A Study on Prevalence of Paediatric Intestinal Worm Infestations and Associated Factors among School-Going Children in Purba Medinipur – A Cross-Sectional Study

Abstract

Background: Mupirocin is a topical antibiotic used extensively for decolonization of
MRSA carriers in both hospital and community settings. Its easy application and
effectiveness in nasal and skin colonization sites make it a frontline agent in MRSA
infection control. However, increasing resistance to mupirocin, particularly highlevel
resistance, is a growing concern that compromises decolonization strategies and
increases the risk of persistent colonization and transmission. Objective: To
determine the prevalence of low-level mupirocin resistance among MethicillinResistant Staphylococcus aureus (MRSA) isolates from various clinical specimens
and to analyze the association of mupirocin resistance with different clinical sources
and patient demographics in a tertiary care hospital setting. Methods:
This prospective study was conducted in the Department of Microbiology at a
tertiary care hospital over 12 months. A total of 114 MRSA isolates, confirmed by
cefoxitin disc diffusion, were subjected to mupirocin susceptibility testing using 5 µg
discs on Mueller-Hinton agar. Resistance was categorized based on inhibition zones:
≤13 mm indicated resistance, ≥14 mm indicated sensitivity. Due to resource
limitations, high-level resistance testing using 200 µg discs or molecular methods
was not performed. Results: Among 114 MRSA isolates, 6 (5.26%) exhibited lowlevel resistance to mupirocin, while 108 (94.73%) remained sensitive. No high-level
resistance was detected. The majority of resistant isolates were derived from pus
(4/6), followed by blood (1) and sputum (1). Urine, vaginal, and pleural fluid isolates
were fully sensitive to mupirocin. The rate of resistance observed aligns with Indian
studies and is lower than rates reported internationally. Conclusion: Low-level
mupirocin resistance was detected in a small proportion of MRSA isolates. Although
high-level resistance was not observed, the continued use of mupirocin, especially in
unregulated topical applications, risks resistance escalation. Routine mupirocin
sensitivity screening is recommended, alongside antimicrobial stewardship to
preserve the efficacy of this vital topical agent.