Staphylococcus aureus: prevalence and shifting antibiotic landscape in clinical samples from a tertiary care hospital
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20252841Keywords:
Antimicrobial resistance, Methicillin resistance Staphylococcus aureus, Hospital acquired infectionsAbstract
Background: Staphylococcus aureus is a versatile pathogen causing myriads of detrimental infections in both hospital-acquired and community-acquired settings with its notorious ability to develop antimicrobial resistance (AMR). As the world is battling the persistent rise in antimicrobial resistance (AMR), MRSA (Methicillin-resistant Staphylococcus aureus) is a major concern. Adequate data and information about evolving landscape of antibiotic resistance in S. aureus is essential for effective interventions to contain the global crisis of AMR.
Methods: A total of 1545 isolates of S. aureus from various clinical samples received from January 01, 2023 to December 31, 2023 in a tertiary care hospital were screened for their antibiotic susceptibility pattern (AST). AST was performed by Kirby Bauer Disc diffusion and MIC determination by VITEK 2 AST system and interpretation done as per CLSI M100-S33, 2023 guidelines.
Results: Out of 30,000 clinical samples received and 21% culture positives, S. aureus was found in 5.15% (1545) of cases with 62% being MRSA. A predominance in 20-30 years with female preponderance seen. Cotrimoxazole (82%) was the most effective antibiotic, followed by gentamicin (78%) and clindamicin (71%). While penicillin resistance stood at 96%, and ciprofloxacin reached 91%.
Conclusions: A constant shift is resistance pattern with rising prevalence of MRSA isolates, makes it imperative to customize the treatment protocols as per the healthcare specific antibiogram. Continual screening for S. aureus infections and analysing its antibiotic profile is mandatory to update clinicians on effective clinical management, preventing prolonged hospitalization, compromised patient outcomes, and increased burden on healthcare expenses.
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References
Myles IA, Datta SK. Staphylococcus aureus: an introduction. Semin Immunopathol. 2012;34(2):181-84. DOI: https://doi.org/10.1007/s00281-011-0301-9
Frank DN, Feazel LM, Bessesen MT, Price CS, Janoff EN, Pace NR. The human nasal microbiota and Staphylococcus aureus carriage. PLoS One. 2010;5(5):e10598. DOI: https://doi.org/10.1371/journal.pone.0010598
Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015;28(3):603-61. DOI: https://doi.org/10.1128/CMR.00134-14
Turner NA, Sharma-Kuinkel BK, Maskarinec SA, Eichenberger EM, Shah PP, Carugati M, et al. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nat Rev Microbiol. 2019;17(4):203-18. DOI: https://doi.org/10.1038/s41579-018-0147-4
Ajulo S, Awosile B. Global antimicrobial resistance and use surveillance system (GLASS 2022): Investigating the relationship between antimicrobial resistance and antimicrobial consumption data across the participating countries. PLoS One. 2024;19(2):e0297921. DOI: https://doi.org/10.1371/journal.pone.0297921
CLSI. Performance standards for antimicrobial susceptibility testing, M100, 33rd ed. Clinical and Laboratory Standards Institute, Wayne, PA; 2023.
Patil SS, Suresh KP, Shinduja R, Amachawadi RG, Chandrashekar S, Pradeep S, et al. Prevalence of methicillin-resistant staphylococcus aureus in India: a systematic review and meta-analysis. Oman Med J. 2022;37(4):e440. DOI: https://doi.org/10.5001/omj.2022.22
Sangeeta Joshi, Pallab Ray, Vikas Manchanda, Jyoti Bajaj, Vikas Gautam, Parijath Goswami, et al. Methicillin resistant Staphylococcus aureus (MRSA) in India: prevalence & susceptibility pattern. Indian J Med Res. 2013;137(2):363-9.
Mohanty S, Behera B, Sahu S, Praharaj AK. Recent pattern of antibiotic resistance in Staphylococcus aureus clinical isolates in Eastern India and the emergence of reduced susceptibility to vancomycin. J Lab Physicians. 2019;11(4):340-45. DOI: https://doi.org/10.4103/JLP.JLP_39_19
Sader HS, Farrell DJ, Jones RN. Antimicrobial susceptibility of Gram-positive cocci isolated from skin and skin-structure infections in European medical centres. Int J Antimicrob Agents. 2010;36(1):28-32. DOI: https://doi.org/10.1016/j.ijantimicag.2010.03.016
Tracy LA, Furuno JP, Harris AD, Singer M, Langenberg P, Roghmann MC. Staphylococcus aureus infections in US3986-3990 veterans, Maryland, USA, 1999-2008. Emerg Infect Dis. 2011;17:441-8. DOI: https://doi.org/10.3201/eid1703.100502
Mehta Y, Hegde A, Pande R, Zirpe KG, Gupta V, Ahdal J, et al. Methicillin-resistant Staphylococcus aureus in Intensive Care Unit Setting of India: A Review of Clinical Burden, Patterns of Prevalence, Preventive Measures, and Future Strategies. Indian J Crit Care Med. 2020;24(1):55-62. DOI: https://doi.org/10.5005/jp-journals-10071-23337
Kaushik A, Kest H, Sood M, Steussy BW, Thieman C, Gupta S. Biofilm Producing Methicillin-Resistant Staphylococcus aureus (MRSA) Infections in Humans: Clinical Implications and Management. Pathogens. 2024;13(1):76. DOI: https://doi.org/10.3390/pathogens13010076
Sharma A, Kalita JM, Nag VL. Screening for Methicillin-resistant Staphylococcus aureus carriage on the hands of healthcare workers: an assessment for hand hygiene practices. Indian J Crit Care Med 2019;23(12):590-92. DOI: https://doi.org/10.5005/jp-journals-10071-23296
Kotwani A, Holloway K. Trends in antibiotic use among outpatients in New Delhi, India. BMC Infect Dis. 2011;11(1):99. DOI: https://doi.org/10.1186/1471-2334-11-99
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