Phenotypic characterization and Molecular detection of Inducible and Constitutive Clindamycin resistance among Staphylococcus aureus isolates in a Tertiary Care Hospital

2021 ◽  
pp. 3799-3804
Author(s):  
Mahalakshmi G. ◽  
Neelusree P. ◽  
Kalyani M.
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Phenotypic Characterization ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Significant Difference

Background: Staphylococcus aureus is Gram positive cocci. The pyogenic bacteria which is responsible for a variety of diseases that ranges in severity from mild skin and soft tissue infections to life-threatening conditions such as endocarditis, pneumonia, and sepsis. There is a scenario of increasing Methicillin-resistant Staphylococcus aureus (MRSA) infections, the macrolide-lincosamide-streptogramin B (MLSB) group of antibiotics they have different structure with same mechanism of action which serves as one good alternative. There is a frequency of increasing Methicillin Resistant Staphylococcus aureus (MRSA) infections and their change in antimicrobial resistance pattern. There is a concern about use of this antibiotic in the presence of Erythromycin resistance because of the possibility of inducible resistance among the members of Macrolide, lincosamide, Strepto-gramin B (MLSB) group. The invitro resistance exhibited by Staphylococcus aureus to erythromycin, Clindamycin, and other drugs of MLSB groups is due to the expression of ribosomal methylases(erm) genes. The detection of inducible Clindamycin resistance can limit the effectiveness of these drugs. Objective of the study: To isolate of Staphylococcus aureus from various clinical samples to differentiate between Methicillin resistant Staphylococcus aureus (MRSA) and Methicillin sensitive Staphylococcus aureus (MSSA) by conventional methods. To detect inducible and constitutive Clindamycin resistance in Staphylococcus aureus isolates by D test. To detect ermA gene responsible for resistance by PCR. Methodology: This cross sectional study was done for a period of six months. Totally 106 Staphylococcus aureus isolates was obtained various clinical samples were processed using standard guidelines. Result: From the 106 isolates of Staphylococcus aureus 67(63.3%) were MSSA and 39(36.7%) were MRSA. D-test was positive in n=9 of the n=21 MRSA and n=17 of the n=85 MSSA, which denotes inducible Clindamycin resistance. N- 9 of MRSA and n=13(22%) of MSSA showed Constitutional Clindamycin resistance. The statistics show that there is a significant Difference in constitutive resistance between MRSA and MSSA. In India ermA gene is most prevalent, out of 22 d-test positive n=13 ermA gene were detected (n=3-MRSA and n=10-MSSA) by using conventional PCR. Conclusion: The MLSB family of antibiotics is one such alternative and CD is preferred. Clinical microbiology laboratories should report inducible Clindamycin resistance in Staphylococcus aureus and D-test can be used as a simple, auxiliary and reliable method to Delineate inducible and constitutive Clindamycin resistance in routine clinical laboratories.

scholarly journals Antibiotic Susceptibility Pattern of Nosocomial Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nepal

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Bidya Shrestha ◽  
B M Pokhrel ◽  
T M Mohapatra
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Test Method ◽  
University Teaching ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Methicillin Resistant

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), the most common cause ofnosocomial infection has been a major cause of morbidity and mortality around the world. They arenormally resistant to most of the antibiotics used in clinical practice. This study has been carried outto fi nd out the resistance pattern among S. aureus.Methods: During November 2007 to June 2008, clinical samples from patients with nosocomialinfection were processed for culture and sensitivity following standard methodology in microbiologylaboratory, Tribhuvan University teaching hospital, Kathmandu, Nepal.Results: Among 149 Staphylococcus aureus isolates, highest resistance was observed against Penicillin(91.94%) followed by Fluoroquinolone (61.74%), Erythromycin (52.94%), Gentamicin (46.98%),Cotrimoxazole (42.95%), Tetracycline (40.94%) and others, whereas susceptibility was observedmaximum against Chloramphenicol (94.85%) followed by Rifampicin (92.61%), Tetracycline(59.06%), Cotrimoxazole (57.04%), and others. None of the isolates were resistant to Vancomycinand Teicoplanin. Of these isolates 44.96 % of the isolates were Methicillin resistant S. aureus (MRSA).Resistance to Penicillin, Fluoroquinolone, Erythromycin, Gentamicin, Co-trimoxazole and Tetracyclinewere associated signifi cantly with MRSA isolates (X2= 8.779, p<0.05, X2= 74.233, p<0.05, X2= 84.2842,p<0.05, X2= 108.2032, p<0.05, X2= 88.1512, p<0.05 and X2= 79.1876, p<0.05 respectively). Althoughmost of the Methicillin sensitive S. aureus (MSSA) isolates were susceptible to both Rifampicinand Chloramphenicol, only Rifampicin susceptibility was signifi cantly associated with them (X2=10.1299, p<0.05). Among three Biochemical tests for the detection of β lactamase detection namelychromogenic, iodometric and acidimetric test, chromogenic test method had highest sensitivity andspecifi city.Conclusions: Since MRSA comprised a greater part of S. aureus isolates and were multi-resistant,patients infected by such strains should be identifi ed and kept in isolation for hospital infectioncontrol and treated with second line of drug like vancomycin.Key Words: β lactamase, methicillin resistant Staphylococcus aureus,methicillin sensitive Staphylococcus aureus, resistance pattern

scholarly journals Phenotypic study of Macrolide-Lincosamide-Streptogramin B Resistance in Staphylococcus aureus and their relationship with Methicillin-Resistant Staphylococcus aureus (MRSA) at Tertiary Care in Eastern Nepal

2016 ◽  
Vol 5 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Ganesh Kumar Singh ◽  
Bigu Kumar Chaudhari ◽  
Kamal Prasad Parajuli
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance ◽  
Constitutive Resistance ◽  
Antibiotic Susceptibility Test

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

scholarly journals Prevalence and antimicrobial susceptibility of methicillin resistant Staphylococcus aureus in tertiary care hospital

2016 ◽  
Vol 7 (3) ◽  
pp. 72-77
Author(s):  
Sunita Chandrakar ◽  
Sk. Khairul Enam ◽  
Animesh Panda ◽  
Smita Bawankar ◽  
Dhruba Hari Chandi
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Care Hospital ◽  
Medical Sciences ◽  
Methicillin Resistant ◽  
Clinical Complications ◽  
Hospital Acquired

Background : Methicillin Resistant Staphylococcus aureus (MRSA) infections are important causes of morbidity, mortality in hospitals & the community worldwide. MRSA has been known to acquire resistance to most antibiotics like ?- lactams & aminoglycosides so these strains are more virulent. Aims and Objectives : Therefore the knowledge & determination of prevalence of MRSA & their current antimicrobial profile becomes necessary to the clinicians to avoid clinical complications from community-acquired & hospital acquired MRSA infection. Materials and Methods : A total of 205 of different samples from different clinical specialties were collected & processed by appropriate microbiological technique like staining, culture, biochemical test & antimicrobial susceptibility test by the use of different antibiotic discs. Results :  The present study shows that 47 out of 105 men comprising 44.76%, whereas in case of females it was 29% i.e 29 out of 100 cases. MRSA percentage of males was higher than the MRSA percentage of female. It proves that men were more prone to acquire the infection by MRSA strain.  Out of 205 clinical samples, 76 were identified as MRSA so the prevalence rate was 37.07% but all the multidrug resistance MRSA were mostly sensitive towards antibiotics like Vancomycin (100%), Rifampicin (100%), Amoxicillin (77.77%) & Amikacin (61.19). Conclusion : In conclusion, vancomycin are considered for treatment to eradicate the MRSA.Asian Journal of Medical Sciences Vol. 7(3) 2016 72-77

scholarly journals Colonization and Antibiotic Resistance Profiling of Methicillin Resistant Staphylococcus Aureus (Mrsa) in Patients from Tertiary

2020 ◽  
Vol 1 (3) ◽  
pp. 31-39
Author(s):  
Madiha Khan ◽  
Wafa Komal ◽  
Mushtaq A. Saleem ◽  
Naveed Ahmad ◽  
Zara Rafaque ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Culture Media ◽  
Tertiary Care ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Clinical Samples ◽  
Care Hospital ◽  
Cross Sectional ◽  
Methicillin Resistant

The methicillin resistant Staphylococcus aureus (MRSA) is affecting the economy worldwide contributing to the increased morbidity and treatment costs. The present cross sectional study was conducted to determine the association of MRSA with kidney and liver patients from Tertiary Care Hospital in Lahore, Pakistan and its antibacterialresistance patterns. The study was conducted for the period of one year; from April 2019 to April 2020. A total of 1984 different samples were obtained and examined for bacterial cultures using standard procedures. From total samples, 51.05% were collected from male and the rest 48.95% were collected from females including different age groups. Samples were inoculated on different culture media for isolation of S. aureus and susceptibility testing. A total of 253/1984 clinical samples exhibited S. aureus characteristics while 39 of 253 S. aureus (15.41%) were identified as MRSA. MRSA strains were found highly resistant to Amikacin (AK), Cefoxitin (FOX),Clindamycin (DA), Fusidic acid (FD), Gentamicin (CN) and Tobramycin (TOB) while highest sensitivity was noted against Vancomycin (100%) and Linezolid (100%). The presence of MRSA and multidrug resistance pose serious therapeutic burden to critically ill patients. A systematic and concerted effort is essential to identify high-risk patients rapidly and to reduce the burden of antimicrobial resistance.

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