mupirocin and Skin-Diseases

Mupirocin was introduced into clinical practice in the UK in 1985, and has proved to be an extremely effective treatment of skin infections and one of the most successful topical antibiotics for the clearance of nasal Staphylococcus aureus isolates including those resistant to methicillin. It is currently registered for use in more than 90 countries worldwide. Unfortunately resistance was described shortly after its initial use. Many of the issues regarding its use are reviewed here, together with the mechanisms, genetics, surveillance and epidemiology of resistance, particularly in staphylococci. The various factors that increase resistance and how they might be controlled are also discussed.

Topics: Anti-Bacterial Agents; Drug Resistance, Microbial; Drug Utilization; Humans; Methicillin Resistance; Mupirocin; Practice Patterns, Physicians'; Skin Diseases; Staphylococcal Infections; Staphylococcus aureus

The Isoleucyl-tRNA synthetase (IARS) catalyzes isoleucine to the corresponding tRNA, maintaining the accuracy of gene translation. Its role in psoriasis has been not investigated so far. In this study, we aimed to investigate the mechanisms underlying the efficacy of IARS inhibitor, mupirocin, treatment for psoriasis.. The expression of IARS was determined by immunofluorescence, Western blot and qRT-PCR in normal healthy control- and psoriatic human skin. An imiquimod (IMQ) -induced psoriasis-like skin disease model was used to study the phenotypes changed by an IARS inhibitor, mupirocin (MUP). Endotypes were analyzed by RNA-seq, R&D Luminex multi-factor technique, ELISA, immunofluorescence and flow cytometry. Additionally, the effect of MUP on epidermal keratinocytes (KCs) were conducted in-vitro in primary cultured human KCs.. We found the expression of IARS was higher in psoriatic skin than in healthy controls. In IMQ-induced psoriasis-like C57BL/6 J mouse model, MUP reversed IMQ-induced keratinocytes proliferation, expression of inflammatory cytokines and infiltration of immune cells. Furthermore, in cultured human keratinocytes, MUP inhibited proliferation, but promoted apoptosis, which may be related with STAT3 signaling pathway.. Our finding of blocking the infiltration of immune cells by inhibiting the formation of IARS, could be one mechanism to explain the effect of MUP in the treatment of psoriasis. Developing strategies targeting suppression IARS should open new perspectives for the treatment of psoriasis. Video Abstract.

Topics: Animals; Humans; Imiquimod; Isoleucine-tRNA Ligase; Mice; Mice, Inbred C57BL; Mupirocin; Psoriasis; Skin Diseases

Topics: Administration, Cutaneous; Anti-Bacterial Agents; Balanitis; Biopsy; Diagnosis, Differential; Foreskin; Humans; Male; Mupirocin; Ointments; Skin; Skin Diseases; Treatment Outcome

Staphylococcus aureus is the primary pathogen responsible for the majority of human skin infections, and meticillin-resistant S. aureus (MRSA) currently presents a major clinical concern. The overuse of Mupirocin, the first-line topical antibacterial drug over 30 years, has led to the emergence of Mupirocin-resistant MRSA, creating a clinical concern. The antimicrobial peptide Omiganan was touted to be a promising antibacterial drug candidate due to its rapid membrane-disrupting bactericidal mode of action, entering clinical trials in 2005 as a topical gel to prevent catheter site infections. However, drug development ceased in 2009 due to a lack of efficacy. We postulate this to be due to proteolytic degradation caused by endogenous human skin proteases. Herein, we tested our hypothesis using Omiganan and its all-D enantiomer in a human skin protease stability assay, followed by anti-MRSA activity assay against of a panel of clinical MRSA isolates, a bactericidal/static determination and a time-kill assay to gauge all-D Omiganan's potential for further topical antibacterial drug development.

Topics: Administration, Topical; Anti-Bacterial Agents; Antimicrobial Cationic Peptides; Humans; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Mupirocin; Peptide Hydrolases; Protein Stability; Skin Diseases; Staphylococcal Infections; Stereoisomerism

Bullous impetigo (BI) is a common dermatologic condition, particularly in children, yet confusion regarding its diagnosis and treatment persists. This study measured pediatricians' ability to diagnose and appropriately treat BI and explored factors that might influence pediatricians' accuracy in managing BI.. We administered an expert-validated survey to 64 pediatrics house staff and faculty at three Johns Hopkins Medicine facilities. The survey requested demographic information, diagnoses for five "unknown" cases, and preferred treatments for localized and widespread BI.. Overall, BI was diagnosed correctly 31.9% of the time. There was little difference between house staff and faculty performance, although faculty 50 years of age and older demonstrated better diagnostic acumen. Regarding treatment of localized BI, 92% of faculty members and 84.6% of house staff listed mupirocin as first- or second-line treatment. The second most common medication listed for localized BI was bacitracin. Regarding treatment of widespread BI, faculty listed cephalexin or clindamycin as first- or second-line treatment 56.0% of the time and house staff listed one of these two medications 51.3% of the time. Results for faculty 50 years of age and older were comparable.. Improved pediatrician proficiency in the diagnosis and treatment of BI is needed for safe, cost-effective management. Physician age and experience appear to have a limited effect on the accuracy of BI diagnosis and management. Future educational efforts must be directed at trainees and their instructors.

Topics: Child; Clinical Competence; Dermatology; Humans; Impetigo; Mupirocin; Primary Health Care; Skin Diseases

The Panton-Valentine leukocidin is associated with staphylococcal skin and pulmonary infections. We describe a school outbreak of skin infections and the public health response to it. Nasal carriage of a Panton-Valentine leukocidin-positive Staphylococcus aureus clone was detected only in previously ill classmates and their family members.

Topics: Anti-Bacterial Agents; Bacterial Toxins; Carrier State; Child; Chlorhexidine; Disease Outbreaks; Electrophoresis, Gel, Pulsed-Field; Exotoxins; Humans; Leukocidins; Mupirocin; Nasal Mucosa; Polymerase Chain Reaction; Skin Diseases; Staphylococcus aureus; Switzerland

We performed a prospective study of Staphylococcus aureus nasal carriage in patients on chronic haemodialysis to determine the role of cutaneous colonization in the aetiology of recurrent nasal colonization. From February 2000 to September 2001, 71 patients on chronic haemodialysis in the dialysis unit at a university hospital were screened monthly for S. aureus nasal carriage. Carriers received nasal mupirocin for five days and were tested for nasal and cutaneous carriage two days later and monthly thereafter. Using genotyping results, recurrence was defined as relapse if pretreatment and subsequent nasal isolates were clonally identical; if the isolates were different, it was considered recolonization. Thirty-nine patients (55%) were nasal carriers: 11 initially and 28 during follow-up. Among the mupirocin-treated patients, the eradication of S. aureus nasal carriage rate was 88.5%. Nasal recurrence was documented in 17 patients (43.5%), and S. aureus nasal strains were available for molecular typing in 14 patients with a total of 23 recurrence episodes. On the basis of pulsed-field gel electrophoresis analysis, 16 (70%) recurrence episodes were considered relapses and seven were considered (30%) recolonizations. Among the episodes of relapse, prior cutaneous colonization was detected in only three cases. In haemodialysis patients, the majority of nasal carriage recurrences after mupirocin therapy were due to relapses. Cutaneous colonization does not appear to be relevant in the development of these relapses.

Topics: Anti-Bacterial Agents; Carrier State; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mupirocin; Nose Diseases; Recurrence; Renal Dialysis; Skin Diseases; Spain; Staphylococcal Infections

Topics: Anti-Bacterial Agents; Bacterial Infections; Dermatomycoses; Fatty Acids; Humans; Immune Tolerance; Mupirocin; Skin Diseases; Staphylococcal Skin Infections