Vancomycin intermediate and vancomycin resistant Staphylococcus aureus: an upcoming threat
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252022Keywords:
Vancomycin-resistant Staphylococcus aureus, Vancomycin-intermediate Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus, Staphylococcus aureus, VancomycinAbstract
Background: Either community or hospital settings, Staphylococcus aureus is a significant pathogen that causes mild localized infections of the skin to potentially fatal systemic infections. The increasing evidence of reduced vancomycin susceptibility (RVS) and vancomycin resistance in clinical MRSA isolates is troubling. There aren't many therapeutic options available for such isolates. We have identified the most current pattern of antimicrobial resistance and specifically evaluated Staphylococcus aureus's susceptibility profile to vancomycin. vancomycin-intermediate Staphylococcus aureus and isolates of Staphylococcus aureus that are resistant to vancomycin.
Methods: Non-duplicate, consecutive isolates of S. aureus obtained from January 2021 to June 2022 were subject to antimicrobial susceptibility testing using standard disk diffusion tests or epsilometer tests according to the clinical laboratory standards institute 2021 requirements.
Results: The total of 315 S. aureus were isolated during study period. Swab and pus sample shows highest isolation followed by other sample types. A total of 202 (64.1%) isolates were MRSA, while 111 (35.2%) were Inducible clindamycin positive ( ICR Positive). Antibiotic resistance observed is, penicillin (303/315, 96.1%), Ofloxacin (266/315, 84.4%), levofloxacin (255/315, 80.9%), Azithromycin (190/315, 60.3%) followed by other class of antibiotic groups. In our study Vancomycin , Linezolid and Teicoplanin are 100% sensitive. Vancomycin resistance is not noted in any isolates but we have 7 Vancomycin intermate isolates.
Conclusions: Gate keeping in advent use of antibiotic is paramount importance to control the antibiotic resistance. As well as continuous laboratory monitoring of various antibiotic resistance pattern is needed.
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References
Mohanty S, Behera B, Sahu S, Praharaj AK. Recent pattern of antibiotic resistance in Staphylococcus aureus clinical isolates in Eastern India and the emergence of reduced susceptibility to vancomycin. J Lab Phys. 2019;11(04):340-5. DOI: https://doi.org/10.4103/JLP.JLP_39_19
Kim MN, Hwang SH, Pyo YJ, Mun HM, Pai CH. Clonal spread of Staphylococcus aureus heterogeneously resistant to vancomycin in a university hospital in Korea. J Clin Microbiol. 2002;40(4):1376-80. DOI: https://doi.org/10.1128/JCM.40.4.1376-1380.2002
Bamigboye BT, Olowe OA, Taiwo SS. Phenotypic and molecular identification of vancomycin resistance in clinical Staphylococcus aureus isolates in Osogbo, Nigeria. European J Microbiol Immunol. 2018;8(1):25-30. DOI: https://doi.org/10.1556/1886.2018.00003
Hiramatsu K, Hanaki H, Ino T, Yabuta K, Oguri T, Tenover FC. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. The J Antimicrob Chemoth. 1997;40(1):135-6. DOI: https://doi.org/10.1093/jac/40.1.135
Goldrick B. First Reported Case of VRSA in the United States: An alarming development in microbial resistance. AJN The American J Nurs. 2002;102(11):17. DOI: https://doi.org/10.1097/00000446-200211000-00015
Krishna G, Thrimothi D, Srilekha V. Functional Nanomaterials in Antimicrobial Therapy for Antibiotic-Resistant Bacterial Infections. InEmerging Paradigms for Antibiotic-Resistant Infections: Beyond the Pill. Singapore: Springer Nature Singapore. 2024: 277-293. DOI: https://doi.org/10.1007/978-981-97-5272-0_13
Clinical and Laboratory Standards Institute. Performance Standards for antimicrobial Susceptibility Testing: 25th Informational Supplement. Clinical and Laboratory Standards Institute Document M100-S25. 31st ed. Wayne, PA: Clinical and Laboratory Standards Institute. 2021.
Clinical and Laboratory Standards Institute. Performance Standards for antimicrobial Susceptibility Testing: 25th Informational Supplement. Clinical and Laboratory Standards Institute Document M100-S25. 32nd ed.. Wayne, PA: Clinical and Laboratory Standards Institute. 2022.
Gardete S, Tomasz A. Mechanisms of vancomycin resistance in Staphylococcus aureus. J Clin Invest 2014;124(7):2836–40. DOI: https://doi.org/10.1172/JCI68834
Howden BP, McEvoy CR, Allen DL, Chua K, Gao W, Harrison PF, et al. Evolution of multidrug resistance during Staphylococcus aureus infection involvesmutation of the essential two component regulator WalKR. PLoSPathog2011;7(11):1002359. DOI: https://doi.org/10.1371/journal.ppat.1002359
Peng H, Hu Q, Shang W, Yuan J, Zhang X, Liu H, et al. WalK (S221P), a naturally occurring mutation, confers vancomycin resistance in VISA strain XN108. JAntimicrob Chemother 2017;72(4):1006–13. DOI: https://doi.org/10.1093/jac/dkw518
Hu J, Zhang X, Liu X, Chen C, Sun B. Mechanism of reduced vancomycinsusceptibility conferred by walK mutation in community-acquiredmethicillin-resistant Staphylococcus aureus strain MW2. Antimicrob Agents Chemother. 2015;59(2):1352–5. DOI: https://doi.org/10.1128/AAC.04290-14
McEvoy CR, Tsuji B, Gao W, Seemann T, Porter JL, Doig K, et al. Decrease dvancomycin susceptibility in Staphylococcus aureus caused by IS256 temperingof WalKR expression. Antimicrob Agents Chemother. 2013;57(7):3240–9. DOI: https://doi.org/10.1128/AAC.00279-13
Yoo JI, Kim JW, Kang GS, Kim HS, Yoo JS, Lee YS. Prevalence of amino acidchanges in the yvqF, vraSR, graSR and tcaRAB genes from vancomycinintermediate resistant Staphylococcus aureus. J Microbiol. 2013;51(2):160–5. DOI: https://doi.org/10.1007/s12275-013-3088-7
Hu Q, Peng H, Rao X. Molecular events for promotion of vancomycin resistancein vancomycin intermediate Staphylococcus aureus. Front Microbiol. 2016;7:1601. DOI: https://doi.org/10.3389/fmicb.2016.01601
Gardete S, Kim C, Hartmann BM, Mwangi M, Roux CM, Dunman PM, et al. Genetic pathway in acquisition and loss of vancomycin resistance in a methicillin resistant Staphylococcus aureus (MRSA) strain of clonal typeUSA300. PLoS Pathog. 2012;8(2):1002505. DOI: https://doi.org/10.1371/journal.ppat.1002505
McGuinness WA, Malachowa N, DeLeo FR. Vancomycin Resistance inStaphylococcus aureus. Yale J Biol Med. 2017;90(2):269–81.
Leclercq R, Derlot E, Duval J, Courvalin P. Plasmid-mediated resistance to vancomycin and teicoplanin in Enterococcus faecium. N Engl J Med. 1988;319(3):157–61. DOI: https://doi.org/10.1056/NEJM198807213190307
Centers for Disease C, Prevention. Staphylococcus aureus resistant tovancomycin–United States, 2002. MMWR Morb Mortal Wkly Rep 2002;51(26):565–7.
Indian Network for Surveillance of Antimicrobial Resistance (INSAR) group, India. Methicillin resistant Staphylococcus aureus (MRSA) in India: Prevalence and susceptibility pattern. Indian J Med Res. 2013;137:363-9.
Anupurba S, Sen MR, Nath G, Sharma BM, Gulati AK, Mohapatra TM. Prevalence of methicillin resistant Staphylococcus aureus in a tertiary referral hospital in Eastern Uttar Pradesh. Indian J Med Microbiol. 2003;21:49-51.
Tiwari HK, Sapkota D, Sen MR. High prevalence of multidrug-resistant MRSA in a tertiary care hospital of Northern India. Infect Drug Resist. 2008;1:57-61. DOI: https://doi.org/10.2147/IDR.S4105
Thati V, Shivannavar CT, Gaddad SM. Vancomycin resistance among methicillin resistant Staphylococcus aureus isolates from intensive care units of tertiary care hospitals in Hyderabad. Indian J Med Res. 2011;134:704-8. DOI: https://doi.org/10.4103/0971-5916.91001
Jain S, Gaind R, Chugh TD. In vitro activity of vancomycin and daptomycin against clinical isolates of Staphylococcus aureus and enterococci from India. Int J Antimicrob Agents. 2013;42:94-5. DOI: https://doi.org/10.1016/j.ijantimicag.2013.02.025
Singh A, Prasad KN, Misra R, Rahman M, Singh SK, Rai RP, et al. Increasing trend of heterogeneous vancomycin intermediate Staphylococcus aureus in a tertiary care center of Northern India. Microb Drug Resist. 2015;21:545-50. DOI: https://doi.org/10.1089/mdr.2015.0004
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