Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis

Khanal, Ashok; Sulochan, G C; Gaire, Amrit; Khanal, Aashis; Estrada, Rolando; Ghimire, Rakesh; Panthee, Suresh

doi:10.1016/j.ijid.2020.11.152

Cited by 18 publications

(19 citation statements)

References 52 publications

(29 reference statements)

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“…Also, most of the clinical laboratories in hospitals including national-level ones rely on biochemical tests to identify organisms. By using similar methods, other different studies conducted in Nepal had reported S. aureus as the predominant bacterial pathogen [ 13 , 33 , 35 , 42 ]; moreover, a high prevalence of S. aureus was also found in different parts of the world [ 43 , 44 ]. This variation may be due to the time, type of samples, and the geographical, seasonal/climatic condition [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 93%

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

Maharjan¹,

Sah

Pyakurel³

et al. 2021

International Journal of Microbiology

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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.

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Section: Discussionmentioning

confidence: 93%

“…The finding of our study was consistent with other previous findings in Nepal [ 30 – 33 ]. However, the prevalence varies in the different parts of Nepal [ 34 , 35 ] and India [ 36 ]. This finding can show the use of beta-lactam antibiotics against Gram-positive organisms in hospital and community settings.…”

Section: Discussionmentioning

confidence: 99%

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

Maharjan¹,

Sah

Pyakurel³

et al. 2021

International Journal of Microbiology

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“…However, the increased incidence of resistance to this antibiotic led to the introduction of methicillin-the first semisynthetic penicillin. Unfortunately, methicillinresistant S. aureus (MRSA) was discovered shortly after, now belonging to multi-drug resistant organisms (MDRO) [38,39]. It is one of the most important serious opportunistic human pathogens involved in nosocomial infections.…”

Section: Discussionmentioning

confidence: 99%

“…Resistance to methicillin primarily derives from acquisition of the mecA gene, which encodes a modified penicillin-binding protein (PBP2a) with low affinity for beta-lactams [40] The treatment of MRSA infection is greatly challenging since it has developed the resistance to almost all types of antibiotics, especially from the beta-lactam group, including penicillins, cephalosporins, monobactams and carbapenems. MRSA strains have also developed resistance to various other clinically used antibiotics such as fluoroquinolones, macrolides, aminoglycosides, daptomycin, and clindamycin creating a great threat to global healthcare [38,39]. Moreover, recent studies indicates that MRSA is continuously evolving as a superbug.…”

Section: Discussionmentioning

confidence: 99%

Biological Activity, Lipophilicity and Cytotoxicity of Novel 3-Acetyl-2,5-disubstituted-1,3,4-oxadiazolines

Paruch

Biernasiuk

Berecka‐Rycerz

et al. 2021

IJMS

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Antibiotic resistance is now a global problem, and the lack of effective antimicrobial agents for the treatment of diseases caused by resistant microbes is increasing. The 3-acetyl-2,5-disubstituted-1,3,4-oxadiazolines presented in this article may provide a good starting point for the development of potential new effective antimicrobial agents useful in the treatment of bacterial and fungal infections. Particular attention is drawn to the 1,3,4-oxadiazole derivative marked with the number 29 with 5-nitrofuran-2-yl substituent in its chemical structure. This substance showed a strong bactericidal effect, especially against Staphylococcus spp., and no cytotoxicity to the L929 normal cell line.

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“…Households with individuals who work at health-care facilities (OR = 9) and those who regularly visit health-care facilities (OR = 24) have a higher prevalence of MRSA than the normal, healthy population. [ 14 ] Therefore, the S. aureus status among ophthalmic staff noted in the current study can be used to implementing strategies to mitigate the risk of MRSA infections in patients seeking eye care.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of methicillin-resistant Staphylococcus aureus and methicillin-sensitive Staphylococcus aureus carrier among staff of a tertiary eye hospital in Saudi Arabia

et al. 2021

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OBJECTIVES: The objective of this study was to estimate the prevalence and risk factors of methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) carriers among staff of a tertiary eye hospital in Saudi Arabia. METHODS: This retrospective study was conducted in 2019. Nasal and axillary swabs of health-care staff were used to determine carriers of MRSA. Bacteria were identified by culture and sensitivity tests. These isolates were grouped as antibiotic resistant, sensitive, and others not in the S. aureus group. Demographics and other determinants were associated with carrier status. RESULTS: We evaluated the carrier status of 430 staff. There were 110 (24.9%; 95% confidence interval [CI]: 21.5, 29.7) S. aureus -positive staff, 21 (11.7%; 95% CI: 11.7, 26.4) of who carried the MRSA strain. Carrier status was significantly higher among physicians (31%) compared to nurses (22.5%) and other staff (5.7%) ( P < 0.001). MRSA carrier status was significantly associated with >5 years of employment at the eye hospital ( P = 0.02). MRSA was significantly associated with staff who were of Indian nationality (75%) compared to other nationalities ( P = 0.04) and those who were at the hospital for <5-year stay compared more than 5 years at the hospital ( P = 0.001). All carriers responded to decolonization treatment. CONCLUSIONS: The high prevalence of MRSA and relatively easy treat MRSA carriers points at the need for universal screening for MRSA carriers among eye health staff.

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Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis

Cited by 18 publications

References 52 publications

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

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

Biological Activity, Lipophilicity and Cytotoxicity of Novel 3-Acetyl-2,5-disubstituted-1,3,4-oxadiazolines

Prevalence and determinants of methicillin-resistant Staphylococcus aureus and methicillin-sensitive Staphylococcus aureus carrier among staff of a tertiary eye hospital in Saudi Arabia

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