Antibiotic resistance pattern of Staphylococcus aureus with reference to MRSA isolates from pediatric patients

Abstract

Background: Staphylococcus aureus is one of the important superbugs distributed throughout the world. It causes minor skin infections to severe complications including nosocomial infections in both hospitals and community settings. These strains have multi-drug resistant property. Hence, they are difficult to manage which increase health-related costs and simultaneously intensifying the need for new antibiotics. The extent of Methicillin-Resistant Staphylococcus aureus (MRSA) in children is largely unknown. The study determines the current status of S. aureus and MRSA causing various infections in pediatric patients visiting International Friendship Children’s Hospital (IFCH). Methods: A cross-sectional study was conducted among patients visiting a hospital. Various clinical specimens were aseptically collected and processed according to standard microbiological procedures. Isolation and identification of S. aureus were done by microscopy, mannitol fermentation, and coagulase positivity. All identified S. aureus isolates subjected to in-vitro antibiogram by Kirby-Bauer disc diffusion technique adopting Clinical and Laboratory Standards Institute (CLSI) guideline. Isolates resistant to cefoxitin were considered to be MRSA. Whereas, isolates produced D-shaped inhibition zone around clindamycin when kept near erythromycin were considered to be Inducible Clindamycin Resistant (ICR). Results: 672 various types of clinical samples were processed from the microbiology laboratory from June and November 2015. Out of 300 culture positive samples, 52 (17.3%) were S. aureus isolates, among them 39 (75.0%) were found to be MRSA. The D-test showed that Macrolide-Lincosamide-Streptogramin-B (MLSB) phenotype was 15.4%. Conclusion: The study shows the MRSA occurrence is prevalent in pediatric patients and newer classes’ drugs are found more effective than β-lactam drugs to treat S. aureus infection. However, restriction on the indiscriminate use of such drugs may be an effective strategy to control the drug resistance. Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Macrolide-Lincosamide-Streptogramin B (MLSB) phenotype, Inducible Clindamycin Resistant (ICR) test or D-zone test, Antibiotic resistance, Nepal

Antibiotic use and resistance pattern at Rumphi District Hospital in Malawi: a retrospective study

“…For instance, Methicillin resistant staphylococcus aureus (MRSA) detected by a 30 µg cefoxitin disk antibiotic expressed resistance towards cephalosporins, oroquinolones, penicillins and macrolides but were usually susceptible to Vancomycin, Chloramphenicol, Tobramycin, Amikacin, Nitrofurantoin, and Tetracycline. The ndings are supported by other previous studies which also found MRSA expressing 100% resistance to penicillins such as ampicillin and 100% sensitivity to Vancomycin [12]. MRSA as well as the intrinsically resistant Pseudomonas aeruginosa are the common cause of hospital acquired infections that make a successful empirical therapy much more di cult to achieve [25].…”

“…Observing antimicrobial resistance (AMR) trends allows for timely identi cation of emerging superbugs as well as developing new interventions, including updating the available national standard treatment guidelines [12]. As part of ensuring full participation in the ght against AMR, Rumphi district hospital antimicrobial stewardships (AMS) committee has been conducting series of AMS activities including participating in global point prevalent survey (GPPS); reviewing and presenting laboratory ndings on AMR and as well as facilitating awareness campaigns to educate healthcare workers on appropriate antibiotics prescribing practices.…”

Meticillin-susceptible Staphylococcus aureus transmission among healthcare workers, patients and the environment in a large acute hospital under non-outbreak conditions investigated using whole-genome sequencing

“…Antimicrobial susceptibility profiling, including meticillin susceptibility confirmation using 30-mg cefoxitin disks (Oxoid, Basingstoke, UK), was undertaken as described previously using a panel of 23 antimicrobial agents and heavy metals by disk diffusion using the European Committee on Antimicrobial Susceptibility Testing methodology and interpretive criteria [13,14]. Isolates were deemed to be multi-drug resistant (MDR) if they exhibited resistance to at least three antibiotic classes in clinical use [15].…”

Antibiotic Resistance Phenotypes of S. Aureus Isolates From Nose and Pharynx of Healthy Young Adults

“…Staphylococcus aureus is very often involved in various types of infections in hospitals and community and especially the methicillin-resistant S. aureus (MRSA) causes a lot of serious health and socioeconomic problems [1,4,7,8,12,13,[15][16][17]. Healthy nasal carriers of S. aureus are estimated to account for approximately 30% of the world's population [10], but some publications suggest that the frequency of nasal carriage of S. aureus is 20 -70%.…”