Isolation of Methicillin Resistant Staphylococcus aureus (module 2011) in Taif Area, Saudi Arabia (original) (raw)
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2010
Nosocomial infections caused by methicillin-resistant staphylococci (MRSA) pose a serious problem in many countries. This study aimed to determine the antibacterial susceptibility patterns of methicillin sensitive and resistant Staphylococcus aureus isolates from the hospitalized patients. Totally 356 isolates of Staphylococcus aureus (S. aureus) including 200, 137 and 19 corresponding to MSSA, MRSA, and intermediate MRSA strains, respectively were isolated. Antibacterial susceptibility patterns of the isolates to 14 antibiotics were examined using Kirby-Bauer method. MICs of 15 antibiotics to 156 MRSA isolates were determined by E test method. Cross-resistances of MRSA isolates (137+19) to the other tested antibiotics were also determined. S.aureus with high frequencies were isolated from the blood, sputum and deep wound samples. All of 200 MSSA isolates were sensitive to oxacillin, vancomycin, tecoplanin, rifampin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid. A gradient of reduced susceptibility of MSSA to cephalexin, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin were evident. MRSA isolates were sensitive to vancomycin, tecoplanin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid, while reduced susceptibility of them to rifampin, co-trimoxazole, clindamycin, cephalexin, tetracycline, ciprofloxacin, erythromycin and gentamicin were observed. MRSA isolates exhibited a high range of cross-resistance to the eight tested antibiotics. Overall, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin showed low activity against MSSA and MRSA isolates which may indicate they are not suitable to be used in clinical practices. To preserve the effectiveness of antibiotics, rational prescription and concomitant application of preventive measures against the spread of MRSA are recommended.
innovative publication
Staphylococcus aureus remains as one of the most potent bacterial human pathogen because of its expression of various virulence factors and also due to its property of multidrug resistance. A total of 468 non –duplicate S.aureus strains obtained from various clinical specimens were included in the study. Methicillin Resistant S.aureus (MRSA) strains were screened for DNase production using DNase agar, hemolytic property of the isolates were detected in 5% sheep blood agar plates, hemagglutination property of the isolates were demonstrated using 1% O group RBC's,slime production was detected using congo red agar medium and biofilm production was quantitatively assayed by microtitre plate method. Antimicrobial susceptibility profile was studied for the MRSA isolates. Out of 468 S.aureus strains, 114(24%) strains were detected as MRSA. Among the MRSA strains 99(86%) were positive for DNase, 77(67%) were showed beta hemolysis, 49 (42%) strains were positive for hemagglutination, 70 (61%) were slime producers, most of the strains were biofilm producers, 4(3.5%) were non-adherent, 85(74%) were weakly adherent, 23(20%) were moderately adherent and 2(1.7%) were strongly adherent. About 56%, 60% and 63% of the isolates were resistant to cotrimoxazole, erythromycin and ciprofloxacin respectively and about 22% and 33% of the isolates showed resistance towards clindamycin and gentamicin respectively. All the isolates were sensitive to vancomycin, teicoplanin and linezolid. About 10(8.7%) strains showed high level mupirocin resistance (HLMR) and 1(0.8%) strain showed low level mupirocin resistance (LLMR). Both HLMR and LLMR (100%) strains showed susceptibility to fusidic acid. MRSA infections remain a major threat in both community and nosocomial settings. Therefore a thorough understanding of its virulence mechanisms and regular surveillance of antimicrobial susceptibility pattern will help the clinician to choose appropriate treatment options and to control the emergence of multidrug resistant strains.
2014
Purpose: Staphylococcus aureus is a flexible pathogen causing variety of infections in humans and other animals. The current investigation was aimed to study the prevalence rate and sensitivity profile of MRSA strains isolated from clinical samples to various antimicrobial agents. Methods: Isolates from three different clinical specimens; pus, body fluids and blood were obtained from patients, belonging to various parts of District Peshawar of Khyber Pakhtunkhwa. Each sample was processed by conventional method using blood, MacConkey and CLED agar. Staphylococcus aureus was identified and confirmed by Gram staining, catalase test and coagulase test. Antibiotic susceptibility pattern of MRSA to different antibiotics was confirmed by standard Kirby-Bauer disc diffusion method. Results: A total of 855 clinical samples were studied, out of which 45 (5.26%) were found positive for MRSA, among which 32 (71%) were from pus samples, 8 (18%) were from fluids samples and 5 (11%) were from blood samples. The frequency of MRSA strains was more in males (69%) than in females (31%). All MRSA isolates showed complete resistance to oxacillin, ampicillin and penicillin and complete sensitivity to linezolid, teicoplanin, and vancomycin. These MRSA strains also showed various degrees of resistance to other antimicrobials such as ceftriaxone (77.77%), cefoxitin (64.44%), erythromycin (82.22%), clindamycin (71.11%), co-amoxiclav (75.55%), fusidic acid (66.66%), and gentamycin (73.3%). Conclusion: Our results show lower MRSA prevalence in Peshawar than the previous reports in Peshawar and other areas of Pakistan. However; since MRSA is multidrug resistant, proper culture sensitivity test should be carried out for proper choice of antibiotic/s to treat MRSA infections.
Methicillin Resistant Staphylococcus Aureus (Mrsa)
The Professional Medical Journal
Background:Methicillin resistant Staphylococcus aureus (MRSA) is one of the notorious bugs to cause nosocomial human infections worldwide. However its prevalence and susceptibility pattern quite varies in hospitals among different countries or within same country.Objectives: To study the prevalence and antibiotic susceptibility pattern of MRSA isolated from pus sample.Study Design: Cross sectional study.Period:6 months. Setting:Tertiary care hospital of district Rahim Yar Khan -Punjab, Pakistan at its microbiology laboratory.Materials and Methods:A total 100 clinical specimen of pus and wounds were collected from various indoor and outdoor department of this institute. .The Staphylococcus aureus was identified on the basis of colony morphology, Gram’s stain, and biochemical tests.Antibiotic susceptibility pattern was done according to CLSI guidelines.Results:Out of 100 clinical sample of pus and wounds, 21 coagulase positive staph. aureus were isolated, 14 (66.7%) strains were found...
Trends in antibiotic resistance among methicillin-resistant Staphylococcus aureus (MRSA) isolates
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) has become the most important multidrug-resistant pathogen worldwide, causing significant morbidity and increased healthcare costs. Hospital acquired MRSA are usually associated with increased expression of multiple antibiotic resistance genes. In hospitals, prolonged hospital stay and antibiotic therapy, especially with beta–lactam antibiotics and fluoroquinolones, predispose patients to acquisition of MRSA. Materials and Method: From October 2015 to October 2016. 100 strains of MRSA were isolated from various clinical specimens from different patients. The screening and confirmation of MRSA production was done by Cefoxitin disc diffusion method. Antibiotic susceptibility test for MRSA was done using Kirby-Bauer disk diffusion method for conventional antibiotics. Results: resistance pattern was Pefloxacin (87%), Ofloxacin (75%), Ciprofloxacin (61%), Erythromycin (65%), Cotrimoxazole (61%), Clindamycin (57%), Cefipime (40%), Tetracycline (29%), Gentamicin (24%), Amikacin (13%), Linezolid (0%), Teicoplanin (0%) and Vancomycin (0%). Inducible clindamycin resistance was 38%. Among risk factors, 74% patients had the history of administration of antibiotics, 70% are Hospitalized patients. 58% of the patients are having foreign bodies in situ. 31% are community acquired and 69% are hospital acquired MRSA. Conclusion: The selection of antimicrobial agent should be based on in vitro susceptibility and the hospital-based antibiotic policies must be strictly followed. There should be constant surveillance for susceptibility pattern of MRSA as well as to detect emergence of vancomycin resistance. In addition to good infection control practices, the rational use of antimicrobial agents is one of the major steps in reducing the growing problem of antibiotic resistance.
ANTIBIOTIC RESISTANCE TRENDS IN INDIGENOUS METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) ASSOCIATED WITH BACTEREMIA , 2017
Methicillin resistant S. aureus (MRSA) are on verge globally. Such multi resistant S. aureus are difficult to treat and are responsible for increased treatment cost. Persistent follow up of infection control policies and determining antibiogram of MRSA are perquisite for the proper management of MRSA. In this scenario, the present study was planned to rule out the prevalence of MRSA and its miscellaneous antibiotic resistance trends. Non-replicate (3017) cultures of S. aureus isolated from blood were collected and identified by various biochemical tests. Antibiotic susceptibility experiment was accomplished by Kirby Bauer disc diffusion procedure. Data was analysed through Chi-square test and T-test to determine the significance difference by using Microsoft Excel 2007. S. aureus isolates were 48%, 44% and 38% resistant to Cefoxitin (FOX), Ciprofloxacin (CIP) and Erythromycin (E), respectively. Out of total S. aureus isolates, 48% and 52% were found Methicillin resistant S. aureus (MRSA) and Methicillin sensitive S. aureus (MSSA), all were sensitive to Vancomycin. In MSSA Mean/Average resistance was 7.5 with SD value 7.5 and in MRSA, Mean/Average resistance and SD values were 43 and 32, respectively. P-value of was found 0.0015. Increased resistance profiles were observed in MRSA as Cefoxitin resistance (100%), Cefoxitin-Ciprofloxacin resistance (75%), Cefoxitin-Erythromycin resistance (57%) and Cefoxitin-Ciprofloxacin-Erythromycin resistance (47%). The Vancomycin, Clindamycin and Fusidic Acid were observed most effective antibiotics. Inappropriate and selective use of antibiotics and poor infection control practices are responsible for the high emergence of multiple drug resistant MRSA strains.
Perspectives of Methicillin-Resistant Staphylococcus Aureus (MRSA)
2016
Staphylococcus aureus is a gram positive, non-motile bacterium which normally colonizes in skin and mucosa of human and animal, transmitted by direct contact or via contaminated surfaces, which causes infections like skin infections , respiratory infections and food poisoning. Methicillin is a narrow spectrum beta-lactam antibiotic of the penicillin class which was previously used for the treatment of infections caused by Staphylococcus aureus. In 1948 it was observed that 50% of staphylococcal isolates from patients in a United Kingdom hospital were resistant to penicillin. Since then 90 to 95% strains of S. aureus were resistant to penicillin. In 1959 methicillin, a penicillinase-resistant penicillin was introduced to overcome the penicillin-resistant Staphylococcus aureus, but after few years, S. aureus strain became resistant to methicillin also and so the birth of MRSA occurred. MRSA has been detected in wide range of species including companion animal and wildlife animal. Pigs are considered to be true reservoir hosts for MRSA, causing mastitis in cattle, dogs are more infected with MRSA in comparison to cats, in horses most of the cases of MRSA infections were reported in large studs. MRSA has been isolated from wild animals like cottontail rabbit, lesser yellow migratory shore bird, Wild rat, wood mice red deer, Iberian ibex, vulture, wild boar etc. Certain facts showed that these organisms can be transferred from human to animals and from animals to humans. Most of MRSA infections are skin infections producing symptoms like cellulitis, boils, abscesses, sty, carbuncles, impetigo and rash. For the diagnosis of MRSA antimicrobial susceptibility tests (AST) such as agar disc diffusion technique is used. Cefoxitin disc diffusion is the most sensitive methods for detecting MRSA isolates showing negative and positive predictive values of 100% and 98%, respectively. For the treatment of clinical cases of MRSA, antibiotics such as trimethoprim-sulphamethoxazole, clindamycin and doxycycline, topical treatments and other measures have been used successfully.
2016
To study the Antibiotic resistance determination of S. aureus isolates and screening for MRSA. This was in-vitro study on MRSA isolates received from clinical samples in the department of microbiology during three months (January 2015-March 2015). Staphylococci were identified by catalase, coagulase and DNAse tests. The samples were cultured on blood agar and MacConkey's agar plates. Antibiotic susceptibility tests were carried out by disc diffusion method. The disc used was Amikacin (30μg), Doxycycline (30μg), Co-trim0oxazole (25μg), Gentamicin (10μg), Penicilin (10μg), Erythromycin (15μg), Clindamycin (2μg), Vancomycin (30μg), Linezolid (30μg), Cefoxitin (30μg), Fusidic acid (10 g), Chloramphenicol (30μg) and Ciprofloxacin (5μg). Our results indicate that out of 112 positive isolates of S. aureus, 34 (30.35%) were found to be MRSA. These isolates were also resistant to different commonly prescribed other anti-staphylococcal antibiotics. A total of 34 (30.35%) MRSA was isolated...
Archives of Pediatric Infectious Diseases, 2017
Background: Methicillin resistant Staphylococcus aureus (MRSA) are one of the most common and important pathogens, accounting for diverse nosocomial and community-acquired infections. The serious concern about these bacteria is the development of antibiotic resistance. Objectives: The present study was conducted to investigate the frequency of MRSA strains, their epidemiological and molecular relationships and antibiotic susceptibility patterns of isolated strains from university teaching hospitals of Tabriz, Northwestern Iran (during years 2014 and 2015). Methods: A total of 215 non-repetitive clinical isolates of S. aureus were identified using standard methods. The MRSA isolates were detected by the combination of phenotypic and genotypic methods. The presence of pvl gene and SCCmec types was determined by PCR and multiplex PCR, respectively. The MRSA isolates, in which the presence of mecA gene had been confirmed by PCR, were subjected to Rep-PCR analysis. Resistance to antibacterial agents was determined by disk diffusion, screening agar, and E-test methods. Results: All S. aureus isolates were positive for nuc gene and 87 (40.5%) of them revealed the presence of mecA gene, confirming them as MRSA. All isolates were found to be sensitive to linezolid and vancomycin. However, a reduced sensitivity of 3 MRSA isolates to vancomycin was observed (MIC = 6 µg/mL). SCCmec type III was the most prevalent (79.31%), followed by type IVd (13.80%) and type I (6.90%). The PVL occurrence was detected in 33 (15.35%) S. aureus isolates. The MRSA isolates could be divided to 2 main clusters, indicating the possible clonal relatedness of MRSA isolates. Conclusions: The MRSA isolates with SCCmec type III were the predominant MRSA strains in this area. The majority of MRSA isolates were MDR. Linezolid and vancomycin were found as suitable antibiotics for the treatment of MRSA. The results of typing methods indicated possible clonal relatedness among MRSA isolates. Therefore, routine infection control surveillance is necessary for the prevention of epidemic emergence.