Prevalence of methicillin resistant coagulase negative staphylococci in a tertiary care hospital
,
Abstract
Background and Objectives: Presence of methicillin and multidrug resistance has associated coagulase negative staphylococci (CNS) with high morbidity and mortality worldwide. The present study was carried out to study the susceptibility pattern of CNS to various antimicrobial agents and to determine the prevalence of CNS methicillin resistance in our hospital setting.
Materials and Methods: A total of 300 strains of CNS isolated from various clinical specimens were subjected to speciation and their antimicrobial sensitivity testing was studied by Kirby Bauer disc diffusion method. Methicillin resistance was studied by observing minimum inhibitory concentration (MIC) of Oxacillin by macrobroth dilution method and E test. Susceptibility to vancomycin was determined by vancomycin screen agar test and minimum inhibitory concentration by macrobroth dilution test.
Results: All the isolates were susceptible to vancomycin, linezolid and teicoplanin in disc diffusion test while maximum resistance was noted against penicillin (100%) followed by ciprofloxacin (36.3%), norfloxacin (34.3%), gentamicin (34%), nitrofurantoin (29.9%), erythromycin (27.9%) and amikacin (22.7%). Fifty two percent (n = 156) of the isolates were found to be resistant to methicillin. A comparison between resistance patterns of methicilin resistant and methicillin sensitive strains showed that methicillin resistant isolates had higher level of resistance to other antibiotics.
Conclusions: The high level of resistance among CNS to commonly used antimicrobial agents in our hospital is a matter of great concern and can be prevented by practices of effective infection control measures.
Washington WC, Allen SD, Jand WM, Koneman W, Procop G, Schreckenberger PC. Gram Positive Cocci- part1. In: Koneman’s Color Atlas and Textbook of Diagnostic Microbiology . 6th ed., Lippincot Philadelphia 2001: 624-671.
Gahrn-Hansen B. Coagulase negative staphylococci and micrococci in clinical microbiology. Dan Med Bull 1987; 34: 96-114.
Kloss WE, Bannerman TL. Update on clinical significance of coagulase negative staphylococci. Clin Microbiol Rev1994; 7: 117-140.
Wayne PA. Clinical and Laboratory standards institute 2005. Performance standards for antimicrobial susceptibility testing: fifteenth informational supplement. M100-S15. 2005.
Miles RS, Amyes SGB. Laboratory control of antimicrobial therapy. In: Collee JG, Fraser AG, Marmion BP, Simmons A (eds), Mackie and McCartney Practical Medical Microbiology. 14th ed., Vol. 2, Churchill Livingstone, London 1996;151-78.
Tiwari HK, Sen MR. Emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India. BMC Infect Dis 2006; 6: 156.
Singhal R, Dhawan S, Mohanty S, Sood S, Kapil A, Dhawan B, et al. Species distribution and antimicrobial susceptibility of coagulase negative staphylococci in a tertiary care hospital. Ind J Med Res 2006; 123: 569-570.
Gill VJ, Selepak ST, Williams EC. Species identification and antibiotic susceptibility of coagulase negative staphylococci isolated from clinical specimens. J Clin Microbiol 1983; 18: 1314-1319.
Chaudhury A, Kumar AG. In vitro activity of antimicrobial agents against oxacillin resistant staphylococci with special reference to Staphylococcus haemolyticus. Ind J Med Microbiol 2007; 25: 50-52.
Udo EE, Jacob LE, Chugh TD. Antimicrobial resistance of coagulase negative staphylococci from a Kuwait hospital. Microb Drug Resist 2009; 1: 315-320.
Marsik FJ, Brake Sylvia. Species identification and susceptibility to 17 antibiotics of coagulase negative staphylococci isolated from clinical specimens. J Clin Microbiol 1982; 15: 640-645.
Goyal R, Singh NP, Kumar A, Kaur I, Singh M, Sumita N, et al. Simple and economical methods of speciation and resistotyping of clinically significant coagulase negative staphylococci. Ind J Med Microbiol 2006; 24:201-204.
Shrikhande S, Thakar YS, Pathak AA, Saoji AM. Species distribution of clinical isolates of staphylococci.Ind J Pathol Microbiol 1996; 39: 207-210.
Patricia AK, Shashikala, Sheela DC, Srinivasan S, Reba Kanungo. Profile of coagulase negative staphylococci associated with infections in a tertiary care hospital. Biomed 2007; 21: 28.
Mohan V, Jindal N, Aggarwal P. Species distribution and antibiotic sensitivity pattern of coagulase negative staphylococci isolated from various clinical specimens. Ind J Med Microbiol 2002; 20: 45-46.
Singh S, Banerjee G, Aggarwal SK, Kumar M, Singh RK. Simple method for speciation of clinically significant coagulase negative staphylococci and its antibiotic sensitivity/resistant pattern in nicu of tertiary care centre. Ind Medica 19 (2).
Oliveria ADD, Azevedoz PA, Sousa LB, Niero CV, Lottenberg C, Martino MDV, et al. Laboratory detection methods for methicillin resistance in coagulase negative staphylococcus isolated from ophthalmic infections. Arq Bras Oftalmol 2007; 70: 667-675.
Menesez GA, Harish BN, Sujatha S, Vinathini K, Parija SC. Emergence of vancomycin intermediate staphylococcus species in southern India. J Clin Microbiol 2008; 57: 911-912.
| Files | ||
| Issue | Vol 2 No 4 (2010) | |
| Section | Articles | |
| Keywords | ||
| Coagulase negative Staphylococci minimum inhibitory concentration E test | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
