IJCRR - 7(10), May, 2015
Pages: 55-60
A COMPARATIVE STUDY OF OXACILLIN SCREEN AGAR, OXACILLIN DISC DIFFUSION AND CEFOXITIN DISC DIFFUSION, OXACILLIN E-TEST METHOD FOR ROUTINE SCREENING OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS
Author: Anamika Vyas, Megha Sharma, Sanjeev Kumar, Mrityunjay Kumar, Sudhir Kumar Mehra
Category: General Sciences
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Abstract:
Background: Methicillin resistant staphylococcus aureus (MRSA) has been recognized as one of the major pathogen in both hospital and community settings. MRSA strains are frequently resistant to different class of antibiotics. Multi drug antimicrobial resistance among MRSA is a matter of concern for clinicians. Therefore, an accurate detection of MRSA in microbiology laboratory is essential for patient management and epidemiological purpose including hospital infection control.
Aim: The present study was undertaken to compare various phenotypic methods (oxacillin disc diffusion, cefoxitin disc diffusion, oxacillin screen agar) for detection of MRSA using E test MIC oxacillin as gold standard method. We also aimed to study the resistance pattern of the MRSA isolates.
Materials and Methods: A total of 50 staphylococcus aureus strain which were isolated from different clinical specimens were included in this study. All isolates were tested for methicillin resistance by oxacillin disc diffusion, cefoxitin disc diffusion and oxacillin screen agar test considering E test MIC for oxacillin as gold standard. All the isolates were tested for antibiotic susceptibility testing by kirby bauer disc diffusion method against a predefined panel of antimicrobials and intepretation was done according to CLSI guidelines.
Result: Among the 50 staphylococcus auresus isolates 23 (46%) isolate were identified as MRSA by E test MIC method. Cefoxitin disc diffusion test showed 100% sensitivity and 92% specificity while oxacillin disc diffusion test and oxacillin screen agar test showed 100% sensitivity and 74% specificity. The resistance percentage of MRSA isolate to erythromycin, ciprofloxacin, levofloxacin, cotrimoxazole and gentamycin was 70%, 96%, 57%, 52% and 43% respectively. All isolates were sensitive to vancomycin, linezolid and tigecycline.
Conclusion: Our study revealed that cefoxitin disc diffusion test had high sensitivity and high specificity as compared to other phenotypic methods used routinely to detect MRSA. This method is technically less demanding even can be used along with antibiotic sensitivity testing, cost effective and can be the best option to detect MRSA in clinical settings with constraint facilities. Vancomycin is still the drug of choice for treatment of MRSA, However regular monitoring of vancomycin sensitivity should be done as reduced susceptibility to vancomycin has been reported from all over the globe and is a matter of concern for clinicians.
Keywords: MRSA, Cefoxitin disc diffusion, Oxacillin disc diffusion
Citation:
Anamika Vyas, Megha Sharma, Sanjeev Kumar, Mrityunjay Kumar, Sudhir Kumar Mehra. A COMPARATIVE STUDY OF OXACILLIN SCREEN AGAR, OXACILLIN DISC DIFFUSION AND CEFOXITIN DISC DIFFUSION, OXACILLIN E-TEST METHOD FOR ROUTINE SCREENING OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS International Journal of Current Research and Review. 7(10), May, 55-60
References:
1. Diekema DJ, BootsMiller DJ, Vaughn TE, Woolson RF, Yankey JW. Antimicrobial resistance trends and outbreak frequency in United States hospitals. Clin. Infect. Dis.2004; 38:78-85.
2. Goosens H. European Status of resistance in nosocomial infections. Chemotherapy.2004; 51:177-181.
3. Verma S, Joshi S, Chitnis V, Hemwani N, Chitnis D. Growing problems of Methicillin Resistance Staphylococci-Indian Scenario Indian J. Med Sci 2000;54(12):535-40.
4. Rajaduraipandi K, Mani KR, Panneerselvam K, Mani M, Bhaskar M and Manikandan P. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: A multicentre study. Indian J. Med. Microbiol 2006;24(1):34-8.
5. Chambers HF. The changing epidemiology of staphylococcus aureus Emerg. Infec. Dis.2001;7:178-182.
6. Brown DF, Edward DI, Hawkey PM, Morrison D, Ridgway GL, Towner KJ, et.al. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant staphylococcus aureus (MRSA). J. Antimicrob chemother 2005; 56(6):1000-18
7. Rabhar M, Yaghoobi M, Fattahi A.Comparision of different laboratory methods for detection of Methicillin Resistant Staphylococcus aureus.Pak J med Sci. 2006;22(4):442-5.
8. Brown D.F. Detection of methicillin/oxacillin Resistance in staphylococci. J Antimicrob chemother. 2001;48 suppl 1:65-70.
9. Swenson JM, Patel JB, Jorgensen JK. Special phenotypic methods for detecting antibacterial resistance, chapter 74. In:Murray PR, Baron ES, Jorgensen JH, Landry ML Pfaller MA, editors. Manual of Clinical Microbiology. 9th ed. Washington DC:ASM Press 2007 P.1175-76.
10. Tiemersma EW, Bronzwaer SL, Lyytikainen O, Degener JE, Schrijnemakers P, Bruinsma N, et.al. Methicillin-resistant staphylococcus aureus in Europe, 1999-2002. Emerg. Inf. Dis. 2004; 10(9):34-7.
11. Tiwari HK, Sapkota D, Das AK, Sen MR. Assesment of different methods to detect Methicillin Resistnt Staphylococus aureus. Southeast Asian J.Trop Med Public Health 2009;40:801-06
12. Velasco D, Mar Tomas MD, Cartelle M, Beciero A, Perez A, Molina F et al Evaluation of different methods for detecting methicillin (oxcillin) resistance in staphylococcus aureus. J. Antimicrob Chemother 2005; 55(3):379-82.
13. Baird D, Staphylococcus : Cluster forming gram positive cocci. In:Mackie and McCartney Practical Medical Microbiology, Colle J.G, Fraser A.G., Marmion BP., Simmons A, (14th Ed) Churchill Livingstone, 1996, PP:245-261.
14. Clinical Laboratory Standard Institute. Performance standard for Antimicrobial susceptibility testing ; twentieth Informational supplement CLSI documentM100-S20.Wayne, PA:CLSI;2009
15. Swenson J.M., Williams, P.P., Killgore, G., O’Hara C.M. and Tenover FC . Performance of eight methods, including two new rapid methods, for detection of oxacillin resistance in a challenge set of staphylococcus aureus organisms J. Clin Microbial.2001; 39: 3785-3788.
16. Oberoi L, Kaur R. and Aggarwal A. Prevalence and antimicrobial susceptibility pattern of Methicillin Resistant Staphylococcus aureus (MRSA) in a rural tertiary care hospital in North India . IJABPT 2012;3(1):200-05.
17. Anupurba S, Sen MR, Nath G, Sharma BM, Gulati AK, Mohapatra T.M. Prevalence of methicillin resistant Staphylococcus aureus in tertiary referral hospital in Eastern Uttar Pradesh, Indin J. Med Microbial 2003;21(1):49-51.
18. Tiwari H.K, Sen M.R. emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India. BMC Infect Dis 2006;6:156.
19. Kumari N, Mohapatra TM, Singh YI. Prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) in a tertiary - care hospital in Eastern Nepal. J. Nepal Med Assoc 2008; 47(170):53-56.
20. Tahnkiwale SS, Roy S, Jalgaonkar SV Methicillin reistance among isolates of staphylococcus aureus: Antibiotic sensitivity pattern and phage typing. Ind J Med Sci 2002;56:330- 334.
21. Sasirekha B, Usha M.S., Amruta A.J., Ankit S, Brinda N, Dviya R. Evaluation and Comparision of different phenotypic tests to detect Methicillin Resistant Staphylococcus aureus and their Biofilm Production. Int J.PharmTech Res.2012 ; 4(2) : 532-541.
22. Ercis S, Sancak B, Hascelik G. A comparision of PCR detection of mec A with oxacillin disk susceptibility testing in different media and sceptor automated system for both staphylococcus aureus and coagulase negative staphylococci isolates. Indian J Med Microbial 2008;26(1):21-24.
23. Tiwari HK, Sapkota D, Das AK and Sen MR. Assesment of different methods to detect Methicillin Resistant Staphylococcus aureus. Southeast Asian J. Trop Med Public Health 2009;40(4):801-06.
24. Mathews A.A., Thomas M., Appalaraju B., Jayalakshmi J., Evaluation and Comparision of tests to detect methicillin Resistant S. aureus. Ind J. Pathol Microbial 2010;53(1):79- 82
25. Cauwelier B, Gordts B, Descheemaecker P, Van Landuyt H, Evaluation of a disk diffusion method with cefoxitin (30µg) for detection of methicillin resistant Staphylococcus aureus Eur. J. Clin Microbial. Infect Dis.2004; 23(5):389-392.
26. Anand K.B., Agarwal P., Kumar S., Kapila K., Comparison of cefoxitin disc dffusion test, oxacillin screen agar, and PCR for mecA gene for detection of MRSA. Ind. J. Med. Microbiol. 200; 27(1):27-29.
27. Rahbar M., Safadel N., Evalution of cefoxitin disk diffusion test for routine detection of methicillin resistant Staphylococcus aureus. Iran J. Patholol.2006;1(4):145-148.
28. Qureshi A.H., Rafi S., Qureshi S.M., Ali A.M., The current susceptibility patterns of MRSA to conventional antistaphylococcal antimicrobials at Rawalpindi. Pak. J. Med. Sci. 2004; 20:361-364.
29. Kandle S.K., Ghatole M.P., Takpare A.Y., Hittinhalli V.B., Yemul V.L., Bacteriophage typing and antibiotic sensitivity pattern of staphylococcus aureus from clinical specimen in and around Solapur (South Maharashtra). J. commun. dis. 2003; 35:17-23.
30. Udo E.E., Sweih A.N., Mokaddas e., Johny M., Dhar R., Gomaa H.H., Obaid I.A., Rotimi V.O., Antibacterial resistance and their genetic location in MRSA isolated in Kuwait hospitals, 1994-2004. BMC Infect. Dis.;2006, 6(1):168.
31.Baddour MM, Abuelkheir MM, Fatani AJ. Comparison of mecA polymerase chain reaction with phenotypic methods for the detection of methicillin-resistant Staphylococcus aureus. Curr. Microbiol.2007; 55: 73-479.
32. Jain A, Agarwal A, Verma RK . Cefoxitin disc diffusion test for detection of meticillin-resistant Staphylococci. J. Med. Microbiol.2008; 57:957-961.
33. Matos PD, Schuenck RP, Cavalcante FS, Caboclo RM, Santos KR . Accuracy of phenotypic methicillin susceptibility methods in the detection of Staphylococcus aureus isolates carrying different SCCmec types. Mem. Inst. Oswaldo. Cruz.2010; 105:931-934.
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