Antibiotic resistance and biofilm production among the strains of Staphylococcus aureus isolated from pus/wound swab samples in a tertiary care hospital in Nepal

Abstract

BackgroundThe increasing drug resistance along with inducible clindamycin resistance, methicillin resistance and biofilm production among the strains of Staphylococcus aureus are present as the serious problems to the successful treatment of the infections caused by S. aureus. So, the main objectives of this study were to determine the antimicrobial susceptibility patterns along with the rates of inducible clindamycin resistance, methicillin resistance and biofilm production among the strains of S. aureus isolated from pus/wound swab samples.MethodsA total of 830 non-repeated pus/wound swab samples were processed using standard microbiological techniques. The colonies grown were identified on the basis of colony morphology, Gram’s stain and biochemical tests. Antimicrobial susceptibility testing was performed by Kirby–Bauer disc diffusion technique. Detection of inducible clindamycin resistance was performed by D test, while detection of methicillin resistant S. aureus (MRSA) was performed by determination of minimum inhibitory concentration of oxacillin by agar dilution method. Similarly, detection of biofilm formation was performed by microtiter plate method. Strains showing resistance to three or more than three different classes of antibiotics were considered multidrug resistant.ResultsTotal 76 samples showed the growth of S. aureus, among which 36 (47.4%) contained MRSA and 17 (22.4%) samples were found to have S. aureus showing inducible clindamycin resistance. Among the S. aureus isolated from outpatients, 41.9% were MRSA. Highest rates of susceptibility of S. aureus were seen toward linezolid (100%) and vancomycin (100%). Similarly, S. aureus isolated from 35 (46.1%) samples were found to be biofilm producers. Higher rate of inducible clindamycin resistance was seen among MRSA in comparison to methicillin susceptible S. aureus (MSSA). Similarly, higher rates of multidrug resistance and methicillin resistance were found among biofilm producing strains in comparison to biofilm non producing strains.ConclusionsThe rate of isolation of MRSA from community acquired infections was found to be high in Nepal. Increased rate of inducible clindamycin resistance as compared to previous studies in Nepal was noted. So for the proper management of the infections caused by S. aureus, D test for the detection of inducible clindamycin resistance should be included in the routine laboratory diagnosis. Further, detection of biofilm production should also be included in the routine tests. Linezolid and vancomycin can be used for the preliminary treatment of the serious infections caused by S. aureus.

A Sea Hare L-Amino Acid Oxidase to Fight Multiple Antibiotic-Resistant Staphylococcus Aureus

“…Resistance to erythromycin, sulfamethoxazole-trimethoprim and clindamycin reached 58%, 43% and 28%, respectively. Particularly among the MRSA, the prevalence of resistant to those antibiotics was very elevate (87%, 83% and 60%, respectively) in comparison to the rates reported in previous studies [20][21][22]. Nowadays, it is common to see such resistance profiles, especially against clindamycin, due to haphazard use of these antibiotics [22].…”

“…Other studies have also reported high prevalence of MRSA in clinical samples [20][21][22]. Nowadays, vancomycin is used as drug of choice for treating MRSA, but the emergence of vancomycin intermediate-sensitive S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA) has limited even this therapeutic route [2].…”

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“…Other studies have also reported high prevalence of MRSA in clinical samples [20][21][22]. Nowadays, vancomycin is used as drug of choice for treating MRSA, but the emergence of vancomycin intermediate-sensitive S. aureus (VISA) and vancomycin-resistant S. aureus (VRSA) has limited even this therapeutic route [2].…”

When Micro Drives the Macro: A Fresh Look at Disease and its Massive Contributions in the Hindu Kush-Himalaya

“…Antibiotic resistance has been one of the biggest threats for environmental, public, and veterinary health resulting in the failure of treatment, cost of treatment, and the increase in morbidity and mortality of the MS in Nepal (Thapa et al 2016;Baral et al 2013;Belbase et al 2017). This issue is evidenced by identification of the resistivity of one or more antibiotic/s to Acinetobacter, Citrobacter, Enterobacter, E. coli, Mycobacterium tuberculosis, Pseudomonas, Vibrio cholerae, Klebsiella pneumoniae, Proteus, Staphylococcus, Streptococcus pneumoniae, S. pyogenes, Shigella spp., S. typhi, S. paratyphi A, Salmonella species, Neisseria gonorrhoeae, in clinical, subclinical, veterinary, and environmental samples (Lamichhane et al 2014;Chaudhary et al 2017;Rijal et al 2017;Bansal et al 2015;Dhakal et al 2007).…”