Reduced Daptomycin Susceptibility in Clinical MRSA Isolates Showing Vancomycin MIC Creep Phenomenon

Introduction: Infections caused by Methicillin Resistant Staphylococcus aureus (MRSA) are associated with increased morbidity, longer antimicrobial therapy, etc. First option for treating invasive MRSA infections is glycopeptide vancomycin. Daptomycin, a lipopeptide rapidly bactericidal invitro against MRSA, is an acceptable alternative. Aim: To identify MRSA isolates from clinical specimens and assess their vancomycin and daptomycin susceptibility pattern. Materials and Methods: The cross-sectional study was conducted over a period of six months (January 2019 to June 2019) on 90 clinical samples in a rural teaching hospital in Pune, Maharashtra, India, including all samples except sputum received in the Microbiology laboratory. MRSA isolates were tested for vancomycin and daptomycin susceptibility by Epsilometer (E) test Minimum Inhibitory Concentration (MIC) method. Results: Among 90 MRSA isolates, most were from pus (51) followed by Urine (23), Blood (9), followed by Miscellaneous samples (7). Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 16.0 software. All MRSA isolates in this study were susceptible to daptomycin with MIC in the range of 0.25-1 μg/mL with maximum isolates (39) with MIC of 0.38 μg/mL. Vancomycin MIC creep phenomenon was observed in 68 isolates. All these isolates also showed reduced susceptibility to daptomycin. Conclusion: MRSA in hospital set up mandates strict infection control practices in place. Daptomycin can be a good therapeutic alternative to treat infections caused by MRSA keeping in mind its therapeutic limitations and prior vancomycin usage in the same patient. Empirical therapy should always be based on antibiogram pattern. Adherence to hospital antibiotic policy and constant surveillance of antimicrobial resistance is the need of the hour.

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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 ◽

Methicillin Resistant 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.

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

THE JOURNAL OF MICROBIOLOGY AND MOLECULAR GENETICS ◽

10.52700/jmmg.v1i3.11 ◽

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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Molecular Confirmation of Vancomycin-Resistant Staphylococcus aureus with vanA Gene from a Hospital in Kathmandu

International Journal of Microbiology ◽

10.1155/2021/3847347 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Meera Maharjan ◽

Anil Kumar Sah ◽

Susil Pyakurel ◽

Sabita Thapa ◽

Susan Maharjan ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Empirical Therapy ◽

Conventional Polymerase Chain Reaction ◽

Cross Sectional Study ◽

Diffusion Method ◽

Clinical Samples ◽

Cross Sectional ◽

Drug Of Choice ◽

Vana Gene ◽

Vancomycin Resistant

Staphylococcus aureus, a commensal on the skin and in the nasal cavity of humans, is one of the most serious cases of nosocomial infections. Moreover, methicillin-resistant S. aureus (MRSA) is a leading cause of morbidity and mortality worldwide. For the treatment of MRSA infections, vancomycin is considered as a drug of choice. However, the emergence of vancomycin resistance among MRSA isolates has been perceived as a formidable threat in therapeutic management. To estimate the rate of vancomycin-resistant S. aureus (VRSA) and to detect the vancomycin-resistant genes, namely, vanA and vanB, among the isolates, a hospital-based cross-sectional study was conducted from July to December 2018 in Annapurna Neurological Institute and Allied Science, Kathmandu, Nepal. S. aureus was isolated and identified from different clinical samples and processed for antibiotic susceptibility testing by the modified Kirby–Bauer disc diffusion method. The screening of MRSA was performed as per Clinical and Laboratory Standard Institute (CLSI) guidelines. VRSA was confirmed by the minimum inhibitory concentration (MIC) method by employing E-test strips. All the phenotypically confirmed VRSA were further processed to detect the vanA and vanB gene by using the conventional polymerase chain reaction (PCR) method. A total of 74 (20.3%) S. aureus were isolated, and the highest percentage of S. aureus was from the wound samples (36.5%). Of 74 S. aureus isolates, the highest number (89.2%) was resistant to penicillin, and on the other hand, linezolid was found to be an effective drug. Likewise, 45 (60.81%) were found to be MRSA, five (11.11%) were VRSA, and 93.2% of S. aureus isolates showed an MAR index greater than 0.2. Two VRSA isolates (40%) were positive for the vanA gene. The higher prevalence of MRSA and significant rate of VRSA in this study recommend routine surveillance for the MRSA and VRSA in hospital settings before empirical therapy.

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Control Rate of Diabetic and Hypertensive Adult Patients in Association with Demographic and Healthy Behaviour Factors in Garmian- Kurdistan Region

Kurdistan Journal of Applied Research ◽

10.24017/science.2016.1.2.3 ◽

2016 ◽

Vol 1 (2) ◽

pp. 12-19

Author(s):

Muaf Abdulla Karim ◽

Jamal Kareem Shakor ◽

Bootan Hasan Ahmed ◽

Dlzar Omer Qadir ◽

Saleem Saaed Qader

Keyword(s):

Risk Factors ◽

Cross Sectional Study ◽

Study Data ◽

Probability Method ◽

Cross Sectional ◽

The Social ◽

Health Related ◽

High Control ◽

Set Up ◽

Social Demographic

Hypertension and diabetes mellitus (DM) are the two major inter-correlated risk factors of cardiovascular diseases, which considered as the major causes of morbidity and mortality. This study is set up to determine control rate, and the social demographic and health related behaviours risk factors in association with control rate in hypertensive and/or diabetes patients who are under treatment. Cross sectional study was carried out in this study. Data have been collected by well-trained paramedics through direct interviews using structured questionnaire with the participants. A conventional sampling which is one of the main types of non-probability method was used for collecting data. SPSS version 16 was used for analysing data. 338 patients were recruited into the study, 150(44.1%) of participants with hypertension,88(25.9%) with diabetes and the rest 100(29.4%) with both diseases. Patients who diagnosed with hypertension weremore under control 83 (55.3%) in comparison with diabetic23(26.1%) and patients who were diagnosed both conditions 18(18.0%). High control rate was observed in hypertension patients compared to diabetes and those diagnosed both conditions. Cor morbidity was the main cause of uncontrolled rate.

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The Prevalence of antimicrobial resistance in Staphylococcus aureus and coagulase-negative Staphylococci strains isolated from inpatients

10.21203/rs.3.rs-24115/v1 ◽

2020 ◽

Author(s):

Parva Farmehr ◽

Javad fathi ◽

Mahtab Hadadi ◽

mohammad motamedifar

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Susceptibility ◽

Antibacterial Agents ◽

Methicillin Resistance ◽

Cross Sectional Study ◽

Clinical Samples ◽

Coagulase Negative Staphylococci ◽

Cross Sectional ◽

Antibiotic Policy ◽

Southwest Of Iran

Abstract Objectives Globally nosocomial infection is a significant problem. Methicillin resistance Staphylococcus aureus (MRSA) and Methicillin resistance coagulase negative staphylococci (MRCoNS) are major causes of nosocomial infections. Aim of this study was to determine the prevalence and antimicrobial susceptibility of MRSA and MRCoNS in the southwest of Iran. This cross-sectional study was conducted on 221 non-duplicated staphylococci isolates collected from teaching hospital in Shiraz. The prevalence of MRSA and MRCoNS in clinical samples was identified with conventional microbiological tests. After identification, all of the isolates were subjected to antimicrobial susceptibility test and PCR to identify the presence of femA, mecA and pvl genes.Result 168 (76%) S. aureus and 53 (24%) CoNS were detected. 70 (41.7%) MRSA among 168 S. aureus, and 26 (15.48%) MRCoNS among 53 CoNS were examined. Chloramphenicol (65%) and Gentamicin (23%) were the most active antibacterial agents against MRSA and MRCoNS, whereas these isolates were susceptible to SXT (100%). The frequency of pvl gene among S. aureus strains was 3.57%. There is need for developing the antibiotic policy and limiting the use of powerful antibiotics.

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The Prevalence of antimicrobial resistance in Staphylococcus aureus and coagulase-negative Staphylococci strains isolated from inpatients

10.21203/rs.3.rs-24115/v2 ◽

2020 ◽

Author(s):

Parva Farmehr ◽

Javad fathi ◽

Mahtab Hadadi ◽

mohammad motamedifar

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Susceptibility ◽

Antibacterial Agents ◽

Cross Sectional Study ◽

Clinical Samples ◽

Coagulase Negative Staphylococci ◽

Cross Sectional ◽

Antibiotic Policy ◽

Methicillin Resistant ◽

Southwest Of Iran

Abstract Objectives: Globally nosocomial infection is a significant problem. Methicillin resistant Staphylococcus aureus (MRSA) and Methicillin resistant coagulase negative staphylococci (MRCoNS) are major causes of nosocomial infections. Aim of this study was to determine the prevalence and antimicrobial susceptibility of MRSA and MRCoNS in the southwest of Iran. This cross-sectional study was conducted on 221 non-duplicated staphylococci isolates collected from teaching hospital in Shiraz. The prevalence of MRSA and MRCoNS in clinical samples was identified with conventional microbiological tests. After identification, all of the isolates were subjected to antimicrobial susceptibility test and PCR to identify the presence of femA, mecA and pvl genes. Results: 70 (41.7 %) MRSA among 168 S. aureus, and 26 (15.48%) MRCoNS among 53 CoNS were examined. All of the isolates were susceptible to Trimethoprim/Sulfamethoxazole (100%). Chloramphenicol (65%) and Gentamicin (23%) were the other most active antibacterial agents against MRSA and MRCoNS. The frequency of pvl gene among S. aureus strains was 3.57%. There is need for developing the antibiotic policy and limiting the use of powerful antibiotics.

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Prevalence of Staphylococcus aureus Isolated from Clinical Samples in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.4673 ◽

2019 ◽

Vol 57 (220) ◽

Author(s):

Jyotshna Sapkota ◽

Manisha Sharma ◽

Beena Jha ◽

Chandra Prakash Bhatt

Keyword(s):

Staphylococcus Aureus ◽

Confidence Interval ◽

Methicillin Resistant Staphylococcus Aureus ◽

Cross Sectional Study ◽

Aureus Strain ◽

Clinical Samples ◽

Wound Infections ◽

Sectional Study ◽

Cross Sectional ◽

Methicillin Resistant

Introduction: Staphylococcus aureus is one of the commonest cause of nosocomial infections. Resistant Staphylococcus aureus strain has become a matter of concern. This study was done to find out the prevalence of Staphylococcus aureus from different clinical samples. Methods: The descriptive cross-sectional study was carried out in the Clinical Microbiology laboratory from January 2019 to June 2019. Ethical approval was received from the Institutional Review Committee (Ref: 28122018010). Six hundred sixty-six sample size was calculated. Convenient sampling was done. Staphylococcus aureus was identified on the basis of its microscopy and morphological characteristics followed by catalase and coagulase test. Antibiotic sensitivity test of misolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Statistical analysis was done by Excel 2018, point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of the 666 bacteria isolated from clinical specimens, 133 (19.96%) were Staphylococcus aureus at 95% confidence interval (129.91-136.01%). Seventy nine (78.95%) of which is isolated from pus and wound infections. Out of 133 Staphylococcus aureus, 70.64% were Methicillin-Resistant Staphylococcus aureus. Conclusions: This study provides valuable information regarding the high prevalence of Staphylococcus aureus from pus and wound infections. The alarming number of Methicillin-Resistant Staphylococcus aureus is worrisome finding. Antibiotics like Vancomycin and Linezolid which has not developed resistance should be cautiously used only in Methicillin-Resistant Staphylococcus aureus cases.

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Conflict Avoidance in Old Age

GeroPsych ◽

10.1024/1662-9647/a000168 ◽

2017 ◽

Vol 30 (2) ◽

pp. 61-70 ◽

Cited By ~ 4

Author(s):

Lia Oberhauser ◽

Andreas B. Neubauer ◽

Eva-Marie Kessler

Keyword(s):

Social Support ◽

Perceived Social Support ◽

Well Being ◽

Cross Sectional Study ◽

Conflict Avoidance ◽

Subjective Well Being ◽

Sectional Study ◽

Cross Sectional ◽

Adult Lifespan ◽

Set Up

Abstract. Conflict avoidance increases across the adult lifespan. This cross-sectional study looks at conflict avoidance as part of a mechanism to regulate belongingness needs ( Sheldon, 2011 ). We assumed that older adults perceive more threats to their belongingness when they contemplate their future, and that they preventively react with avoidance coping. We set up a model predicting conflict avoidance that included perceptions of future nonbelonging, termed anticipated loneliness, and other predictors including sociodemographics, indicators of subjective well-being and perceived social support (N = 331, aged 40–87). Anticipated loneliness predicted conflict avoidance above all other predictors and partially mediated the age-association of conflict avoidance. Results suggest that belongingness regulation accounts may deepen our understanding of conflict avoidance in the second half of life.

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Socio-Demographic Factors and Health-Related Behaviors Associated with Gerontology

GIS Business ◽

10.26643/gis.v14i6.11943 ◽

2019 ◽

Vol 14 (6) ◽

pp. 359-370

Author(s):

Dr. Ravi S. Dalawai

Keyword(s):

Cross Sectional Study ◽

Work Culture ◽

Chi Square ◽

Cross Sectional ◽

The Social ◽

Health Related ◽

Chi Square Test ◽

Current Scenario ◽

Socio Demographic Factors ◽

Insight Into

Indian population is in growing trend from 942.2 million in 1994 to 1.36 billion in 2019.Among this six per cent of India's population was of the age 65 and above (UNFPA, 2019). Today the work culture is totally changed. Both husband and wife are forced to work in the current scenario and unable to take care of their parents. The changing structure created increased problems for old age people leads to loneliness, psychological, physical health and financial insecurity. The study paper provides insight into the social and demographic factor and health related sickness of the oldest people. This research explained the cross-sectional study included a representative sample (n=116) of adults aged ≥60 years. The sample was chosen using a four-stage stratified random-cluster survey sampling method .The Chi Square test and ANOVA test was analyzed using SPSS20.

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Perceived social support and burden of care of male and female caregivers of patient with schizophrenia

Indian Journal of Psychiatric Social Work ◽

10.29120/ijpsw.2017.v8.i1.7 ◽

2017 ◽

Vol 8 (1) ◽

pp. 10

Author(s):

Narendra Kumar Singh ◽

Nishant Goyal

Keyword(s):

Social Support ◽

Perceived Social Support ◽

Family Members ◽

Well Being ◽

Cross Sectional Study ◽

Burden Of Care ◽

Cross Sectional ◽

Male And Female ◽

The Social ◽

The Difference

Background: Schizophrenia is associated with a high familial, social and economic burden. Schizophrenia is also associated with a high level of disability which may create impediments on the social and economic areas of the patients as well as on their respective family networks. Families with schizophrenia may encounter problems such as impairment of health and well being of other family members, restriction of social activities of the family members and shrinking of support from the social network. Aims: The present study examined the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. Methods: This was a cross-sectional study examining the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. The sample consisted of 60 (30 male and 30 female) caregivers of the patients with the diagnosis of schizophrenia as per ICD-10-DCR. Results and Conclusion: This study revealed that male caregivers perceived more social support and less burden of care as compared to female caregivers. Key words: Gender, social support, burden

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