scholarly journals Antibiotic resistance pattern of Staphylococcus aureus with reference to MRSA isolates from pediatric patients

2019 ◽  
Author(s):  
Raja Ram Gurung ◽  
Prashanna Maharjan ◽  
Ganga GC

Abstract Background: Staphylococcus aureus is one of the important superbugs distributed throughout the world. It causes minor skin infections to severe complications including nosocomial infections in both hospitals and community settings. These strains have multi-drug resistant property. Hence, they are difficult to manage which increase health-related costs and simultaneously intensifying the need for new antibiotics. The extent of Methicillin-Resistant Staphylococcus aureus (MRSA) in children is largely unknown. The study determines the current status of S. aureus and MRSA causing various infections in pediatric patients visiting International Friendship Children’s Hospital (IFCH). Methods: A cross-sectional study was conducted among patients visiting a hospital. Various clinical specimens were aseptically collected and processed according to standard microbiological procedures. Isolation and identification of S. aureus were done by microscopy, mannitol fermentation, and coagulase positivity. All identified S. aureus isolates subjected to in-vitro antibiogram by Kirby-Bauer disc diffusion technique adopting Clinical and Laboratory Standards Institute (CLSI) guideline. Isolates resistant to cefoxitin were considered to be MRSA. Whereas, isolates produced D-shaped inhibition zone around clindamycin when kept near erythromycin were considered to be Inducible Clindamycin Resistant (ICR). Results: 672 various types of clinical samples were processed from the microbiology laboratory from June and November 2015. Out of 300 culture positive samples, 52 (17.3%) were S. aureus isolates, among them 39 (75.0%) were found to be MRSA. The D-test showed that Macrolide-Lincosamide-Streptogramin-B (MLSB) phenotype was 15.4%. Conclusion: The study shows the MRSA occurrence is prevalent in pediatric patients and newer classes’ drugs are found more effective than β-lactam drugs to treat S. aureus infection. However, restriction on the indiscriminate use of such drugs may be an effective strategy to control the drug resistance. Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Macrolide-Lincosamide-Streptogramin B (MLSB) phenotype, Inducible Clindamycin Resistant (ICR) test or D-zone test, Antibiotic resistance, Nepal

2021 ◽  
Vol 14 (5) ◽  
pp. 420
Author(s):  
Tanveer Ali ◽  
Abdul Basit ◽  
Asad Mustafa Karim ◽  
Jung-Hun Lee ◽  
Jeong-Ho Jeon ◽  
...  

β-Lactam antibiotics target penicillin-binding proteins and inhibit the synthesis of peptidoglycan, a crucial step in cell wall biosynthesis. Staphylococcus aureus acquires resistance against β-lactam antibiotics by producing a penicillin-binding protein 2a (PBP2a), encoded by the mecA gene. PBP2a participates in peptidoglycan biosynthesis and exhibits a poor affinity towards β-lactam antibiotics. The current study was performed to determine the diversity and the role of missense mutations of PBP2a in the antibiotic resistance mechanism. The methicillin-resistant Staphylococcus aureus (MRSA) isolates from clinical samples were identified using phenotypic and genotypic techniques. The highest frequency (60%, 18 out of 30) of MRSA was observed in wound specimens. Sequence variation analysis of the mecA gene showed four amino acid substitutions (i.e., E239K, E239R, G246E, and E447K). The E239R mutation was found to be novel. The protein-ligand docking results showed that the E239R mutation in the allosteric site of PBP2a induces conformational changes in the active site and, thus, hinders its interaction with cefoxitin. Therefore, the present report indicates that mutation in the allosteric site of PBP2a provides a more closed active site conformation than wide-type PBP2a and then causes the high-level resistance to cefoxitin.


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


KYAMC Journal ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Abdullah Akhtar Ahmed ◽  
Md Abdus Salam ◽  
Md Shakhaowat Hossain ◽  
Md Babul Aktar ◽  
Nusrat Akhtar Juyee ◽  
...  

Background: Antimicrobial resistance in pathogens is a growing concern for health. It is a great concern around the globe about the threat of increasing antimicrobial resistance. In response to this concerns, medical experts have proposed initiatives to curtail the spread of antimicrobial resistance in pathogenic bacteria. We have taken this surveillance study in KYAMCH to contain the spread of antimicrobial resistance.Objectives: To determine the prevalence of MRSA from different clinical samples and to record its current status to commonly used anti Staphylococcus antibiotics.Methods: The clinical samples were taken to the laboratory and within four hours cultured for isolates and identification pathogens. Finally, antibiotic sensitivity testing of the isolated Staphylococcus aureus was performed. Results: More than 80% of MRSA isolates were resistant to ampicillin (98%) followed by amoxicillin, cefixime and azithromycin with 94%, 93.5% and 85% respectively and maximum sensitivity toward tobramycin with 86% followed by 85% gentamicin and 79% meropenem.Conclusion: The detected trend in antibiotic resistance patterns of methicillin-resistant and methicillin-sensitive Staphylococcus aureus in this study is alarming. This has created a huge clinical burden in the hospital settings as well as in the community.KYAMC Journal Vol. 9, No.-1, April 2018, Page 6-10


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Saliha Bounar-Kechih ◽  
Mossadak Taha Hamdi ◽  
Hebib Aggad ◽  
Nacima Meguenni ◽  
Zafer Cantekin

Multiresistant and especially Methicillin-Resistant Staphylococcus aureus (MRSA) poses a serious public health problem that requires their immediate identification and antibiotic resistance characteristics. In order to determine antibiotic resistance S. aureus poultry and bovine origin, 8840 samples were collected from slaughterhouses in the northern region of Algeria between years 2009 and 2014. 8375 samples were from an avian origin (1875 from laying hens and 6500 from broiler chickens) and the rest was from bovine origin. Bacteriological isolation and identification were made by classical culture method and antibiotic resistance patterns were determined by disc diffusion test. The prevalence of S. aureus was 42% in laying hens, 12% in broilers, and 55% in bovine samples. The prevalence of MRSA was 57%, 50%, and 31% in laying hens, broiler chickens, and bovine, respectively. While MRSA strains isolated from poultry showed cross-resistance to aminoglycosides, fluoroquinolones, macrolides, sulphonamides, and cyclins, those isolated from bovine also revealed similar multiresistance except for sulphonamide. This high percentage of methicillin resistance and multidrug resistance in S. aureus poultry and bovine origin may have importance for human health and curing of human infections.


Author(s):  
Mahalakshmi G. ◽  
Neelusree P. ◽  
Kalyani M.

Background: Staphylococcus aureus is Gram positive cocci. The pyogenic bacteria which is responsible for a variety of diseases that ranges in severity from mild skin and soft tissue infections to life-threatening conditions such as endocarditis, pneumonia, and sepsis. There is a scenario of increasing Methicillin-resistant Staphylococcus aureus (MRSA) infections, the macrolide-lincosamide-streptogramin B (MLSB) group of antibiotics they have different structure with same mechanism of action which serves as one good alternative. There is a frequency of increasing Methicillin Resistant Staphylococcus aureus (MRSA) infections and their change in antimicrobial resistance pattern. There is a concern about use of this antibiotic in the presence of Erythromycin resistance because of the possibility of inducible resistance among the members of Macrolide, lincosamide, Strepto-gramin B (MLSB) group. The invitro resistance exhibited by Staphylococcus aureus to erythromycin, Clindamycin, and other drugs of MLSB groups is due to the expression of ribosomal methylases(erm) genes. The detection of inducible Clindamycin resistance can limit the effectiveness of these drugs. Objective of the study: To isolate of Staphylococcus aureus from various clinical samples to differentiate between Methicillin resistant Staphylococcus aureus (MRSA) and Methicillin sensitive Staphylococcus aureus (MSSA) by conventional methods. To detect inducible and constitutive Clindamycin resistance in Staphylococcus aureus isolates by D test. To detect ermA gene responsible for resistance by PCR. Methodology: This cross sectional study was done for a period of six months. Totally 106 Staphylococcus aureus isolates was obtained various clinical samples were processed using standard guidelines. Result: From the 106 isolates of Staphylococcus aureus 67(63.3%) were MSSA and 39(36.7%) were MRSA. D-test was positive in n=9 of the n=21 MRSA and n=17 of the n=85 MSSA, which denotes inducible Clindamycin resistance. N- 9 of MRSA and n=13(22%) of MSSA showed Constitutional Clindamycin resistance. The statistics show that there is a significant Difference in constitutive resistance between MRSA and MSSA. In India ermA gene is most prevalent, out of 22 d-test positive n=13 ermA gene were detected (n=3-MRSA and n=10-MSSA) by using conventional PCR. Conclusion: The MLSB family of antibiotics is one such alternative and CD is preferred. Clinical microbiology laboratories should report inducible Clindamycin resistance in Staphylococcus aureus and D-test can be used as a simple, auxiliary and reliable method to Delineate inducible and constitutive Clindamycin resistance in routine clinical laboratories.


2014 ◽  
Vol 8 (12) ◽  
pp. 1511-1517 ◽  
Author(s):  
Solmaz Ohadian Moghadam ◽  
Mohammad Reza Pourmand ◽  
Farzaneh Aminharati

Introduction: Burns are the most serious forms of trauma and a major cause of mortality worldwide. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common pathogens of burn wound infections; treatment has faced serious problems due to antibiotic resistance in these strains. Biofilm formation, which increases antibiotic resistance capabilities and is considered to be a virulence factor, also causes treatment failure and recurrent staphylococcal infections in burn patients. Methodology: A total of 135 pus/wound swabs were collected; S. aureus was identified by confirmatory tests. The icaA/D and mecA genes were detected in DNA extracts by polymerase chain reaction assay separately. To determine the prevalence of biofilm formation, a modified Congo red agar and the microtiter plate method were used. Investigation of antibiotic resistance was performed using the disk diffusion method. Results: S. aureus (48.87%) was identified in 65 (48.87%) samples, of which 40 (61.53%) were confirmed to be MRSA. Among MRSA and methicillin-sensitive S. aureus (MSSA) isolates, 97.5% and 60% produced biofilm, respectively. Resistance of MRSA isolates to amikacin, ceftriaxone, ciprofloxacin, erythromycin, gentamicin, mupirocin, rifampin, tetracycline, and tobramycin was 64.1%, 76.92%, 51.28%, 87.18%, 71.8%, 10.26%, 5.13%, 89.74%, and 61.54%, respectively. All MRSA and MSSA isolates were susceptible to fusidic acid, linezolid, teicoplanin, tigecycline, and vancomycin. Conclusions: The high prevalence of biofilm-producing, drug-resistant S. aureus isolates in our study suggests that epidemiological studies on the characteristics of common strains found in burn centers and a definition of their antibiotic resistance pattern would be helpful for therapeutic decisions.


2020 ◽  
Vol 1 (3) ◽  
pp. 31-39
Author(s):  
Madiha Khan ◽  
Wafa Komal ◽  
Mushtaq A. Saleem ◽  
Naveed Ahmad ◽  
Zara Rafaque ◽  
...  

The methicillin resistant Staphylococcus aureus (MRSA) is affecting the economy worldwide contributing to the increased morbidity and treatment costs. The present cross sectional study was conducted to determine the association of MRSA with kidney and liver patients from Tertiary Care Hospital in Lahore, Pakistan and its antibacterialresistance patterns. The study was conducted for the period of one year; from April 2019 to April 2020. A total of 1984 different samples were obtained and examined for bacterial cultures using standard procedures. From total samples, 51.05% were collected from male and the rest 48.95% were collected from females including different age groups. Samples were inoculated on different culture media for isolation of S. aureus and susceptibility testing. A total of 253/1984 clinical samples exhibited S. aureus characteristics while 39 of 253 S. aureus (15.41%) were identified as MRSA. MRSA strains were found highly resistant to Amikacin (AK), Cefoxitin (FOX),Clindamycin (DA), Fusidic acid (FD), Gentamicin (CN) and Tobramycin (TOB) while highest sensitivity was noted against Vancomycin (100%) and Linezolid (100%). The presence of MRSA and multidrug resistance pose serious therapeutic burden to critically ill patients. A systematic and concerted effort is essential to identify high-risk patients rapidly and to reduce the burden of antimicrobial resistance.


2018 ◽  
Vol 16 (2) ◽  
pp. 172-174 ◽  
Author(s):  
Laxmi Kant Khanal ◽  
Ram Prasad Adhikari ◽  
Ankita Guragain

Background: Methicillin resistant Staphylococcus aureus is a global health challenge nowadays creating problem in antibiotic therapy. This study was aimed to generate resistance pattern of Methicillin resistant Staphylococcus aureus to various antibiotics in order to formulate antibiotic policy for control of Methicillin resistant Staphylococcus aureus in Nepal.Methods: This was a cross-sectional study conducted at the department of Clinical Microbiology, Nepal Medical College Teaching Hospital, from April 2015 to March 2016. A total of 142 S. aureus isolated from various clinical specimens. were screened for Methicillin resistant Staphylococcus aureus by cefoxitin disc method according to Clinical and Laboratory Standards Institute guidelines.Results: Out of 142 S. aureus isolates, 30 (21.1%) were detected as Methicillin resistant Staphylococcus aureus by cefoxitin disc method. Most of the Methicillin resistant Staphylococcus aureus (25/30) were isolated from pus which were collected from OPD patients. Antibiotic sensitivity pattern showed all Methicillin resistant Staphylococcus aureus isolates were sensitive to vancomycin.Conclusions: Prevalence of Methicillin resistant Staphylococcus aureus was found to be 21.1%, and all Methicillin resistant Staphylococcus aureus appear 100% sensitive to vancomycin. Keywords: .


Sign in / Sign up

Export Citation Format

Share Document