Dhungel S, Rijal KR, Yadav B, Dhungel B, Adhikari N, Shrestha UT, Adhikari B, Banjara MR, Ghimire P. Methicillin-Resistant
Staphylococcus aureus (MRSA): Prevalence, Antimicrobial Susceptibility Pattern, and Detection of
mecA Gene among Cardiac Patients from a Tertiary Care Heart Center in Kathmandu, Nepal.
Infect Dis (Lond) 2021;
14:11786337211037355. [PMID:
34483665 PMCID:
PMC8414605 DOI:
10.1177/11786337211037355]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 07/17/2021] [Indexed: 11/16/2022] Open
Abstract
Background:
Methicillin Resistant Staphylococcus aureus (MRSA) is a
significant human pathogen associated with nosocomial infections.
mecA in the S. aureus is a marker of
MRSA. The main objective of this study was to detect mecA
and vanA genes conferring resistance in S.
aureus among cardiac patients attending Sahid Gangalal National
Heart Centre (SGNHC), Kathmandu, Nepal between May and November 2019.
Methods:
A total of 524 clinical samples (blood, urine, sputum) were collected and
processed. Bacterial isolates were tested for antimicrobial susceptibility
test (AST) and screening for MRSA was carried out by cefoxitin disc
diffusion method. Minimum inhibitory concentration (MIC) of vancomycin for
MRSA was established by agar dilution method and chromosomal DNA was
extracted and used in polymerase chain reaction targeting the
mecA and vanA genes.
Results:
Out of 524 specimens, 27.5% (144/524) showed bacterial growth. Among 144
culture positive isolates, S. aureus (27.1%; 39/144) was
the predominant bacteria. Among 39 S. aureus isolates, all
isolates were found resistant to penicillin followed by erythromycin (94.9%;
37/39), gentamicin (94.9%; 37/39) and cefoxitin (87.2%; 34/39). Out of 39
S. aureus, 87.2% (34/39) were MRSA. Among 34 MRSA, 8.8%
(3/34) were vancomycin intermediate S. aureus (VISA). None
of the MRSA was resistant to vancomycin. All of the 3 VISA isolates were
obtained from inpatients. Of 39 S. aureus, 82.1% (32/39)
harbored mecA gene. Similarly, the entire VISA isolates and
94.1% (32/34) of the MRSA isolates were tested positive for
mecA gene.
Conclusions:
High prevalence of MRSA among the cardiac patients indicates the increasing
burden of drug resistance among bacterial isolates. Since infection control
is the crucial step in coping with the burgeoning antimicrobial resistance
in the country, augmentation of diagnostic facilities with routine
monitoring of drug resistance is recommended.
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