PREVALENCE AND ANTIBIOGRAM OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS ISOLATES AT A TERTIARY CARE HOSPITAL IN BANGALORE, SOUTH INDIA

Kala Yadhav M. L.; Gayathri J. Panicker

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IJCRR - 6(17), September, 2014

Pages: 37-40

PREVALENCE AND ANTIBIOGRAM OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS ISOLATES AT A TERTIARY CARE HOSPITAL IN BANGALORE, SOUTH INDIA

Author: Kala Yadhav M. L., Gayathri J. Panicker

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Abstract:

Background: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. MRSA is an important cause of nosocomial infections worldwide. Objectives: The aim of this study was to determine the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) from clinical samples in a tertiary care hospital and to analyse the antibiotic susceptibility patterns of MRSA isolates. Materials and Methods: Various clinical specimens were cultured and staphylococcus aureus was identified using standard tests like catalase test, slide and tube coagulase and growth on Mannitol salt Agar. All staph isolates were then tested for routine antibiotic sensitivity by Kirby - Bauer disc – diffusion method following CLSI guidelines. MRSA were then identified from amongst the Staph isolates by using cefoxitin (10 mcg) discs by the disc-diffusion method. The D-test was performed on all isolates of Staphylococcus aureus to identify erythromycin induced clindamycin resistance. Results: The prevalence of MRSA in our study was found to be 66.84%. Linezolid and Vancomycin proved to be effective against 93.89% and 89.31% of MRSA isolates. There was statistically significant resistance to Penicillin,Cefoxitin and Oxacillin (p<0.0001) and significant sensistivity to Linezolid and Vancomycin among MRSA. Also, 35.11% of MRSA isolates and 24.62% of MSSA isolates showed erythromycin induced clindamycin resistance in the study. Conclusion: MRSA infection in the hospital set up is on the rise and is a cause of worry due to resistance to commonly prescribed drugs. Regular surveillance and antibiotic sensitivity testing in hospitals can help to formulate antibiotic and other strategies for reducing the load and severity of MRSA infections world-over.

Keywords: Staphylococcus aureus, MRSA, Cefoxitin, Clindamycin, Linezolid, Vancomycin.

Citation:

Kala Yadhav M. L., Gayathri J. Panicker. PREVALENCE AND ANTIBIOGRAM OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS ISOLATES AT A TERTIARY CARE HOSPITAL IN BANGALORE, SOUTH INDIA International Journal of Current Research and Review. 6(17), September, 37-40

References:

1. Vidya Pai, Venkatakrishna I Rao, and Sunil P Rao. Prevalence and Antimicrobial Susceptibility Pattern of Methicillin-resistant Staphylococcus Aureus [MRSA] Isolates at a Tertiary Care Hospital in Mangalore, South India. J Lab Physicians. 2010 Jul-Dec;2(2):82-84. Cookson B. Staphylococcus aureus. In: Emmerson M, Kibbler C, Hawkey P eds. Principles of Clinical Bacteriology. Oxford: John Wiley, 1997; 109–30.

2. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. Clinical and Laboratory Standards Institute, Wayne, PA 2012.

3. Cookson B. Staphylococcus aureus. In: Emmerson M, Kibbler C, Hawkey P eds. Principles of Clinical Bacteriology. Oxford: John Wiley, 1997; 109–30.

4. Chandrashekar D K et al. Prevalence of Methicillin Resistant Staphylococcus aureus in a tertiary care hospital in Gulbarga, Karnataka, J. of Pharmaceutical and Biomedical Sciences. June 2012,19(19)1-3.

5. Shilpa Arora, Pushpa Devi, Usha Arora, Bimla Devi. Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in a tertiary care hospital in Northern India. J Lab Physicians. 2010 Jul-Dec;2(2):78-81.

6. Tiwari HK, Sapkota D, Sen MR. High prevalence of multidrug-resistant MRSA in a tertiary care hospital of northern India. Infection and Drug Resistance. 2008;1:57–61

7. Bal AM1 , Gould IM. Antibiotic resistance in Staphylococcus aureus and its relevance in therapy. Expert Opin Pharmacother. October 2005;6(13):2257-69.

8. Kandle SK, Ghatole MP, Takpere AY, Hittinhalli VB, Yemul VL. 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

9. Yilmaz G, Aydin K, Iskender S, Caylan R, Koksal I. Detection and prevalence of inducible clindamycin resistance in staphylococci. J Med Microbiol. 2007;56:342–5.

10. Kavitha Prabhu, Sunil Rao, and Venkatakrishna Rao. Inducible Clindamycin Resistance in Staphylococcus aureus Isolated from Clinical Samples. J Lab Physicians. 2011 JanJun; 3(1): 25–27.

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