scholarly journals Staphylococcus aureus with inducible clindamycin resistance and methicillin resistance in a tertiary hospital in Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Devi Thapa ◽  
Susil Pyakurel ◽  
Sabita Thapa ◽  
Suresh Lamsal ◽  
Mahesh Chaudhari ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Methicillin Resistance ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Antibiotic Susceptibility Testing ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

Abstract Background Staphylococcus aureus is a global public health issue in both community and hospital settings. Management of methicillin-resistant S. aureus (MRSA) infections are tough owing to its resistance to many antibiotics. Macrolide-lincosamide-streptogramin B (MLSB) antibiotics are commonly used for the management of MRSA. This study was aimed to determine the occurrence of inducible clindamycin- and methicillin-resistant S. aureus at a tertiary care hospital in Kathmandu, Nepal. Methods A total of 1027 clinical samples were processed following standard laboratory procedures and antibiotic susceptibility testing of S. aureus was performed by disc diffusion method. MRSA isolates were detected phenotypically using cefoxitin disc, and inducible clindamycin resistance was detected phenotypically using the D-zone test. Results Of 1027 samples, 321 (31.2%) were culture positive, of which 38 (11.8%) were S. aureus. All S. aureus isolates were susceptible to vancomycin, and 25 (67%) of S. aureus isolates were multidrug-resistant. Similarly, 15 (39.5%) of S. aureus were MRSA and 14 (36.5%) were inducible clindamycin-resistant phenotypes. Conclusion Inducible clindamycin and methicillin resistance were common in S. aureus. This emphasizes that the methicillin resistance test and the D-zone test should be incorporated into the routine antibiotic susceptibility testing in hospital settings.

scholarly journals Prevalence of constitutive and inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in a tertiary care institute in North India

2017 ◽  
Vol 5 (7) ◽  
pp. 3120
Author(s):  
Jeevan Shetty ◽  
Zarrin Afroz
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Antibiotic Susceptibility Testing ◽  
Sensitivity Testing ◽  
Inducible Clindamycin Resistance

Background: Clindamycin is an important drug used in the treatment of Methicillin Sensitive Staphylococcus aureus (MSSA) as well as in Methicillin-resistant Staphylococcus aureus (MRSA) infections. This drug is widely used in the treatment of skin and soft tissue infections caused by them. Therapeutic failure caused by macrolide-lincosamine-streptogramin B constitutive and inducible clindamycin resistance (MLSBc and MLSBi) is being more commonly reported.Methods: The present study was conducted over a period of six months from October 2016 to March 2017 to know the incidence of MLSBc and MLSBi in Staphylococcus aureus (S. aureus) isolates obtained in our hospital by D-test as per CLSI guidelines. A total of 130 isolates of S.aureus were obtained from different clinical specimens which included pus/ wound swab (n=266), urine (n=577), sputum (n=225), blood (n=221), throat swab (n=71), ear/eye discharge (n=21), high vaginal swab (n=20) and body fluids (n=50). All the isolates were subjected to antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Amoxyclav, Erythromycin, Clindamycin, Co-trimoxazole, Tetracycline, Ofloxacin, Gentamicin, Linezolid and Vancomycin were the antibiotics used.Results: Out of 130 (8.9%) isolates of S. aureus obtained from 1451 clinical samples, 82 (63.1%) were found to be MSSA and 48 (36.9%) were MRSA. Among S. aureus, 43 (33.1%) isolates showed MLSBc resistance, 22 (16.9%) isolates showed MLSBi resistance and 20 (15.4%) isolates showed MS phenotype. The remaining 45 (34.6%) isolates remained sensitive to Erythromycin. Among MSSA, MLSBc were observed in 18 (22%) isolates and MLSBi in 9 (11%) while in MRSA, MLSBc were observed in 25 (52.1%) isolates and MLSBi in 13 (27.1%) isolates. Almost all clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing. Both MLSBc and MLSBi resistance was significantly higher (p<0.05) in MRSA than in MSSA.Conclusions: The study emphasizes the importance of conducting D test along with routine antibiotic susceptibility testing for better utilization of clindamycin in S. aureus infections.

scholarly journals Prevalence of Methicillin-resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Hospital in Northern India

2010 ◽  
Vol 2 (02) ◽  
pp. 078-081 ◽  
Author(s):  
Shilpa Arora ◽  
Pushpa Devi ◽  
Usha Arora ◽  
Bimla Devi
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Diffusion Method ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Sensitivity Pattern

ABSTRACT Aim: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. We report the prevalence and antibiotic susceptibility pattern of MRSA in the hospitals attached to GMC, Amritsar, Punjab. Materials and Methods: The study comprised of 250 coagulase-positive staphylococci (COPS) isolated from a total of 6743 clinical specimens (like pus, blood, urine, high vaginal swab, sputum, etc.) of patients admitted in hospitals attached to Government Medical College, Amritsar from January 2008−February 2009. Routine antibiotic susceptibility testing was performed and interpreted as per standard guidelines. Methicillin resistance was detected using oxacillin and cefoxitin disc diffusion method, oxacillin screen agar method, and minimum inhibitory concentration using broth macrodilution method. Results: A total of 115 (46%) strains were found to be methicillin resistant. Multidrug resistance was observed in 73% MRSA strains. However, no strain was resistant to vancomycin. Conclusion: Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is required to reduce MRSA prevalence.

scholarly journals Detection of inducible clindamycin resistance in Staphylococcus aureus from various samples in a tertiary care hospital

2019 ◽  
Vol 7 (12) ◽  
pp. 4696
Author(s):  
Rohit Kumar ◽  
Jagarti . ◽  
Mrinmoy Sarma ◽  
Gautam Shalini
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Inducible Clindamycin Resistance

Background: The increasing frequency of MRSA infections and rapidly changing patterns in antimicrobial resistance, led to renewed interest in the usage of Macrolides-Lincosamide-Streptogramin B (MLSB) antibiotics to treat Staphylococcus aureus infection. Clindamycin is an important drug used in the treatment of MRSA and MSSA infection. The aim of this study was to determine inducible and constitutive clindamycin resistance among clinical isolates of Staphylococcus aureus by D-test.Methods: During a period of 6 months from July 2018 to December 2018, a total of 100 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Methicillin-resistance was determined by using the cefoxitin (30 µg) disc. Incidence of MLSBc and MLSBi in Staphylococcus aureus isolates by D-test as per CLSI guidelines.Results: Out of 100 isolates of Staphylococcus aureus obtained from 350 clinical samples, 70(70%) were found to be MRSA and 30(30%) were MSSA. Among 100 Staphylococcus aureus isolates, 40% isolates showed MLSBi resistance, 28% isolates showed MLSBc resistance, 6% isolates showed MS phenotype and 26% isolates showed Sensitive phenotype. MLSBc and MLSBi were found to be higher in MRSA as compared to MSSA (21%, 27% and 7%, 10% respectively). All clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing.Conclusions: Continuous surveillance of the MLSB resistance is important and required before the prescription of clindamycin to treat MRSA infections.

scholarly journals Study of antibiotic resistance profiling of Staphylococcus aureus isolated from clinical specimens of the patients attending a tertiary teaching hospital from Chhattisgarh

2017 ◽  
Vol 5 (11) ◽  
pp. 4808
Author(s):  
Archana Bhimrao Wankhade ◽  
Sanjibkumar Panda ◽  
Riddhi Hathiwala ◽  
Yogendra Keche
Keyword(s):  
Staphylococcus Aureus ◽  
Multidrug Resistance ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Antibiotic Susceptibility Testing ◽  
Microbiological Methods ◽  
Tertiary Teaching

Background: Staphylococcus aureus is a pathogen causing wide spectrum of infections. It has tendency for the development of multidrug resistance thereby exposing the selection of appropriate treatment. Therefore, the present study was undertaken to find out the antibiotic susceptibility pattern of Staphylococcus aureus isolated from various clinical samples in teaching tertiary hospital.Methods: Total 85 Staphylococcus aureus was isolated from clinical samples (pus, urine, sputum and blood) tested. Identification of Staphylococcus aureus was done by standard conventional microbiological methods. Antibiotic susceptibility testing was done by using disk diffusion method as per CLSI guidelines.Results: Staphylococcus aureus was isolated maximum from pus samples followed by urine samples. Antibiotic susceptibility testing showed highest resistance against Penicillin (69%) and Erythromycin (51%) followed by Cotrimoxazole (50%) & Nitrofurantoin (50%). All the strains were sensitive to Vancomycin. Amongst the urine isolates all were sensitive to Norfloxacin. These percentages of sensitivities are characteristically higher in our study than the previous studies in the literature. In addition, out of 85 Staphylococcus aureus isolates, 26 isolates showed sensitivity   to all antibiotics.Conclusions: From the present study we conclude that though the Staphylococcus aureus is usually having multidrug resistance pattern. So regular antimicrobial susceptibility surveillance is essential for area‐wise monitoring of the resistance patterns. This will be beneficial to preserve the effectiveness of antibiotics and for better patient management.

scholarly journals Susceptibility of Clinical Isolates of Staphylococcus aureus to Ceftaroline

2021 ◽  
Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
The United States ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital

Introduction: Methicillin-Resistant Staphylococcus aureus(MRSA) infection is a major global healthcare problem, the prevalence of which varies from 25-50% in India. It is known to cause Skin and Soft tissue Infections (SSI), endovascular infections, endocarditis, pneumonia, septic arthritis, osteomyelitis, and sepsis. Vancomycin is the drug of choice for treating severe MRSA infections. Ceftaroline, a fifth-generation cephalosporin has been approved by the United States Food and Drug Administration (US FDA) for treating acute bacterial SSI caused by susceptible micro-organisms including MRSA, Community acquired respiratory tract infection, MRSA bacteremia and endocarditis. Aim: To assess the susceptibility of clinical isolates of S. aureusto ceftaroline, in a Tertiary Care Hospital. Materials and Methods: This prospective study was conducted in the Department of Microbiology of a Tertiary Care Hospital over a period of two months from June 2019 to July 2019. S.aureus isolates from various clinical samples were screened for methicillin resistance by disc diffusion method using cefoxitin disc and ceftaroline susceptibility of these isolates was assessed by E-strip method. The isolates were classified as ceftaroline susceptible, Susceptibility Dose Dependent (SDD) and ceftaroline resistant respectively as per CLSI guidelines. A descriptive analysis of the data was done and the results were presented as frequencies and percentages. Results: All the S.aureus isolates were found to be susceptible to ceftaroline. Methicillin Sensitive Staphylococcus aureus(MSSA) isolates had lower Minimum Inhibitory Concentration (MIC) when compared to MRSA. The highest MIC among MRSA was 0.5 μg/mL. Conclusion: Ceftaroline can be considered as an effective alternative for treatment of infections caused by MRSA.

scholarly journals Phenotypic study of Macrolide-Lincosamide-Streptogramin B Resistance in Staphylococcus aureus and their relationship with Methicillin-Resistant Staphylococcus aureus (MRSA) at Tertiary Care in Eastern Nepal

2016 ◽  
Vol 5 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Ganesh Kumar Singh ◽  
Bigu Kumar Chaudhari ◽  
Kamal Prasad Parajuli
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Constitutive Resistance ◽  
Antibiotic Susceptibility Test

Background Resistance to antimicrobial agents is prevalent among Staphylococci. This has led to wide uses of macrolide-lincosamide-streptogramin B (MLSB) antibiotics to Staphylococcus aureus (S. aureus) infections. MLSB though chemically distinct, have similar target site and mode of action. The multiple mechanisms are responsible for resistance to MLSB antibiotics which can lead to clinical failure. The aim of the study was to investigate the frequency of inducible and constitutive clindamycin resistance among clinical isolates of S. aureus and their relationship with Methicillin-resistant Staphylococcus aureus (MRSA).Material & Methods A total of 336 unique Staphylococcus aureus isolates from different clinical samples obtained from patients were studied. Antibiotic susceptibility test was performed by Kirby- Bauer disc diffusion method. “D test” was performed to detect inducible clindamycin resistance as per CLSI guidelines. MRSA was detected using Cefoxitin (30μg) and results were interpreted according to CLSI criteria.Results Inducible clindamycin resistance was seen in 45 (13.39%), constitutive clindamycin resistance was seen among 58 (17.26%) while MS phenotype was observed among 38(11.30%) of isolates. Inducible resistance as well as constitutive resistance was higher among MRSA as compared to MSSA (21.11%, 4.48% and 21.11%, 12.82%respectively).Conclusion The Successful use of clindamycin for the treatment of infection caused by S. aureus can be predicted based on the result of simple and inexpensive D test.Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, 1-5

scholarly journals Antimicrobial Resistance Patterns and Plasmid Profiles of Methicillin Resistant Staphylococcus aureus Isolated from Clinical Samples

2019 ◽  
Vol 7 (1) ◽  
pp. 8-14
Author(s):  
Gaurav Agrahari ◽  
Amrit Koirala ◽  
Roshan Thapa ◽  
Mahesh Kumar Chaudhary ◽  
Reshma Tuladhar
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Antibiotic Susceptibility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Plasmid Profile ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Plasmid Profiles ◽  
Resistance Patterns

Methicillin-resistant Staphylococcus aureus (MRSA), showing resistance to several antibiotics is a global health problem associated with considerable mortality and morbidity. Antibiotic susceptibility test is a commonly used method to characterize MRSA in epidemiologic studies. Additionally, plasmid profile has been reported to be useful in tracing the epidemiology of antibiotic resistance. This research was conducted to determine the antimicrobial resistance patterns and plasmid profiles of MRSA isolated from clinical samples at KIST Medical College, Imadol, Kathmandu, Nepal. All the clinical specimens sent to the laboratory were processed by standard microbiological techniques and antibiotic susceptibility testing was done by the modified Kirby Bauer disc diffusion method. Further, plasmid profiling was done by Alkaline-lysis method. A total of 27 (38.02%) MRSA were isolated from 71 S. aureus positive samples. MRSA showed the highest resistance towards penicillin (92.60%) and ampicillin (92.60%). In contrast, high levels of sensitivity were shown towards vancomycin (85.19%) and tetracycline (85.19%). Out of 27 MRSA positive samples, single plasmids were isolated from only 6 (22.22%) MRSA isolates. Antibiograms alone are inadequate to accomplish the characterization of MRSA during epidemiological studies. However, plasmid profile analysis in conjunction with the antibiotic susceptibility pattern is valuable in the epidemiological investigation of MRSA, and for reducing MRSA prevalence and treatment cost.

scholarly journals A study of nasal carriage of methicillin-resistant staphylococcus aureus in patients undergoing hemodialysis in a tertiary care hospital of Punjab

2021 ◽  
Vol 8 (10) ◽  
pp. 4933
Author(s):  
Prabhjot Singh Dhillon ◽  
Vishal Sharma ◽  
Manpreet Kaur Brar ◽  
Durgesh Thakur ◽  
Rupali Rishu ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Susceptibility Testing ◽  
Methicillin Resistance ◽  
Nasal Carriage ◽  
Hemodialysis Patients ◽  
Healthy Population ◽  
Carrier Status ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Increased Risk

Background: Infection is one of the major problems encountered in hemodialysis patients. The mortality rate among the patients undergoing hemodialysis remains unsatisfactorily high. Hemodialysis patients have higher nasal carriage rate of Staphylococcus aureus than the healthy population. In long-term hemodialysis patients, colonization is a significant problem and is associated with an increased risk of the bloodstream infections. The antimicrobial resistance to this pathogen is increasing rapidly, and the consequences of methicillin resistance for the outcomes of Staphylococcus aureus infections are drastic.Methods: Two swabs were collected from anterior nares of patients undergoing hemodialysis, and then these swabs were transferred to microbiology laboratory for processing. Isolated strains were subjected to antimicrobial susceptibility testing using Kirby-Bauer disc diffusion. Methicillin resistance was detected by using cefoxitin disc. Inhibition zone diameters were measured as per CLSI criteria. Vancomycin screen agar test was done. Brain heart infusion agar plates containing 6 µg/ml of vancomycin were used. S. aureus ATCC 29213 was used as reference strain.Results: It was observed that 38% (38/100) of the hemodialysis patients were carriers of S. aureus followed by CoNS, followed by aerobic spore bearers. All the S. aureus isolates (100%, 38/38) were methicillin-resistant (MRSA).Conclusions: Staphylococcal nasal carrier status in hemodialysis patients along with antibiotic susceptibility testing should be done in routine and infection control practices should be followed to prevent the transmission of MRSA among chronic hemodialysis patients.

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