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

Author(s):  
Archana Bhimrao Wankhade ◽  
Sanjibkumar Panda ◽  
Riddhi Hathiwala ◽  
Yogendra Keche

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.

Author(s):  
Jeevan Shetty ◽  
Zarrin Afroz

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.


2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Devi Thapa ◽  
Susil Pyakurel ◽  
Sabita Thapa ◽  
Suresh Lamsal ◽  
Mahesh Chaudhari ◽  
...  

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.


Author(s):  
Beena Hosdurg Bhaskar ◽  
Shalini Shenoy Mulki ◽  
Sangeeta Joshi ◽  
Ranjeeta Adhikari ◽  
Bhavana Malavalli Venkatesh

Objective: There is an increasing use of colistin consequent to increase in the infections caused by carbapenem-resistant Klebsiella pneumoniae.The present study was conducted to determine the minimum inhibitory concentration (MIC) of colistin and the resistance pattern of colistin in carbapenem-resistant K. pneumoniae (CRKP) strains in our intensive care unit (ICU).Methods: Antibiotic susceptibility testing for other antimicrobial agents was done by Kirby-Bauer disk diffusion method. MIC of colistin was determined by agar dilution method. The results of antibiotic susceptibility testing were interpreted as per Clinical Laboratory Standard Institute guidelines 2016 and MIC of colistin were interpreted as per European Committee on Antimicrobial susceptibility testing. The carbapenem resistance was phenotypically detected by modified hodge test and imipenem/imipenem ethylenediaminetetraacetic acid disk method.Results: Out of 518 K. pneumoniae, 329 were resistant to carbapenems, and 91 isolates showed resistance to colistin. The MIC of colistin ranged between 4 and >512 ug/ml and MIC90 was 16 ug/L and MIC50 was 4 ug/ml. A majority of the colistin-resistant isolates were found in multidisciplinary ICU (85/91).Conclusion: The emergence of colistin-resistant strains is a major problem due to limited treatment options for infections caused by CRKP carbapenemase producing K. pneumoniae. Colistin should not be used alone, combination therapy should be preferred.


Author(s):  
Javid Sisakhtpour ◽  
Fatemeh Savaheli Moghadam ◽  
Sepideh Khodaparast ◽  
Nima Khoramabadi ◽  
Ashraf Mohabati Mobarez

Background. Clostridium (Clostridioides) difficile is recognized as the major cause of healthcare antibiotic-associated diarrhea. We surveyed a molecular epidemiological correlation between the clinical isolates from two general hospitals in Iran through clustering toxigenic types and antibiotic susceptibility testing (AST) accuracy. Methods. Study population included 460 diarrhoeic specimens from inpatients with a history of antibiotic therapy. All samples underwent enriched anaerobic culture, confirmed by detection of gluD gene with PCR. Toxin status and AST were assessed by the disk diffusion method (DDM) and minimal inhibitory concentrations (MICs) of metronidazole, vancomycin, and rifampin. C. difficile outbreak was analyzed through conventional PCR by tracing toxin genes and Homebrew pulsed-field gel electrophoresis (PFGE) for characterizing isolates within our healthcare systems. Results. A total of 29 C. difficile strains were isolated by enriched anaerobic culture from the clinical samples. Among them, 22 (4.8%) toxigenic profiles yielded toxins A and B (tcdA, tcdB) and binary toxins (cdtA, cdtB). The minimum inhibitory concentration (MIC) was 18.1% and 9% for vancomycin and metronidazole, and all isolates were susceptible to rifampicin and its minimum inhibitory concentration was at <0.003 μg/mL. The most dominant toxigenic and antibiotic-resistant “pulsotype F” was detected through PFGE combined with multiple Clostridial toxigenic pattern and AST. Conclusions. DNA fingerprinting studies represent a powerful tool in surveying hypervirulent C. difficile strains in clinical settings. Resistance to vancomycin and metronidazole, as first-line antibiotics, necessitate accomplishment of proper control strategies and also prescription of tigecycline as a more appropriate option.


2018 ◽  
Vol 4 ◽  
pp. 23-31
Author(s):  
Sarita Manandhar ◽  
Sarashwoti Adhikari ◽  
Sujeeb Rajbhandari

Objectives: In order to determine the prevalence of multi-drug resistance along with AmpC and metallo-β-lactamase producing P. aeruginosa, a six month cross-sectional study was carried out at Shahid Gangalal National Heart Center.Methods: A total of 756 clinical specimens were analyzed for bacteriological profile. The bacterial isolates were identified by cultural and biochemical techniques. Antibiotic susceptibility testing of the isolates was performed by Kirby-Bauer disc diffusion method. MDR isolates were screened and tested for MBL and AmpC production. Ceftazidime resistant isolates were tested for MBL and Cefoxitin resistant isolates for AmpC.Results: Among all the clinical samples analyzed, P. aeruginosa was detected in 75 samples (9.92%). Antibiotic susceptibility testing showed Imipenem as the most effective drug with susceptibility of 76% followed by Piperacillin-Tazobactam (74.7%) and Piperacillin (41.3%). Out of 75 P. aeruginosa isolates, 53 (70.6%) of them were found to be resistant to at least three out of four anti-pseudomonal agents, thus were considered as MDR. Out of 53 multi-drug resistant P. aeruginosa (MDRPA), all were resistant to ceftazidime whereas 85% (45/53) were resistant to cefoxitin. Out of 53 isolates, 11 (20.75%) showed positive result for MBL. Similarly, 7 out of 45 i.e. 13.2% were found to be AmpC producers.Conclusion: This study signified the high prevalence of MDRPA which is an alarming rate. Also multiple β-lactamase producing P. aeruginosa were detected which can further complicate the treatment options. Regular monitoring of antibiotic susceptibility and rational use of antibiotics would be helpful in eliminating the outbreaks of multiple β-lactamase producing MDRPA.


Author(s):  
Muhammad Ali

The research was aimed to evaluate the antibiotic susceptibility pattern of Staphylococcus species from clinical samples obtained from some hospitals in Kano metropolis, Nigeria. The ear swab, high vaginal swab (HVS), wound swab and urine samples from the patients attending the hospitals were collected and inoculated onto the surface of freshly prepared Nutrient agar for bacterial isolation. The bacteria isolated were identified by conventional microbiological methods namely; Gram staining, biochemical test (such as catalase, coagulase, and DNase test), mannitol salt agar and heamolysis test. The isolates were subjected to antibiotic susceptibility testing using the agar disc diffusion method. The result showed that S. aureus was highly susceptible to Ciprofloxacin 105 (68.63%), Gentamicin 102 (66.67%), Levofloxacin 95 (62.08%) and Amikacin 90 (58.82%), S. epidermidis was highly susceptible to Gentamicin 13 (61.90%), Levofloxacin 12 (57.14%) and Nitrofurantoin 11 (52.38%) while S. saprophyticus was highly susceptible to Cefoxitin 7 (77.78%), Gentamicin 6 (66.67%) and Nitrofurantoin 5 (55.56%). On the other hand, S. aureus was highly resistant to Cefuroxime 153 (100%), Ceftazidime 150 (98.04%), Amoxicillin/clavulanic acid 120 (78.43%) and Cloxacillin 111 (72.55%), S. epidermidis was highly resistant to Ceftazidime 20 (95.24%), Cloxacillin 19 (90.48%) then Cefoxitin, Erythromycin and Amoxicillin/clavulanic acid with 15 (71.43%) both. S. saprophyticus was highly resistant to Cefepime 9 (100%), Cloxacillin 8 (88.89%), Ceftazidime 7 (77.78%), Imipenem and Erythromycin with 6 (66.67%) respectively. There is a statistical difference in the sensitivity of the isolates against the antibiotics used at p<0.05. It is concluded that Staphylococcus species develop resistance to some classes of antibiotics.


Author(s):  
G. A. C. Ezeah ◽  
M. C. Ugwu ◽  
A. O. Ekundayo ◽  
O. F. Odo ◽  
O. C. Ike ◽  
...  

Vancomycin resistant enterococci (VRE) are a major medical concern globally. Their significantly greater prevalence and the ability to transfer resistance to vancomycin from other bacteria made them an object of interest and intense research. The isolates of Enterococcus sp. were subjected to antibiotic susceptibility testing before curing. The three Enterococcus species exhibited different antibiotic resistance profile. Pre-curing antibiotic resistance of nosocomial isolates compared with community acquired isolates revealed that high percentage of the nosocomial isolates were resistant to antibiotics compared to community isolate. Post-curing antibiograms of the isolates showed different resistant and susceptibility pattern. Also, DNA plasmid pre-curing and post curing analysis of the isolates showed different resistance pattern. Six of the 15 representative isolates selected on the basis of their high pre-curing antibiotic resistance for plasmid analysis with 0.8% agarose electrophoresis were positive for plasmid DNA. Four (4) of the positive isolates (E. faecium, E. faecium, E. faecalis, and E. avium) had plasmid fragment of greater than 1000 bp while two (2) of them (E. faecalis and E. faecalis) had fragments of between 100 and 500 bp. The remaining nine (9) had no plasmid DNA. The study revealed the pathogenicity factors demonstrated with the enterococcal isolates.


2019 ◽  
Vol 7 (1) ◽  
pp. 8-14
Author(s):  
Gaurav Agrahari ◽  
Amrit Koirala ◽  
Roshan Thapa ◽  
Mahesh Kumar Chaudhary ◽  
Reshma Tuladhar

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.


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