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Spontaneous loss of MupA-mediated high-level mupirocin resistance was observed inStaphylococcus aureus , although the isolate gave a PCR-positive test result formupA . Sequencing of themupA gene identified a single base-pair deletion that resulted in a frameshift mutation and loss of functional protein. Reversion to the wild-type allele and restoration of high-level resistance occurred with high frequency (&gt;10−6 ), indicating the transient nature of MupA polymorphism.

Transient Loss of High-Level Mupirocin Resistance in Staphylococcus aureus Due to MupA Polymorphism