scholarly journals STAPHYLOCOCCUS AUREUS INFECTIONS AND THEIR ANTIBIOTIC SUSCEPTIBILITY PROFILE AT A TERTIARY CARE HOSPITAL

Author(s):  
Anthony N Ofulah ◽  
Shashidhar Vishwanath ◽  
Shashidhar Vishwanath ◽  
Barnini Banerjee ◽  
Shashidhar Vishwanath ◽  
...  

  Objective: Staphylococcus aureus remains an important bacterial pathogen causing diverse infections which are both nosocomial and community acquired. Increasing resistance among S. aureus to various antibiotics is a cause of concern.Methods: A prospective observational study of 4 months duration was conducted to analyze the spectrum of infections caused by S. aureus and to study its antimicrobial resistance to commonly used antibiotics. Specimens from various clinical sites received in the laboratory for culture and sensitivity were processed as per standard techniques. Identification and susceptibility testing of S. aureus isolates were done using automated systems.Results: A total of 234 S. aureus isolates were obtained during the study period. Males accounted for 70.1% (n=164) of patients with S. aureus infections. These patients were uniformly distributed across all age groups. S. aureus was most commonly isolated from pus and exudates (64.5%) followed by respiratory specimens (20.5%) and mainly cultured from the skin and soft tissue infections (56%). Methicillin-resistant S. aureus (MRSA) accounted for 47% (n=110) of isolates. Higher rates of susceptibility were noted for tetracycline (95.3%), gentamicin (85.4%), and trimethoprim/ sulfamethoxazole (88%). Low susceptibility rate was seen for ciprofloxacin (11.2%). Inducible clindamycin resistance was seen in 22.4% (n=50) isolates. Methicillin-sensitive S. aureus isolates were found to be more susceptible to non-beta lactam antibiotics than the methicillin-resistant isolates.Conclusion: A high frequency of MRSA was found in our study. Regular surveillance of antimicrobial resistance profile of this most frequent pathogen is necessary to aid in providing appropriate empirical antibiotic therapy.

KYAMC Journal ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 177-181
Author(s):  
Md Abdus Salam ◽  
Md Mahabub Alom ◽  
Md Sultan Mahmud

Background: Antimicrobial resistance in health care-associated pathogens is a growing concern for healthcare and for public health. In response to these concerns, medical experts, professional societies and agencies, such as the Centers for Disease Control and Prevention (CDCP), have proposed initiatives to curtail the spread of antimicrobial resistance in pathogenic bacteria. Objectives: The purpose of the study was to observe the disease pattern and demographic characteristics of patient attending at the outpatient department of Otolaryngology in a tertiary care hospital suffering from sore throat and methicillin resistant Staphylococcus Aureus (MRSA) positive pharyngo-tonsillitis. Materials and Methods: This is a retrospective study carried out at the outpatient department of Otolaryngology in Khwaja Yunus Ali Medical College and Hospital for the period of January, 2016 to December, 2017. Data were collected based on history, clinical examinations and culture and sensitivity report of throat swab of the patients. Result: A total of 339 patients were studied of which 49.56% were male and 50.44% were female. The mean age was 30 years; maximum patient (36.28%) belongs to 21-30 years of age. Maximum patient (76%) were come from out of Sirajganj district specially North Bengal. Regarding result of throat swab of C/S 58.11% patients were MRSA positive, 26.84% patients were MRSA negative and15.04% patients has no growth. Conclusion: It is illogical to treat all sore throats with antibiotics. A large scale multi-center study should be performed in the country. A uniform data system should be constructed for Chronic Pharyngo-tonsillitis caused by Methicillin resistant Staphylococcus aureus in Bangladesh. KYAMC Journal Vol. 9, No.-4, January 2019, Page 177-181


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.


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.


Author(s):  
Joel Manyahi ◽  
Sabrina J. Moyo ◽  
Said Aboud ◽  
Nina Langeland ◽  
Bjørn Blomberg

AbstractDifficult-to-treat infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are of concern in people living with HIV infection as they are more vulnerable to infection. We aimed to identify molecular characteristics of MRSA colonizing newly diagnosed HIV-infected adults in Tanzania. Individuals newly diagnosed with HIV infection were recruited in Dar es Salaam, Tanzania, from April 2017 to May 2018, as part of the randomized clinical trial CoTrimResist (ClinicalTrials.gov identifier: NCT03087890). Nasal/nasopharyngeal isolates of Staphylococcus aureus were susceptibility tested by disk diffusion method, and cefoxitin-resistant isolates were characterized by short-reads whole genome sequencing. Four percent (22/537) of patients carried MRSA in the nose/nasopharynx. MRSA isolates were frequently resistant towards gentamicin (95%), ciprofloxacin (91%), and erythromycin (82%) but less often towards trimethoprim-sulfamethoxazole (9%). Seventy-three percent had inducible clindamycin resistance. Erythromycin-resistant isolates harbored ermC (15/18) and LmrS (3/18) resistance genes. Ciprofloxacin resistance was mediated by mutations of the quinolone resistance-determining region (QRDR) sequence in the gyrA (S84L) and parC (S80Y) genes. All isolates belonged to the CC8 and ST8-SCCmecIV MRSA clone. Ninety-five percent of the MRSA isolates were spa-type t1476, and one exhibited spa-type t064. All isolates were negative for Panton-Valentine leucocidin (PVL) and arginine catabolic mobile element (ACME) type 1. All ST8-SCCmecIV-spa-t1476 MRSA clones from Tanzania were unrelated to the globally successful USA300 clone. Carriage of ST8 MRSA (non-USA300) was common among newly diagnosed HIV-infected adults in Tanzania. Frequent co-resistance to non-beta lactam antibiotics limits therapeutic options when infection occurs.


2020 ◽  
Vol 12 (03) ◽  
pp. 230-232
Author(s):  
Dhruv Mamtora ◽  
Sanjith Saseedharan ◽  
Ritika Rampal ◽  
Prashant Joshi ◽  
Pallavi Bhalekar ◽  
...  

Abstract Background Blood stream infections (BSIs) due to Gram-positive pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) are associated with high mortality ranging from 10 to 60%. The current anti-MRSA agents have limitations with regards to safety and tolerability profile which limits their prolonged usage. Levonadifloxacin and its oral prodrug alalevonadifloxacin, a novel benzoquinolizine antibiotic, have recently been approved for acute bacterial skin and skin structure infections including diabetic foot infections and concurrent bacteremia in India. Methods The present study assessed the potency of levonadifloxacin, a novel benzoquinolizine antibiotic, against Gram-positive blood stream clinical isolates (n = 31) collected from January to June 2019 at a tertiary care hospital in Mumbai, India. The susceptibility of isolates to antibacterial agents was defined following the Clinical and Laboratory Standard Institute interpretive criteria (M100 E29). Results High prevalence of MRSA (62.5%), quinolone-resistant Staphylococcus aureus (QRSA) (87.5%), and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) (82.35%) were observed among bacteremic isolates. Levonadifloxacin demonstrated potent activity against MRSA, QRSA, and MR-CoNS strains with significantly lower minimum inhibitory concentration MIC50/90 values of 0.5/1 mg/L as compared with levofloxacin (8/32 mg/L) and moxifloxacin (2/8 mg/L). Conclusion Potent bactericidal activity coupled with low MICs support usage of levonadifloxacin for the management of BSIs caused by multidrug resistant Gram-positive bacteria.


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