Screening and Detection of Heterogenous Vancomycin Intermediate Staphylococcus aureus in Hospital Kuala Lumpur Malaysia, Using the Glycopeptide Resistance Detection Etest and Population Analysis Profiling

Ramli, Siti Roszilawati; Neoh, Hui Min; Aziz, Muhammad Nazri; Hussin, Supyan

doi:10.4081/idr.2012.e20

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…Reduced susceptibility of S. aureus to vancomycin has been increasingly reported worldwide, constituting one of the major global AMR problems [ 26 ]. Heterogeneous vancomycin-intermediate S. aureus (hVISA) associated with treatment failure has emerged in Malaysian hospitals since 2009 and was increasingly reported during the past decade [ 27 , 28 ]. Local health authorities should closely monitor vancomycin use in the healthcare settings to slow down, if not completely prevent, the development of resistance to this last-resort drug for the treatment of MRSA infections.…”

Section: Discussionmentioning

confidence: 99%

Genetic mechanisms and correlated risk factors of antimicrobial-resistant ESKAPEE pathogens isolated in a tertiary hospital in Malaysia

Ngoi

Chong

Ponnampalavanar

et al. 2021

Antimicrob Resist Infect Control

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Background Knowledge on the epidemiology, genotypic and phenotypic features of antimicrobial-resistant (AMR) ESKAPEE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., and Escherichia coli) and their association with hospital-acquired infections (HAIs) are limited in Malaysia. Therefore, we evaluated the AMR features and resistance mechanisms of the ESKAPEE pathogens collected in a tertiary hospital located in the capital of Malaysia. Methods A total of 378 AMR-ESKAPEE strains were obtained based on convenience sampling over a nine-month study period (2019–2020). All strains were subjected to disk diffusion and broth microdilution assays to determine the antimicrobial susceptibility profiles. Polymerase chain reaction (PCR) and DNA sequence analyses were performed to determine the AMR genes profiles of the non-susceptible strains. Chi-square test and logistic regression analyses were used to correlate the AMR profiles and clinical data to determine the risk factors associated with HAIs. Results High rates of multidrug resistance (MDR) were observed in A. baumannii, K. pneumoniae, E. coli, and S. aureus (69–89%). All organisms except E. coli were frequently associated with HAIs (61–94%). Non-susceptibility to the last-resort drugs vancomycin (in Enterococcus spp. and S. aureus), carbapenems (in A. baumannii, P. aeruginosa, and Enterobacteriaceae), and colistin (in Enterobacteriaceae) were observed. Both A. baumannii and K. pneumoniae harbored a wide array of extended-spectrum β-lactamase genes (blaTEM, blaSHV, blaCTX-M, blaOXA). Metallo-β-lactamase genes (blaVEB, blaVIM, blaNDM) were detected in carbapenem-resistant strains, at a higher frequency compared to other local reports. We detected two novel mutations in the quinolone-resistant determining region of the gyrA in fluoroquinolone-resistant E. coli (Leu-102-Ala; Gly-105-Val). Microbial resistance to ampicillin, methicillin, and cephalosporins was identified as important risk factors associated with HAIs in the hospital. Conclusion Overall, our findings may provide valuable insight into the microbial resistance pattern and the risk factors of ESKAPEE-associated HAIs in a tertiary hospital located in central Peninsular Malaysia. The data obtained in this study may contribute to informing better hospital infection control in this region.

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Section: Discussionmentioning

confidence: 99%

Genetic mechanisms and correlated risk factors of antimicrobial-resistant ESKAPEE pathogens isolated in a tertiary hospital in Malaysia

Ngoi

Chong

Ponnampalavanar

et al. 2021

Antimicrob Resist Infect Control

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“…So far, no MRSA isolate in Malaysia has been reported to be fully resistant to vancomycin, though incidence of hetero-VISAs (vancomycin intermediate S. aureus ) and vancomycin MIC creep have been reported [ 10 , 13 , 30 , 31 ]. We did not perform vancomycin MIC determination for our MRSA strains during the first phase of HCTM’s surveillance.…”

Section: Discussionmentioning

confidence: 99%

Methicillin-Resistant Staphylococcus aureus (MRSA) Clonal Replacement in a Malaysian Teaching Hospital: Findings from an Eight-Year Interval Molecular Surveillance

et al. 2021

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Periodical surveillance on nosocomial pathogens is important for antimicrobial stewardship and infection control. The first methicillin-resistant Staphylococcus aureus (MRSA) molecular surveillance in Hospital Canselor Tuanku Muhriz (HCTM), a Malaysian teaching hospital, was performed in 2009. The dominant clone was identified as an MRSA carrying SCCmec type III-SCCmercury with ccrC and sea+cna toxin genes. In this study, we report the findings of the second HCTM MRSA surveillance carried out in 2017, after an interval of 8 years. Antibiotic susceptibility testing, SCCmec, toxin gene, and spa typing were performed for 222 MRSA strains isolated in 2017. Most strains were resistant to ciprofloxacin, erythromycin, clindamycin, cefoxitin, and penicillin (n = 126, 56.8%), belong to SCCmec type IV (n = 205, 92.3%), spa type t032 (n = 160, 72.1%) and harboured seg+sei toxin genes (n = 172, 77.5%). There was significant association between resistance of the aforementioned antibiotics with SCCmec type IV (p < 0.05), t032 (p < 0.001), and seg+sei carriage (p < 0.05). Results from this second MRSA surveillance revealed the occurrence of clonal replacement in HCTM during an interval of not more than 8 years. Investigation of the corresponding phenotype changes in this new dominant MRSA clone is currently on-going.

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Global distribution of heterogeneous vancomycin-intermediate Staphylococcus aureus strains (1997–2021): a systematic review and meta-analysis

Keikha,

Karbalaei

2024

Journal of Global Antimicrobial Resistance

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Screening and Detection of Heterogenous Vancomycin Intermediate Staphylococcus aureus in Hospital Kuala Lumpur Malaysia, Using the Glycopeptide Resistance Detection Etest and Population Analysis Profiling

Cited by 7 publications

References 10 publications

Genetic mechanisms and correlated risk factors of antimicrobial-resistant ESKAPEE pathogens isolated in a tertiary hospital in Malaysia

Genetic mechanisms and correlated risk factors of antimicrobial-resistant ESKAPEE pathogens isolated in a tertiary hospital in Malaysia

Methicillin-Resistant Staphylococcus aureus (MRSA) Clonal Replacement in a Malaysian Teaching Hospital: Findings from an Eight-Year Interval Molecular Surveillance

Global distribution of heterogeneous vancomycin-intermediate Staphylococcus aureus strains (1997–2021): a systematic review and meta-analysis

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