scholarly journals Antibiotics Susceptibility Pattern of Bacteria Isolated from Ready-To-Eat Vegetables Sold in Mohammadu Gumi Market, Kaduna, Nigeria

2021 ◽  
Vol 16 (2) ◽  
pp. 131-137
Author(s):  
A.F. Obajuluwa ◽  
A. Kefas ◽  
S.K. Parom
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Susceptibility ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Resistant Bacteria ◽  
Antibiotics Resistance ◽  
Salmonella Spp ◽  
Methicillin Resistant ◽  
Agar Disc

Background: Freshly consumed vegetables are considered to have more nutritional value than cooked ones. However, they are a potential source of foodborne illnesses due to possible microbial contamination, this poses safety threat.Objectives: This study was carried out to determine the bacteriological quality of ready-to-eat vegetables sold in Mohammadu Gumi market, Kaduna and to determine the antibiotics resistance pattern of the bacteria isolates.Methods: A total of 40 samples of cabbage were collected. Gram staining, growth on selective media and biochemical tests were carried out to identify the isolates. Antimicrobial susceptibility testing was done using the Kirby-Bauer agar disc diffusion method. Methicillin resistant Staphylococcus aureus isolates were detected with the use of cefoxitin disc agar diffusion test.Results: A total of 46 bacteria isolates were obtained with a total colony count range from 4 – 9 x 106CFU/ml. The following bacteria were isolated:   aureus (41.3%), Escherichia coli (28.3%), Salmonella spp (19.6%),  Pseudomonas aeruginosa (8.7%) and Serratia spp (2.2%). The result of antimicrobial susceptibility test showed thatthe isolates were highly susceptible to ofloxacin: Staphylococcus aureus, Pseudomonas aeruginosa, Serratia spp (100%), E. coli (92.3%) and Salmonella spp (87.5%). The isolates were all resistant to penicillin and ampicillin while 89.5% of the Staphylococcus aureus isolates were phenotypically methicillin resistant Staphylococcus aureus.Conclusion: This study showed that the vegetables (cabbage) were highly contaminated with antibiotic resistant bacteria, this can be a source of infection to the consumers and a potential means of transmitting multidrug resistant bacteria strains in the community.

scholarly journals Bacterial profile and antimicrobial susceptibility patterns of otitis media among children in Qatar

2019 ◽  
Vol 7 (9) ◽  
pp. 3311
Author(s):  
Qasem Buhaibeh ◽  
Tawfik Dhaiban ◽  
Eiman Alyafei ◽  
Amjad Salman Al-Jundi Abdulsalam
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Otitis Media ◽  
Antimicrobial Susceptibility ◽  
Harmful Effect ◽  
Resistance Pattern ◽  
Resistant Bacteria ◽  
Klebsiella Pneumonia ◽  
Susceptibility Patterns

Background: Otitis Media (OM) common diseases affecting children below 5 years of age with a harmful effect on their hearing and health status. Data about the bacterial profile and current antimicrobial resistance status of Otitis Media in the region is scarce. Objective of this study determine the causative organisms of Otitis Media and antimicrobial  susceptibility patterns among children in a Primary Health Care Corporation (PPHC) centers, Qatar.Methods: A cross-sectional study was conducted in PPHC from Jan 2016 to Dec 2017. A total of 181 patients with Otitis Media presented to PHCC centers were enrolled in the study. Socio-demographic and clinical data were documented and analysed.Results: A total of 181 children, an almost equal number of male (49.7%) and female (50.3%) participants were involved in the study. 51.4% of participants were ≤5 years of age. Bacteria isolated were: Pseudomonas Aeruginosa (27.6%), Hemophilus Influenza (13.3%), Staphylococcus Aureus (11.6%), Methicillin-Resistant Staphylococcus Aureus (MSRA) (11.0%), Streptococcus Pyogenes (10.5%), Streptococcus Pneumonia (6.6%), Moraxella Catarrhalis (2.2%), Klebsiella Pneumonia (0.6%). The sensitivity of Pseudomonas Aeruginosa was (100%) to cotrimoxazole, vancomycin, and piperacillin, (96%) to cefepime and gentamicin, and was (88.2%) to ciprofloxacin. MRSA sensitivity was (100%) to vancomycin, rifampicin, and teicoplanin, (89%) to clindamycin.Conclusion: Pseudomonas Aeruginosa was the most frequent isolated bacteria. An overall antimicrobial resistance pattern seen in bacteria isolates ranges from 0% to 66.7%. The antimicrobial-resistant rate was observed for Ampicillin, Augmentin, and cefuroxime whereas ciprofloxacin, cefepime, chloramphenicol, cotrimoxazole, gentamicin, vancomycin, and amikacin were found effective for the isolated resistant bacteria.

scholarly journals Antimicrobial susceptibility pattern and multidrug resistance ındex in Pseudomonas aeruginosa among clinical isolates in Denizli, Turkey

2018 ◽  
Vol 20 (3) ◽  
Author(s):  
Selma Kırac ◽  
Dilek Keskin ◽  
Muradiye Yarar
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Resistance Index ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Susceptibility Pattern ◽  
Antimicrobial Susceptibility Pattern ◽  
Agar Disc ◽  
Sensitivity Pattern

Background: Pseudomonas aeruginosa is an important hospital infection agent causing morbidity and mortality with the ability to gain resistance to many antimicrobials. The objective of this study was to determine the sensitivity profiles of nosocomial P.aeruginosa isolates in Denizli, Turkey.Methods: A total 120 P. aeruginosa strains which were isolated from specimens sent to the microbiology laboratory between January 2015 and December 2015 were investigated. Antimicrobial resistance was determined by agar disc diffusion method using Mueller-Hinton agar according to Clinical and Laboratory Standards Institute recommendations.Results: With respect to sensitivity pattern, the most sensitive antimicrobials were  Amikacin, colistin, tobramisin, netilmicin and gentamicin  and the resistance rates were detected as 97%, 96%, 92%, 90%, 83%, respectively over 120 P. aeruginosa strains. The sensitivity rates for the other antimicrobials were 56% for Piperacilin and 54% for Tazobactam. P. aeruginosa strains 62 (52%) isolates showed multiple antimicrobial resistance to 13 antimicrobialsConclusion: To prevent the spread of the resistant bacteria, it is critically important to have strict antimicrobial policies while surveillance programmes for multidrug resistant organisms and infection control procedures need to be implemented. In the meantime, it is desirable that the antimicrobial susceptibility pattern of bacterial pathogens like P. aeruginosa in specialized clinical units to be continuously monitored and the results readily made available to clinicians so as to minimize the development of resistance.

Antibiotics resistance profile of Staphylococcus aureus isolated from selected surfaces in a university campus

2020 ◽  
Vol 15 (1) ◽  
pp. 21-27
Author(s):  
Campus. Bamidele Tolulope Odumosu ◽  
Amina Oluwatoyin Adelowotan ◽  
Olanike Maria Buraimoh ◽  
Ighodaro Grace Oghogho
Keyword(s):  
Staphylococcus Aureus ◽  
Virulence Genes ◽  
Total Sample ◽  
Health Concern ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Antibiotics Resistance ◽  
Resistance Profile ◽  
Antibiotic Susceptibility Test ◽  
Potential Reservoir

Antibiotic-resistant bacteria are serious public health concern. Methicillin-resistant Staphylococcus aureus (MRSA) infections are steadily increasing but the potential reservoir and risk in the environment are poorly investigated. A total of 284 environmental swabs were collected from 2 faculties of the University and screened for the presence of S. aureus by standard biochemical assays, 16S rRNA and S. aureus nuc gene amplification for the molecular identification of the isolates. Antibiotic susceptibility test was done by disc diffusion method while the detection of resistance and virulence genes were investigated by Polymerase Chain Reaction (PCR). Of the total sample collected, 190 (47.50%) S. aureus were recovered of which > 80% were resistant to more than 3 antibiotics. Considerable resistance profile was observed among the isolates and there were positive amplifications for aph (3’)-IIIa and aac (6’)-Ie-aph (2’), ermB tetL and tetK genes. There was no amplification for the investigated virulence genes among the isolates. High presence of multiply resistant S. aureus from environmental surfaces suggests the campus environment is a potential reservoir of S. aureus infection Keywords: Antimicrobial Resistance, Staphylococcus aureus, virulence, antibiotics.

scholarly journals Bacteriological Profile and Antimicrobial Susceptibility Patterns of Bacteria Isolated from Pus/Wound Swab Samples from Children Attending a Tertiary Care Hospital in Kathmandu, Nepal

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Salu Rai ◽  
Uday Narayan Yadav ◽  
Narayan Dutt Pant ◽  
Jaya Krishna Yakha ◽  
Prem Prasad Tripathi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Susceptibility ◽  
Gram Negative Bacteria ◽  
Wound Infections ◽  
Gram Negative ◽  
Methicillin Resistant ◽  
Gram Positive Bacteria ◽  
Wound Swab ◽  
Susceptibility Patterns

In Nepal, little is known about the microbiological profile of wound infections in children and their antimicrobial susceptibility patterns. Total of 450 pus/wound swab samples collected were cultured using standard microbiological techniques and the colonies grown were identified with the help of biochemical tests. The antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion technique. Methicillin-resistantStaphylococcus aureusisolates were detected by using cefoxitin disc and confirmed by determining minimum inhibitory concentrations (MIC) of oxacillin. 264 (59%) samples were culture positive. The highest incidence of bacterial infections was noted in the age group of less than 1 year (76%). Out of 264 growth positive samples, Gram-positive bacteria were isolated from 162 (61%) samples and Gram-negative bacteria were found in 102 (39%) samples.Staphylococcus aureus(99%) was the predominant Gram-positive bacteria isolated andPseudomonas aeruginosa(44%) was predominant Gram-negative bacteria. About 19% ofS. aureusisolates were found to be methicillin-resistant MIC of oxacillin ranging from 4 μg/mL to 128 μg/mL. Among the children of Nepal, those of age less than 1 year were at higher risk of wound infections by bacteria.Staphylococcus aureusfollowed byPseudomonas aeruginosawere the most common bacteria causing wound infections in children.

scholarly journals Methicillin-Resistant Staphylococcus Aureus (mrsa) as a Cause of Nosocomial Wound Infections

2010 ◽  
Vol 10 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Maida Šiširak ◽  
Amra Zvizdić ◽  
Mirsada Hukić
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Susceptibility Testing ◽  
Antimicrobial Susceptibility Testing ◽  
Diffusion Method ◽  
Wound Infections ◽  
Common Cause ◽  
Methicillin Resistant ◽  
Mrsa Infection

Postoperative wound infections represent about 16% of hospital-acquired infections. Staphylococcus aureus is the most common cause of nosocomial wound infections. Increased frequency of Methicillin-re- sistant Staphylococcus aureus (MRSA) in hospitalized patients and possibility of vancomycin resistance requires permanent control of MRSA spread in the hospital.The purpose of this study was to analyse the frequency of Methicillin-resistant Staphylococcus aureus (MRSA) in the swabs taken from the surgical wounds, the presence of MRSA infection in surgical departments and to examine antimicrobial susceptibility of MRSA isolates.Wound swabs were examined from January 2006 to December 2008. The isolates were identified by conventional methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc-diffusion method as per NCCLS guidelines.A total of 5755 wound swabs were examined: 938 (16,3%) swabs were sterile and 4817 (83,7%) were positive. Staphylococcus aureus was isolated in 1050 (22,0%) swabs and it was the most common cause of wound infections. MRSA was isolated from 12,4% samples in 2006, from 6,7% samples in 2007 and from 3,7% samples during 2008. Wound infections caused by MRSA dominated in the department of plastic surgery (24,4%) and in the department of orthopaedic surgery (24,1%). Antimicrobial susceptibility testing showed that 73% of MRSA isolates were with the same antibiotic sensitivity pattern (antibiotyp)- sensitive only to vancomycin, tetracycline, fucid acid and trimethoprim/sulfamethoxasole.Our results show decreasing of MRSA infection in the surgical wards. These results appear to be maintained with strategies for preventing nosocomial infection: permanent education, strong application of protocols and urging the implementation of strict infection control policy.

scholarly journals A study on Methicillin resistant Staphylococcus aureus mastitis in dairy cows

2014 ◽  
Vol 6 (2) ◽  
pp. 356-361 ◽  
Author(s):  
D. Chandrasekaran ◽  
P. Venkatesan ◽  
K. G. Tirumurugaan ◽  
A. P. Nambi ◽  
P. S. Thirunavukkarasu ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Dairy Cows ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Clinical Mastitis ◽  
Penicillin G ◽  
Diffusion Method ◽  
Isolation And Identification ◽  
Methicillin Resistant ◽  
Milk Samples ◽  
Agar Disc

Methicillin-resistant Staphylococcus aureus (MRSA) poses a serious problem in dairy animals suffering from mastitis. The study was carried out to evaluate the incidence of Methicillin resistant S. aureus from clinical mastitis milk samples and their antibiotic resistance profile and characterised with respect to the molecular features that contributed to the resistance in these pathogens. Isolation and identification of Methicillin resistant S. aureus were performed from acute clinical mastitis samples. The isolates were tested using agar disc diffusion method for their antimicrobial susceptibility and modified resazurin assay micro dilution technique for MIC to 8 different antimicrobial drugs. A total of 235 clinical mastitis milk samples from dairy cows were cultured for incidence of S. aureus. Methicillin resistant S. aureus was isolated from a total of 12 (44.25%) of the 116 S. aureus samples. Based on the antimicrobial sensitivity and MIC results, MRSA isolates were found sensitive to gentamicin, enrofloxcain, amoxicillin+sulbactam, ceftriaxone and resistant to amoxicillin, oxytetracycline, penicillin G and oxacillin. Most of MRSA isolates were found to be multi-drug resistant. MRSA alert kit test and mecA and blaZ target gene PCR were found to be useful in the confirmation of MRSA.

scholarly journals Antimicrobial Susceptibility and Coagulase Typing of MRSA Strains at Mymensingh Medical College

2016 ◽  
Vol 1 (2) ◽  
pp. 56-60 ◽  
Author(s):  
Abul Hossain Khan ◽  
AKM Shamsuzzaman ◽  
Shyamal Kumar Paul ◽  
Md. Murshed Alam ◽  
Md. Chand Mahmud
Keyword(s):  
Staphylococcus Aureus ◽  
Drug Resistance ◽  
Antimicrobial Susceptibility ◽  
Fusidic Acid ◽  
Vancomycin Resistance ◽  
Resistance Pattern ◽  
Methicillin Resistant ◽  
Medical College ◽  
Drug Resistance Pattern ◽  
Mrsa Strains

Antimicrobial susceptibility and coagulase typing of Staphylococcus aureus isolates, with particular emphasis to Methicillin Resistant S. aureus (MRSA), were studied among strains isolated from various types of specimens collected at Mymensingh. A newly developed panel of anti-sera against different coagulase enzymes was used for coagulase typing. The study included 79 strains of S. aureus and of those, 40 were identified as MRSA on the basis of resistance to oxacillin (1 gm) discs. The rate of resistance of S. aureus to different antibiotics observed: penicillin (88.61%), oxacillin (48.10%), cephradine (44.30%), gentamicin (27.85%), erythromycin (34.18%), fusidic acid (25.0%) and rifampicin (20.0%). None of the isolates showed vancomycin resistance. Both MRSA and non-MRSA strains were found belonging to Coagulase type VI. Drug resistance pattern and coagulase type of MRSA strains indicated a homogenous epidemiologic origin that needs further exploration including strains from different geographic locations.Bangladesh J Med Microbiol 2007; 01 (02): 56-60

scholarly journals Prevalence of Methicillin-Resistant Staphylococcus aureus in Shrines

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Charu Arjyal ◽  
Jyoti KC ◽  
Shreya Neupane
Keyword(s):  
Staphylococcus Aureus ◽  
Research Work ◽  
High Rate ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Human Beings ◽  
Antibiotic Resistant ◽  
Mannitol Salt Agar ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) infection in human beings and animals is concerning; it stands out as one of the leading agents causing nosocomial and community infections. Also, marginally increasing drug resistance in MRSA has limited therapeutic options. This study focuses on estimating the prevalence of MRSA in shrines, a place where human and animal interaction is frequent, sharing antibiotic-resistant bacteria, antibiotic-resistant genes, and diseases. A total of 120 environmental swabs were collected from targeted areas during the study period, March 2018 to May 2018. Staphylococcus aureus was identified by growth on mannitol salt agar (MSA), and MRSA by growth on mannitol salt agar containing 4 μg Oxacillin, Gram staining, and conventional biochemical test. Isolates of S. aureus were characterized by antibiotic susceptibility testing using the disc diffusion method. MRSA and methicillin-sensitive S. aureus (MSSA) proportion were 19% and 81%, respectively; a high rate of MRSA was observed in isolates from Thapathali (28.6%). MSSA isolates showed a high rate of resistance to erythromycin (64.7%). MRSA isolates were resistant to gentamicin (50%), cotrimoxazole (25%), erythromycin (50%), and ciprofloxacin (25%). The isolates were susceptible to linezolid (100%), clindamycin (100%), ciprofloxacin (75%), erythromycin (50%), tetracycline (100%), and cotrimoxazole (75%). Intermediate resistance was also found in gentamicin (50%). Of the 11 MSSA isolates that were erythromycin resistant and clindamycin sensitive, 6 (54.5%) showed the inducible clindamycin resistance (ICR) pattern and 2 MRSA isolates that were erythromycin resistant and clindamycin sensitive showed ICR pattern. Fifteen MSSA isolates were β-lactamase positive, whereas only two MRSA isolates showed β-lactamase production. There exists a minimal research work on infectious diseases that are shared between primates and animals. This study suggests the pervasiveness of MRSA/MSSA in the shrines, which may be a primary place for pathogen exchange between humans and primates.

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Kyiv Surgical Hospital (Ukraine)

2017 ◽  
Vol 1 (2) ◽  
pp. 73-83
Author(s):  
A.G. Salmanov ◽  
O.M. Verner
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Fusidic Acid ◽  
The Other ◽  
Antibiotics Resistance ◽  
Methicillin Resistant ◽  
Surgical Department ◽  
Epidemiologic Surveillance ◽  
Total Prevalence ◽  
Vitek 2

Objective — to determine the prevalence of methicillin-resistant strains of Staphylococcus aureus, isolated from patients different departments in Kyiv Surgical Hospital. Materials and methods. Between June 2015 and December 2015, a total of 128 S. aureus isolates were collected from the pus samples of the patients with SSI in a surgical hospital in Kyiv, Ukraine. The identification and antimicrobial susceptibility of the cultures were determined, using automated microbiology analyzer VITEK 2 Compact (bioMerieux, France). Susceptibility to antibiotics was determined using VITEK 2 AST-P580 card (bioMerieux, France), which included 20 antibiotics (benzylpenicillin, oxacyllin, cefoxitin, gentamycin, tobramycin, levofloxacin, moxifloxacin, erythromycin, clindamycin, linezolid, teicoplanin, vancomycin, tetracycline, tigecycline, fosfomicin, nitrofurantoin, fusidic acid, mupirocin, rifampicin, and trimethoprim/ sulphamethoxazole) and a cefoxitin test, designed for detection of staphylococci resistance to methicillin. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute (CLSI). Results and discussion. Based on antimicrobial susceptibility analysis, the most active antibiotics found in the study were linezolid, tigecycline, and mupirocin, showing growth inhibition of 100 % strains tested. Susceptibility to the other antimicrobials was also on a high level: 99 % of strains were found susceptible to nitrofurantoin and trimethoprim/sulphamethoxazole, 98 % — to fusidic acid, 97 % — to moxifloxacin, 96 % — to teicoplanin, 95 % — to vancomycin and fosfomicin, 93 % — to gentamycin, and 92 % — to tobramycin. Susceptibility to levofloxacin (89 %), tetracycline (88 %), rifampin (87 %), erythromycin (84 %), and clindamycin (79 %) was observed to be some lower. Research of MRSA prevalence in Kyiv Surgical Hospital (Ukraine) shown, that 11 % of staphylococci strains, isolated from patients having nosocomial infections (SSI), had multiple resistance to antibiotics. Resistance S. aureus to oxacyllin came up to 19 %. Further, 35.7 % of MRSA strains were resistant only to the group of beta-lactamic antibiotics, while the rest — also to the other classes of antibiotics. Conclusions. MRSA in surgical hospital, being a subject of the research is considered to be a serious therapeutic and epidemiologic problem. Total prevalence of MRSA in hospital was evaluated as 19 %, varying in every surgical department studied. Antibiotics revealed the most effective for treatment of MRSA infections were linezolid, mupirocin, tigecycline, vancomycine, teicoplanin, moxifloxacin, nitrofurantoin, fusidic acid, and trimethoprim/sulphamethoxazole. Taking into account the constant changes and significant differences of the S. aureus resistance levels observed in various regions, the constant monitoring of antibiotic resistance to antimicrobials in every in-patient medical institution is required and on the base of the local obtained results to elaborate the hospital record sheets. Antibiotics application tactics should be determined in accordance with the local data of resistance to them in each surgical inpatient institution. The system of epidemiologic surveillance over microbial resistance should be established on the local, regional, and national levels.

scholarly journals Methicillin Resistant Staphylococcus aureus Isolated from Wound Infections

2018 ◽  
Vol 5 ◽  
pp. 19-24
Author(s):  
Jyoti Shrestha ◽  
Krishan Govinda Prajapati ◽  
Om Prakash Panta ◽  
Pramod Poudel ◽  
Santosh Khanal
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Inhibition Zone ◽  
High Rate ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Wound Infections ◽  
Mannitol Salt Agar ◽  
Methicillin Resistant ◽  
Antibiotic Susceptibility Test

Objectives: The aim of this study was to determine the prevalence of methicillin resistant Staphylococcus aureus (MRSA) and antibiotic resistance pattern of the isolates from wound infections. Methods: A total of 706 wound specimens including pus and wound swab were analyzed in the laboratory of B and B Hospital, Lalitpur from May to October 2014. The specimens were cultured on Blood Agar and Mannitol Salt Agar plates and incubated at 37°C for 24 hours. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method. Strains resistant to cefoxitin (30mcg) with inhibition zone ≤ 21mm were identified as MRSA. Results: Out of 366 bacterial isolates, 90 (24.6%) were S. aureus and among them 16.7% were MRSA and 54.4% multi-drug resistant (MDR). All isolates were sensitive to vancomycin and most of the isolates were sensitive to cefoxitin (83.3%). High rate of resistance was observed towards penicillin (98.9%) and ampicillin (86.7%). All MRSA isolates and 52.9% of methicillin sensitive S. aureus (MSSA) were MDR. Conclusion: MRSA incidence is increasing in the population, and therapeutic measures are few and accompanied by diverse side effects. It is noteworthy to state that vancomycin is still the first line drug although vancomycin-resistant strains have been reported.

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