DRUG RESISTANCE PATTERNS OF CLINICAL ISOLATES OF STAPHYLOCOCCUS AUREUS IN TERTIARY CARE CENTER OF SOUTH INDIA
Keywords:Antibiotic susceptibility pattern, Drug resistance, Methicillin resistant Staphylococcus aureus (MRSA), antibiotic resistance, Staphylococcus aureus
Objectives: StaphylococcusÂ aureus were initially described in 1961 and emerged in the last decade as one of the most important nosocomial pathogens. The current study was undertaken to provide data for empirical selection of appropriate antibiotics for the treatment of diseases caused by S.Â aureus.
Methods: Various clinical samples like pus, urine, stool, sputum, blood and other body fluids of patients were selected for study from June 2012 to June 2013. StaphylococcusÂ aureus were identified by various biochemical tests and antimicrobial susceptibility testing of the isolates were performed by Kirby Bauer disc diffusion method. Detection of the MRSA was done by Oxacillin disc diffusion method.
Results: A total of 137 isolates of S. aureus were obtained over duration of 12 months. These included isolates from the sample of pus, urine, sputum, body fluids. Out of 137 S. aureus strains isolated, 62 (45.3%) were identified as MRSA and 75 (54.7%) were identified as MSSA based on oxacillin disk diffusion method. Anti-biograms revealed the high level of resistance among MRSA isolates when compared to MSSA isolates The most effective agent against MRSA isolates was linezolid (96.8%sensitive), followed by tetracycline (90.9%) and piperacillin/tazobactam (80.6%).
Conclusion: The prevalence of MRSA in our hospital was high. Therefore to reduce the incidence of infections due to MRSA, we suggest implementation of the strict antibiotic policy guidelines and continuous monitoring of antibiotic susceptibility patterns of such pathogens.
Boucher HW, Corey GR. Epidemiology of methicillin-resistant Staphylococcus aureus. Clin Infect Dis 2008;46(Suppl 5):S344â€“S9.
Metri BC, Peerapur BV, P Jyothi. Comparison of antimicrobial resistance pattern of hospital-and community-acquired Methicillin resistant Staphylococcus aureus. J Chem Pharm Res 2014;6:201-5.
Anand KB, Agrawal P, Kumar S, K Kapila K. Comparison of cefoxitin disc diffusion test, oxacillin screen agar, and PCR for mecA gene for detection of MRSA. Indian J Med Microbiol 2003;27:27-9.
Anupurba S, Sen MR, Nath G, Sharma BM, Gulati AK, Mohapatra TM. Prevalence of methicillin resistant Staphylococcus aureus in a tertiary referral hospital in eastern Uttar Pradesh. Indian J Med Microbiol 2003;21:49-51.
Vermaa S, Joshii S, Chitniss V, Hemwanii N, Chitniss D. Growing problem of methicillin resistant staphylococci-Indian scenario. Indian J Med Sci 2000;54:535-40.
Betty AF, Daniel FS, Alice SW. (Editors) Staphylococcus, Micrococcus and similar organisms, Chapter 19. In: Baily and Scott's Diagnostic Microbiology. 11th edn. (Mosby Inc: St. Louis); 2002. p. 284.
Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing; 16th information supplement (M100-S16). Clinical and Laboratory Standards Institute, Wayne, Pa; 2006.
Isenberg HD. editor. Clinical microbiology procedures hand book. 2nd ed. Washington DC: ASM Press; 2004.
Brown DF, Edwards DI, Hawkey PM, Morrison D, Ridgway GL, Towner KJ, et al. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphyloccocus aureus. J Antimicrob Chemother 2005;56:1000-18.
Jones RN. Key considerations in the treatment of complicated Staphylococcal infections. Clin Microbiol Infect 2008;14:3-9.
Buzaid N, Elzouki AN, Taher I, Ghenghesh KS. Methicillin-resistant Staphylococcus aureus (MRSA) in a tertiary surgical and trauma hospital in Benghazi, Libya. J Infection Developing Countries 2011;5:723-6.
Madani TA. Epidemiology and clinical features of methicillin-resistant Staphylococcus aureus (MRSA) at the University Hospital, Jeddah, Saudi Arabia. J KAU. Med Sci 2008;10:3-12.
Mathanraj S, Sujatha S, Sivasangeetha K, Parija SC. Screening for methicillin-resistant Staphylococcus aureus carriers among patients and health care workers of a tertiary care hospital in south India. Indian J Med Microbiol 2009;27:62-4.
Kali1 A, Stephen S, Umadevi S, Kumar S, Joseph NM, Srirangaraj S. changing trends in resistance pattern of methicillin resistant Staphylococcus aureus. J Clin Diagn Res 2013;7:1979-82.
Charlebois ED, Bangsberg DR, Moss NJ, Moore MR, Moss AR, Chambers HF, et al. Population-based community prevalence of methicillin-resistant Staphylococcus aureus in the urban poor of San Francisco. Clin Infect Dis 2002;34:425-33.
Sanjana RK, Shah R, Chaudhary N, Singh YI. Prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) in CMS-teaching hospital: a preliminary report. J College Med Sci Nepal 2010;6:1-6.
Mathews AA, Thomas M, Appalaraju B, Jayalakshmi J. Evaluation and comparison of tests to detect methicillin resistant S. aureus. Indian J Pathol Microbiol 2010;53:79-82.
Fluit AC, Wielders CLC, Verhoef JF, Schmitz J. Epidemiology and susceptibility of 3,051 Staphylococcus aureus isolates from 25 university hospitals participating in the european SENTRY study. J Clin Microbiol 2001:39:3727-32.
Subedi S, Brahmadathan KN. Antimicrobial susceptibility patterns of clinical isolates of Staphylococcus aureus in Nepal. Clin Microbiol Infect 2005;11:235-7.
Akpaka PE, Kissoon S, Henry W, Swanston WH, Monteil M. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus isolates from Trinidad & Tobago. Ann Clin Microbiol Antimicrob 2006;5:16.
Indian network for surveillance of antimicrobial resistance group, India. Methicillin resistant Staphylococcus aureus (MRSA) in India: Prevalence and susceptibility pattern. Indian J Med Res 2013;137:363-9.
Simor AE, Ofner-Agostini M, Bryce E, Green K, McGee A, Mulvey A, et al. The canadian nosocomial infection surveillance program health Canada: Evolution of methicillin-resistant Staphylococcus aureus in Canadian hospitals: 5 years of national surveillance. CMAJ 2001;165:21-6.
Swanston WH. Methicillin-resistant Staphylococcus aureus. West Indian Med J 1999;48:20-2.
Saikia L, Nath R, Choudhury B, Sarkar M. Prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus in Assam. Indian J Crit Care Med 2009;13:156-8.
Kumari N, Mohapatra TM, Singh YI. Prevalence of Methicillin resistant Staphylococcus aureus in a tertiary-care hospital in Eastern Nepal. J Nepal Med Assoc 2008;47:53-6.