ABSTRACT
Background: Increasing prevalence of Methicillin-resistant Staphylococcus aureus (MRSA), a major pathogen in both health care facilities and community, is an escalating public health concern. Knowledge of prevalence of MRSA and their current antimicrobial profile becomes necessary in the selection of appropriate empirical treatment of these infections. Aims & Objectives: To estimate the prevalence of MRSA & to evaluate its antibiotic sensitivity pattern and to determine Bacteriophage typing for epidemiological purposes. Methods: A total of 182 isolates of Staphylococcus aureus, collected over a period of two years, were screened by various phenotypic assays. Randomly selected 50 MRSA isolates were sent to Maulana Azad Medical College, New Delhi, for Bacteriophage typing. Antibiotic sensitivity test was done by Kirby Bauer’s disc diffusion method. Results: Among the 182 isolates, 120(65.93 %) were identified as MRSA & 62(34.07 %) were identified as MSSA by various phenotypic methods. 50 isolates was sent for PhageTyping. 42(84%) strains were typable. 35(70%) strains belonged to phage III, 1(2%) to phage group II, 6(12%) to more than one phage groups. More than70% strains were resistant to Co-Trimoxazole, Erythromycin, Ciprofloxacin and Gentamicin, but were highly sensitive to Chloramphenicol and Clindamycin. 100% sensitivity was observed with Vancomycin, Teicoplanin and Linezolid. Conclusion: It is alarming that the present study reports a high prevalence (65.94%) of MRSA infection. In our study, 70% of the MRSA isolates belong to group III Phage, especially phage no.47. Despite the glycopeptides, Chloramphenicol, and preferably Clindamycin can be used to treat Staphylococcus infections.
ABSTRACT
Background: Now considered as one of the most important Nosocomial pathogen, enterococci have been found to possess virulence factors like biofilm formation and are increasingly exhibiting antimicrobial resistance in India. This study was undertaken to estimate the prevalence of enterococci from various clinical samples simultaneously correlating their virulence property and antimicrobial resistance, in addition to speciation. Methods: A total of 126 enterococcal isolates from various clinical samples were included and processed according to standard protocols and speciation was based on Facklam and Collins conventional method. Virulence determinants like hemolysin, gelatinase and biofilm formation were assessed by phenotypic tests. Antibacterial susceptibility pattern was determined by Kirby Bauer disc diffusion method with recommended drugs including high level aminoglycoside resistance. Minimum inhibitory concentration (MIC) for vancomycin was done by E-test. Results: Out of 1746 clinical samples, enterococci accounted for 7.22%. They consisted of E. faecium 52.38%, E. faecalis 32.54%, and E. avium 15.08% isolated from urine 8.26%, pus 8.44%, blood 0.56% and body fluids 1.28%. Study on virulence factors revealed that 19.84% strains produced gelatinase, 18.25% produced hemolysin and 73.81% produced biofilm. High level resistance to gentamycin and streptomycin were 4.76% and 5.56% respectively. Vancomycin resistance was 3.17%. Conclusions: This study indicates the change in epidemiology of enterococcal infections from E. faecalis to E. faecium and low prevalence of vancomycin resistant enterococcus (VRE) in our region. To maintain the low level of resistance, improvement of antibiotic policies and hospital infection control is essential.