A PROSPECTIVE STUDY OF ANTIBIOGRAM OF VANCOMYCIN RESISTANT (VANA) GENE POSITIVE METHICILLIN SENSITIVE STAPHYLOCOCCUS AUREUS ISOLATES IN RURAL AND URBAN TERTIARY CARE SETUPS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 95
Abstract
BACKGROUND Vancomycin resistant Staphylococcus aureus isolates are innately resistance to other routinely used antibiotics. The present study was developed in identifying the vancomycin A (vanA) gene loci among methicillin sensitive Staphylococcus aureus (MSSA) isolates collected from rural and urban tertiary care setups. MATERIALS AND METHODS Staphylococcus aureus was confirmed by gram staining biochemical tests. Vancomycin resistance identified by agar dilution, E-test, disc diffusion and PCR methods were followed by antibiogram. RESULTS In this study 16665 samples were analysed, out of which 6538 were from rural and 10127 were from urban regions. In rural regions, Methicillin Sensitive Staphylococcus aureus (MSSA) constituted 401 (6.1%) and Methicillin Resistant Staphylococcus aureus (MRSA) 531 (8.1%); whereas in urban MSSA constituted 524 (5.2%) and MRSA 771 (7.6%). By using agar dilution method, Vancomycin Sensitive Staphylococcus aureus (VSSA) isolated in rural setup was 359 (89.5%), vancomycin intermediate resistant Staphylococcus aureus (VISA) was 35 (8.7%) and Vancomycin Resistant Staphylococcus aureus (VRSA) was 7 (1.8%), but in case of urban setup VSSA isolated was 451 (86.1%), VISA 52 (9.9%) and VRSA 21 (4.0%). VISA and VRSA strains obtained from Agar dilution method were further confirmed by E-Test, disc diffusion and PCR methods. E-Test results for rural and urban setup were VSSA 2 (4.7%) and 1 (1.4%); VISA 33 (78.6%) and 51 (69.8%); VRSA 7 (16.7%) and 21 (28.8%), whereas disc diffusion results shown for VISA was 31 (73.8%) and 66 (90.4%), but in case of PCR VISA was 32 (76.2%) and 46 (63.0%), and VRSA 7 (16.7%) and 21 (28.8%). Cloxacillin (COX), Azithromycin (AZM), Gentamicin (G), Ciprofloxacin (CIP), Gatifloxacin (GAT), Tetracycline (TE), Cefoperazone (CPZ) and Piperacillin with tazobactam (PIT) were found to be highly significant (P < 0.05) and Cefuroxime (CXM) and Linezolid (LZ) were found to be not significant (P > 0.05) in Rural and Urban tertiary care centres. CONCLUSION Highest drug resistance was found in VRSA and then VISA strains of both setups. Piperacillin + tazobactam, tetracycline and linezolid were found to be useful drugs in treating VISA and VRSA infections.
Authors and Affiliations
Anil Kumar Hanumanthu, Srinivas B
Keywords
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- EP ID EP280578
- DOI 10.14260/jemds/2017/1511
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