Recent pattern of antibiotic resistance in Staphylococcus aureus clinical isolates in Eastern India and the emergence of reduced susceptibility to vancomycin

Srujana Mohanty; Bijayini Behera; Subhrajyoti Sahu; Ashok Kumar Praharaj

doi:10.4103/JLP.JLP_39_19

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(04): 340-345
DOI: 10.4103/JLP.JLP_39_19

Original Article

Recent pattern of antibiotic resistance in Staphylococcus aureus clinical isolates in Eastern India and the emergence of reduced susceptibility to vancomycin

Srujana Mohanty

Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

,

Bijayini Behera

Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

,

Subhrajyoti Sahu

Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

,

Ashok Kumar Praharaj

Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

› Author Affiliations

Abstract

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Abstract

PURPOSE: We aimed to determine the recent pattern of antibiotic resistance and assess the vancomycin susceptibility profile of clinical Staphylococcus aureus in view of emerging reports of vancomycin creep, reduced vancomycin susceptibility (RVS), including heterogeneous vancomycin-intermediate S. aureus (hVISA) and vancomycin-intermediate S. aureus, and vancomycin resistance in S. aureus isolates.

MATERIALS AND METHODS: Consecutive, nonduplicate isolates of S. aureus between July 2015 and June 2016 were subjected to antimicrobial susceptibility testing using standard disk diffusion test or Etest as per the Clinical and Laboratory Standards Institute 2015. Detection of hVISA was done by glycopeptide resistance detection Etest according to the manufacturer's instructions in strains with vancomycin minimum inhibitory concentration of 1–2 μg/ml.

RESULTS: A total of 284 S. aureus were obtained from pus (175, 61.6%), respiratory tract (31, 10.9%), urine (27, 9.5%), blood (25, 8.8%), body fluids (18, 6.3%), and catheter tips (8, 2.8%). 127 (44.7%) isolates were methicillin resistant, and 158 (55.6%) were multidrug resistant. High resistance was observed to penicillin (81.7%), erythromycin (62.3%), and ciprofloxacin (52.1%), whereas the resistance was low to gentamicin (5.3%), rifampicin (8.1%), and doxycycline (9.5%). Two hundred and fifty-one (88.3%) isolates were fully susceptible to vancomycin, whereas 33 (11.6%) demonstrated RVS. All were uniformly susceptible to linezolid, tigecycline, and daptomycin.

CONCLUSIONS: A moderately high percentage of S. aureus isolates demonstrated RVS, which may limit its usefulness in methicillin-resistant isolates and may be associated with increased complications in methicillin-susceptible infections. In view of increasing glycopeptide resistance, the susceptibility status of vancomycin along with other antibiotics among clinical S. aureus isolates should be investigated periodically.

Keywords

Heterogenous vancomycin-intermediate Staphylococcus aureus - methicillin-resistant Staphylococcus aureus - Staphylococcus aureus - vancomycin - vancomycin-intermediate Staphylococcus aureus

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References

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