Future Trends in the Treatment of MRSA in Pakistan

Journal of Islamabad Medical and Dental College Pub Date : 2022-06-30 DOI:10.35787/jimdc.v11i2.672

M. Noorulamin, Dr. Zarafshan Badar Zarafsah, Dr. Ayesha Janjua, Azhar Iqbal, Dr. Sobia Humerah, Dr. Pakeeza Arzoo Shaiq

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引用次数: 1

Abstract

Background: The Methicillin resistant Staphylococcus aureus (MRSA) is accountable for community and hospital acquired infections. Due to over and misuse of antibiotics, MRSA isolates are becoming multidrug resistant even with linezolid and vancomycin. The objective of this study was to determine recent antimicrobial profile of MRSA, isolated from different clinical samples and current treatment options for MRSA, other than vancomycin and Linezolid. Methodology: This cross-sectional study was conducted at Foundation university medical college from Jan 2019 to Dec 2020. Total 918 samples of blood, pus swab, throat swab, tracheal swab, wound swab, endotracheal tube (ETT) tips, Catheter tips, axillary swab and suction tips received by using aseptic techniques, for culture and sensitivity in different hospitals of Rawalpindi and Islamabad, were taken. Isolated pathogens were identified using standard protocols and susceptibility testing was done by Kirby-Bauer disc diffusion method. Results: Out of 918 samples, MRSA was isolated in 96 (10.4%) samples and most frequently observed in 27% (n=26) blood samples. The mean age of enrolled patients was 52.02 (SD±16.1) years, the infection was largely seen in age group 46-55(24%) and in 57% (n=52) male population. MRSA showed higher resistance to levofloxacin 78.1% (n=75), ciprofloxacin 75% (n=72), erythromycin 70.8% (n=68) and gentamycin 62.5% (n=60). The susceptibility of older drug chloramphenicol and Trimethoprim-sulfamethoxazole was found 61% & 49% respectively. MRSA isolates were highly susceptible to vancomycin (96.8%), linezolid (89.5%) and teicoplanin (70.85%). Alarmingly, 2.1% (n=2) MRSA isolates showed resistance to vancomycin. Conclusion:Vancomycin resistant MRSA is a matter of great concern, because of unawareness among health administrative departments and public, self-medication, lack of surveillance system and non-availability of antibiotic policy. Keywords: Antibiotics, MRSA, Vancomycin, Chloramphenicol

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巴基斯坦MRSA治疗的未来趋势

背景:耐甲氧西林金黄色葡萄球菌(MRSA)是社区和医院获得性感染的主要原因。由于抗生素的过度和滥用，MRSA分离株甚至对利奈唑胺和万古霉素也具有多重耐药性。本研究的目的是确定最近MRSA的抗菌谱，从不同的临床样本分离和MRSA目前的治疗方案，除了万古霉素和利奈唑胺。方法:本横断面研究于2019年1月至2020年12月在基础大学医学院进行。在拉瓦尔品第和伊斯兰堡的不同医院，采用无菌技术采集了918份血样、脓液拭子、咽喉拭子、气管拭子、伤口拭子、气管插管(ETT)针尖、导管针尖、腋下拭子和吸引针尖，用于培养和敏感。分离病原菌采用标准方法鉴定，药敏试验采用Kirby-Bauer圆盘扩散法。结果:在918份样本中，96份(10.4%)样本分离到MRSA, 27% (n=26)血样中最常见。入组患者的平均年龄为52.02 (SD±16.1)岁，感染主要发生在46 ~ 55岁年龄组(24%)和57% (n=52)的男性人群中。MRSA对左氧氟沙星78.1% (n=75)、环丙沙星75% (n=72)、红霉素70.8% (n=68)、庆大霉素62.5% (n=60)的耐药率较高。老药氯霉素和甲氧苄啶磺胺甲恶唑的敏感性分别为61%和49%。MRSA对万古霉素(96.8%)、利奈唑胺(89.5%)和替柯planin(70.85%)高度敏感。令人担忧的是，2.1% (n=2) MRSA分离株对万古霉素有耐药性。结论:由于卫生行政部门和公众对万古霉素耐药的认识不高、自我药疗不足、缺乏监测系统和缺乏抗生素政策，耐万古霉素MRSA是一个值得高度关注的问题。关键词:抗生素，MRSA，万古霉素，氯霉素

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Journal of Islamabad Medical and Dental College

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审稿时长

16 weeks