Changing Trends in Resistance Pattern of Methicillin Resistant Staphylococcus aureus

Abstract

Background: Methicillin resistance in Staphylococcus aureus is associated with multidrug resistance, an aggressive course, increased mortality and morbidity in both community and health care facilities. Monitoring of newly emerging and prevalent Methicillin Resistant Staphylococcus aureus (MRSA) strains for their resistance patterns to conventional as well as novel drugs, are essential for infection control. Aims:To study the changing trends in resistance patterns of MRSA at our hospital. Settings and Design:This cross sectional study was carried out in a 750 bed tertiary care hospital in south India.

Gram positive bugs - bugging us in today’s era. A study from a tertiary care hospital in Punjab (North India)

“…Increasing resistance of MRSA in recent years has had a significant impact on several aspects of patient care and infection control. Methicillin resistance is often associated with simultaneous resistance for macrolides, quinolones and Cotrimoxazole [9]. The distribution of Enterococci among the various samples, where they were most commonly found in urine and least in blood was in concordance to the trends seen among other studies [10,15].…”

“…The MRSA and VRE strains demonstrated 97.73 % susceptibility to Daptomycin, which was lower than that seen in other studies [9], [12]. Another group has reported >99 per cent susceptibility of Daptomycin against Staphylococci from Asia pacific region [21].…”

“…The same study and a few others showed lower resistance towards Clindamycin by MRSA as compared to our study (62.5 %).Clindamycin has been used successfully for the treatment of infection caused by MRSA in the past [12]. Kali et al conducted a study where MRSA isolates also showed higher resistance to Cotrimoxazole (82.3%) and Ciprofloxacin (76.4%) as compared to our data [9].…”

“…Like most of the recent studies our study also showed that none of the MRSA were resistant to Vancomycin by MIC testing using E test [9], [12] According to the clinical data of patients with confirmed VRSA in the US, several predisposing characteristics were found, including previous exposure with Vancomycin, severe underlying illness, and a history of MRSA and VRE infection or colonization. This suggests that, once MRSA strains and VRE strains occur in same patient or the surrounding environment at the same time, the probability of VRSA infections may increase [20].…”

“…Progress in medical technology and injudicious intensive use of broad spectrum antibiotics in the hospitals has been responsible for emergence of new strains of these organisms and replacement of the previous strains. These multi-drug resistant strains have now spread in the community to cause community acquired infections [9]. Enterococci has emerged as a major cause of nosocomial infections, recognized as the 3rd most common cause of bacteraemia and the second most common cause of hospital acquired urinary tract infections (second only to E.coli) [10], [11].…”