Prevalence of vanA Gene among Methicillin Resistant S. aureus Strains Isolated from Burn Wound Infections in Menoufia University Hospitals

2020 ◽  
Vol 29 (3) ◽  
pp. 97-104
Author(s):  
Amira H. Elkhyat ◽  
Amal F. Makled ◽  
Ahmed M. Albeltagy ◽  
Tarek F. Keshk ◽  
Amal M. Dawoud

Background: Staphylococcus aureus is a leading cause of burn wound infection. Vancomycin resistance among methicillin-resistant Staphylococcus aureus (MRSA) is becoming a worldwide growing threat. Objectives: to detect the prevalence of MRSA in burn patients and its antibiotic susceptibility patterns. In addition, the resistance patterns of MRSA to vancomycin and the prevalence of vanA gene among MRSA isolates were investigated. Methodology: A total 250 clinical samples were obtained from patients admitted to Burn Unit in Menoufia University Hospitals. Identification and antimicrobial susceptibility testing of S. aureus isolates were performed. Cefoxitin disk diffusion method was used to identify MRSA strains. Vancomycin resistance was determined by agar dilution method. Detection of mecA and vanA genes by multiplex PCR was done. Results: Staphylococcus aureus represented 43.3% of all isolates. By cefoxitin disc diffusion method, 94% (79/84) of isolated S. aureus were MRSA that showed a high resistance to most antimicrobials used with rates ranged from 40.5 % to 100%. Phenotypically among MRSA isolates, vancomycin sensitive S. aureus (VSSA), vancomycin-intermediate S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA) were 59.5%, 15.2%, 25.3% respectively. Among MRSA isolates, 17 (21.5%) isolates had vanA gene by PCR (16 isolates were VRSA and one isolate was VSSA).Conclusion: This study is considered as an alarm demonstrating that implementation of proper infection control measures is mandatory to control spread of such resistant strains in our hospital.

2014 ◽  
Vol 52 (196) ◽  
pp. 977-981 ◽  
Author(s):  
Prakash Chandra Pahadi ◽  
Upendra Thapa Shrestha ◽  
Nabaraj Adhikari ◽  
Pradeep Kumar Shah ◽  
Ritu Amatya

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.


2019 ◽  
Vol 6 ◽  
pp. 59-62
Author(s):  
Ranjana K.C. ◽  
Ganga Timilsina ◽  
Anjana Singh ◽  
Supriya Sharma

Objectives: To isolate methicillin resistant Staphylococcus aureus (MRSA) from anterior nares of dairy workers and dairy products and assess the antibiotic susceptibility pattern of the isolates. Methods: Swab samples collected from anterior nares of dairy workers and dairy product (butter) were inoculated into mannitol salt agar and incubated at 37ºC for 24 hours. Identification was done based on colony characteristics, Gram's staining, catalase, oxidase and coagulase test. Antibiotic susceptibility testing was done by modified Kirby Bauer disc diffusion method. MRSA was confirmed by using cefoxitin disc. Results: A total of 109 S. aureus (98 from dairy workers and 11 from butter samples) were isolated. Out of them 32 MRSA were isolated from dairy workers and 4 from butter samples. The association between age group and MRSA was found insignificant (p = 0.115). The association of MRSA between male and female workers was found significant (>0.05). About 86% of the MRSA isolates were susceptible to Gentamicin (86.11%) followed by Ciprofloxacin (77.78%). Conclusion: Detection of MRSA among dairy workers and dairy products warrants proper handling and adequate control measures to prevent transmission of MRSA from dairy industry.


1970 ◽  
Vol 6 (1) ◽  
pp. 121-126 ◽  
Author(s):  
MA Islam ◽  
MM Alam ◽  
ME Choudhury ◽  
N Kobayashi ◽  
MU Ahmed

The minimum inhibitory concentration (MIC) represents the concentration of antimicrobial at which there is complete inhibition of growth of organism. In order to determine the MIC of cloxacillin, 10 MRSA were previously detected from 40 clinical isolates of Staphylococcus aureus by polymerase chain reaction (PCR). Agar plate dilution test was used to determine the MIC of cloxacillin. The clinical samples were collected from Mymensingh Medical College Hospital, Mymensingh. The study was done in the Department of Medicine, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh from July 2006 to June 2007. The MIC of the cloxacillin for 5 MRSA strains were ≥32 (mg/ml), for 1 MRSA strain was ≥ 128(mg/ml) and for another 4 MRSA strains were above ≥128 (mg/ml). Antimicrobial susceptibility test of the isolated organisms were done by disc diffusion method. On antibiotic susceptibility test, MRSA strains showed 100% resistant against penicillin, oxacillin, cloxacillin and amoxycillin. Cent per cent susceptibility of MRSA was found against vancomycin, ciprofloxacin, erythromycin, fusidic acid and rifampicin. Key words: Minimum inhibitory concentration (MIC), antibiotic resistance, cloxacillin, methicillin-resistant Staphylococcus aureus (MRSA) DOI = 10.3329/bjvm.v6i1.1350 Bangl. J. Vet. Med. (2008). 6 (1): 121-126


2020 ◽  
Vol 15 (5) ◽  
Author(s):  
Arezoo Bostanmaneshrad ◽  
Jamileh Norouzi ◽  
Gita Eslami ◽  
Ali Hashemi

Background: Efflux pump is a significant resistance mechanism in Staphylococcus aureus. A total of 100 patients with bacteremia from Shahid Beheshti University Hospitals of Tehran in Iran were tested for the expression of efflux pump genes, contributing to S. aureus antimicrobial resistance. Objectives: this study was conducted to identify resistance pattern, and to evaluate the inhibitory effect of efflux pump, MIC of ciprofloxacin, and expression levels of norA, norB, and norC efflux pump genes in the presence of an efflux pump inhibitor against MDR S. aureus. Methods: A total of 100 MRSA isolates were investigated in different hospitals of Shahid Beheshti University of Medical Sciences from April 2017-2018. Owing to new consensus guidelines from the Clinical and Laboratory Standards Institute (CLSI), both the Kirby-Bauer disk diffusion test and micro-dilution method were used to evaluate antimicrobial susceptibility. Efflux pump activity using carbonyl cyanide 3-chlorophenylhydrazone (CCCP) was identified as a chemical efflux pump inhibitor. E-test was used to determine Vancomycin-resistant antibiotic. Broth micro-dilution method for S. aureus isolates resistant to ciprofloxacin has been developed for minimum inhibitory concentration (MIC) of ciprofloxacin and CCCP and their composition. Quantitative Real-time Polymerase Chain Reaction (qRT-PCR) was used to investigate the expression level of norA, norB, and norC efflux pump genes. Results: A total of 38 of 45 MRSA isolates (84.4%) showed resistance to ciprofloxacin. Moreover, 100% of isolates had the norA and norB genes. Further, 95% of S. aureus isolates had the norC gene. According to this study, ciprofloxacin MIC has decreased by CCCP compared to ciprofloxacin. There was an increase in the expression level of norA, norB, and norC efflux pump genes in methicillin-resistant and ciprofloxacin-resistant S. aureus strains based on RT- PCR. In this study, four different spA types were obtained as the most prevalent type of spA by t037and t790 (23.3%) and t030 (14.1%) and t044 (12.2%). Conclusions: This study indicates that the prevalence of ciprofloxacin-resistant S. aureus strains has a rising trend among MRSA clinical isolates. The ability of S. aureus isolates to be converted into drug-resistant strains using efflux pump mechanism has become a widespread concern.


2016 ◽  
Vol 5 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Ganesh Kumar Singh ◽  
Bigu Kumar Chaudhari ◽  
Kamal Prasad Parajuli

Background Resistance to antimicrobial agents is prevalent among Staphylococci. This has led to wide uses of macrolide-lincosamide-streptogramin B (MLSB) antibiotics to Staphylococcus aureus (S. aureus) infections. MLSB though chemically distinct, have similar target site and mode of action. The multiple mechanisms are responsible for resistance to MLSB antibiotics which can lead to clinical failure. The aim of the study was to investigate the frequency of inducible and constitutive clindamycin resistance among clinical isolates of S. aureus and their relationship with Methicillin-resistant Staphylococcus aureus (MRSA).Material & Methods A total of 336 unique Staphylococcus aureus isolates from different clinical samples obtained from patients were studied. Antibiotic susceptibility test was performed by Kirby- Bauer disc diffusion method. “D test” was performed to detect inducible clindamycin resistance as per CLSI guidelines. MRSA was detected using Cefoxitin (30μg) and results were interpreted according to CLSI criteria.Results Inducible clindamycin resistance was seen in 45 (13.39%), constitutive clindamycin resistance was seen among 58 (17.26%) while MS phenotype was observed among 38(11.30%) of isolates. Inducible resistance as well as constitutive resistance was higher among MRSA as compared to MSSA (21.11%, 4.48% and 21.11%, 12.82%respectively).Conclusion The Successful use of clindamycin for the treatment of infection caused by S. aureus can be predicted based on the result of simple and inexpensive D test.Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, 1-5


2019 ◽  
Vol 7 (1) ◽  
pp. 8-14
Author(s):  
Gaurav Agrahari ◽  
Amrit Koirala ◽  
Roshan Thapa ◽  
Mahesh Kumar Chaudhary ◽  
Reshma Tuladhar

Methicillin-resistant Staphylococcus aureus (MRSA), showing resistance to several antibiotics is a global health problem associated with considerable mortality and morbidity. Antibiotic susceptibility test is a commonly used method to characterize MRSA in epidemiologic studies. Additionally, plasmid profile has been reported to be useful in tracing the epidemiology of antibiotic resistance. This research was conducted to determine the antimicrobial resistance patterns and plasmid profiles of MRSA isolated from clinical samples at KIST Medical College, Imadol, Kathmandu, Nepal. All the clinical specimens sent to the laboratory were processed by standard microbiological techniques and antibiotic susceptibility testing was done by the modified Kirby Bauer disc diffusion method. Further, plasmid profiling was done by Alkaline-lysis method. A total of 27 (38.02%) MRSA were isolated from 71 S. aureus positive samples. MRSA showed the highest resistance towards penicillin (92.60%) and ampicillin (92.60%). In contrast, high levels of sensitivity were shown towards vancomycin (85.19%) and tetracycline (85.19%). Out of 27 MRSA positive samples, single plasmids were isolated from only 6 (22.22%) MRSA isolates. Antibiograms alone are inadequate to accomplish the characterization of MRSA during epidemiological studies. However, plasmid profile analysis in conjunction with the antibiotic susceptibility pattern is valuable in the epidemiological investigation of MRSA, and for reducing MRSA prevalence and treatment cost.


2018 ◽  
Vol 9 (2) ◽  
pp. 281-286
Author(s):  
T. V. Sklyar ◽  
K. V. Lavrentievа ◽  
V. G. Gavrilyuk ◽  
N. V. Kurahina ◽  
M. O. Vereshchaha ◽  
...  

The therapy of infections, caused by methicillin-resistant Staphylococcus aureus (MRSA) with multiple resistance to antibiotics remains one of the most acute problems all over the world. It is all the more complicated since a priori the MSRA strains are not sensitive to the group of β-lactam antibiotics and multiresistant isolates are resistant to other groups of antimicrobial preparations, including antibiotics of choice (rifampicin, vancomycin, fusidic acid, co-trimoxazole and linezolid). From the samples of biomaterials of patients with pathological processes of different localization, we isolated 335 strains of bacteria, which were identified as Staphylococcus aureus, 169 (50.4%) of which were methicillin-resistant variants: 57.5% cultures were isolated from the nasal discharge; 50.7% – from faeces at intestinal dysbioses; by 40.0% – from conjunctival discharge, pharyngeal swab, outer ear swab and sputum; 33.3% – from urine samples. Antibiotic susceptibility of the isolated cultures was estimated by the disc-diffusion method and the method of serial dilution. The MRSA strains appeared to be most resistant to gentamycin, erythromycin (by 59.5% of cultures) and ciprofloxacin (53.3% of isolates), most sensitive – to vancomycin, co-trimoxazole and fusidic acid. The frequency of isolation of the cultures that are resistant to antibiotics did not exceed 4.1%. Rifampicin suppressed the growth of 75.8% and linezolid – of 100.0% of strains. Depending on the kind of biomaterial taken, MRSA strains, isolated from the nasal cavity, outer ear, urine samples, samples of sputum and faeces at intestinal dysbioses proved to be most resistant to the tested antimicrobial preparations. Rifampicin- and vancomycin-resistant strains of methicillin-resistant staphylococci made up 21.3% of the total number of the detected MRSA. They were most often isolated from the clinical samples taken from the nasal cavity and faeces. When determining minimal inhibitory concentration (MIC) of rifampicin and vancomycin, which are antibiotics of choice for treatment of infections caused by multiresistant MRSA, it was found that for 55.5% of the MRSA strains isolated from faeces, MIC of rifampicin coincided with the threshold value for this antibiotic and for 44.5%, it exceeded the threshold value by 2 times (4 µg/ml). 22.2% of them were characterized by the critical value of susceptibility to vancomycin (MIC ≥ 2 µg/ml). From rifampicin- and vancomycin-resistant MRSA stains, isolated from the nasal cavity, MIC of rifampicin coincided with the threshold value for this antibiotic for 66.7% of cultures, and exceeded it at least by 2 times for 33.3%. 11.1% of them were characterized by the critical level of susceptibility to vancomycin (MIC ≥ 2 µg/ml) and by 3.7% of strains exceeded MIC by 2 and 4 times respectively (4 and 8 µg/ml).


Author(s):  
Swati S. Kale ◽  
Ashwini Patil

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.


2015 ◽  
Vol 13 (2) ◽  
pp. 35-38
Author(s):  
Sabita Bhatta ◽  
Babli Basu ◽  
Chandrasekhar Narharrao Chaudhary ◽  
Ashok Kumar Praharaj

Introduction: Tigecycline is a novel glycylcycline  derivative of the tetracycline with activity against a wide range of  organisms including Methicillin resistant Staphylococcus aureus, Vancomycin  resistant  Enterococcus , Extended spectrum beta lactamase   producing  (Escherichia coli , Klebsiella  pneumonia)  and Acinetobacter species.  The aim of the study was to assess effectiveness of the drug against methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant enterococci (VRE), ESBL producers and carbapenem resistant Acinetobacter baumannii and to compare the efficacy of different methods of antimicrobial susceptibility testing for Tigecycline.Methods: A total of 250 clinical isolates were processed and identified by conventional methods. In all the 250 isolates, antimicrobial susceptibility was carried out by disc diffusion method , Minimum inhibitory test by agar dilution method (MIC) and in 30 isolates of A baumannii  MIC was also done by E test.Results: Out of 250 isolates, 236 isolates were sensitive to tigecycline by agar dilution method while only 159 were sensitive by disk diffusion method.Conclusion: Marked discordance was observed between the results of two different methods (DDT & Agar dilution method) for E coli, Klebsiella spp and A baumannii, where significant number of isolates were resistant to tigecycline by DDT as compared to AD method. But results of MIC by agar dilution method & E test were in concordance for A. baumannii.


2012 ◽  
Vol 81 (3) ◽  
pp. 225-227 ◽  
Author(s):  
Milenko Zutic ◽  
Ivana Cirkovic ◽  
Ljiljana Pavlovic ◽  
Jelena Asanin ◽  
Snezana Jovanovic ◽  
...  

Methicillin-resistant Staphylococcus aureus is a highly important human pathogen that is also a significant concern in veterinary medicine. Despite the high prevalence of colonization, clinical infections with methicillin-resistant Staphylococcus aureus appear to be rare in pigs. Methicillin-resistant Staphylococcus aureus was isolated from a sow with endometritis and her five piglets with dermatitis originating from a Serbian farm. Identification of the strains was done by automated system and confirmed by polymerase chain reaction for mecA and nuc genes. Detection of Staphylococcal Cassette Chromosome mec type was performed by multiplex polymerase chain reaction. Antimicrobial susceptibility testing on erythromycin, clindamycin, gentamicin, kanamycin, tobramycin, ciprofloxacin, tetracycline, trimethoprim/sulfamethoxazole and vancomycin was done by disc diffusion method. Six isolated strains from the infected sow and her piglets showed resistance only to tetracycline beside resistance to all beta-lactam antibiotics. In the tested methicillin-resistant Staphylococcus aureus isolates, Staphylococcal Cassette Chromosome mec type V was present. To our knowledge, this finding is the first documented detection of methicillin-resistant Staphylococcus aureus from pigs’ clinical samples in Serbia. The results of our study indicate the emergence of methicillin-resistant Staphylococcus aureus in a pig farm in Serbia highlighting the threat of this antibiotic-resistant microorganism as a pathogen causing both animal and human infections.


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