Mupirocin sensitivity and biofilm producer of methicillin resistant<i> Staphylococcus</i><i> aureus</i> at Dr. Moewardi General Hospital Surakarta

Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a pathogenic bacterium that causes infections in all parts of the body as reported worldwide. Individual management of carriers and patients infected with MRSA includes nasal decolonization using 2% mupirocin ointment. Extensive use of mupirocin may increase the risk of mupirocin resistance. The ability to form biofilm would increase antibiotic resistance in MRSA. This research was conducted to observe the mupirocin resistance, antibiotic sensitivity patterns and biofilm producer of MRSA isolates obtained from Dr. Moewardi General Hospital (RSDM) Surakarta. Methods: This research is a descriptive study with a cross-sectional analytic approach using MRSA isolates from the Clinical Microbiology Laboratory of RSDM Surakarta. The samples we used were all MRSA isolates from the Clinical Microbiology Laboratory of RSDM Surakarta collected from May -October 2022. Mupirocin sensitivity test using the Kirby Bauer diffusion method. The ability to form biofilms using a microtiter plate assay, and the pattern of antibiotic sensitivity in MRSA using the results of the antibiotic sensitivity test from Vitek2. Results: Sixty-four MRSA isolates were obtained from various clinical specimens based on the cefoxitin screen using Vitek2. There are 5 MRSA isolates that show high mupirocin resistance. The ability to form biofilms in MRSA isolates was found 40.6% weak, 21.9% moderate, and 37.5% negative biofilm. All MRSA isolates were resistant to benzylpenicillin and sensitive to tigecycline. Most of the MRSA isolates were resistant to ciprofloxacin and levofloxacin (70.3% and 68.7%), as well as gentamicin, erythromycin and tetracycline (64.1%; 59.4%; and 56.3%). Conclusion: We should pay attention to the evidence of high-level mupirocin resistant, MDR and biofilm producers from MRSA isolates in this study. A comprehensive implementation of infection control and antimicrobial stewardship programs would be useful to manage MRSA infection.