scholarly journals Prevalence of MRSA and Antimicrobial Susceptibility Staphylococcus aureus in Clinical Samples in National Capital Region, India

Author(s):  
Pradeep Kumar ◽  
Geeta Gupta ◽  
Gajendra Kumar Gupta ◽  
Vashishth Mishra ◽  
Gaurav Gupta

Background: Infections caused by Staphylococci are frequently linked to indwelling medical equipment. These are extremely difficult to treat with antibiotics. In India, the prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA) varies from 30 to 70%, resulting in high mortality, increased economic burden, and high treatment failure in tertiary care hospitals. Rapid and reliable identification of MRSA is critical for infection management and avoiding the needless use of antibiotics. Materials and Methods: This prospective study was carried out in the Department of Microbiology, Santosh Medical College, Ghaziabad, from the 1st of August 2020 to the 31st of January 2021. MRSA isolates were screened and confirmed using standard methods recommended by the Clinical and Laboratory Standards Institute (CLSI). Methicillin resistance, in Staphylococcus aureus strains, was evaluated using oxacillin/cefoxitin. The Kirby-Bauer disc diffusion technique was used to assess the antibiotic susceptibility pattern of all MRSA strains. Results: In this investigation, MRSA was identified in 29.4% of the 384 Staphylococcus aureus strains. When compared to females, men outnumbered females. Cefoxitin detects a greater amount of MRSA than oxacillin. In this investigation, the majority of MRSA was found in pus samples. Conclusion: MRSA prevalence is known to vary depending on geographical region, hospital type, investigated population, and technique of detection used. Given the clinical implications of MRSA infection and its fast transmission capability, MRSA strains must be monitored on a regular basis.

Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai

Introduction: Methicillin-Resistant Staphylococcus aureus(MRSA) infection is a major global healthcare problem, the prevalence of which varies from 25-50% in India. It is known to cause Skin and Soft tissue Infections (SSI), endovascular infections, endocarditis, pneumonia, septic arthritis, osteomyelitis, and sepsis. Vancomycin is the drug of choice for treating severe MRSA infections. Ceftaroline, a fifth-generation cephalosporin has been approved by the United States Food and Drug Administration (US FDA) for treating acute bacterial SSI caused by susceptible micro-organisms including MRSA, Community acquired respiratory tract infection, MRSA bacteremia and endocarditis. Aim: To assess the susceptibility of clinical isolates of S. aureusto ceftaroline, in a Tertiary Care Hospital. Materials and Methods: This prospective study was conducted in the Department of Microbiology of a Tertiary Care Hospital over a period of two months from June 2019 to July 2019. S.aureus isolates from various clinical samples were screened for methicillin resistance by disc diffusion method using cefoxitin disc and ceftaroline susceptibility of these isolates was assessed by E-strip method. The isolates were classified as ceftaroline susceptible, Susceptibility Dose Dependent (SDD) and ceftaroline resistant respectively as per CLSI guidelines. A descriptive analysis of the data was done and the results were presented as frequencies and percentages. Results: All the S.aureus isolates were found to be susceptible to ceftaroline. Methicillin Sensitive Staphylococcus aureus(MSSA) isolates had lower Minimum Inhibitory Concentration (MIC) when compared to MRSA. The highest MIC among MRSA was 0.5 μg/mL. Conclusion: Ceftaroline can be considered as an effective alternative for treatment of infections caused by MRSA.


2018 ◽  
Vol 10 (1) ◽  
pp. 108-115
Author(s):  
Manjunath Chavadi ◽  
Rahul Narasanna ◽  
Ashajyothi Chavan ◽  
Ajay Kumar Oli ◽  
Chandrakanth Kelmani. R

Introduction:Methicillin-resistantStaphylococcus aureus(MRSA) is the major threat that is a result of the uncontrolled use of antibiotics causing a huge loss in health, so understanding their prevalence is necessary as a public health measure.Objective:The aim of this study was to determine the prevalence of methicillin-resistant MRSA and virulence determinant among associatedS. aureusfrom the clinical samples obtained from various hospital and health care centers of the Gulbarga region in India.Materials and Methods:All the collected samples were subjected for the screening ofS. aureusand were further characterized by conventional and molecular methods including their antibiotic profiling. Further, the response of methicillin antibiotic on cell morphology was studied using scanning electron microscopy.Results:A total 126S. aureuswas isolated from the clinical samples which showed, 100% resistant to penicillin, 55.5% to oxacillin, 75.3% to ampicillin, 70.6% to streptomycin, 66.6% to gentamicin, 8.7% to vancomycin and 6.3% to teicoplanin. The selected MRSA strains were found to possessmecA(gene coding for penicillin-binding protein 2A) andfemA(factor essential for methicillin resistance)genetic determinants in their genome with virulence determinants such as Coagulase (coa) and the X region of the protein A (spa)gene. Further, the methicillin response in resistantS. aureusshowed to be enlarged and malformed on cell morphology.Conclusion:The molecular typing of clinical isolates ofS. aureusin this study was highly virulent and also resistant to methicillin; this will assist health professionals to control, exploration of alternative medicines and new approaches to combat Staphylococcal infections more efficiently by using targeted therapy.


2017 ◽  
Vol 3 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Shahana Khanam ◽  
Jalaluddin Ashraful Haq ◽  
SM Shamsuzzaman ◽  
Md Motlabur Rahman ◽  
Kazi Zulfiquer Mamun

Background: Glycopeptides such as vancomycin are frequently the choice of antibiotics for the treatment of infections caused by methicillin resistant Staphylococcus aureus (MRSA). For the last 7 years incidence of vancomycin intermediate S. aureus and vancomycin resistant S. aureus (VISA and VRSA respectively) has been increasing in various parts of the world.Objective: The present study was carried out to find out the presence of VISA and VRSA among isolated MRSA strains.Methodology: This cross sectional study was carried out in the Department of Microbiology in Dhaka medical college during period of January 2010 to December 2011. All S. aureus isolates were screened to detect methicillin resistance and then all MRSA isolates were subjected for MIC testing against vancomycin and oxacillin by agar dilution method, disc diffusion testing and PCR for mecA and pvl genes detection.Result: A total 112 S. aureus were isolated from 500 nasal swab sample collected from adult patients who were admitted in various departments and wards in Dhaka Medical College Hospital. Among 38 MRSA strains out of 112 Staph aureus isolates 3(7.89%) strains were resistance to vancomycin of which 2(5.26%) strains had MIC > 256 mg/mL and one strain had MIC 256mg/mL. All vancomycin resistance strains had MIC of oxacillin > 256 mg/mL. All isolates possess mec-A gene.Conclusion: The present study reveals that emergence of VRSA upon admission at a tertiary care of hospital in Bangladesh. Continuous efforts should be made to prevent the spread and the emergence of VRSA by early detection of the resistant strains and using the proper infection control measures in the hospital setting.Bangladesh Journal of Infectious Diseases 2016;3(1):11-16


Author(s):  
Rohit Kumar ◽  
Jagarti . ◽  
Mrinmoy Sarma ◽  
Gautam Shalini

Background: The increasing frequency of MRSA infections and rapidly changing patterns in antimicrobial resistance, led to renewed interest in the usage of Macrolides-Lincosamide-Streptogramin B (MLSB) antibiotics to treat Staphylococcus aureus infection. Clindamycin is an important drug used in the treatment of MRSA and MSSA infection. The aim of this study was to determine inducible and constitutive clindamycin resistance among clinical isolates of Staphylococcus aureus by D-test.Methods: During a period of 6 months from July 2018 to December 2018, a total of 100 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Methicillin-resistance was determined by using the cefoxitin (30 µg) disc. Incidence of MLSBc and MLSBi in Staphylococcus aureus isolates by D-test as per CLSI guidelines.Results: Out of 100 isolates of Staphylococcus aureus obtained from 350 clinical samples, 70(70%) were found to be MRSA and 30(30%) were MSSA. Among 100 Staphylococcus aureus isolates, 40% isolates showed MLSBi resistance, 28% isolates showed MLSBc resistance, 6% isolates showed MS phenotype and 26% isolates showed Sensitive phenotype. MLSBc and MLSBi were found to be higher in MRSA as compared to MSSA (21%, 27% and 7%, 10% respectively). All clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing.Conclusions: Continuous surveillance of the MLSB resistance is important and required before the prescription of clindamycin to treat MRSA infections.


Author(s):  
Fahimeh Nourbakhsh ◽  
Vajiheh Nourbakhsh ◽  
Samaneh Borooni ◽  
Elaheh Tajbakhsh ◽  
Dana Daneshmand

Background and Aims: Based on the results, Staphylococcus aureus is one of the serious infectious agents found in community and hospitals with remarkable potential for high morbidity and mortality around the globe. The present study was carried out for molecular investigation of methicillinresistant Staphylococcus aureus strains and Staphylococcal Chromosomal Cassette mec (SCCmec) phenotypes isolated from the intensive care unit in Hazrat Fatemeh Zahra hospital of Isfahan. Materials and Methods: A total of 76 clinical wound samples were collected from Hazrat Fatemeh Zahra Hospital in Isfahan and evaluated by polymerase chain reaction (PCR) methods. The Methicillin resistance Staphylococcus aureus (MRSA) screening was performed by genotypic and phenotypic methods; also antibiotic resistance pattern was determined by using the disk diffusion method and related genes by PCR. Results: Totally, 53 (69.7%) out of 76 clinical samples were positive for MRSA. Of the 76 MRSA strains, 39 (63.51%) were PVL positive (51.3%). The most commonly infected samples were collected from wounds (40.8%). The most commonly detected antibiotic resistance genes were mecA (89.61%), tetK (88.23%), tetM (49.15%) and msrA (46.93%). Resultantly, it was shown that MRSA has the highest level of resistance against methicillin (98%), penicillin (97.24%), tetracycline (89.64%). It was also revealed that the most commonly detected SCCmec types in the MRSA strains are types II (14.53%) and III (16.82%). Conclusions: In summary, this paper argues that the orderly surveillance of hospital-associated infections and initial management and supervision of the antibiotic resistance patterns are required to control the prevalence of MRSA.


2016 ◽  
Vol 12 (3) ◽  
pp. 83-88
Author(s):  
Sangita Thapa ◽  
Lokendra Bahadur Sapkota

Background & Objectives: The objective of this study was to isolate and identify Staphylococcus species from different samples clinical samples and to determine the current trend regarding the incidence and distribution of inducible clindamycin resistance in clinical isolates of Staphylococcus aureus and CONS.Materials & Methods: A total of 264 isolates of staphylococcus species were isolated from various clinical samples. Clinical samples were cultured and Staphylococcus species were identified using standard microbiological methods recommended by the American Society for Microbiology (ASM). Methicillin resistance was confirmed using cefoxitin and oxacillin disks. Inducible clindamycin resistance was identified using D-zone test.Results: Among 264 erythromycin resistant staphylococcus species, 213 (80.6%) were S. aureus and 51 (19.3%) were CONS. Out of 213 erythromycin resistant isolates of S. aureus, 140 (65.7%) were MRSA and 73 (34.2%) were MSSA whereas out of 51 erythromycin resistant isolates of CONS, 28 (54.9%) were MRCNS and 23 (45%) were MSCNS. Constitutive MLSB phenotype and Inducible MLSB phenotype was higher among both MRSA and MRCNS isolates. MS phenotype was more predominant among 11 (5.1%) MSSA and 5 (9.8%) MSCNS isolates compared to 9 (4.2%) in MRSA and 2 (3.9%) in MRCNS.Conclusion: The prevalence of constitutive & inducible clindamycin resistance in staphylococcus isolates was high among both MRSA and MRCNS. Hence the implementation of D-test routinely, will reveal the iMLSB & cMLSB phenotype & will guide the clinicians whether to use clindamycin in staphylococcal infections when erythromycin resistance is present.


2020 ◽  
Vol 13 ◽  
pp. 117863612097269
Author(s):  
Shesh Narayan Kandel ◽  
Nabaraj Adhikari ◽  
Binod Dhungel ◽  
Upendra Thapa Shrestha ◽  
Khadga Bikram Angbuhang ◽  
...  

Introduction: Methicillin resistant Staphylococcus aureus (MRSA) is a major human pathogen associated with nosocomial and community infections. mecA gene is considered one of the important virulence factors of S. aureus responsible for acquiring resistance against methicillin. The main objective of this study was to explore the prevalence, antibiotic susceptibility pattern, and mec A gene. Methods: A total of 39 isolates of S. aureus were isolated from 954 clinical specimens processed in Microbiology laboratory of Himal Hospital, Kathmandu. Antimicrobial susceptibility test (AST) was performed by Kirby-Bauer disc diffusion method using cefoxitin, and performed Polymerase Chain Reaction (PCR) for amplification of mecA gene in MRSA isolates. Results: Out of 954 clinical samples, (16.2%; 153/954) samples had bacterial growth. Among 153 culture positive isolates, 25.5% (39/153) were positive for S. aureus. Among 39 S. aureus (61.5%; 24/39) were multiple drug resistant (MDR). On AST, amoxicillin was detected as the least effective while vancomycin was the most effective. The prevalence of methicillin resistance was 46% (18/39) of which 72.2% (13/18) were positive for mecA gene in PCR assay. Conclusion: One in 4 culture positive isolates from the clinical specimens were S. aureus, of which almost two-thirds were MDR. Around half of the MDR showed MRSA and significant proportion of them were positive for mecA gene. This study concludes that the mecA gene is solely dependent for methicillin resistance in S. aureus but the presence of gene is not obligatory. PCR detection of the mecA gene is reliable, valid and can be suggested for the routine use in diagnostic laboratories.


2019 ◽  
Vol 10 (2) ◽  
pp. 1474-1480
Author(s):  
Vamsi Muni Krishna P ◽  
Sreenivasulu Reddy V ◽  
Praveen Kumar V ◽  
Suresh P

Staphylococci spp has been reported as a major cause of hospital and community-associated infections. Staphylococcus aureus is the most common pathogen causing a variety of infections relatively begins minor skin in sections (abscess. cellulitis, staphylococcal scalded skin syndrome) to live threating systemic infections like endocarditis, septic arthritis, pneumonia joint, and bone infections, toxic shock syndrome. Methicillin resistance was reported in 1961 and emerged in the last several decades as one of the most important nosocomial pathogens which were reported just one year of the launch of methicillin. MRSA now a day a big problem is because it is creating life threating problems medical institutions. The knowledge of MRSA prevalence and current antibiogram profile is necessary for the selection of appropriate treatment for related infections. Isolation and identification of Staphylococcus aureus were done by standard conventional microbiological methods. The Methicillin-resistant Staphylococcus aureus strains were tested by using Cefoxitin 30μg disc on Mueller - Hinton agar and antibiotic susceptibility testing were done by Kirby-Bauer disc diffusion method according to Clinical and Laboratory Standards Insititute guidelines (CLSI). All the 164 MRSA (100%) strains were sensitive to Tigecycline, Vancomycin, Teicoplanin followed by Linezolid (92. 68%). Tigecycline, Vancomycin, Teicoplanin has until now excellent activity against clinical isolates of Methicillin-resistant Staphylococcus aureus.


2021 ◽  
Vol 8 (4) ◽  
pp. 266-270
Author(s):  
Erdal Özbek ◽  
Hakan Temiz ◽  
Nida Özcan ◽  
Hasan Akkoc

Objective: In this study, it was aimed to determine the in vitro susceptibilities of Methicillin-Resistant Staphylococcus aureus (MRSA) strains to fluoroquinolone, linezolid, tigecycline, and quinupristin/dalfopristin as well as the macrolide-lincosamide-streptogramin B (MLSB) resistance phenotype. Materials and Methods: A total of 94 MRSA strains isolated from various clinical samples in our hospital laboratory between January 2020 and September 2020 were included. The in-vitro susceptibilities of MRSA strains against fluoroquinolone, linezolid, tigecycline, and quinupristin/dalfopristin were determined by Kirby-Bauer disc diffusion assay according to The European Committee on Antimicrobial Susceptibility Testing (EUCAST).  The E test assay was used for evaluation of tigecycline susceptibility. The D-zone test was performed with erythromycin (15 μg) and clindamycin (2 μg) discs to determine the MLSB resistance. Besides, bacterial identification, antibiotic susceptibility tests including methicillin resistance and MLSB phenotype determination were performed by using VITEK 2 Gram-positive diagnostic kits (Bio-Mérieux/France). Results: Results: Among 94 MRSA strains included, resistance rates to ciprofloxacin, moxifloxacin, tigecycline, and quinupristin/dalfopristin were found as 71% (67 isolates) 64% (60 isolates), 17% (16 isolates), and 2% (2 isolates), respectively. Resistance was not detected for linezolid. A total of 36 (49%) isolates showed cMLSB resistance phenotype, while 18(19%) had iMLSB resistance. The methicillin susceptibility (MS) phenotype – strains resistant to erythromycin and susceptible to clindamycin- was not detected. Conclusion: Very little resistance was found to linezolid, quinupristin/dalfopristin and tigecycline. Therefore, these antibiotics may be beneficial for the proper treatment of infections caused by MLSB-resistant isolates.


2020 ◽  
pp. 28-30
Author(s):  
Neha Jha ◽  
R. S. Prasad ◽  
P. N. Jha ◽  
Debarshi Jana

Background: Methicillin Resistant Staphylococcus aureus (MRSA) prevalence is increasing worldwide and it remains as a major cause of morbidity and mortality in hospitalised patients due to its versatile behaviour towards antibiotics. Aims: This study was done to find out the prevalence and antimicrobial susceptibility pattern of MRSA isolates at our hospital setup, in order to guide policy on the appropriate use of antibiotics. Settings and Design: The study was a prospective observational study, carried out in the Department of Microbiology, Darbhanga Medical College, Laheriasarai, Bihar. Methods and Material: A total number of 288 strains of Staphylococcus aureus were isolated from various clinical samples received in the laboratory. Staphylococcus aureus was identified by routine standard operative procedures. Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method and the results were interpreted following Clinical Laboratory Standards Institute (CLSI) guidelines. Methicillin resistance was screened by using oxacillin disks [1 mcg]. Statistical analysis used: Data obtained was analysed and presented in counts and percentages. 95 % confidence interval values were also calculated. Results: Methicillin resistance was documented in 120 [41.6%] Staphylococcus aureus isolates. Most of them were isolated from pus, wound swabs, urine and respiratory samples. All MRSA isolates were resistant to penicillin and cefepime. The resist-ance was high to tetracycline, erythromycin, co-trimoxazolepiperacillin / tazobactam, and ciprofloxacin; moderate to amino-glycosides, clindamycin, chloramphenicol and levofloxacin. All MRSA strains were susceptible to vancomycin. Overall, 63.3% [76/120] of MRSA strains were found to be resistant to more than 6 antimicrobials tested. Conclusions: Our study emphasizes the need for regular surveillance and formulation of a strict drug policy on the appropriate use of antibiotics to control MRSA infections. This would also minimise the irrational use of vancomycin and the emergence of vancomycin resistant Staphylococcus aureus [VRSA].


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