scholarly journals Prevalence of carriage of community-acquired Methicillin-resistant Staphylococcus aureus among children attending the pediatric OPD at a tertiary care hospital

2018 ◽  
Vol 5 (5) ◽  
pp. 1956 ◽  
Author(s):  
Vishnurajan Radhakrishnan ◽  
Saranya Ravichandran ◽  
Senthamarai Murugaiyan Vadivelu ◽  
Shankar Radhakrishnan

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are commonly recognized in persons without traditional risk factors. Nasal carriage of MRSA is an important risk factor for subsequent MRSA infection and transmission of this pathogen. The aim of this study was to estimate the prevalence of carriage of community acquired MRSA and to describe its antibiotic susceptibility pattern among the pediatric population.Methods: A prospective longitudinal study was conducted in our hospital for a period of 6 months. All pediatric patients age less than 15 years attending the pediatric OPD were included in the study. A total of 325 children were included in the study based on our inclusion and exclusion criteria. Nasal smear was collected by tilting back the child’s head and gently inserting a sterile cotton swabs pre-wetted with sterile saline and slowly rotating against the turbinate of both anterior nares. The following antibiotics were tested for sensitivity pattern: penicillin, pipercillin, erythromycin, clindamycin, cotrimoxazole, vancomycin, linezolid, rifampin, ciprofloxacin and daptomycin. Any S. aureus that is resistant to Cefoxitin was defined as MRSA.Results: The prevalence of Staphylococcus aureus was found to be 26.7% of the entire microorganism detected and 6.4% (n = 21) of the entire study subjects had methicillin resisitant Staphylococcus aureus. Of testing the susceptibility of the various antibiotics vancomycin was the only drug found to be 100% sensitive followed by linezolid and pipericillin (90%). 50% sensitivity was seen with erythromycin and very poor sensitivity was seen in cefuroxime and ciprofloxacin (<50%).Conclusions: CA-MRSA strains tend to replace HA-MRSA in health-care settings, making infection control measures less effective. Hospital based antibiotic policy has to be created and strictly followed to minimize the burden of antibiotic resistance. 

2010 ◽  
Vol 2 (02) ◽  
pp. 078-081 ◽  
Author(s):  
Shilpa Arora ◽  
Pushpa Devi ◽  
Usha Arora ◽  
Bimla Devi

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.


2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Aneela Khawaja ◽  
Faiqa Arshad ◽  
Rabiya Jamil

Introduction: The versatility of Staphylococcus aureus has been transformed as “Methicillin resistant Staphylococcus aureus”. The most challenging are the disastrous virulence patterns being expressed due to the selection pressure of antibiotics. For assessing the prevalence of methicillin resistant Staphylococcus aureus; screening by cefoxitin disc (30µg) diffusion method is still a realistic approach among conventional phenotypic methods, being applied in most of the laboratories. This reliable and feasible technique contributes significantly for MRSA detection. This study has been designed to evaluate the prevalence and identify the sensitivity pattern of methicillin resistant Staphylococcus aureus isolates from different clinical specimens in a tertiary care hospital. Study Design: Descriptive study. Setting: Pathology Department, Microbiology Laboratory, PGMI. Period: January 2015 to December 2015. Materials & Methods: A total 713 clinical isolates of Staphylococcus aureus were processed. Identification and confirmation of Staphylococcus aureus was done by colony morphology on blood agar, gram stain, catalase, coagulase and DNA-ase tests. Screening for methicillin resistance was done using cefoxitin disc (30mg, OXOID); while different antibiotic discs were used to assess the sensitivity profile by Modified Kirby-Bauer Disc Diffusion method according to CLSI guidelines (2016). Results: Out of 713 Staphylococcus aureus isolates, 92 (12.90%) isolates were labelled as methicillin resistant by cefoxitin disc diffusion test. Out of 92 MRSA isolates, 57 (14.65%) were recovered from male patients and 35 (10.80%) from female patients. While, 60 (65.22%) MRSA isolates showed hemolysis on blood agar. Among 92 MRSA isolates, 41 (44.57%) were recovered from pus specimen. Resistance to trimethoprim/sulfamethoxazole was highest (65.22%) after penicillin (100%); while all the MRSA isolates were 100% sensitive to both vancomycin and linezolid. Conclusion: The prevalence of MRSA in hospital care settings is of great clinical concern. To combat this public health threat effectively, continuous surveillance of health-care associated infections, along with local antibiotic sensitivity pattern of MRSA; as well as formulation of a definite antibiotic policy is required.


2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Bidya Shrestha ◽  
B M Pokhrel ◽  
T M Mohapatra

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), the most common cause ofnosocomial infection has been a major cause of morbidity and mortality around the world. They arenormally resistant to most of the antibiotics used in clinical practice. This study has been carried outto fi nd out the resistance pattern among S. aureus.Methods: During November 2007 to June 2008, clinical samples from patients with nosocomialinfection were processed for culture and sensitivity following standard methodology in microbiologylaboratory, Tribhuvan University teaching hospital, Kathmandu, Nepal.Results: Among 149 Staphylococcus aureus isolates, highest resistance was observed against Penicillin(91.94%) followed by Fluoroquinolone (61.74%), Erythromycin (52.94%), Gentamicin (46.98%),Cotrimoxazole (42.95%), Tetracycline (40.94%) and others, whereas susceptibility was observedmaximum against Chloramphenicol (94.85%) followed by Rifampicin (92.61%), Tetracycline(59.06%), Cotrimoxazole (57.04%), and others. None of the isolates were resistant to Vancomycinand Teicoplanin. Of these isolates 44.96 % of the isolates were Methicillin resistant S. aureus (MRSA).Resistance to Penicillin, Fluoroquinolone, Erythromycin, Gentamicin, Co-trimoxazole and Tetracyclinewere associated signifi cantly with MRSA isolates (X2= 8.779, p<0.05, X2= 74.233, p<0.05, X2= 84.2842,p<0.05, X2= 108.2032, p<0.05, X2= 88.1512, p<0.05 and X2= 79.1876, p<0.05 respectively). Althoughmost of the Methicillin sensitive S. aureus (MSSA) isolates were susceptible to both Rifampicinand Chloramphenicol, only Rifampicin susceptibility was signifi cantly associated with them (X2=10.1299, p<0.05). Among three Biochemical tests for the detection of β lactamase detection namelychromogenic, iodometric and acidimetric test, chromogenic test method had highest sensitivity andspecifi city.Conclusions: Since MRSA comprised a greater part of S. aureus isolates and were multi-resistant,patients infected by such strains should be identifi ed and kept in isolation for hospital infectioncontrol and treated with second line of drug like vancomycin.Key Words: β lactamase, methicillin resistant Staphylococcus aureus,methicillin sensitive Staphylococcus aureus, resistance pattern


Author(s):  
Shamim Rahman ◽  
Ragini Ananth Kashid

MRSA causes nosocomial and community based infections. It is associated with significant mortality and morbidity. Resistance in MRSA is encoded by mecA gene. Anterior nares are the ecological niche of Staphylococcus aureus. HCWs who are colonized with MRSA, act as agents of cross contamination of hospital and community acquired MRSA. Treating MRSA infections is a therapeutic challenge as it is resistant to beta lactam group of drugs. Therefore, there is a need for rapid and accurate detection of MRSA carriage in HCWs and to understand its antibiotic susceptibility pattern.The objective of the present study is to estimate the occurrence of MRSA in HCWs, using phenotypic and genotypic methods. A prospective study for six months was conducted after obtaining Institutional Ethical Committee clearance. Anterior nasal swabs of those HCWs who gave informed consent were taken processed for culture and sensitivity as per standard protocol. To detect MIC for oxacillin, E-strip method was used. mecA gene detection was done by PCR. A total of 300 HCWs were sampled.14.66% (44/300) of the isolates were identified as Staphylococcus aureus, of which 10 isolates were detected as MRSA. The overall isolation rate of MRSA is 3.33 %(10/300). MRSA carriage was high amongst nurses (5/59, 8.47%), followed by doctors (4/105, 3.80%).Antibiotic sensitivity pattern showed that highest resistance was to penicillin (75%) followed by amoxiclav (70.45 %).9 MRSA isolates were detected as mecA gene positive by PCR. MRSA carriers were decontaminated successfully with 2% mupirocin ointment and 2% chlorhexidine shampoo. This study reiterates the need for rapid and accurate identification of HCWs who have nasal colonization with MRSA, for reinforcing hospital infection control measures and decontamination protocol. This will help prevent the spread of MRSA in our community.


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