Microbiological profile and antibiotic susceptibility pattern of Gram-positive isolates at a tertiary care hospital

Abstract

OBJECTIVES: Gram-positive infections such as those by Staphylococcus aureus have contributed to the disease burden by increasing the morbidity and mortality rates in India. This study aims to determine the prevalence and the antibiotic susceptibility pattern of Gram-positive pathogens at a tertiary care hospital, Mumbai, Maharashtra, India. MATERIALS AND METHODS: This retrospective cross-sectional study was carried out from January, 2015 to December, 2017, at a tertiary care hospital in Mumbai, India. The clinical isolates were cultured, and identification was done using Vitek 2 culture system. The antibiotic susceptibility testing was done as per the Clinical Laboratory Standard Institute guidelines. RESULTS: Out of 2132 (29%) Gram-positive isolates, S. aureus (49%) was the most common encountered pathogen, followed by Enterococcus spp. (24.5%) and coagulase-negative Staphylococcus (16%). Majority of the S. aureus were observed in patients with skin and soft-tissue infections (61.2%) followed by those suffering from respiratory (41%) and bloodstream infections (35%). Among the infections caused by S. aureus, the prevalence of methicillin resistance was 30%. While the MRSA isolates showed lower sensitivity toward co-trimoxazole (39%), clindamycin (30%), erythromycin (23%), and ciprofloxacin (10%), they showed higher susceptibility to linezolid (98%), vancomycin (98%), and teicoplanin (98%). All the isolates were found to be sensitive to daptomycin and tigecycline. While vancomycin-resistant enterococci (VRE) formed 7.5%, the linezolid-resistant enterococcus species was as high as 4.1%. CONCLUSION: The study showed a high prevalence of MRSA and VRE, thereby emphasizing the increasing antimicrobial resistance pattern of the Gram-positive pathogens. Therefore, there is an urgent need for novel antimicrobial stewardship to restrict the ongoing resistance rate among the isolates.

Profile of Staphylococcus Aureus Isolated From Patients Admitted in a Tertiary Care Hospital With Especial Reference To Methicillin Resistance

“…However, all our clinical isolates of S.aureus showed higher susceptibility to linezolid, vancomycin and teicoplanin (100% each). Similarly, higher susceptibility to linezolid (98%), vancomycin (98%), 9 and teicoplanin (98% )have been reported by others, thus emphasizing judicious use of these reserve drug in routine clinical 13 practice. Antibiotics like linezolid and vancomycin are the only alternative therapeutic agents for these MDR pathogens.…”

Antibiotic Susceptibility Pattern of Methicillin Sensitive and Resistant Staphylococcus aureus from Clinical Isolates in a Tertiary Care Hospital at Mathura, Western Uttar Pradesh

“…In the current study we report a prevalence of 67.3% in this hospital. Other studies have documented 20.3% of MRSA from Gujarat, 26.14% from Nepal, 29% from Mumbai and Mangalore, 53% from Pune and around 80% from Bubaneswar showing the varying prevalence of MRSA [15][16][17][18][19][20] . This wide variation in prevalence rate might be due to study design, inclusion and exclusion criteria, types of specimen, laboratory protocols, study duration, population included, phenotypic or genotypic characteristics studied etc.…”

“…Researchers have also reported varying level of resistance to clindamycin and doxycycline among MRSA. Gupta et al 6 in his studies reported 75.5% of MRSA isolates were resistant to clindamycin and in contrast, Mamtora et al 17 reported 73% of MSSA strains were resistant. In our study 50% of MRSA and 25% of the MSSA strains were resistant to clindamycin.…”

“…Data on the prevalence of MRSA is not uniform. Literature has documented a significant variation in the prevalence rate from different parts of India and between countries [1][2][3][4][5][6][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] . Studies from India report MRSA prevalence ranging from 6.9% to 87% 9 .…”

Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital

“…On the other hand, they reported that resistance to vancomycin (34.0%) and teicoplanin (18.8%) was more frequent in E. faecium strains. Mamtora et al [11] reported that Enterococcus spp were highly susceptible to linezolid (96%), vancomycin (92%), and teicoplanin (93.3%) while being resistant to erythromycin and ciprofloxacin. Zallipour et al [12] reported the highest antibiotic resistance rates against tetracycline (93.5%), erythromycin (87%), and ciprofloxacin (80%) in E. faecalis isolates.…”