Recent pattern of antibiotic resistance in Staphylococcus aureus clinical isolates in Eastern India and the emergence of reduced susceptibility to vancomycin

Abstract

PURPOSE: We aimed to determine the recent pattern of antibiotic resistance and assess the vancomycin susceptibility profile of clinical Staphylococcus aureus in view of emerging reports of vancomycin creep, reduced vancomycin susceptibility (RVS), including heterogeneous vancomycin-intermediate S. aureus (hVISA) and vancomycin-intermediate S. aureus, and vancomycin resistance in S. aureus isolates. MATERIALS AND METHODS: Consecutive, nonduplicate isolates of S. aureus between July 2015 and June 2016 were subjected to antimicrobial susceptibility testing using standard disk diffusion test or Etest as per the Clinical and Laboratory Standards Institute 2015. Detection of hVISA was done by glycopeptide resistance detection Etest according to the manufacturer's instructions in strains with vancomycin minimum inhibitory concentration of 1–2 μg/ml. RESULTS: A total of 284 S. aureus were obtained from pus (175, 61.6%), respiratory tract (31, 10.9%), urine (27, 9.5%), blood (25, 8.8%), body fluids (18, 6.3%), and catheter tips (8, 2.8%). 127 (44.7%) isolates were methicillin resistant, and 158 (55.6%) were multidrug resistant. High resistance was observed to penicillin (81.7%), erythromycin (62.3%), and ciprofloxacin (52.1%), whereas the resistance was low to gentamicin (5.3%), rifampicin (8.1%), and doxycycline (9.5%). Two hundred and fifty-one (88.3%) isolates were fully susceptible to vancomycin, whereas 33 (11.6%) demonstrated RVS. All were uniformly susceptible to linezolid, tigecycline, and daptomycin. CONCLUSIONS: A moderately high percentage of S. aureus isolates demonstrated RVS, which may limit its usefulness in methicillin-resistant isolates and may be associated with increased complications in methicillin-susceptible infections. In view of increasing glycopeptide resistance, the susceptibility status of vancomycin along with other antibiotics among clinical S. aureus isolates should be investigated periodically.

Prevalence of Vancomycin Resistance among Clinical Isolates of MRSA from Different Governorates in Egypt

“…The levels of resistance to azithromycin and doxycycline were found to be 37.80%, while resistance to gentamicin was 22.05%. These levels were higher compared to Mohanty et al 26 . However, in our study we reported a lower resistance level to levofloxacin and ciprofloxacin compared to Mohanty et al (2019) who reported a higher resistance to ciprofloxacin (52.1%) 26 .…”

“…These levels were higher compared to Mohanty et al 26 . However, in our study we reported a lower resistance level to levofloxacin and ciprofloxacin compared to Mohanty et al (2019) who reported a higher resistance to ciprofloxacin (52.1%) 26 . For nitrofurantoin, the level of resistance was 19.96% which is comparable to 20% resistance reported by Hasan et al 27 .…”

The Prevalence and Antimicrobial Susceptibility Pattern of Gram-Positive Pathogens: Three-Year Study at a Tertiary Care Hospital in Mumbai, India

“… 10 Among the S. aureus , the overall MRSA prevalence in our study was 33.6% which was lower than studies from various centers across India where the prevalence rates vary from 38.6% to 52%. 15 16 17 Moreover, we observed that the MRSA prevalence rose from 29.5% in 2016 to 35% in 2018. This pattern was very similar to the recent reports which highlighted that over a decade, the MRSA prevalence has gradually escalated from 29% in 2009 18 to 39% in 2018.…”

Antimicrobial Resistance: The 'Other' Pandemic!

“…ICMR reports 50% of nosocomial S. aureus as methicillin resistant in the year 2020 [ 16 ]. Few centers are now reporting high vancomycin MICs of 2 µg/mL (though classified as sensitive, this MIC is often associated with failure of therapy) [ 35 ]. The prevalence of vancomycin intermediate S. aureus (VISA) and vancomycin resistant S. aureus (VRSA) is low in India.…”