Vancomycin Resistant Staphylococcus aureus
Reported from Tertiary Care Hospital in Nepal
Urmila Lama1, Dharmendra Shah2,
Upendra Thapa Shrestha3*
1 Department of
Microbiology, Kantipur College of Medical Science, Sitapaila, Kathmandu
2 Manmohan Memorial
Medical College and Teaching Hospital, Swoyambhu, Kathmandu
3 Central Department
of Microbiology, Tribhuvan University, Kirtipur, Kathmandu
*Corresponding address: Upendra Thapa
Shrestha, Central Department of Microbiology, Tribhuvan University, Kirtipur
Email: upendrats@gmail.com
ABSTRACT
Objectives: The study was conducted to assess the rate of Methicillin-resistant Staphylococcus aureus (MRSA) among
patients and healthcare personnel at Manmohan Memorial College and Teaching Hospital,
Kathmandu, Nepal and to evaluate the minimum inhibitory concentration of
Vancomycin to MRSA isolates.
Methods: A total of 1433 different clinical specimens from patients and 33 nasal
swabs from healthcare personnel were subjected to bacteriological investigation
following standard protocol. S. aureus
were isolated and identified by using standard Microbiological tools. Those
isolates were subjected to Antimicrobial susceptibility testing using modified
Kirby-Bauer’s disc diffusion method following CLSI guidelines.
Results: The rate of S. aureus carriage
was found to be 65 (18.9%) in the samples from clinical patients and 24 (72.7%)
in the samples from healthcare personnel. The rate of MRSA was found to be 57 (85.1%)
in patients and 24 (100%) in healthcare personnel. The high distribution of
MRSA was found in female of age group 21-30 years (patients: 10.4%; healthcare
personnel: 70.8%). Amikacin was found to be most effective antimicrobial. All S. aureus isolates were found to be
multidrug resistant (100%). On performing D-test, 10 (17.5%) and 22 (38.6%) of MRSA from clinical
specimens showed inducible and constitutive Clindamycin resistance
respectively. Whereas, 11 (45.8%) and 4
(16.7%) of MRSA from nasal swabs were found to be inducible and constitutive
Clindamycin resistance respectively. Upon performing minimum
inhibitory concentration (MIC) test for clinical isolates, 3.5% (2) of MRSA
were found to be Vancomycin resistant (VRSA), 54.4% (31) were Vancomycin
intermediate (VISA) and 42.1% (24) were found to be Vancomycin sensitive (VSSA).
All of the nasal swab MRSA isolates were found sensitive to Vancomycin. Congo
red agar method was done for biofilm production. For clinical isolates, 32
(47.8%) were found to be strong, 6 (8.9%) moderate and 29 (43.3%) were non
biofilm producer. For nasal swab isolates, 66.7% (16) and 33.3% (8) were found
as strong and non-biofilm producer respectively.
Conclusion: This study reported the case of VRSA which hasn’t been reported in Nepal.
Though present study showed that Vancomycin remains the main choice of
treatment of MRSA infection. Therefore, to preserve its value, use of
vancomycin should be limited only to those cases where there are clearly
needed.
For full article: Please download from the link below
https://microbiotu.edu.np/index.php/journals/
For Citation: Lama et al. 2017; TUJM 4(1): 63-72
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