Antibiogram of Staphylococcus aureus in a Tertiary Care Hospital: Changing Trends

Methicillin resistant Staphylococcus aureus (MRSA) is major cause of nosocomial and community infections. Its prevalence varies with country and with hospitals within a country. Therefore, it is important for continuous surveillance in hospitals and other healthcare facilities in order to limit the spread of infections caused by MRSA. To determine the antibiogram of Staphylococcus aureus in a tertiary care hospital and to determine the change in trends in the antimicrobial susceptibility pattern of Staphylococcus aureus. To determine the prevalence of MRSA in a tertiary care hospital. This cross- sectional study was conducted at the Department of Microbiology, SMSR, Sharda University and Hospital. A total of 100 strains identified by morphological and biochemical characteristics were tested for antibiotic susceptibility using Kirby-Bauer disc diffusion method and the Prevalence of Inducible Clindamycin Resistance among the isolates. 100 out of 13,639 isolates clinical comprising samples were obtained Pus (78.6%), Blood (7%), Swab (4.1%), Sputum (4.1%), Urine (4.1%), Semen (2%). Maximum MRSA were obtained from pus samples (81%). However, out of total 7 isolates of Staphylococcus aureus obtained from blood 4 were MRSA and 3 were MSSA. The prevalence of MRSA that is (40%) infections was a high in our setup and is comparable to studies done earlier. This trend is particularly alarming for Staphylococcus aureus because of the severity and diversity of disease caused by this uniquely versatile pathogen.

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Phenotypic Detection of Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus aureus in Bharatpur Hospital

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i3.28490 ◽

2020 ◽

Vol 16 (3) ◽

Author(s):

Ramesh Sharma Regmi ◽

Sujan Khadka ◽

Sanjeep Sapkota ◽

Swekshya Thapa Magar ◽

Sanjib Adhikari ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Treatment Failure ◽

Tertiary Care ◽

Clinical Isolates ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Disc Diffusion ◽

Cross Sectional ◽

Inducible Clindamycin Resistance

Background: Clindamycin is regarded as a reserve drug in the treatment of staphylococcal infections. Among few therapeutic alternatives available for treatment of erythromycin-resistant Staphylococcus aureus infections, clindamycin has several advantages but major limitation in its use is the development of resistance resulting in treatment failure. Routine clindamycin susceptibility test may fail to detect such inducible resistance which can be detected by Double disc diffusion test (D-test). The present study was undertaken to determine the incidence of inducible clindamycin resistance among clinical isolates of S. aureus in a tertiary care hospital in central Nepal. Methods: A cross-sectional study was carried out among the patients visiting Bharatpur Hospital from September to November 2019. A total of 1279 clinical samples were examined for the identification of S. aureus by standard microbiological procedures. Antibiotic susceptibility testing of the isolates was done by Kirby-Bauer disc diffusion method and all the erythromycin-resistant isolates were subjected to D-test for the phenotypic detection of inducible clindamycin resistance according to CLSI guidelines (2016). Results: S. aureus was recovered from 4.5% (58/1279) samples of which 35 isolates were Methicillin-Resistant Staphylococcus aureus (MRSA) and 23 were multi-drug resistant (MDR). Tetracycline was found to be the most effective antibiotic whereas erythromycin was the least effective. D-test revealed that 39.7% isolates showed iMLSB phenotype, 3.5% showed cMLSB phenotype and 56.8% showed MS phenotype. The percentage of inducible and constitutive resistance was seen higher amongst MRSA isolates compared to Methicillin-Sensitive Staphylococcus aureus (MSSA) isolates. Incidence of S. aureus was found higher among females and in the age group 20-30 years and in pus samples (p<0.01). Conclusions: Routine testing of inducible clindamycin resistance is suggested among the clinical isolates of erythromycin-resistant Staphylococci to avoid treatment failure.

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Methicillin- and Inducible Clindamycin-ResistantStaphylococcus aureusamong Patients with Wound Infection Attending Arba Minch Hospital, South Ethiopia

International Journal of Microbiology ◽

10.1155/2019/2965490 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Mohammedaman Mama ◽

Addis Aklilu ◽

Kassahun Misgna ◽

Molla Tadesse ◽

Eyerusalem Alemayehu

Keyword(s):

Staphylococcus Aureus ◽

Wound Infection ◽

Methicillin Resistance ◽

Demographic Data ◽

Cross Sectional Study ◽

Diffusion Method ◽

Cross Sectional ◽

Methicillin Resistant ◽

Inducible Clindamycin Resistance ◽

Antimicrobial Susceptibility Pattern

Background. Wound infection is one of the most common hospital-acquired infections. Different bacteria cause infection, of whichStaphylococcus aureusis one of the known bacteria in causing infection with increased drug-resistant isolates.Objective. To assess the prevalence and antimicrobial susceptibility pattern of methicillin and inducible clindamycin-resistantStaphylococcus aureusamong patients with wound infections attending Arba Minch Hospital.Methods. A facility-based cross-sectional study was conducted from April to June 2017. A pretested questionnaire was used to collect demographic data and clinical characteristics. Wound swabs were cultured and identified by standard techniques. Antibiotic susceptibility tests were performed by the Kirby–Bauer disc diffusion method. Methicillin resistance was detected using the cefoxitin (30 μg) antibiotic disc while inducible clindamycin resistance was detected by the D-zone test. The data were analyzed using Statistical Package for Social Science, version 20.pvalue <0.05 was considered statistically significant.Results. A total of 161 patients were enrolled and a majority of them were female (90, 50.9%). Among the collected samples, 79 (49.7%) were positive forS. aureus; of this, methicillin resistance accounted for 65 (82.3%). Out of 22 (27.8%) erythromycin-resistant isolates, 19 (24.1%) showed inducible clindamycin resistance. Methicillin-resistantS. aureusshowed higher resistance against tetracycline (72.3%) followed by cotrimoxazole (43.1%) and 100% sensitivity to vancomycin. The overall prevalence of inducible clindamycin resistance among methicillin-resistant isolates was 16 (24.6%).Conclusion. The increasing prevalence of methicillin-resistantS. aureusand the coresistance against other therapeutic options like clindamycin is becoming an obstacle in the treatment of infections which need attention from concerned bodies.

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