Threat of multidrug resistant Staphylococcus aureus in Western Nepal

Bhatta, Dharm Raj; Cavaco, Lina; Nath, Gopal; Gaur, Abhishek; Gokhale, Shishir; Bhatta, Dwij Raj

doi:10.1016/s2222-1808(15)60900-8

Cited by 10 publications

(17 citation statements)

References 17 publications

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“…In this study; 19.3% (110/570) samples showed growth of S. aureus which is almost similar to that of Belbase et al (2017) which showed 20.37% and 20.9% growth of S. aureus respectively [15]. However, in other studies showed 51.52% and 30.40% of S. aureus respectively, which were comparatively higher rates than that of the present study which may be because of large sample size and long study period [4,22]. In this study, the rates of infection in indoor and outdoor patients were 46.36% and 53.64% respectively which were comparable to the study of Belbase et al (2017) as inpatients (43.4%) and outpatients (56.6%) [15].…”

Section: Discussionsupporting

confidence: 61%

“…The infection was higher within the age group of 20-30 years (32.7%) and lower at 10-20 years (14.5%) and ≥60 years (10%). But in the other studies, the rates of S. aureus were higher in the age group ≤10 years which were 24% and 49.1% respectively [4,23]. Fig.…”

Section: Discussionmentioning

confidence: 84%

“…The severity of the infections ranges from mild to severe life-threatening infec-tions like septicemia, meningitis, pneumonia and endocarditis [2,3]. Infection imposes a high and increasing burden on health care resources as well as increased morbidity and mortality [4]. S. aureus produces many virulence factors, such as the production of biofilm, hemolysins, leukocidins, proteases, enterotoxins, exfoliative toxins, and immunemodulatory factors [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…The antibiotic resistance among S. aureus is a major problem and has posed a serious therapeutic challenge for clinicians [4]. The core resistance phenotype mostly associated with S. aureus persistence to methicillin is due to its expression of penicillin-binding protein, PBP 2a [14].…”

Section: Introductionmentioning

confidence: 99%

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Biofilm Formation and Detection of icaD Gene in Staphylococcus aureus Isolated from Clinical Specimens

Karki¹,

Sah²,

Lamichhane³

et al. 2019

TOMICROJ

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Background: S. aureus is found to be a major source of community as well as hospital acquired infections. The increase in antimicrobial resistance and emergence of multidrug resistance has become a big threat worldwide. The biofilm formation of S. aureus influenced the survival and persistence in both environment and host. Aim: The study was conducted with the aim to evaluate in-vitro biofilm formation and the presence of icaD gene in S. aureus from clinical isolates of S. aureus. Methods: A total of 570 wound/pus samples were processed by standard microbiological techniques. Colony morphology, Gram’s staining and biochemical tests were used for the identification of S. aureus. Antimicrobial susceptibility test was performed by Kirby-Bauer disc diffusion technique and methicillin-resistant S. aureus was detected by using cefoxitin antibiotics. The production of biofilm was screened by Congo Red Agar and finally, the presence of icaD gene was determined by PCR. Results: Out of 570 samples, a total 19.3% (110/570) samples showed the growth of S. aureus. Among which 59.1% (65/110) were multi-drug resistant. Similarly, 26.4% (29/110) isolates were methicillin-resistant S. aureus. Among MRSA isolates 93.1% (27/29) were MDR with more than 3 classes of antibiotics. Biofilm production was shown by 95.45% (105/110) and 77.3% (85/110) isolates on Congo Red Agar and presence of icaD gene respectively. Conclusion: In this study, the significant association was observed in phenotypic production of biofilm and the presence of icaD gene for the genotypic expression of biofilm. There were also increasing rates of MRSA and multidrug resistance S. aureus.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Biofilm Formation and Detection of icaD Gene in Staphylococcus aureus Isolated from Clinical Specimens

Karki¹,

Sah²,

Lamichhane³

et al. 2019

TOMICROJ

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“…MRSA isolated from prosthetic devices showed a 67% resistance to amikacin and 87% resistance to gentamycin; these results disagreed with those of a previous study. The antibiogram of azithromycin (88%), erythromycin (88%), ciprofloxacin (97%), trimethoprim/sulphamethoxazole (71%) was quite similar to that reported in a study conducted in Nepal 12 ; similar results were also reported in Iran except for fusidic acid 13 . Some studies reported a high prevalence of resistance to fusidic acid (60%) and clindamycin (71%) which strongly agreed with the results of the present study 14 .…”

supporting

confidence: 83%

Prevalence and antibiogram of methicillin resistant Staphylococcus aureus isolated from medical device-related infections; a retrospective study in Lahore, Pakistan

Sohail

Latif

2017

Rev. Soc. Bras. Med. Trop.

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Introduction: With the advancement of medicine and surgery, various types of medical devices have become part of treatment strategies. Methods: Identification and antimicrobial sensitivity testing were done according to CLSI guidelines following standard microbiological practices. Results: Urinary catheter infections (31%) were most frequent followed by central venous catheter (18%) and orthopedic implants (15%). Methicillin resistant Staphylococcus aureus (MRSA) was a major cause of device-related infection after Escherichia coli (21%); other pathogens were Klebsiella pneumoniae (14%), Pseudomonas spp. (10%), Acinetobacter spp. (8%) and Candida species (7%). None of MRSA was resistant to vancomycin (MIC ≥16µg/mL). Resistance rates were 98% and 97% for ofloxacin and ciprofloxacin, respectively. Conclusions: Escherichia coli and MRSA are major pathogens of medical device-related infections.

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Prevalence, antimicrobial susceptibility pattern and multidrug resistance of methicillin-resistantStaphylococcus aureusisolated from clinical samples at a tertiary care teaching hospital: an observational, cross-sectional study from the Himalayan country, Nepal

Adhikari,

Basyal,

Rai

et al. 2023

BMJ Open

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ObjectiveWe sought to determine the prevalence and antimicrobial susceptibility pattern of methicillin-resistantStaphylococcus aureus(MRSA) isolated from the clinical samples at a tertiary care hospital in Nepal.MethodsCross-sectional, observational study design.Study settingThe study was carried out at a tertiary care facility, the largest public hospital, Tribhuvan University Teaching Hospital (TUTH), Nepal.ParticipantsA total of 7433 clinical samples from hospital inpatients and outpatients available in the TUTH microbiology laboratory were examined. The study included clinical samples from the patients of either sex and across all age groups that had been clinically determined to haveS. aureusinfections.ResultsOf 7433 clinical samples analysed,S. aureuswas recovered from 499 (6.71%). The prevalence of MRSA was discovered to be 26.4% (95% CI 21.6% to 30.4%). The major sources of MRSA were pus, 71 (18.5%). MRSA isolates encountered 100% resistance to penicillin and cloxacillin, followed by ciprofloxacin (80.5%), erythromycin (79.8%), cephalexin (64.9%), cotrimoxazole (61.1%) and clindamycin (58.5%). Chloramphenicol (17.9%), and gentamicin (27.4%), on the other hand, exhibited minimal resistance. None of the isolates were resistant to vancomycin (0.0%). Prevalence of multidrug resistance (MDR) was markedly higher in MRSA, 94.05% (95% CI 89.4% to 98.6%), compared with methicillin-sensitiveS. aureus, 52.12% (95% CI 46.2% to 57.8%).ConclusionOur study indicated a high rate of MRSA and MDR-SA (Multidrug-resistant Staphylococcus aureus) prevalence in a Nepalese tertiary care hospital. Therefore, given the widespread burden of MRSA and the threat of the emergence of resistance to commonly used antibiotics, there is a need for the development, adoption and enforcement of appropriate control policies in these hospital settings. Regular surveillance, reporting mechanism as well as prudent use of antimicrobial agents are crucial to combating the progression of MDR-MRSA prevalence and antibiotic resistance.

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Threat of multidrug resistant Staphylococcus aureus in Western Nepal

Cited by 10 publications

References 17 publications

Biofilm Formation and Detection of icaD Gene in Staphylococcus aureus Isolated from Clinical Specimens

Biofilm Formation and Detection of icaD Gene in Staphylococcus aureus Isolated from Clinical Specimens

Prevalence and antibiogram of methicillin resistant Staphylococcus aureus isolated from medical device-related infections; a retrospective study in Lahore, Pakistan

Prevalence, antimicrobial susceptibility pattern and multidrug resistance of methicillin-resistantStaphylococcus aureusisolated from clinical samples at a tertiary care teaching hospital: an observational, cross-sectional study from the Himalayan country, Nepal

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