scholarly journals Phenotypic and Genotypic Detection of Methicillin Resistant Staphylococcus aureus in Health Care Workers and Its Containment in a Tertiary Care Hospital, in South India

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.

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. 


Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 954
Author(s):  
Vikas Saini ◽  
Charu Jain ◽  
Narendra Pal Singh ◽  
Ahmad Alsulimani ◽  
Chhavi Gupta ◽  
...  

Antimicrobial resistance (AMR) is an emerging public health problem in modern times and the current COVID-19 pandemic has further exaggerated this problem. Due to bacterial co-infection in COVID-19 cases, an irrational consumption of antibiotics has occurred during the pandemic. This study aimed to observe the COVID-19 patients hospitalized from 1 March 2019 to 31 December 2020 and to evaluate the AMR pattern of bacterial agents isolated. This was a single-center study comprising 494 bacterial isolates (blood and urine) that were obtained from patients with SARS-CoV-2 admitted to the ICU and investigated in the Department of Microbiology of a tertiary care hospital in Delhi, India. Out of the total bacterial isolates, 55.46% were gram negative and 44.53% were gram positive pathogens. Of the blood samples processed, the most common isolates were CoNS (Coagulase Negative Staphylococcus) and Staphylococcus aureus. Amongst the urinary isolates, most common pathogens were Escherichia coli and Staphylococcus aureus. A total of 60% MRSA was observed in urine and blood isolates. Up to 40% increase in AMR was observed amongst these isolates obtained during COVID-19 period compared to pre-COVID-19 times. The overuse of antibiotics gave abundant opportunity for the bacterial pathogens to gradually develop mechanisms and to acquire resistance. Since the dynamics of SARS-COV-2 are unpredictable, a compromise on hospital antibiotic policy may ultimately escalate the burden of drug resistant pathogens in hospitals. A shortage of trained staff during COVID-19 pandemic renders it impossible to maintain these records in places where the entire hospital staff is struggling to save lives. This study highlights the extensive rise in the use of antibiotics for respiratory illness due to COVID-19 compared to antibiotic use prior to COVID-19 in ICUs. The regular prescription audit followed by a constant surveillance of hospital infection control practices by the dedicated teams and training of clinicians can improve the quality of medications in the long run and help to fight the menace of AMR.


2020 ◽  
Vol 2 (2) ◽  
pp. 9-15
Author(s):  
Niraj Kumar Keyal ◽  
Mahendra Shrestha ◽  
Partima Sigdel Ghimire

 Background: Empirical antibiotics are used in the intensive care unit based on developing countries’ guidelines due to a lack of a bacteriological profile of individual ICU and institution policy. Therefore, this study was conducted to know the antibiogram of the intensive care unit and to make institution policy for antibiotic use in ICU. Materials and methods: It was a prospective descriptive cross-sectional study conducted in the mixed surgical and medical intensive care unit of a tertiary care hospital for one year in 625 patients. Various clinical samples were collected aseptically and organisms were identified by the cultural characteristics, morphology, gram stain, and different biochemical test. Antimicrobial susceptibility was done with a disc diffusion test. Data collection was done in a preformed sheet that included all tested antibiotic and demographic variables. Statistical analysis was done by using statistical package for the social sciences. The result was presented as frequency and percentage. Results: Out of 625 samples, 135(22%) showed growth in culture. Among them, 96(71%) and 39(29%) were gram-negative bacilli and gram-positive cocci respectively. The tracheal aspirate was the most common type of specimen which comprised 49(36.29%) isolates. The most common organism was Staphylococcus aureus which accounts for 27(20%) isolates, followed by Acinetobacter baumanni 25(18.51%), Klebsiella pneumoniae 22(16.29%) and Pseudomonas aeurignosa 21(15.55%). The incidence of multidrug-resistant and extended drug resistance was 44(32.5%) and 45(33%) respectively. Meanwhile, the incidence of methicillin-resistant staphylococcus aureus was 70%. However, in the case of Acinetobacter baumannii and Enterobacteriaceae, all were sensitive to polymyxin B and meropenem. Conclusion:Antibiotics should be prescribed based on the antibiogram of individual intensive care units that can decrease antibiotic resistance. Polymyxin B and meropenem can be prescribed for gram-negative bacilli and vancomycin for Staphylococcus aureus.


2017 ◽  
Vol 3 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Shahana Khanam ◽  
Jalaluddin Ashraful Haq ◽  
SM Shamsuzzaman ◽  
Md Motlabur Rahman ◽  
Kazi Zulfiquer Mamun

Background: Glycopeptides such as vancomycin are frequently the choice of antibiotics for the treatment of infections caused by methicillin resistant Staphylococcus aureus (MRSA). For the last 7 years incidence of vancomycin intermediate S. aureus and vancomycin resistant S. aureus (VISA and VRSA respectively) has been increasing in various parts of the world.Objective: The present study was carried out to find out the presence of VISA and VRSA among isolated MRSA strains.Methodology: This cross sectional study was carried out in the Department of Microbiology in Dhaka medical college during period of January 2010 to December 2011. All S. aureus isolates were screened to detect methicillin resistance and then all MRSA isolates were subjected for MIC testing against vancomycin and oxacillin by agar dilution method, disc diffusion testing and PCR for mecA and pvl genes detection.Result: A total 112 S. aureus were isolated from 500 nasal swab sample collected from adult patients who were admitted in various departments and wards in Dhaka Medical College Hospital. Among 38 MRSA strains out of 112 Staph aureus isolates 3(7.89%) strains were resistance to vancomycin of which 2(5.26%) strains had MIC > 256 mg/mL and one strain had MIC 256mg/mL. All vancomycin resistance strains had MIC of oxacillin > 256 mg/mL. All isolates possess mec-A gene.Conclusion: The present study reveals that emergence of VRSA upon admission at a tertiary care of hospital in Bangladesh. Continuous efforts should be made to prevent the spread and the emergence of VRSA by early detection of the resistant strains and using the proper infection control measures in the hospital setting.Bangladesh Journal of Infectious Diseases 2016;3(1):11-16


2021 ◽  
Vol 8 (4) ◽  
pp. 1253
Author(s):  
Arnab Mandal ◽  
Swapan Das

Background: India, has an estimated burn incidence of 6-7 million annually. Nearly 10% of these are life threatening and require hospitalization, and main cause of mortality and morbidity of these burn patients were wound infection and sepsis after 1st 24 hours. The present study was tried to determine specific pattern of burn wound infections, and antibiotic susceptibility of those isolates.Methods: After matching inclusion and exclusion criteria, total 55 patients were taken for this institution based, prospective observational study. Wound swabs were collected on day 7 and cultured aerobically in MacConkey agar and 5% blood agar and antibiotic susceptibility testing was done on Muller Hinton agar using Kirby-Bauer disc diffusion method.Results: Among study population 69.1% patients were female and majority (29.1%) of the patients belongs to age group from 21 to 30. It was found that 48 wound swabs were positive for microorganisms, of which Pseudomonas aeruginosa was most common isolated organism (23.6%), followed by Klebsiella pneumoniae (16.4%) and Staphylococcus aureus (14.5%). The most effective antibiotic found in this study was piperacillin/tazobactam, followed by imipenem/cilastatin.Conclusions: It was seen that gram-negative organisms were more prevalent. Pseudomonas aeruginosa was the most common microorganism and piperacillin/tazobactam was most effective antibiotic.


Author(s):  
B. Anurag ◽  
T. Ramasamy ◽  
S. Ramesh ◽  
K.S. Sriraam ◽  
L. Kalaiselvi ◽  
...  

Background: A study was carried out to screen milk borne Staphylococcus aureus for resistance against Beta lactam antibiotics. Methods: A total of 45 milk samples were collected over a period of three months from large animal outpatient unit of Madras Veterinary College Hospital, Chennai. Upon collection of samples, ABST followed by its growth in Mannitol Salt Agar was carried out as part of the phenotypic screening. Genotypic screening for Staphylococcus screening was done with the help of PCR by using nuc and mec A primers. MIC for ceftriaxone and cloxacillin was carried out with the samples that were found positive for Staphylococcus aureus. The antibiotic sensitivity pattern is presented: Fluoroquinolones (87.5% sensitive), aminoglycosides (72.5% sensitive), Amoxicillin-Clavulanic acid (Amoxyclave) (72.5% sensitive). The MSA positive samples were subjected to molecular identification with the help of PCR. Result: The results revealed 10 samples positive for Staphylococcus aureus and 5 among them positive for mecA gene. The MIC results were as follows: MIC50-10.95µg/ml and MIC90- 87.510.95µg/ml for ceftriaxone and MIC50- 43.75 µg/ml and MIC90- 87.5µg/ml for cloxacillin, indicating emergence of resistance. However, further studies are required in a larger sample size that can help us to attain more conclusive results.


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):  
. Preeja ◽  
Sanath Kumar ◽  
Veena A Shetty

Introduction: Methicillin Sensitive Staphylococcus aureus(MSSA) is a significant human pathogen, involved in both hospital and community associated settings. MSSA, being more susceptible to antibiotics compared to Methicillin Resistant Staphylococcus aureus(MRSA), is found to acquire Multidrug Resistance (MDR) and with the presence of virulence factors can pose difficulty in patient treatment. Aim: To study the prevalence and antibiotic resistance profile of MSSA from community and hospital associated infections. Materials and Methods: The present cross-sectional study was conducted in tertiary care hospital in Mangalore, Karnataka, India from January 2015 to February 2017. Three hundred and five Staphylococcus aureuswere isolated from various clinical specimens and tested for methicillin susceptibility using cefoxitin disc. Antibiotic resistance profiles against 23 antibiotics were determined by disc diffusion method. The difference was compared for antibiotic sensitivity with respect to Community Associated Methicillin Sensitive Staphylococcus aureus (CA-MSSA) and Hospital Associated Methicillin Sensitive Staphylococcus aureus (HA-MSSA) and Chi-square test was used for statistical analysis. Results: Of 305 MSSA isolated, 219 (71.8%) were CA-MSSA and 86 (28.2%) were HA-MSSA. S. aureus was isolated mostly from Skin and Soft Tissue Infections (SSTI, 61.3%). Resistance was observed against ciprofloxacin (64.6%), erythromycin (43.9%), ofloxacin (42.3%), clindamycin (20.7%), ampicillin (100%) and penicillin (90.5%). There was a significant difference (p<0.05) between the resistance of CA-MSSA and HA-MSSA against cefotaxime and co-trimoxazole. Conclusion: The present study showed the increasing prevalence of MSSA in the community and hospital settings with the emergence of MDR which has to be dealt immediately with appropriate control measures.


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