scholarly journals Emergence of Vancomycin Resistant Staphylococcus aureus during Hospital Admission at a Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 3 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Shahana Khanam ◽  
Jalaluddin Ashraful Haq ◽  
SM Shamsuzzaman ◽  
Md Motlabur Rahman ◽  
Kazi Zulfiquer Mamun
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Control Measures ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Care Hospital ◽  
Medical College ◽  
Nasal Swab Sample ◽  
Vancomycin Resistant

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

scholarly journals The study of reduced susceptibility of methicillin resistant Staphylococcus aureus to various antibiotics with special reference to glycopeptides in a tertiary care hospital in central India

2019 ◽  
Vol 6 (4) ◽  
pp. 1426
Author(s):  
Swati S. Kale ◽  
Ashwini Patil
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Care Hospital ◽  
Diagnostic Laboratory ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Agar Dilution

Background: Staphylococcus aureus has emerged over the past several decades as a leading cause of hospital-associated and community acquired infections. Methicillin resistant S. aureus (MRSA), which are often resistant to several classes of antibiotics, is the most common cause of nosocomial infections and pose a great threat to the world. Vancomycin is regarded as the first-line drug for treatment of MRSA but resistance to this drug is being reported now a day.Methods: It was carried out for a period between January 2014 to June 2017 in the microbiology diagnostic laboratory. MRSA detection was performed by cefoxitin disk diffusion method. Screening for the vancomycin intermediate and the vancomycin resistant S. aureus (VISA and VRSA respectively) was carried out by using vancomycin screen. MIC (minimum inhibitory concentration) of vancomycin was tested by agar dilution method and E strip on all MRSA isolates.Results: A total of 287 S. aureus clinical isolates were included in the study. All MRSA were inoculated on vancomycin screen agar. Visible growth was present in 8 isolates. Five (3.73%) MRSA isolates with MIC of 4 were termed VISA (vancomycin intermediate S. aureus) by agar dilution method. Six isolates had the MIC of 4 and were termed as VISA.Conclusions: As disc diffusion method is not recommended by CLSI for S. aureus, vancomycin screen agar and MIC determination by either of the methods viz. agar dilution or E test can be used.

scholarly journals Growing Resistance to Vancomycin among Methicillin Resistant Staphylococcus Aureus Isolates from Different Clinical Samples

2014 ◽  
Vol 52 (196) ◽  
pp. 977-981 ◽  
Author(s):  
Prakash Chandra Pahadi ◽  
Upendra Thapa Shrestha ◽  
Nabaraj Adhikari ◽  
Pradeep Kumar Shah ◽  
Ritu Amatya
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Control Measures ◽  
Clinical Samples ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Methicillin Resistant

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), majorly associated with nosocomial and community infections worldwide, are emerging as resistant strains to many antibiotics narrowing down the efficacy of antimicrobial therapy. In order to investigate the changing resistant pattern of MRSA to empirical drugs, the study was carried out at KIST Medical College and Hospital, Nepal. It also aims to determine the minimum inhibitory concentration of vancomycin among MRSA. Methods: Altogether 3500 clinical samples including 1303 blood, 1489 urine and 708 body fluids were collected and processed. Isolated S. aureus were further screened for methicillin resistance by Kirby-Bauer disk diffusion technique using cefoxitin (30μg) disk. All MRSA were subjected to in vitro determination of MIC of vancomycin by agar dilution method as recommended by CLSI guidelines. Results: Total 287 S. aureus were isolated from the different clinical samples. Altogether 248 (86.41%) were found to be multidrug resistance (MDR) while 42 (14.63%) of the isolates were methicillin resistance with the highest prevalence in the age group of 16-30. All 42 (100%) MRSA isolates were resistant to ampicillin and penicillin followed by 41 (97.62%), 32 (76.19%), 31(73.81%), 29 (69.05%), 9 (21.43%) and seven (16.67%) to cefotaxime, gentamycin, cotrimoxazole, erythromycin, tetracycline and ciprofloxacin respectively. Although all MRSA strains were sensitive to vancomycin on disc diffusion, four isolates were intermediates in vitro determination of MIC of vancomycin. The break point for vancomycin was found to be 15mm. Conclusions: The increment in vancomycin MIC among MRSA is alarming. Strict control measures to prevent MRSA spread and a routine surveillance for VRSA must be incorporated in hospitals.  Keywords: mdr; mrsa; mic; visa; vrsa.

scholarly journals Resistance pattern of methicillin resistant Staphylococcus aureus among nasal isolates of HIV infected patients in a tertiary care hospital

2019 ◽  
Vol 7 (2) ◽  
pp. 428
Author(s):  
Manish Kumar Diwakar ◽  
Ankur Goyal ◽  
Sapna Goyal
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Meca Gene ◽  
Nasal Carriage ◽  
Control Group ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Increased Risk ◽  
Nasal Swab Sample

Background: Patients infected with HIV have an increased risk of nasal Staphylococcus aureus carriage as well as consecutive staphylococcal infections and is a major reservoir for MRSA which is potential risk factors for community acquired MRSA. Knowing the Nasal carriage status of Staphylococcus aureus and their Antibiogram will be beneficial for effective management of these patients.Methods: Nasal swab sample were collected from all the participants and processed for culture and identification of Staphylococcus aureus and their antimicrobial sensitivity. All the Staphylococcus aureus isolates were tested for Methicillin resistance by Oxacillin screen agar test, cefoxitin disc diffusion test and further confirmed by mecA gene PCR.Results: In this study out of 220 HIV seropositive patients, 43.64% isolates were confirmed to be S. aureus, 18.75% MRSA and 81.25% were MSSA. Cefoxitin disc diffusion showed 100% specificity (95% CI; 97.05%-100.00%), 100% sensitivity (95% CI; 83.89-100.00%) and 100% accuracy (95% CI; 97.47% to 100.00%) while comparing with gold standard mecA gene PCR. Among the nasal carriers; males (60%) ware dominant on females (40%). 31-50 years age group was strongly associated with MRSA nasal carriage. None of the isolates were resistant against lenozolid, teicoplanin and vancomycin while ampicillin (75%), ciprofloxacin (62.5%), clindamycin (59.38%) and cotrimoxazole (53.13%) showed increased resistance against S. aureus nasal carriage.Conclusions: Resistance among HIV positive persons for all antibiotics showed statistically significant while compared to control group. Cefoxitin disc diffusion can be used as surrogate agent for mecA gene detection.

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

2021 ◽  
Author(s):  
Shamim Rahman ◽  
Ragini Ananth Kashid
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Meca Gene ◽  
Control Measures ◽  
Care Hospital ◽  
Beta Lactam ◽  
Accurate Identification ◽  
Mortality And Morbidity ◽  
Sensitivity Pattern ◽  
Hospital Infection Control

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.

scholarly journals Susceptibility of Clinical Isolates of Staphylococcus aureus to Ceftaroline

2021 ◽  
Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
The United States ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital

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.

First Outbreak of Colonization and Infection With Vancomycin-ResistantEnterococcus faeciumin a Tertiary Care Hospital in Singapore

2006 ◽  
Vol 27 (9) ◽  
pp. 991-993 ◽  
Author(s):  
Maciej Piotr Chlebicki ◽  
Moi Lin Ling ◽  
Tse Hsien Koh ◽  
Li Yang Hsu ◽  
Ban Hock Tan ◽  
...  
Keyword(s):  
Infection Control ◽  
Enterococcus Faecium ◽  
Public Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Vancomycin Resistant

We report the first outbreak of vancomycin-resistantEnterococcus faeciumcolonization and infection among inpatients in the hematology ward of an acute tertiary care public hospital in Singapore. Two cases of bacteremia and 4 cases of gastrointestinal carriage were uncovered before implementation of strict infection control measures resulted in control of the outbreak.

scholarly journals Risk factors for intestinal colonization with vancomycin resistant enterococci’ A prospective study in a level III pediatric intensive care unit

2018 ◽  
Vol 10 (01) ◽  
pp. 089-094 ◽  
Author(s):  
Rajesh Amberpet ◽  
Sujatha Sistla ◽  
Subhash Chandra Parija ◽  
Ramachandran Rameshkumar
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Gut Colonization ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
A Prospective Study

Abstract PURPOSE: Vancomycin-resistant enterococci (VRE) emerged as one of the major nosocomial pathogens across the globe. Gut colonization rate with VRE is higher in patients admitted to intensive care units (ICUs) due to the higher antibiotic pressure. VRE colonization increases the risk of developing infection up to 5–10 folds. The aim of this study was to determine the rates of VRE colonization among the patients admitted to pediatric ICU (PICU) and risk factors associated with it. MATERIALS AND METHODS: Rectal swabs were collected after 48 h of admission to PICU from 198 patients. The samples were inoculated onto bile esculin sodium azide agar with 6 mg/ml of vancomycin. Growth on this medium was identified by the standard biochemical test, and minimum inhibitory concentration of vancomycin and teicoplanin was detected by agar dilution method. Resistance genes for vancomycin were detected by polymerase chain reaction. Risk factors were assessed by logistic regression analysis. RESULTS: The rates of VRE colonization in patients admitted to PICU was 18.6%. The majority of the isolates were Enterococcus faecium (75.6%) followed by Enterococcus faecalis (24.4%). One patient acquired a VRE bloodstream infection (2.6%) among colonized patients, and none of the noncolonized patients acquired the infection. Consumption of vancomycin was found to be the only risk factor significantly associated with VRE colonization. CONCLUSION: Routine surveillance and isolation of patients found to be VRE colonized may not be possible in tertiary care hospitals; however, educating health-care workers, promoting handwashing with antiseptic soaps or solutions, and antibiotic Stewardship policy may help in the reduction of vancomycin resistance and VRE colonization.

scholarly journals Detection of Oxacillin (Methicillin)-resistant Staphylococcus aureus Isolated from a Tertiary-care Hospital, Georgetown, Guyana

2020 ◽  
pp. 1-7
Author(s):  
Paul Cheddie ◽  
Drovashti Seepersaud ◽  
Tereasia Ramlochan
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Prevalence Survey ◽  
Methicillin Resistant ◽  
Broth Microdilution Method

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.

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