RESUMEN
Background: Methicillin-resistant staphylococcus aureus (MRSA) poses persistent threat, affecting both healthcare environment and communities, with substantial impact on infection rates, morbidity, mortality, and healthcare costs. Vancomycin, a longstanding cornerstone in MRSA treatment, but with the emergence of vancomycin resistant MRSA (VRSA), necessitating alternative antimicrobial solutions. Linezolid, stands out as a promising candidate. It has unique advantages such as an absence of renal toxicity and improved lung parenchymal diffusion compared to vancomycin, making it an appealing choice, especially for healthcare-acquired pneumonia by MRSA. Methods: This cross-sectional study investigated linezolid susceptibility in 158 MRSA isolates using both disk diffusion and agar dilution method. Results: Results indicated that the majority of isolates exhibited linezolid susceptibility, with 53.16% showing a minimum inhibitory concentration (MIC) of ?2 礸/ml. However, two MRSA isolates, constituting 1.27% of the sample, displayed a MIC of 8 礸/ml, named them as a linezolid-resistant MRSA (LRSA). These findings align with previous research, mirroring resistance rates observed in different regions. Notably, vigilance against linezolid resistance is crucial, particularly due to its status as a last-resort MRSA treatment. Conclusions: Remarkably, a 100% concordance was found between the disk diffusion and MIC methods for detecting linezolid resistance in MRSA, suggesting that the disk diffusion method may be practical choice for laboratories with heavy workloads. However, adherence to CLSI guidelines is essential, and cases of resistance by disk diffusion should be confirmed using MIC methods. Emergence of linezolid-resistant MRSA is a worrisome development, necessitating ongoing surveillance and vigilance.
RESUMEN
Background: Easy access to Suraksha clinics for sexually transmitted infections calls for a review of seroprevalence of syphilis. Methods: Serum samples from attendees of sexually transmitted infections (STI)/ reproductive tract infections (RTI) clinic/antenatal clinic, and samples of high-risk group (HRG: female sex workers and men having sex with men) brought by non-government organizations from 2017-22 were screened for syphilis by Venereal Disease Research Laboratory (VDRL) and Treponema pallidum hemagglutination (TPHA) tests. Samples positive by both tests were considered seropositive for syphilis. Statistical methods used for analysis were chi square test for linear trends and Kruskal Wallis test. Results: In STI clinic percentage positivity for syphilis has shown a statistically significant decline from 2017-22. In RTI clinic the decline was significant from 2017-19 but not significant in the years 2019-22. In antenatal clinic and in HRGs the change in seroprevalence was not significant from 2017-22 and 2017-20 respectively. However, the HRGs showed a significantly increasing trend in syphilis seropositivity from 2020-22. Conclusions: There is a significantly declining trend in the seroprevalence of syphilis in patients attending the STI/RTI clinic from 2017-22 and in HRGs from 2017-20. However, a significant increase in trend in HRG from 2020-22 may have been due to behavioural changes during the lockdown for covid 19 pandemic. A significant decline in syphilis in patients attending the STI and RTI clinic and in HRGs attending the regional centre indicates the effectiveness of consistent detection, treatment and counselling efforts of the national control program on STI in the region.
RESUMEN
Background: Easy access to Suraksha clinics for sexually transmitted infections calls for a review of seroprevalence of syphilis. Methods: Serum samples from attendees of sexually transmitted infections (STI)/ reproductive tract infections (RTI) clinic/antenatal clinic, and samples of high-risk group (HRG: female sex workers and men having sex with men) brought by non-government organizations from 2017-22 were screened for syphilis by Venereal Disease Research Laboratory (VDRL) and Treponema pallidum hemagglutination (TPHA) tests. Samples positive by both tests were considered seropositive for syphilis. Statistical methods used for analysis were chi square test for linear trends and Kruskal Wallis test. Results: In STI clinic percentage positivity for syphilis has shown a statistically significant decline from 2017-22. In RTI clinic the decline was significant from 2017-19 but not significant in the years 2019-22. In antenatal clinic and in HRGs the change in seroprevalence was not significant from 2017-22 and 2017-20 respectively. However, the HRGs showed a significantly increasing trend in syphilis seropositivity from 2020-22. Conclusions: There is a significantly declining trend in the seroprevalence of syphilis in patients attending the STI/RTI clinic from 2017-22 and in HRGs from 2017-20. However, a significant increase in trend in HRG from 2020-22 may have been due to behavioural changes during the lockdown for covid 19 pandemic. A significant decline in syphilis in patients attending the STI and RTI clinic and in HRGs attending the regional centre indicates the effectiveness of consistent detection, treatment and counselling efforts of the national control program on STI in the region.