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The coselection of multidrug-resistant phenotypes has been well documented among systemic antibiotics, but little attention has been paid to topical agents or biocides.
To determine the role that topical antibiotics play in the emergence of multidrug-resistant pathogens, investigators have examined Staphylococcus aureus resistance to fusidic acid and mupirocin in New Zealand, which has risen to 28% during the past 20 years. Resistance was driven mainly by the emergence of strains within the multilocus sequence type 1 (ST1) lineage.
The genetic basis of fusidic acid resistance was determined to be on a mobile staphylococcal chromosomal cassette element, whereas the high-level mupirocin resistance element was found on a plasmid (PNZAK1), which …