scholarly journals Prevalence and Multidrug Resistance Pattern of Methicillin Resistant S. aureus Isolated from Frozen Chicken Meat in Bangladesh

2021 ◽  
Vol 9 (3) ◽  
pp. 636
Author(s):  
Mst. Sonia Parvin ◽  
Md. Yamin Ali ◽  
Sudipta Talukder ◽  
Azimun Nahar ◽  
Emdadul Haque Chowdhury ◽  
...  
Keyword(s):  
Resistance Gene ◽  
Methicillin Resistance ◽  
Meca Gene ◽  
Chicken Meat ◽  
Penicillin G ◽  
Resistance Pattern ◽  
Cross Sectional ◽  
Disk Diffusion Test ◽  
Methicillin Resistant ◽  
Meat Samples

Infections by methicillin-resistant Staphylococcus aureus (MRSA) are continuously expanding within the community. Chicken meat is usually contaminated by MRSA, and this contaminated chicken meat is an important source of foodborne infections in humans. In this study, a cross-sectional supershop survey was conducted to determine the prevalence and antimicrobial resistance pattern of MRSA in 113 domestic frozen chicken meat samples purchased from nine branded supershops available in five divisional megacities of Bangladesh. The study also focused on the determination of methicillin resistance gene in MRSA isolates. S. aureus was identified by standard culture-based and molecular methods, and subjected to antimicrobial susceptibility testing. MRSA was screened by cefoxitin disk diffusion test. Methicillin resistance gene was identified by PCR. Of samples, 54.9% were positive for S. aureus, and, of these, 37.1% isolates were identified as MRSA. All the isolates were multidrug resistant (MDR): 52.2% were resistant to 6–8 antimicrobial classes, and 47.8% isolates to 9–12 classes. Three (3.2%) isolates of S. aureus were possible extensively drug resistant. The highest rates of resistance were observed against cefoxitin (100%), followed by nalidixic acid, ampicillin and oxacillin (97.7%), colistin (91.3%), amoxicillin-clavulanic acid and amoxicillin (87%), penicillin-G and cloxacillin (82.6%), oxytetracycline (78.3%), and cefixime (73.9%). Screening of methicillin resistance gene revealed that 43.5% isolates of MRSA were positive for mecA gene. The high prevalence of MDR MRSA in frozen chicken meat samples in this study emphasizes the need for better sanitary education of food handlers in hygienic practices focusing on their potential role as reservoirs and spreaders of MRSA.

scholarly journals Prevalence and Multidrug Resistance Pattern of Methicillin Resistant S. aureus Isolated from Frozen Chicken Meat in Bangladesh

2021 ◽  
Author(s):  
Mst. Sonia Parvin ◽  
Md. Yamin Ali ◽  
Sudipta Talukder ◽  
Emdadul Haque Chowdhury ◽  
Md. Tanvir Rahman ◽  
...  
Keyword(s):  
Resistance Gene ◽  
Methicillin Resistance ◽  
Meca Gene ◽  
Chicken Meat ◽  
Penicillin G ◽  
Resistance Pattern ◽  
Cross Sectional ◽  
Disk Diffusion Test ◽  
Methicillin Resistant ◽  
Meat Samples

Infections by methicillin-resistant Staphylococcus aureus (MRSA) are continuously expanding within the community. Chicken meat is usually contaminated by MRSA, and this contaminated chicken meat is an important source of foodborne infections in humans. In this study, a cross-sectional supershop survey was conducted to determine the prevalence and antimicrobial resistance pattern of MRSA in 113 domestic frozen chicken meat samples purchased from nine branded supershops available in five divisional megacities of Bangladesh. The study also focused on the determination of methicillin resistance gene in MRSA isolates. S. aureus was identified by standard culture-based and molecular methods, and subjected to antimicrobial susceptibility testing. MRSA was screened by cefoxitin disk diffusion test. Methicillin resistance gene was identified by PCR. Of samples, 54.9% were positive for S. aureus, and, of these, 37.1% isolates were identified as MRSA. All the isolates were multidrug resistant (MDR): 52.2% were resistant to 6−8 antimicrobial classes, and 47.8% isolates to 9−12 classes. Three (3.2%) isolates of S. aureus were possible extensively drug resistant. The highest rates of resistance were observed against cefoxitin (100%), followed by nalidixic acid, ampicillin and oxacillin (97.7%), colistin (91.3%), amoxicillin-clavulanic acid and amoxicillin (87%), penicillin-G and cloxacillin (82.6%), oxytetracycline (78.3%) and cefixime (73.9%). Screening of methicillin resistance gene revealed that 43.5% isolates of MRSA were positive for mecA gene. The high prevalence of MDR MRSA in frozen chicken meat samples in this study emphasizes the need for better sanitary education of food handlers in hygienic practices focusing on their potential role as reservoirs and spreaders of MRSA.

scholarly journals Detection of mecA gene by latex agglutination and its molecular analysis by PCR in methicillin resistant staphylococcus aureus.

2020 ◽  
Vol 27 (07) ◽  
pp. 1363-1370
Author(s):  
Aneela Khawaja ◽  
Iffat Javed ◽  
Sohaila Mushtaq ◽  
Saeed Anwar ◽  
Faiqa Arshad ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Meca Gene ◽  
Latex Agglutination ◽  
Medical Institute ◽  
Cross Sectional ◽  
Methicillin Resistant ◽  
Agglutination Method ◽  
Resistant Strains

Antimicrobial resistance (AMR) is a devastating question that is threatening the health globally. The extensive and indiscriminative use of antibiotics has evolved a notorious resistance in Staphylococcus aureus.  This resistance developed through possession of mecA gene, which codes for modified penicillin binding protein (PBP2a) and the emergent strain being labeled “methicillin resistant Staphylococcus aureus”. Conventional phenotypic techniques for detection of MRSA rely on standardization of cultural characteristics. The drawbacks of diagnostic error to report MRSA include: poor prognosis, expensive treatment, dissemination of multi-drug resistant strains and even treatment failure. Latex agglutination method can be adopted as a more accurate and quick strategy for rapid detection of methicillin resistance. Objectives: To compare detection of mecA gene in methicillin resistant isolates of Staphylococcus aureus by latex agglutination and PCR; by assessing the sensitivity and specificity of both methods. Study Design: Descriptive Cross-Sectional study. Setting: Pathology Department, Post Graduate Medical Institute, Lahore. Period: From January 2015 to December 2015; according to standard operating procedures at Microbiology laboratory. Material & Methods: A total 713 consecutive, non-duplicate isolates of Staphylococcus aureus were processed. Methicillin resistance was determined using cefoxitin (30mg) by Kirby-Bauer method using CLSI guideline (2016), latex agglutination method; and PCR for mecA gene. Results: The results showed that out of 713 Staphylococcus aureus isolates, 92 (12.90%) isolates were resistant to cefoxitin and were labelled as MRSA. majority MRSA isolates recovered from pus (44.57%) and wound swab (20.65%), followed by blood (13.04%), fluid (8.70%), CSF (4.35%), CVP (3.26%), HVS (3.26%) and tracheal secretion (2.17%). By latex agglutination method, 87 (94.50%) were positive for PBP2a; while on PCR mecA gene was detected only in 82 (89.10%) MRSA isolates. When assessed with PCR (gold standard) the sensitivity and diagnostic accuracy of latex agglutination was 100% and 94.57%, respectively. Conclusion: Latex agglutination test can be employed as rapid and reliable diagnostic technique in MRSA isolates for mecA gene detection, where resources for molecular methods are inadequate. This can effectually lessen the misdiagnosis of resistant strains, and over/ ill-use of antibiotics.

scholarly journals Ceftaroline resistance in Staphylococcus pseudintermedius gene mecA carriers

2018 ◽  
Vol 38 (12) ◽  
pp. 2233-2236
Author(s):  
Carolina B. Scherer ◽  
Larissa S. Botoni ◽  
Antônio U. Carvalho ◽  
Kelly M. Keller ◽  
Adriane P. Costa-Val
Keyword(s):  
Methicillin Resistance ◽  
Meca Gene ◽  
Disk Diffusion ◽  
Diffusion Test ◽  
Staphylococcus Pseudintermedius ◽  
Ceftaroline Fosamil ◽  
Disk Diffusion Test ◽  
Methicillin Resistant ◽  
Resistant Strains ◽  
Current Report

ABSTRACT: Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) being a constant concern, ceftaroline fosamil has been recently approved as a new cephalosporin, active against MRSA, for use in humans; only rare cases of resistance have been reported till date. There is no report of resistance to ceftaroline in Staphylococcus pseudintermedius, which is the main bacterium causing dermatitis and otitis in dogs. To evaluate staphylococcal resistance to ceftaroline, 35 isolates of methicillin-resistant S. pseudintermedius (MRSP), carrying the mecA gene, from 26 dogs with folliculitis and nine dogs with external otitis, underwent disk diffusion test with cefoxitin, oxacillin, and ceftaroline. Tests with cefoxitin and oxacillin showed > 90% sensitivity in methicillin resistance detection. In the disk diffusion test, 97.14% (34/35) were resistant to cefoxitin, 94.29% (33/35) to oxacillin, and 31.43% (11/35) to ceftaroline. Of the ceftaroline-resistant strains, 27.27% (3/11) were obtained from the ears of dogs while the rest (8/11) were from the skin. The current report is the first description of MRSP resistance to ceftaroline.

Prevalence and Multidrug Resistance Pattern of Salmonella Carrying Extended-Spectrum β-Lactamase in Frozen Chicken Meat in Bangladesh

2020 ◽  
Vol 83 (12) ◽  
pp. 2107-2121
Author(s):  
MST. SONIA PARVIN ◽  
MD. MEHEDI HASAN ◽  
MD. YAMIN ALI ◽  
EMDADUL HAQUE CHOWDHURY ◽  
MD. TANVIR RAHMAN ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Foodborne Pathogen ◽  
Multidrug Resistant ◽  
Chicken Meat ◽  
Resistance Pattern ◽  
Salmonella Spp ◽  
Policy Makers ◽  
Disk Diffusion Test ◽  
Extended Spectrum ◽  
Meat Samples

ABSTRACT Salmonella is an important foodborne pathogen that causes public health problems globally, and the increase of antimicrobial resistance in Salmonella has intensified the problem. Chicken meat is an important reservoir and disseminator of Salmonella to humans. This study aimed at estimating the burden of Salmonella carrying extended-spectrum β-lactamase (ESBL) and their antimicrobial resistance pattern in 113 domestic frozen chicken meat samples purchased from supershops available in five divisional megacities of Bangladesh. The study also focused on the determination of β-lactamase–, and plasmid-mediated quinolone resistance–encoding genes. All samples were analyzed for the presence of Salmonella using selective media and PCR assay. Antimicrobial susceptibility test was done by disk diffusion test, and ESBL screening was performed by double-disk synergy tests. Resistance genes were detected using multiplex PCR. Of samples, 65.5% were positive for Salmonella spp., and, of these, 58.1% isolates were ESBL producers. All the isolates were multidrug resistant (MDR): 40.5% were resistant to both three to five and six to eight antimicrobial classes; 17.6% were resistant to 9 to 11 classes, and 1.4% isolates to 12 to 15 classes. The highest rates of resistance were observed against oxytetracycline (100%), followed by trimethoprim-sulfamethoxazole (89.2%), tetracycline (86.5%), nalidixic acid (83.8%), amoxicillin (74.3%), and pefloxacin (70.3%). Notably, 48.6% of isolates demonstrated resistance to imipenem. One (1.4%) isolate was possibly extensively drug resistant. All the isolates were positive for the blaTEM gene, 2.7% were positive for blaCTX-M-1, and 20.3% for blaNDM-1. The prevalence of qnrA and qnrS genes was 4.1 and 6.8%, respectively. This study shows that ESBL-producing Salmonella are widespread in frozen chicken meat in Bangladesh, which puts greater responsibility on food processors and policy makers to ensure food safety. HIGHLIGHTS

scholarly journals Panton Valentine Gene in both Community-acquired and Healthcare-acquired Methicillin Resistant Staphylococcus aureus Isolates from Ain Shams University Hospitals

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R A Mohamed ◽  
L F Fathi ◽  
N N Salaheldeen
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Meca Gene ◽  
Cross Sectional Study ◽  
P Value ◽  
University Hospitals ◽  
Cross Sectional ◽  
Mannitol Salt Agar ◽  
Methicillin Resistant

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen that is associated with both hospital and community infections. Panton Valentine leukocidin (PVL) is an important virulence factor of S. aureus that is considered by many authors a marker of community acquired MRSA (CA-MRSA). Aim of the Work This study aimed to determine the prevalence of PVL genes among healthcare acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) and CA-MRSA isolates, and to test the hypothesis that PVL is a reliable marker of CA-MRSA isolates. Material and Methods This comparative cross-sectional study was done on fifteen community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) and fifteen hospital acquired methicillin resistant Staphylococcus aureus (HA-MRSA), obtained from patients attending outpatient clinics, presenting with community-acquired pyogenic infections and patients with healthcare acquired pyogenic infections in Intensive Care Units (ICUs), during the period from May 2017 till February 2018. Clinical specimens included pus and different body fluids. Staphylococcus aureus was isolated and identified using conventional microbiological methods3. Isolates were then tested for methicillin resistance by culture on mannitol salt agar (MSA) with cefoxitin4. The presence of mecA and pvl genes in all MRSA isolates was subsequently detected by PCR5,6. Results Among 15 HA-MRSA isolates, mecA gene was positive in 40% (6/15) of isolates, while pvl gene was positive in 53.3% (8/15) of isolates. Among 15 CA-MRSA isolates, mecA gene was positive in 46.7% (7/15) of isolates, while pvl gene was positive in 26.7% (4/15) of isolates. Conclusion We conclude that pvl gene is not a sole genetic marker for diagnosis CA-MRSA, as there was no significant correlation between mecA that encodes for methicillin resistance and pvl genes among fifteen CA-MRSA isolates (P value =1).

scholarly journals Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus nasal carriage in the West of Iran: a population-based cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elham Ahmadi ◽  
Mohammad Khojasteh ◽  
Seyed Mohammad Mortazavi ◽  
Fatemeh Khan-Mohammadi ◽  
Ali Kazemnia ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Pcr Amplification ◽  
Nasal Carriage ◽  
Health Concern ◽  
Diffusion Method ◽  
The West ◽  
Cross Sectional ◽  
Disk Diffusion Test ◽  
Methicillin Resistant

Abstract Background Several reports designate the recent increase in community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) nasal carriage. Because of the scanty information regarding the nasal carriage sate of MRSA in the west of Iran, the purpose of the present study was to determine the frequency of CA-MRSA in Sanandaj city. Methods Swabs collected from anterior nares of 600 volunteers were analyzed for the presence of S. aureus. The isolates were further investigated for methicillin resistance by using the cefoxitin disk diffusion test, followed by PCR-amplification of the mecA gene. SCCmec types and the presence of the Panton-Valentine Leukocidin (pvl) encoding genes were determined through PCR. Finally, the antimicrobial susceptibility of the isolates was determined by the agar diffusion method. Results Nasal screening identified 181 S. aureus, of which 55 isolates were MRSA. SCCmec types IV and V were detected in MRSA at frequencies of 80 and 20%, respectively. The overall frequency of pvl genes among the MRSA isolates was 14.54%. MRSA isolates were highly susceptible (98.18%) to mupirocin, gentamicin, and fusidic acid. Conclusions The high prevalence of CA-MRSA carriage in the population could pose a serious public health concern for the region. Additionally, advent of drug-resistant pvl-positive strains demands continuous surveillance on the colonization state of CA-MRSA in order to prevent dissemination of the bacterium in the community.

scholarly journals Antibiotic Resistance Pattern and Detection of mecA Gene in Staphylococcus aureus Isolated from Iranian Hamburger Samples

2020 ◽  
Author(s):  
N. Momtaz Bokharaei ◽  
M.M. Soltan Dallal ◽  
M.R. Pourmand ◽  
Z. Rajabi
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Fast Food ◽  
Methicillin Resistance ◽  
Meca Gene ◽  
Food Poisoning ◽  
Penicillin G ◽  
Resistance Pattern ◽  
Antibiotic Resistance Pattern ◽  
Common Causes

Background: Among the bacteria that cause food poisoning, Staphylococcus aureus is one of the most common causes of food poisoning worldwide. The aim of this study was to investigate the presence of S. aureus strains in Iranian hamburgers, analysis of their antibiotic resistance pattern, and molecular detection of mecA gene in isolated strains. Methods: A total of 100 Iranian handmade (traditional) and packaged (factory-made) hamburger samples were investigated for the existence of S. aureus. The pattern of antibiotic resistance and the presence of mecA genes were investigated by disk diffusion and molecular methods, respectively. Data were statistically analyzed by SPSS software v. 24. Results: The prevalence of S. aureus isolated in handmade hamburgers was significantly (p=0.008) higher than packaged ones. Most of 39 isolated S. aureus strains were susceptible to ciprofloxacin (31 isolate), chloramphenicol (27 isolate), and trimethoprim/sulfamethoxazole (37 isolate). The highest antibiotic resistance was observed for penicillin G followed by oxacillin and tetracycline. All isolates were found susceptible to vancomycin and gentamicin. Six S. aureus isolates which were evaluated for methicillin-resistance, contained the mecA gene. Conclusion: The high presence of the S. aureus in Iranian hamburgers and the remarkable antibiotic resistance emphasize the need for policies which enforce hygienic practices within the food industry and fast food outlets.

scholarly journals Multiple Antimicrobial Resistance in Methicillin-Resistant Staphylococcus sciuri Group Isolates from Wild Ungulates in Spain

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 920
Author(s):  
Joaquín Rey Pérez ◽  
Laura Zálama Rosa ◽  
Alfredo García Sánchez ◽  
Javier Hermoso de Mendoza Salcedo ◽  
Juan Manuel Alonso Rodríguez ◽  
...  
Keyword(s):  
Cervus Elaphus ◽  
Methicillin Resistance ◽  
Bacterial Species ◽  
Sccmec Type ◽  
Meca Gene ◽  
Domestic Animal ◽  
Wild Ungulates ◽  
Methicillin Resistant ◽  
Phenotypic Resistance ◽  
Columbia Blood Agar

The aim of this study was to investigate the presence of methicillin-resistant Staphylococcus (MRS) strains in non-managed wild ungulates present in a typical Mediterranean forest in Spain. For this purpose, nasal swabs were obtained from 139 animals: 90 wild boar (Sus scrofa), 42 red deer (Cervus elaphus) and 7 fallow deer (Dama dama), which were subsequently pre-enriched in BHI+ NaCl (6.5%) (24 h/37 °C), and then seeded in Columbia blood agar (24 h/37 °C)). The presence of the mecA gene was investigated by PCR, first from the confluent and then from individual colonies. A total of 10 mecA+ colonies were obtained of which only seven showed phenotypic resistance to oxacillin/cefoxitin (methicillin resistance). All MRS strains belonged to the Staphylococcus sciuri group. Methicillin-resistant Staphylococcus aureus (MRSA) was not detected. In addition, a significant number of MRS strains showed resistance to other antimicrobials, mainly β-lactam (7/7), gentamicin (7/7), fusidic acid (6/7) and quinupristin–dalfopristin (6/7), showing an irregular correlation with their coding genes. The genetic profiles grouped the seven strains obtained according to the bacterial species but not in relation to the animal source or the geographical place of origin. The presence of SCCmec type III, common to animals and humans, has been detected in three of the strains obtained. In conclusion, the study reveals that the wild ungulates investigated play a role as potential reservoirs of multi-resistant strains of MRS. Such strains, due to their characteristics, can be easily transferred to other wild or domestic animal species and ultimately to humans through their products.

scholarly journals THE DIFFERENCE OF E.COLI CONTENT IN THE CHICKEN MEAT IN THE SOUTH KEPUTRAN TRADITIONAL MARKET AND SUPERMARKET ' X ' OF SURABAYA CITY

2019 ◽  
Vol 14 (1) ◽  
pp. 24
Author(s):  
Athalla Permana ◽  
R. Bambang W
Keyword(s):  
Bacterial Contamination ◽  
Chicken Meat ◽  
Personal Hygiene ◽  
Food Handler ◽  
The South ◽  
Cross Sectional ◽  
E Coli ◽  
Traditional Market ◽  
The Difference ◽  
Meat Samples

Hygiene and sanitation practices in chicken influenced Eschericia coli bacterial contamination in food. A Study conducted by Sasmita and Juwita mentioned that there was positively E.coli content in chicken meat in supermarket. Thus, the purpose of this study was to assess the difference of E.Coli content in chicken meat and personal hygiene of food handler. It was an observational study with cross sectional approach. The population of this study included traditional market sellers and supermarkets. The sample of this study consisted of 14 samples of chicken meat in which 7 samples came from the South Keputran traditional market and other 7 samples came from Supermarket ‘X’. Moreover, 7 traditional market sellers and 2 supermarkets were involved to be examined. Variables of the study were E.coli content in chicken meat from Traditional Market of South Keputran and Supermarket ‘X’ and personal hygiene. Samples of chicken meat was done by accidental sampling. Data were collected through interview and observation, whereas the difference of E-Coli content was analyzed using statistical test. The results of this study indicated that one of chicken meat samples positively contained E.Coli bacteria, and no significant differences of the E.coli content were found on the chicken meat samples from both the Traditional Market of South Keputran and Supermarket ‘X’. The suggestion that can be given to Supermarket ‘X’ seller is to control and pay close attention to the sanitation process from suppliers to retails

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
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Pediatric Patients ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Current Status ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Isolation And Identification ◽  
Cross Sectional ◽  
Methicillin Resistant

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

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