Prevalence of methicillin resistant Staphylococcus aureus in Lumbini Medical College and Teaching Hospital, Palpa, Western Nepal

Abstract

BackgroundMultidrug resistant Staphylococcus aureus is common in both tertiary and primary health care settings. Emergence of methicillin resistance in S. aureus (MRSA) along with macrolide, lincosamide, streptogramin B (MLSB) has made treatment of Staphylococcal infection more challenging. The main objective of this study was to detect MRSA, MLSB (inducible; MLSBi and constitutive; MLSBc) resistant S. aureus using phenotypic methods and to determine their antibiogram.MethodsVarious samples were collected from 1981 patients who attended Lumbini Medical College and Teaching Hospital (LMCTH) during the period of 6 months from September 2015 to February 2016. Out of a total of 1981 samples, 133 S. aureus were isolated. Cefoxitin was used to detect MRSA by the disk diffusion test. Inducible clindamycin resistance (MLSBi) was detected by the D-zone test. The antibiotic profile of all isolates was tested by a modified Kirby Bauer disk diffusion method.ResultsAmong 133 S. aureus, there were 58 (43.6%) MRSA, 34 (25.6%) MLSBi and 30 (22.6%) MLSBc. Of a total of 64 MLSB, a significant proportion (62.5%) was MRSA (p < 0.001). Among 11 different antibiotics that were tested for S. aureus, MRSA showed significant resistance to 9 (p < 0.05) with the exception of vancomycin and linezolid. All the isolates were 100% sensitive to linezolid. MLSBi organisms were 100% sensitive to vancomycin and linezolid. Both MLSBi and MLSBc showed a higher degree of resistance to multiple antibiotics (p < 0.05).ConclusionsIsolation of MRSA, MLSBi and MLSBc were remarkably high. Routine use of simple and cost effective methods such as the disk diffusion test by cefoxitin for MRSA and the D-zone test for MLSBi organisms can easily identify these isolates. Antibiotic resistance profiles from this study can optimize the treatment of multi-drug resistant S. aureus.

Characteristics of Staphylococcus aureus Isolated From Clinical Specimens in a Tertiary Care Hospital, Kathmandu, Nepal

“…Among bacterial isolates, 1/4th of them were S. aureus. The findings of our study are consistent with other studies reported from School of Health & Allied Sciences, Pokhara University, 22 Chitwan, 16 B&B hospital, Lalitpur, 30 Manipal Teaching Hospital, Pokhara, 31 Lumbini Medical College and Teaching Hospital, Palpa, 20 Alka Hospital, Lalitpur, 23 and Birendra Military Hospital, Kathmandu. 32 …”

“… 16 - 22 Past studies conducted at different settings in Nepal have shown the prevalence of MRSA ranging from 26.1% to 57.1%. 16 - 18 , 20 , 21 , 23 Increasingly in recent years, more studies have been carried out to explore the prevalence of MRSA infections in Nepal. Nevertheless, all these studies were mostly concentrated in phenotypic characterization with antimicrobial susceptibility test.…”

Prevalence of Staphylococcus aureus Isolated from Clinical Samples in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

“…Earlier reports of MRSA from Nepal reported a prevalence of 21.1%-69.1%. 11 , 14 - 16 Our result showed the prevalence of MRSA as 70.64% which is alarmingly high as betalactam group of drugs are extensively used in our settings to treat bacterial infections. But this study is in accordance with data published by WHO in 2014.…”

“…21 A significant difference in antibiotic resistance between MRSA and MSSA was observed in case of amikacin, ciprofloxacin, gentamycin and erythromycin which correlated with other studies from Nepal. 11 , 14 - 16 …”

Methicillin Resistant Staphylococcus aureus in Health Care Workers of a Tertiary Care Infectious Disease Hospital in Nepal

“…MRSA once confi ned to hospitals, health care environments and patients frequenting such facilities, now has become a serious problem for communities due to its emergence as a major cause of the community- which results the emergence of novel strains furthering the challenges in the fi ght with AMR (Thapa et al 2020). A number of studies are conducted in Nepal which have estimated the prevalence of MRSA ranging from 26.1% to 57.1% (Ansari et al 2014;Kumari et al 2008;Khanal and Jha 2010;Raut et al 2017;Bhomi et al 2016;Shahi et al 2018;Thapa et al 2020;Kandel et al 2020). Although there seems a large number of studies are based on MRSA but almost all studies are merely relied on the phenotypic detection.…”