Emerging Antimicrobial Resistance in Staphylococcus and Spectrum of Oral Oxazolidinone Linezolid in Multidrug Resistant Staphylococcus in a Tertiary Care Hospital

Abstract

Introduction: Staphylococcus species is an asymptomatic colonizer which has exhibited increasing resistance to various antimicrobial agents in the recent times. Although, the organism was naturally susceptible to all the antimicrobial agents, it has acquired multi drug resistance via various mechanisms. In view of rising prevalence antimicrobial resistance, this study was undertaken to study the prevalence of methicillin resistance and the emergence of linezolid resistance amongst the Staphylococcal isolates obtained from various clinical samples in a tertiary care hospital. Material and Methods: This study was conducted from July 2017 to December 2018 in a tertiary care hospital. Clinical specimens were processed, and Staphylococcal isolates were identified using standard microbiological techniques. Antimicrobial resistance pattern of all the Staphylococcal isolates was determined and interpreted as per the latest CLSI guidelines. Results: A total of 989 Staphylococcal isolates were obtained amongst which 498 (49.44%) were found to be methicillin resistant. Highest antimicrobial resistance was observed to beta lactam antibiotics followed by azithromycin and fluoroquinolones. 26 (2.628%) strains of Staphylococcal species were found to be resistant to linezolid while they retained sensitivity to Vancomycin. Conclusion: The emergence of drug resistance in various microorganisms has been a cause of global concern. Rising trend of resistance has been observed to methicillin and linezolid especially in indoor patients of the Intensive care units. This study highlights the high prevalence of Methicillin resistance in both Staphylococcus aureus and Coagulase negative Staphylococcus species in a tertiary care hospital in Amritsar, India. Although, linezolid resistance is emerging at a slow pace, adequate measures must be undertaken to preserve the therapeutic armoury.

Linezolid-resistance Staphylococcus aureus – Prevalence, Emerging Resistance Mechanisms, Challenges and Perspectives

“…Azhar et al 48 showed 34 % and the other conducted by Thool et al 53 reported 23.5 % prevalence of LRSA in pus as given in Table. 34,36,[43][44][45]48,49,[52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71] It can be seen from the data that going through the countries (Geographical region), the majority of LRSA was from Europe and Asia. The data on Linezolid resistance in S. aureus and the cause of Linezolid resistance (if any) is not sufficiently reported among southeast Asian countries.…”