

15/227 (6.6)

–

–

√

–

–

–

√

–

–

–

–

√b

[50]

South Africa

Human

123/248 (49.6)

–

–

√

√

–

–

–

–

–

–

–

√c

[32]

South Africa

Human

202/2709 (7.5)

–

–

–

–

√

–

–

–

–

√

√

–

[51]

South Africa

Human & Environment

4/13 (30.8)

–

–

–

–

–

√

–

–

–

–

–

–

[34]

  1. KEY: BSAC British Society for Antimicrobial Chemotherapy, CLSI Clinical and Laboratory Standards Institute, EUCAST European Committee on Antimicrobial Susceptibility Testing, NA Not Available, PCR Polymerase Chain Reaction, √: test was performed. -: test was not performed
  2. aThe widely accepted breakpoints: ≤4 mg/l (susceptible), 8–256 mg/l (low-level resistance) and ≥ 512 mg/l (high-level resistance) was utilized in this study: Kresken M, Hafner D, Schmitz FJ, Wichelhaus TA. Prevalence of mupirocin resistance in clinical isolates of Staphylococcus aureus and Staphylococcus epidermidis. Results of the antimicrobial resistance surveillance study of the Paul-Ehrlich Society for Chemotherapy, 2001. Int J Antimicrob Agents, 2004, 23:577–81. bGrowth within a 14-mm zone of inhibition with the 5 μg mupirocin disk detected low-level resistance, while growth to the edge of the 200 μg mupirocin disk indicated high-level resistance according to: Udo EE, Farook VS, Mokadas EM, Jacob LE, Sanyal SC. Molecular fingerprinting of mupirocin-resistant methicillin-resistant Staphylococcus aureus from a burn unit. Int J Infect Dis, 1999,3:82–7. cThe widely accepted breakpoints: ≤4 mg/l (susceptible), 8–256 mg/l (low-level resistance) and ≥ 512 mg/l (high-level resistance) was utilized in this study: Udo EE, Al-Sweih N, Mokaddas E, Johny M, Dhar R, Gomaa HH, Al-Obaid I, Rotimi VO. Antibacterial resistance and their genetic location in MRSA isolated in Kuwait hospitals, 1994–2004. BMC Infect Dis, 2006;6:168