Original Articles

Current Antibiotic Resistance Trend in Clinical Isolates of Staphylococcus aureus from a Tertiary Care Hospital

Abstract

Background: Staphylococcus aureus (S. aureus) has remained always an important pathogen of common infections acquired in community and as  well as serious nosocomial infections. With advent of penicillins and cephalosporins, infections could be effectively treated, but with the global emergence of Methicillin Resistant Staphylococcus aureus strains (MRSA) physicians were  again left  with limited treatment options. This scenario of increasing resistance is even more intense and challenging for developing countries like Pakistan. Hence with this background the study was carried out to establish the frequency of MRSA in clinical specimens and look into the available antibiotic treatment options.Methods: Samples of  pus, blood, urine, body fluids and catheter tips submitted for culture  in  Microbiology department between  August  to  September  2012,  from outdoor and indoor adult patients of Pakistan Institute of Medical Sciences Islamabad, yielding growth of S. aureus were included in the study. After identification by  standard  methods, antibiotic susceptibility of  the  isolates  was performed by Kirby Baeur disc diffusion method. The study was retrospective descriptive and observational.Results: Total  106  S.  aureus  were  isolated. 45.3%  of  them  were  MRSA  and majorities were from pus samples of hospitalized patients. All MRSA were 100% sensitive to vancomycin, whereas 87.5% to chloramphenicol. To rest of the non – beta lactam drugs, resistance of 80% or more was noted.Conclusion: S. aureus is a common clinical isolate from patients in this region of Pakistan and significant number were MRSA especially from hospitalized patients. Treatment options are limited to vancomycin and chloramphenicol.

Lowy FD. Medical progress: Staphylococcus aureus infections. The New Eng J Med 1998; 339 (8):520-32.

Coia JE. Guidelines for the control and prevention of Methicillin Resistant Staphylococcus aureus (MRSA) in healthcare facilities. Hosp Infect 2006; 63 (1): 1-44.

Doebbelling BN. The epidemiology of methicillin resistant Staphylococcus aureus colonization and infection. J Chemotherapeautics 1995; 7: 99-103.

Steinberg JP, Clark CC, Hackman BO. Nosocomial and community acquired Staphylococcus aureus bacteremias from 1980 to 1993: Impact of Intravascular Devices and Methicillin Resistance. Clin Infect Dis 1996; 23: 255-9.

Apple-Baum PC. MRSA-the tip of the iceberg. Clin Microbiol Infect 2006; 12: 3-10.

Gastmeier P, Sohr D, Geffers C, et al. Mortality risk factors with nosocomial Staphylococcus aureus infections in intensive care units: Results from the German nosocomial infection surveillance system (KISS). Infection 2005; 33: 50-5.

Gould IM. The clinical significance of methicillin-resistant Staphylococcus aureus. J Hosp Infect 2005; 61: 277-82.

Ashiq B, Tareen AK. Methicillin resistant Staphylococcus aureus in a teaching hospital of Karachi-a laboratory study. J Pak Med Assoc 1989; 39: 6-9.

Hafiz S, Hafiz AN, Ali L, et al.Methicillin resistant Staphylococcus aureus: A multicentre study. J Pak Med Assoc 2002; 52: 312-515.

Hafeez R, Chughtai A, Aslam M.Prevalence and antimicrobial susceptibility of MRSA.International J Path 2004; 2 (1): 10-5.

Bukhari SZ, Ahmed S, Zia N.Antimicrobial Susceptibility Pattern of Staphylococcus aureus on Clinical isolates and Efficacy of Laboratory tests to Diagnose MRSA: A Multi- Centre Study. J Ayub Med Coll Abbottabad 2011; 23 (1): 139-42.

Centers for Disease Control and Prevention. Four pediatric deaths from community acquired methicillin- resistant S. aureus-Minnesota and North Dakota, 1997-1999. Morb. Mortal. Wkly. Rep. 48:707-710. Available at: http://www.cdc.gov/mmwr/previe w/mmwrhtml/mm4832a2.htm. Accessed April 20, 2005.

Cheesbrough M. District Laboratory Practices in Tropical Countries.2nd edition (part 2). Cambridge university press; 2005.

Performance Standards for Antimicrobial Disc Susceptibility Tests. 11th edition. CLSI Approved Standard M02-A11; January 2012. Clinical and Laboratory Standards Institute. Wayne Pa, USA. Available at: http://antimicrobianos.com.ar/ATB/ wp-content/uploads/2012/11/01-CLSI-M02-A11-2012. pdf.

Methicillin-resistant Staphylococcus aureus (MRSA) Infections. 2013 Sep 13 [updated 2014 May 28]. Centers for Disease Control and Prevention. Atlanta GA, USA. Available at: http://www.cdc.gov/mrsa/community /index.html.

Anderson DJ, Sexton DJ, Kanafani ZA, et al. Severe surgical site infection in community hospitals: epidemiology, key procedures, and the changing prevalence of methicillin-resistant Staphylococcus aureus. Infection Control and Hospital Epidemiology. Infect Control Hosp Epidemiol 2007; 28 (9):1047-53.

Hussain S, Shams R, Ahmad K, et al. Prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) in Surgical Site Infections in a Tertiary Care Hospital. International Journal of Pathology 2005; 3 (2): 81-5.

Javons MP. Calbenin-Resistant Staphylococci. B Med J 1961; i: 124-5.

Qureshi A, Rafi HS, Qureshi SM, et al. The current susceptibility patterns of methicillin resistant Staphylococcus aureus to conventional anti staphylococcus antimicrobials at Rawalpindi. Pak J Med Sci 2004; 20 (4): 361-4.

Bukhari MH. A laboratory study of susceptibility of MRSA. Pak J Med Sci 2004; 20 (3): 229-33.

Perwaiz S, Barakzi Q, Farooqi BJ, et al. Antimicrobial susceptibility pattern of clinical isolates of methicillin resistant Staphylococcus aureus. J Pak Med Assoc 2007; 57 (1): 2-4.

Malik N, Butt T, Bari A. Frequency and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus. J Coll Physicians Surg Pak 2009; 19 (5):287-90.

Kaleem F , Usman J, Hassan A, et al. Sensitivity Pattern of Methicillin Resistant Staphylococcus aureus Isolated from Patients Admitted in a Tertiary Care Hospital of Pakistan. Iran J Microbiol 2010; 2 (3): 143-6.

Rahman S, Mumtaz S, Muffti AJ.Incidence of methicillin resistant Staphylococcus aureus in Peshawar, J Ayub Med Coll Abbottabad 2011;23 (1): 99-101.

Hussain M, Basit A, Khan A, et al.Antimicrobial sensitivity pattern of methicillin resistant Staphylococcus aureus isolated from hospitals of Kohat district, Pakistan. J Inf Mol Biol 2013; 1 (1): 13-6.

Denton M, O'Connell B, Bernard P, et al. The EPISA Study: Antimicrobial Susceptibility of Staphylococcus aureus Causing Primary or Secondary Skin and Soft Tissue Infections in the Community in France, the UK and Ireland. J Antimicrob Chemother 2008; 61 (3):586-8.

Köck R, Mellmann A, Schaumburg F, et al. The Epidemiology of Methicillin-Resistant Staphylococcus aureus (MRSA) in Germany. DtschArztebl Int 2011; 108 (45): 761-7.

Dulon M, Haamann F, Peters C, et al.MRSA prevalence in European healthcare settings: a review.BMC Infect Dis 2011; 11: 138.

Beck WD, Berger-Bachi B, FH Kayser. Additional DNA in methicillin-resistant Staphylococcus aureus and molecular cloning of mec- specific DNA. J Bacteriol 1986; 165:373-8.

Schentag JJ, Hyatt JM, Carr JR, et al.Genesis of methicillin-resistant Staphylococcus aureus (MRSA), how treatment of MRSA infections has selected for vancomycin-resistant Enterococcus faecium, and the importance of antibiotic management and infection control. Clin Infect Dis 1998; 26 (5): 1204-14.

Shrestha B, Pokhrel BM, Mohapatra TM. Antibiotic susceptibility pattern of nosocomial isolates of Staphylococcus aureus in a tertiary care hospital, Nepal. J Nepal Med Assoc 2009; 48: 234-8.

Monnet DL, MacKenzie FM, López-Lozano JM, et al. Antimicrobial Drug Use and Methicillinresistant Staphylococcs aureus, Aberdeen, 1996-2000. Emerg Infect Dis 2004; 10 (8): 1432-41.

Srinivasan A, Dick JD, Perl TM.Vancomyin resistance in S. aureus.Clin microbiol Rev 2002; 15 (3): 430-38.

Mehta A, Rodriguez C, Sheath K, et al. Control of Methicillin Resistant Staphylococcus Aureus in a Tertiary Care Centre: A five Year Study. J Med Microbial 1998; 16: 31-4.

Files
IssueVol 2 No 3-4 (2013) QRcode
SectionOriginal Articles
Published2015-10-12
Keywords
Methicillin-Resistant Staphylococcus aureus Cross Infection Vancomycin

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Ravesh-Barakzai Z, Arshad-Khan J, Hussain S. Current Antibiotic Resistance Trend in Clinical Isolates of Staphylococcus aureus from a Tertiary Care Hospital. J Med Bacteriol. 2015;2(3-4):47-55.