Suppurative Infections in Hospitalized Patients – An Ongoing MRSA Threat

Empiric Antibiotic ◽

Medical Wards

Background: Penicillin resistance among Staphylococcus aureus commonly encountered in the hospital admitted patients. Detection of antibiotic sensitivity in hospital acquired methicillin resistant Staphylococcus aureus infections is important as it has great influence on empiric antibiotic prescription, successful control of infection, prevention of spread of disease and successful patient management. This study aimed to detect the frequency of HA-MRSA from pus samples in a hospital setup with assessment of their antibiotic susceptibility patterns. Method: A cross-sectional study was conducted in the Microbiology department of Basic Medical Science Institute, JPMC, Karachi from January 2015 until December 2015. Pus samples from surgical site wounds, skin lesions, abscesses from surgical and medical wards and ICUs were collected. According to the standards given by CLSI 2014, MRSA testing of the samples was done and susceptibility testing for antibiotics was performed. Inducible clindamycin resistance was detected by D-Test; E Test. determined MIC (minimum inhibitory concentration) for vancomycin. The data was analyzed by SPSS version 16. Result: Out of the 149 MRSA identified from the pus samples, 106 (71.14%) samples were HA-MRSA. The number of male patients was more than the female patients (67.66%). Out of the 106 HA-MRSA, 91(85.8%) were sensitive to TMP/SMX, 98(92.5%) to rifampicin, 12(11.6%) to gentamicin, 85(80.2%) to tetracycline, 11(10.4%) to erythromycin, 37(34.9%) to clindamycin, 20(18.9%) to ciprofloxacin, 106 (100%) to both vancomycin and linezolid. Conclusion: HA-MRSA showed sensitivity to TMP/SMX and vancomycin making them effective drugs to use in combination in superficial infections. The drug linezolid also showed 100% sensitivity.

D-Test as a tool to detect the frequency of clindamycin resistance in community acquired and hospital acquired methicillin resistant Staphylococcus aureus infections (MRSA).

The Professional Medical Journal ◽

10.29309/tpmj/2019.27.01.181 ◽

2020 ◽

Vol 27 (01) ◽

pp. 1-4

Author(s):

Sadaf Razzak ◽

Hina Faisal ◽

Amir Bux Detho ◽

Muhammad Asif Durrani ◽

Fakhuruddin ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Skin Lesions ◽

Cross Sectional Study ◽

Cross Sectional ◽

Methicillin Resistant ◽

Resistant Strains ◽

Medical Wards ◽

Hospital Acquired

Objectives: D-Test as a tool to detect the frequency of clindamycin resistance in community acquired and hospital acquired methicillin resistant Staphylococcus aureus infections. Study Design: A cross-sectional study. Setting: Microbiology department of BMSI, JPMC, Karachi. Period: January 2015 till December 2015. Material & Methods: Pus samples from deep wounds, skin lesions, abscesses, postoperative wounds from surgical, medical wards and OPDs were collected. MRSA testing and susceptibility testing for antibiotics was done according to CLSI2014. The frequency of inducible clindamycin resistance was detected by D-Test of the CA-MRSA and HA-MRSA. Result: In a total of 402 S. aurous isolates, 253 (62.93%) were methicillin-sensitive and 149 (37.06%) were methicillin-resistant. Out of 149 MRSA, 106 (71.14%) were HA-MRSA and 43(28.85%) were CA-MRSA. Among the HA-MRSA, 63(59.8%) were resistant to clindamycin while with D-Test, it increased to 78(73.58%). Out of 43 CA-MRSA, 9 (21.6%) were clindamycin resistant, while with D-Test, the resistance to clindamycin increased to 13 (30.23%). Conclusion: Inducible clindamycin-resistant strains may lead to clindamycin treatment failure in patients with S. aureus infection. Therefore, D-test should be done in priority to detect inducible clindamycin resistance in S. aurous.

Bacterial Etiology of Wound Exudates in Tertiary Care Cancer Patients and Antibiogram of the Isolates

Infectious Diseases Research and Treatment ◽

10.1177/1178633720952077 ◽

2020 ◽

Vol 13 ◽

pp. 117863372095207

Author(s):

Kiran Duwadi ◽

Sujan Khadka ◽

Sanjib Adhikari ◽

Sanjeep Sapkota ◽

Pabitra Shrestha

Keyword(s):

Staphylococcus Aureus ◽

Pathogenic Bacteria ◽

Methicillin Resistance ◽

Tertiary Care ◽

Antibiotic Sensitivity ◽

Cross Sectional Study ◽

Diffusion Method ◽

Disc Diffusion ◽

Biochemical Tests ◽

Cross Sectional

Introduction: Patients with malignancies frequently develop infections as a result of surgical procedures and fungating wounds leading to pus formation. This cross-sectional study was conducted to explore the bacteriological spectra of infections of various cancer sites and their antibiotic sensitivity patterns among the patients visiting minor operation theatre (OT) of B.P. Koirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal. Methods: Over a period of 3 months from September to November 2018, a total of 183 wound exudates and pus samples were collected and analyzed by standard microbiological procedures. Isolates were identified based on the colony characters, Gram staining and an array of biochemical tests. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion technique according to criteria set by CLSI, 2016. Methicillin resistance in Staphylococcus aureus was tested with the help of cefoxitin using disc diffusion method. Results: Out of the 183 samples, 149 (81.4%) were culture positive. Among 13 different isolates identified, S. aureus (43.0%) was predominant followed by E. coli (14.0%). Higher incidence of bacteria was seen among the males (52.3%), in the age group 51 to 60 years (26.8%) and among the patients undergoing surgical intervention to deal with cancer (34.2%). The prevalence of wound infection was significantly affected by gender, age, and treatment regimen ( P < .01). Out of the total 68 S. aureus isolates, 38 (44.1%) were deemed as Methicillin-resistant Staphylococcus aureus (MRSA). Among the 158 isolates, 85 (53.8%) were multi-drug resistant (MDR). Cefepime was the most effective antibiotic for Gram positive isolates whereas both imipenem and meropenem were found to be equally more effective for Gram negative isolates. Conclusion: This study suggests that patients with malignancies harbor pathogenic bacteria; therefore, prudent use of antibiotics is essential to prevent the emergence of MDR pathogens.

Inducible Clindamycin Resistant Staphylococcus aureus among Patients Attending Tertiary Care Centre: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6882 ◽

2021 ◽

Vol 59 (243) ◽

pp. 1111-1115

Author(s):

Shanti Shanti ◽

Sanjib Mani Regmi ◽

Nabina Shrestha

Keyword(s):

Staphylococcus Aureus ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Clinical Samples ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Inducible Clindamycin Resistance

Introduction: Staphylococcus aureus, a superbug, resistant to multiple antibiotics led to growing interest in the usage of macrolide-lincosamide-streptogramin B antibiotics, which are now rapidly developing resistance. This study aims to find the prevalence of inducible clindamycin-resistant Staphylococcus aureus among obtained clinical samples from in-patient and out-patient departments of a tertiary care center. Methods: This is a descriptive cross-sectional study done in clinical samples from the in-patient and out-patient departments of a tertiary care center from September 2020-May 2021. Ethical clearance was taken from the Institutional Review Committee (Ref: 068/2077/2078). Staphylococcus aureus were isolated and antibiotic susceptibility tests were performed by disc diffusion method. Inducible clindamycin and methicillin resistance Staphylococcus aureus were detected using D-test and cefoxitin disc according to Clinical and Laboratory Standards Institute guidelines. Convenient sampling was done and the data was analyzed using Statistical Package for Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among a total of 141 Staphylococcus aureus isolated, the prevalence of inducible clindamycin resistant phenotype was 41 (29.1%) (21.6-36.59 at 95% Confidence Interval). Whereas, 30 (21.3%) were constitutive clindamycin resistant. The inducible 28 (47.5%) and 19 (32.2%) constitutive clindamycin resistance was higher among methicillin-resistant Staphylococcus aureus. Conclusions: The frequency of inducible clindamycin resistance among methicillin resistant Staphylococcus aureus was high, which alarms the use of macrolide-lincosamide-streptogramin B antibiotics in Staphylococcus aureus infections. Hence, D-test should be performed to detect inducible clindamycin resistance in routine testing to prevent treatment failure.

Antibiogram of Staphylococcus aureus in a Tertiary Care Hospital: Changing Trends

International Journal of Current Microbiology and Applied Sciences ◽

10.20546/ijcmas.2021.1010.040 ◽

2021 ◽

Vol 10 (10) ◽

pp. 319-325

Author(s):

Priyanka Pradhan Sneha Mohan ◽

Tarana Sarwat Dalip Kakru

Keyword(s):

Staphylococcus Aureus ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Diffusion Method ◽

Care Hospital ◽

Cross Sectional ◽

Antimicrobial Susceptibility Pattern

Healthcare Facilities ◽

Methicillin resistant Staphylococcus aureus (MRSA) is major cause of nosocomial and community infections. Its prevalence varies with country and with hospitals within a country. Therefore, it is important for continuous surveillance in hospitals and other healthcare facilities in order to limit the spread of infections caused by MRSA. To determine the antibiogram of Staphylococcus aureus in a tertiary care hospital and to determine the change in trends in the antimicrobial susceptibility pattern of Staphylococcus aureus. To determine the prevalence of MRSA in a tertiary care hospital. This cross- sectional study was conducted at the Department of Microbiology, SMSR, Sharda University and Hospital. A total of 100 strains identified by morphological and biochemical characteristics were tested for antibiotic susceptibility using Kirby-Bauer disc diffusion method and the Prevalence of Inducible Clindamycin Resistance among the isolates. 100 out of 13,639 isolates clinical comprising samples were obtained Pus (78.6%), Blood (7%), Swab (4.1%), Sputum (4.1%), Urine (4.1%), Semen (2%). Maximum MRSA were obtained from pus samples (81%). However, out of total 7 isolates of Staphylococcus aureus obtained from blood 4 were MRSA and 3 were MSSA. The prevalence of MRSA that is (40%) infections was a high in our setup and is comparable to studies done earlier. This trend is particularly alarming for Staphylococcus aureus because of the severity and diversity of disease caused by this uniquely versatile pathogen.

Patterns of Constitutive and Inducible Clindamycin Resistance in Staphylococcus aureus Isolated from Clinical Samples by D-test Method, Shiraz, Southwest of Iran

Galen Medical Journal ◽

10.31661/gmj.v3i4.204 ◽

2014 ◽

Vol 3 (4) ◽

pp. 216-21

Author(s):

Mohammad Motamedifar ◽

Hadi Seddigh Ebrahim Sarai ◽

Davood Mansury

Keyword(s):

Staphylococcus Aureus ◽

Medical Center ◽

Cross Sectional Study ◽

Test Method ◽

Teaching Hospitals ◽

Clinical Samples ◽

Cross Sectional ◽

Resistance Patterns ◽

Southwest Of Iran

Background: Macrolides, Lincosamides and type B Streptogramins (MLSB) are commonly used for the treatment of Staphylococcal infections. Inducible MLSB resistance (iMLSB) cannot be identified by standard methods of antibiotic susceptibility testing. D-test appears to be a reliable indicator of iMLSB strains. The aim of this study was to determine the prevalence of Clindamycin resistance phenotypes in Staphylococcus aureus (S.aureus) isolated from clinical samples in Shiraz, southwest of Iran.Materials and Methods: This cross-sectional study was performed on a total of 302 S. aureus isolates which were collected from two teaching hospitals in Shiraz during 2012. Methicillin resistant Staphylococcus aureus (MRSA) were screened based on their resistance to 30μg Cefoxitin disk. 168 Methicillin-sensitive Staphylococcus aureus (MSSA) and 134 MRSA isolates were tested in this study. The isolates were tested for susceptibility to Clindamycin (2 µg) and Erythromycin (15 µg) by Clinical and Laboratory Standards Institute (CLSI) recommended disk diffusion test.Results: Of 302 collected S. aureus isolates, 134 (44.4%) were MRSA and 168 (55.6%) were MSSA. Inducible MLSB resistance was observed in 10.4% of all recovered MRSA and 3% of all MSSA isolates. The majority of MRSA isolates (77.6%) constituted MLSB phenotype (cMLSB); this phenotype was seen in 4.1% of our tested MSSA isolates. Finally, 12.0% of MRSA isolates and 89.9% of MSSA showed sensitivity to both Erythromycin and Clindamycin.Conclusion: Different resistance patterns in hospitals indicated that performing routine D-test for S. aureus infections is highly recommended for each medical center. [GMJ. 2014;3(4):216-21]

Nasopharyngeal Carriage and Antimicrobial Susceptibility Profile of Staphylococcus aureus among Children under Five Years in Accra

Pathogens ◽

10.3390/pathogens10020136 ◽

2021 ◽

Vol 10 (2) ◽

pp. 136

Author(s):

Nicholas T. K. D. Dayie ◽

Mary-Magdalene Osei ◽

Japheth A. Opintan ◽

Patience B. Tetteh-Quarcoo ◽

Fleischer C. N. Kotey ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Susceptibility ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Penicillin G ◽

Nasopharyngeal Carriage ◽

Coagulase Negative Staphylococci ◽

Cross Sectional ◽

Under Five

This cross-sectional study investigated the Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) nasopharyngeal carriage epidemiology in Accra approximately five years post-pneumococcal conjugate vaccines introduction in the country. Archived nasopharyngeal swabs collected from 410 children aged under five years old were bacteriologically cultured. The resultant S. aureus isolates were subjected to antimicrobial susceptibility testing and screening for carriage of the mecA and LukF-PV (pvl) genes, following standard procedures. The data obtained were analyzed with Statistical Products and Services Solutions (SPSS) using descriptive statistics and Chi square tests of associations. The isolated bacteria decreased across coagulase-negative Staphylococci (47.3%, n = 194), S. aureus (23.2%, n = 95), Diphtheroids (5.4%, n = 22), Micrococcus species (3.7%, n = 15), Klebsiella pneumoniae (3.2%, n = 13), Moraxella species and Citrobacter species (1.5% each, n = 6), Escherichia coli, Enterobacter species, and Pseudomonas species (0.9% each, n = 2). The MRSA carriage prevalence was 0.49% (n = 2). Individuals aged 37–48 months recorded the highest proportion of S. aureus carriage (32.6%, 31/95). Resistance of S. aureus to the antibiotics tested were penicillin G (97.9%, n = 93), amoxiclav (20%, n = 19), tetracycline (18.9%, n = 18), erythromycin (5.3%, n = 5), ciprofloxacin (2.1%, n = 2), gentamicin (1.1%, n = 1), cotrimoxazole, clindamycin, linezolid, and teicoplanin (0% each). No inducible clindamycin resistance was observed for the erythromycin-resistant isolates. Three (3.2%) of the isolates were multidrug resistant, of which 66.7% (2/3) were MRSA. The pvl gene was associated with 59.14% (55/93) of the methicillin-sensitive S. aureus (MSSA) isolates, but was not detected among any of the MRSA isolates.

Prevalence of Methicillin Resistant Staphylococcus aureus and Antibiotic Susceptibility Pattern in a Tertiary Hospital in Nepal

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v16i2.20305 ◽

2018 ◽

Vol 16 (2) ◽

pp. 172-174 ◽

Cited By ~ 2

Author(s):

Laxmi Kant Khanal ◽

Ram Prasad Adhikari ◽

Ankita Guragain

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Sensitivity ◽

College Teaching ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Resistance Pattern ◽

Cross Sectional ◽

Methicillin Resistant ◽

Sensitivity Pattern

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: .

Methicillin- and Inducible Clindamycin-ResistantStaphylococcus aureusamong Patients with Wound Infection Attending Arba Minch Hospital, South Ethiopia

International Journal of Microbiology ◽

10.1155/2019/2965490 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Mohammedaman Mama ◽

Addis Aklilu ◽

Kassahun Misgna ◽

Molla Tadesse ◽

Eyerusalem Alemayehu

Keyword(s):

Staphylococcus Aureus ◽

Wound Infection ◽

Methicillin Resistance ◽

Demographic Data ◽

Cross Sectional Study ◽

Diffusion Method ◽

Cross Sectional ◽

Methicillin Resistant ◽

Antimicrobial Susceptibility Pattern

Background. Wound infection is one of the most common hospital-acquired infections. Different bacteria cause infection, of whichStaphylococcus aureusis one of the known bacteria in causing infection with increased drug-resistant isolates.Objective. To assess the prevalence and antimicrobial susceptibility pattern of methicillin and inducible clindamycin-resistantStaphylococcus aureusamong patients with wound infections attending Arba Minch Hospital.Methods. A facility-based cross-sectional study was conducted from April to June 2017. A pretested questionnaire was used to collect demographic data and clinical characteristics. Wound swabs were cultured and identified by standard techniques. Antibiotic susceptibility tests were performed by the Kirby–Bauer disc diffusion method. Methicillin resistance was detected using the cefoxitin (30 μg) antibiotic disc while inducible clindamycin resistance was detected by the D-zone test. The data were analyzed using Statistical Package for Social Science, version 20.pvalue <0.05 was considered statistically significant.Results. A total of 161 patients were enrolled and a majority of them were female (90, 50.9%). Among the collected samples, 79 (49.7%) were positive forS. aureus; of this, methicillin resistance accounted for 65 (82.3%). Out of 22 (27.8%) erythromycin-resistant isolates, 19 (24.1%) showed inducible clindamycin resistance. Methicillin-resistantS. aureusshowed higher resistance against tetracycline (72.3%) followed by cotrimoxazole (43.1%) and 100% sensitivity to vancomycin. The overall prevalence of inducible clindamycin resistance among methicillin-resistant isolates was 16 (24.6%).Conclusion. The increasing prevalence of methicillin-resistantS. aureusand the coresistance against other therapeutic options like clindamycin is becoming an obstacle in the treatment of infections which need attention from concerned bodies.

Bacterial Assessment and Their Antibiotic Sensitivity Patterns of Nasal and Hand Swab Specimens From Food Handlers in Hospital Compounds in Mandalay, Myanmar: A Cross-sectional Descriptive or Observational Study

10.21203/rs.3.rs-75468/v1 ◽

2020 ◽

Author(s):

Si Thu Aung ◽

Aung Aung Nwe

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Sensitivity ◽

Cross Sectional Study ◽

Food Handler ◽

Food Handlers ◽

Isolation And Identification ◽

Cross Sectional ◽

Sensitivity Pattern ◽

Nasal Swabs ◽

The Government

Abstract Background: Microbial contamination of food can occur from contaminated or infected food handlers.Methods: This study aimed to assess type of bacteria and their antibiotic sensitivity pattern of nasal and hand swab samples from food handlers working in hospital compounds, Mandalay city, Myanmar. All eligible food handlers working in the government hospital compound, Mandalay City, Myanmar, were subjected to a cross-sectional study conducted from May to August 2018. Hand and nasal swabs were collected from of food handlers for bacterial isolation and identification. Antibiotic sensitivity patterns of isolated bacteria were determined.Results: Among 111 participants, 92 (82.9%) were bacteria-positive by hand swabs and 77(69.37%) were positive by nasal swab. Among Staphylococcus aureus isolated from nasal swabs, just over a half (51.2%) were resistant to oxacillin (probably methicillin resistant Staphylococcus aureus). There were association between hand contamination and nasal bacterial growth (p<0.001).Conclusion: Bacterial contamination status of the food handler working in hospital compound, Mandalay city, Myanmar, was extremely high.

Prevalence of methicillin-resistant Staphylococcus aureus in a tertiary hospital in Nepal

Public Health Action ◽

10.5588/pha.21.0042 ◽

2021 ◽

Vol 11 (1) ◽

pp. 46-51

Author(s):

P. Pradhan ◽

P. Rajbhandari ◽

S. B. Nagaraja ◽

P. Shrestha ◽

R. Grigoryan ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Sensitivity ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Cross Sectional ◽

Methicillin Resistant ◽

Sensitivity Pattern ◽

Successful Clinical Outcome ◽

Mrsa Infection

SETTING: Patan Hospital, Lalitpur, Nepal.OBJECTIVES: To describe 1) the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and its antibiotic sensitivity pattern; 2) the demographic and clinical characteristics associated with MRSA infections; and 3) the treatment outcomes of in-patients with MRSA infection among patients with S. aureus infection between January 2018 and December 2020.DESIGN: This was a cross-sectional study using electronic and paper-based hospital records of patients with S. aureus infection.RESULTS: Of the 1,804 patients with S. aureus infection, 1,027 patients (57%, 95% CI 55–59) had MRSA. The MRSA were susceptible to vancomycin (100%), linezolid (96%), doxycycline (96%), chloramphenicol (86%) and cotrimoxazole (70%), and resistant to erythromycin (68%), clindamycin (56%), gentamycin (58%), ciprofloxacin (92%) and ofloxacin (91%). The prevalence of MRSA was higher in 2019, among out-patients, and in respiratory samples, and lower in blood samples. Of the 142 in-patients with MRSA, 93% had a successful clinical outcome (cured/improved).CONCLUSION: More than 50% of patients with S. aureus infection had MRSA that were resistant to commonly available antibiotics. This calls for strengthening surveil-lance and good infection control practices in this hospital.