Molecular Confirmation of Vancomycin-Resistant Staphylococcus aureus with vanA Gene from a Hospital in Kathmandu

Abstract

Staphylococcus aureus, a commensal on the skin and in the nasal cavity of humans, is one of the most serious cases of nosocomial infections. Moreover, methicillin-resistant S. aureus (MRSA) is a leading cause of morbidity and mortality worldwide. For the treatment of MRSA infections, vancomycin is considered as a drug of choice. However, the emergence of vancomycin resistance among MRSA isolates has been perceived as a formidable threat in therapeutic management. To estimate the rate of vancomycin-resistant S. aureus (VRSA) and to detect the vancomycin-resistant genes, namely, vanA and vanB, among the isolates, a hospital-based cross-sectional study was conducted from July to December 2018 in Annapurna Neurological Institute and Allied Science, Kathmandu, Nepal. S. aureus was isolated and identified from different clinical samples and processed for antibiotic susceptibility testing by the modified Kirby–Bauer disc diffusion method. The screening of MRSA was performed as per Clinical and Laboratory Standard Institute (CLSI) guidelines. VRSA was confirmed by the minimum inhibitory concentration (MIC) method by employing E-test strips. All the phenotypically confirmed VRSA were further processed to detect the vanA and vanB gene by using the conventional polymerase chain reaction (PCR) method. A total of 74 (20.3%) S. aureus were isolated, and the highest percentage of S. aureus was from the wound samples (36.5%). Of 74 S. aureus isolates, the highest number (89.2%) was resistant to penicillin, and on the other hand, linezolid was found to be an effective drug. Likewise, 45 (60.81%) were found to be MRSA, five (11.11%) were VRSA, and 93.2% of S. aureus isolates showed an MAR index greater than 0.2. Two VRSA isolates (40%) were positive for the vanA gene. The higher prevalence of MRSA and significant rate of VRSA in this study recommend routine surveillance for the MRSA and VRSA in hospital settings before empirical therapy.

Knowledge, Hygienic Practices, and Toxi-Infectious Risks Associated with Ready-to-Eat Gbeli: A Particular Chip Derived from Cassava (Manihot esculenta Crantz) Tuber Vended in Streets of Abomey-Calavi Municipality, Benin

“…SFP is characterized by gastroenteritis and has been recognized as one of the main culprits of food poisoning epidemics worldwide [ 39 ]. Methicillin-resistant strains of S. aureus (MRSA) have recently been classified as high priority bacteria with the potential to cause devastating mortality globally if adequate treatment options are not developed [ 40 ]. The presence of coagulase-positive Staphylococci in the Gbeli remains very worrying.…”

“…The fourth section was related to type of seller, while the last section was related to hygiene and production conditions (source of water, kind of packaging materials, personal hygiene of vendors, environmental sanitation, etc.). It should be noted that forty (40) producers were assisted during Gbeli production in your industrial units in order to identify all steps and conditions of the production. After each interview step, Gbeli ready-to-eat (100 g) were aseptically sampled from vendors at the point of sale.…”

Prevalence and molecular characterization of methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant Staphylococcus aureus (VRSA) in a tertiary care hospital

“…18 In this study, majority of the MRSA were isolated from pus sample which is in accordance with findings of other studies in various places and time duration. [7][8][9]15,16 Staphylococci are predominant etiology of suppurative infections that signifies reason for its high prevalence among pus specimen. 18 According to various literatures, MRSA prevalence is more common among inpatients.…”

“…2 MRSA was reported first time in Nepal in 1990 by Rai et al 3 After that, MRSA have been reported frequently along with recent VRSA infection in our country. [4][5][6][7][8] Resistance genes like mecA and vanA responsible for methicillin and vancomycin resistance respectively, have been reported from various countries including Nepal. [8][9][10][11] Severe infections with MRSA, mediated by PVL gene, also have been reported.…”

“…[4][5][6][7][8] Resistance genes like mecA and vanA responsible for methicillin and vancomycin resistance respectively, have been reported from various countries including Nepal. [8][9][10][11] Severe infections with MRSA, mediated by PVL gene, also have been reported. 9 However, such extensive studies have not been conducted in our context yet.…”