Distribution of MR-CoNS in the clinical staffs of tertiary care hospital

Author(s):  
Sonu S. Ahirwar ◽  
Prabhat Jatav ◽  
Kirti Kushwaha

Methicillin-resistant coagulase-negative staphylococci (MR-CoNS) associated infection is a growing concern in healthcare settings now a day. MR-CoNS are the main infectious agents of the hospital acquired infection. Clinical staffs to patients transmission of resistant strains have caused a rapid increase in the prevalence of antimicrobial resistance in recent years. Growing rate of antimicrobial resistant against available antibiotics of MR-CoNS is a developing problem in low income or lower middle income counties. This study was conducted to determine the occurrence MR-CoNS isolated from different clinical staffs of tertiary care hospital. This prospective study conducted in clinical staffs, nasal swab were collected from all the participants. Screening of CoNS were done on the basis of cultural, morphological and biochemical tests, identification and AST analysis done by VITEK-2 automated system. Methicillin resistance pattern was checked by VITEK-2 and Kirby-Bauer disc diffusion method according to CLSI guideline. A total of 129 nasal swab samples were collected from clinical staffs, of which n=81 isolates (85.6%) were CoNS. Among n=81 CoNS, (48.12%) , (41.97%) , (7.4%) and (2.4%) were reported. Out of n=81 CoNS isolates, n=26 were conformed as MR-CoNS. Maximum methicillin resistance were reported in 53.48% (14/26), 42.30% (11/26), 3.84% (1/26) and 0% (0/26). Theoccurrence rate of MR-CoNS are higher (20.6%) in the healthcare workers and most of the methicillin resistant-CoNS isolates shows high level of resistance against widely used antibiotics but all the isolates susceptible against vancomycin.

Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai

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.


Author(s):  
Kumud Bala ◽  
Ridhima Wadhwa ◽  
Rachana Bohra

Objective: The purpose of the present study was to identify the fermenting and non-fermenting gram negative bacteria from the tertiary care hospital.Methods: The conventional method of identification by biochemical analysis and antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method. Furthermore, analysis of microbes was done by Vitek-2.Results: 424strains of lactose fermenting and non-lactose fermenting gram negative bacilli were isolated from 3097 clinical samples. From the total lactose fermenting bacteria Escherichia coli was the predominant isolate accounting for 50.94% specimens, followed by Klebsiella pneumonia 27.59% and Enterobacter 0.47%. From the total non-lactose fermenting gram negative bacilli Acinetobacter baumannii was the predominant isolate accounting for 12.73% specimens followed by Pseudomonas aeroginosa 6.13%, other isolates were Stenotrophomonas maltophilia 1.17% , Burkholderia cepacia 0.94%. In the present study male were more infected than female. The study also showed that lactose fermenting bacteria were more infectious than non lactose-fermenting bacteria and isolates were from urine samples.Conclusion: Both Non-Lactose Fermenting Gram Negative Bacilli and Lactose Fermenting Gram Negative Bacilli were found to be major contaminants, and are important pathogenic bacteria causing wide range of infections in the tertiary care hospital.Keywords: Lactose fermenting gram negative bacteria, Vitek-2, Tertiary Care Hospital, Kirby-Bauer Disc Diffusion, Lactose non-fermenting gram negative bacteria  


Author(s):  
Paul Cheddie ◽  
Drovashti Seepersaud ◽  
Tereasia Ramlochan

Background and Aim: Methicillin-resistant Staphylocccus aureus (MRSA) continues to be a major problem globally. Previous data had suggested that the prevalence of MRSA infections in the tertiary hospital setting was 51%. The aim of this study was to conduct a point prevalence survey of MRSA infections occurring at a tertiary-care hospital in Georgetown, Guyana, and to determine to what extent methicillin-resistance was occurring among Staphylococcus aureus isolates utilising the minimum inhibitory concentration (MIC) data. Study Design: This study was based on a prospective, analytical design. Place and Duration of Study: Microbiology department, Georgetown Public Hospital Corporation (GPHC), and Department of Medical Technology, University of Guyana, between May 2019 and July 2019. Methodology: A total of 101 consecutive, non-repetitive, laboratory-identified MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) isolates were tested using an oxacillin broth microdilution method. Results: We found that 65.4% of Staphylococcus aureus were oxacillin (methicillin) resistant with a majority of the isolates being high level oxacillin resistant strains (i.e., MICs > 256 μg/ml) (84.85%). Most of the resistant isolates were collected from patients admitted to medical and surgical wards. Conclusion: Methicillin-resistance continues to be a major problem in the hospital setting and conventional techniques are unlikely to identify all of the potentially resistant isolates.


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.


Author(s):  
Nilima R Patil

Background:- Methicillin resistant Staphylococcus aureus (MRSA) are responsible for hospital and community acquired infections. There are many laboratory methods for detection of MRSA. Chromogenic media have been used for the last few years for the quick detection of MRSA. Objective:- Aim of this study was to compare the performance of   conventional methods and chromogenic media for the detection of MRSA in a tertiary care hospital. Material and method: - 200 consecutive isolates of S. aureus confirmed by conventional methods, collected in a tertiary care hospital were used for this study. Cefoxitin and oxacillin disc diffusion test used as conventional methods and Chromogenic media i.e. oxacillin resistant screen agar base (ORSAB) was used for detection of methicillin resistant Staphylococcus aureus. All confirmed MRSA were checked by gold standard mecA base PCR method. Result: - Out of 200 isolates of Staphylococcus aureus, 50,52 and 47 strains were MRSA by Cefoxitin disc diffusion method, oxacillin disc diffusion method and oxacillin resistant screen agar base (ORSAB)  method respectively. Specificity was 100%, 98.66%, 98.66% by Cefoxitin disc diffusion, oxacillin disc diffusion and ORSAB method respectively. Conclusion: - In conclusion, cefoxitin disc diffusion was the best for the phenotypic detection of MRSA because their sensitivity and specificity were better than oxacillin and ORSAB.


2019 ◽  
Vol 19 (3) ◽  
pp. 327-333 ◽  
Author(s):  
Reza Khashei ◽  
Hadi Sedigh Ebrahim-Saraie ◽  
Mahtab Hadadi ◽  
Maysa Ghayem ◽  
Hadi Raeisi Shahraki

Background:Cell phones have become one of the necessary means of life and they are commonly used almost everywhere by every population. Colonized microorganisms on cell phones can be easily cross-transmitted. Given the widespread prevalence of nosocomial infections, this study aimed to determine the frequency of bacterial contamination and antibiotic resistance in cell phones of healthcare workers (HCWs) in a tertiary care hospital, from southwest of Iran.:In this cross-sectional study conducted between April and June 2016, sampling were performed from cell phones of 25 nurses and 75 medical students.Methods:Samples were collected from each cell phone by a moistened cotton swap dipped in normal saline prior and after decontamination with available alcohol-based handrubs. Identification of bacterial isolates was performed by conventional microbiologic methods. Antibiotic susceptibility pattern of the isolates was determined using the disk diffusion method.:The contamination rates of cell phones prior and after disinfection were 88% and 52%, respectively. Ninety-nine (71.2%) out of 139 isolated distinct bacterial colonies prior to cleaning were potentially nosocomial pathogens. Of them, staphylococci (88.9%) were the most prevalent bacteria, in which 40.9% were methicillin-resistant isolates. The majority of Gram-positive and - negative isolates were susceptible to the tested antimicrobials. Totally, contamination rate of cell phones was significantly reduced after decontamination. Regular disinfection of the hands and cell phones was significantly associated with reduction of colonization of the methicillin-resistant isolates.Result & Conclusion:These findings emphasize the restricted use of cell phones and encourage the higher compliance with hygienic practices in hospitals to reduce the risk of nosocomial infections.


Antibiotics ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 3 ◽  
Author(s):  
Aqib Saeed ◽  
Fatima Ahsan ◽  
Muhammad Nawaz ◽  
Khadeja Iqbal ◽  
Kashif Rehman ◽  
...  

Staphylococcus aureus (S. aureus)-associated infections are one of the major threats to public health. The aim of the present study was to determine the antibiotic resistance pattern as well as the genetic characterization of methicillin and vancomycin resistant S. aureus (VRSA) isolated from a tertiary care hospital in Lahore. The S. aureus isolates were isolated from different clinical samples, identified by biochemical testing, and subjected to antibiotic susceptibility testing via the disc diffusion method or broth microdilution method. The methicillin resistance gene (mecA) and vancomycin resistance gene (vanA) were amplified by the polymerase chain reaction. The S. aureus isolates showed high incidences of resistance against methicillin (76%) and moderate incidences of resistance to vancomycin (14%). Isolates were also resistant to several other drugs, such as cefoxitin (76%), ertapenem (83%), ampicillin (81%), tobramycin (78%), moxifloxacin (76%), and tetracycline (74%). An encouraging finding was that 98% of isolates were susceptible to tigecycline, indicating its possible role in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) and VRSA, as well as the multi-drug resistant S. aureus. The mecA gene was detected in 33.3% of tested isolates (10/30), while the vanA gene was also detected in 30% (9/30) of the tested isolates. In conclusion, the frequent presence of methicillin and vancomycin resistance in S. aureus appraises the cautious use of these antibiotics in clinical practices. Furthermore, it is suggested that there should be continuous monitoring of tigecycline treatments in clinical setups in order to delay the development of resistance against it.


Author(s):  
Drovashti Seepersaud ◽  
Tereasia Ramlochan ◽  
Paul Cheddie

Objective: Previous studies done in the hospital setting in Guyana have shown that the frequency of isolation of methicillin-resistant Staphylococcus aureus isolates far exceeds the worldwide estimate of 50%. These past studies have been based on the use of the Kirby-Bauer disk diffusion methodology. The present study was conducted to determine the minimum inhibitory concentration of clinical isolates of methicillin-susceptible and methicillin-resistant S. aureus using the broth microdilution method. Design and Methods: A total of 101 consecutive, non-repetitive S. aureus isolates obtained from the GPHC medical lab during a six-week period were included in the study. These isolates were identified as MRSA and MSSA by laboratory personnel using the cefoxitin disk diffusion method. The oxacillin MICs for all isolates obtained were determined using prepared oxacillin broth microdilution trays with concentrations ranging from 4 μg/ml to 256 μg/ml. All results were interpreted according to CLSI guidelines. Results: The prevalence of MRSA at GPHC was found to be 65.35% with a majority of the isolates being high level oxacillin resistant strains with MICs > 256 μg/ml (84.85%). In our study, most resistant isolates were collected from patients admitted to the FSW (16.67%), Paediatric Wards (13.65%), MSW (13.64%), and FMW (12.12%). Additionally, 35 (79.55%) MSSA were suspected oxacillin susceptible with MIC < 4 μg/ml. The relationship between the cefoxitin disc diffusion and oxacillin broth microdilution results was found to be statistically significant with a p < 0.001. Conclusion: Methicillin-resistance continues to be a major problem in the hospital setting, and this study has should that commonly used conventional techniques are unlikely to identify all of the potentially resistant isolates. Recommendation: The high prevalence and high oxacillin MIC of MRSA at GPHC suggests that more emphasis should be placed on infection control and surveillance programs within the hospital setting.


2008 ◽  
Vol 47 (170) ◽  
Author(s):  
Namrata Kumari ◽  
TM Mohapatra ◽  
YI Sigh

Nosocomial infection is a major problem in the world today. Methicillin-resistant Staphylococcus aureus (MRSA) strains, usually resistant to several antibiotics, shows a particular ability to spread inhospitals and is now present in most of the countries.The aim of the present study was to determine the prevalence of MRSA infections and theirantimicrobial susceptibility pattern in our hospital located in eastern Nepal.Identification of Staphylococcus aureus was confirmed by standard methods and the antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. Interpretation criteriawere those of the national committee for clinical laboratory standards.During a period of one year, out of a total of 750 Staphylococcus aureus strains isolated from variousclinical samples, 196 (26.14%) were found to be Methicillin-resistant. Seventy percent isolates of MRSA were from inpatient departments and amongst them only 10% of the isolates were from intensive care units (ICU). More than 65% of MRSA were found to be resistant to Penicillin, Cephalosporins, Ciprofloxacin, Gentamicin Erythromycin and Tetracycline, while 47.96% of them were resistant to Amikacin. Many MRSA strains were multidrug-resistant. However, no strains were resistant toVancomycin.To reduce the prevalence of MRSA, the regular surveillance of hospital acquired infection, isolationnursing of patients who carry MRSA, monitoring of antimicrobial susceptibility pattern andformulation of a definite antibiotic policy may be helpful.Key words:eastern Nepal, resistant, tertiary-care hospital


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