الفهرس 
Title : Phenotypic and Genotypic characterization of Staphylococcus aureus isolates Showing Mupirocin Resistance
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Abstract
Background and objective: Fusidic acid is widely used as a topical treatment of wound and skin infections. Resistance of S. aureus to fusidic acid may be due to expression of a protein encoded by fusB, fusC or fusD genes causing alternation of the drug target. We aimed in our study to determine the prevalence of fusidic acid resistance among methicillin resistant S. aureus (MRSA) strains isolated from wound and skin infections and to access the expression of fusB, fusC and fusD genes by real time PCR. Materials and Methods: from total 412 S. aureus unrepeated clinical isolates recovered from wound and skin infections in Cairo University hospital; 250 (60.7%) were MRSA isolates. Identification and antibiotic susceptibility testing by disc diffusion method were done according to clinical laboratory institute guidelines (CLSI) and confirmed by Vitek 2 compact system. Real time PCR was done to access expression of fusB, fusC and fusD genes. Results: Among 250 MRSA clinical isolates antibiotics resistance profile were as follows; ciprofloxacin (76.8%), ofloxacin (69.2%), clindamycin (67.6%), gentamicin (50.8%), doxycycline (46.8%), erythromycin (43.6%), rifampicin (24.8%), levofloxacin (24.4%), amikacin (24%), linezolid (1.6%), mupirocin (0.0%) teicoplanin (0.0%), and vancomycin (0.0%). Fusidic acid resistance was detected in 50 isolates (20%).The most common resistance determinant was fusC gene which was found in 14/50 (28%) of all resistant isolates, whereas XI fusB and fusD genes were not detected. Conclusion: Given the fact that data are rare on the prevalence of fusidic acid resistance we found that 20% of MRSA clinical isolates exhibited resistance to fusidic acid because of carriage of the fusC determinant; yet maintained susceptibility to mupirocin (100%) which can be an alternative therapeutic option in wound and skin infections