Surgical Site Infection by Methicillin Resistant Staphylococcus aureus– on Decline?
Introduction: Surgical Site Infection (SSI) is the most common healthcare associated infection that could be averted by antibiotics prophylaxis against the probable offending organisms. As Staphylococcus aureus has been playing a substantial role in the aetiology of SSIs, Methicillin Resistant S...
Main Authors: | , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2016-09-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/8587/21664_CE[Ra]_F(P)_PF1(AHESAK)_PFA(AK).pdf |
Summary: | Introduction: Surgical Site Infection (SSI) is the most common
healthcare associated infection that could be averted by
antibiotics prophylaxis against the probable offending organisms.
As Staphylococcus aureus has been playing a substantial role
in the aetiology of SSIs, Methicillin Resistant Staphylococcus
aureus (MRSA) happens to be a problem while dealing with the
postoperative wound infection.
Aim: To determine the prevalence of SSI caused by MRSA and
the antibiotic sensitivity pattern of MRSA.
Materials and Methods: A cross-sectional study was
conducted at Nil Ratan Sircar Medical College, Kolkata, West
Bengal from July 2009 to December 2012. A total of 19,359
surgical procedures were done of which 3003 culture positive
SSIs have been documented. The clinical samples were
collected from patients of both sexes and all ages suspected to
be suffering from SSI from different specialities. Samples were
processed according to CLSI, 2007 guidelines. The isolated
strains of Staphylococcus aureus were screened for MRSA by
detection of resistance to Cefoxitin disc (zone of inhibition was
≤21 mm) and slidex staph latex agglutination tests were done
on cefoxitin resistant strains to spot phenotypic expression of
mec A gene. Then PCR was performed for detection of mecA
gene. Antibiotic sensitivity test was done following Kirby Bauer
technique.
Results: In this 3½ year study, 1049 Staphylococcus aureus
(34.93%) were reported from 3003 cases of SSI followed by
Escherichia coli (20.34%), Klebsiella spp. (18.08%), Pseudomonas
spp. (7.99%), Acinetobacter spp. (7.49%) respectively. Among
the Staphylococcus aureus, 267 strains were derived as MRSA
(25.45%). MRSA were isolated from 167 (62.54%) male
patients and 100 (37.45%) female patients having surgical site
infections. Inpatients and outpatients distribution of MRSA
were 235 (88.01%) and 32 (11.98%) respectively. Majority of
the MRSA cases were reported from Surgery (12.49%) and
Orthopaedics (11.85%) departments in the age group above
75 years (15.63%). The MRSA strains have been found to be
100% sensitive to linezolid and tigecycline followed by fucidin
(92.51%), mupirocin (88.39%), levofloxacin (75.66%) and
doxycycline (72.28%). No vancomycin resistant strains were
detected, but 3 strains (1.12%) were found to be intermediately
susceptible to it (VISA). Incidence of MRSA in SSI has been
decreased by 15.17 % in 2012 in comparison to 2009. PCR
revealed mecA gene was present in 96.25% of cefoxitin resistant
Staphylococcus aureus strains.
Conclusion: Staphylococcus aureus being the predominant
organism causing SSIs, MRSA needs the attention for its
resistance to commonly used antibiotics in the hospital like
penicillin, cephalosporin group of drugs. Regular monitoring of
the MRSA, involved in the SSI of a particular setup is the basic
requirement to trim down the incidence of the postoperative
wound infections by proper antibiotic prophylaxis. |
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ISSN: | 2249-782X 0973-709X |