EMERGING DRUG RESISTANT STREPTOCOCCAL ISOLATES FROM SKIN AND SOFT TISSUE INFECTIONS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 14
Abstract
BACKGROUND Streptococcal species are the cause of a variety of skin and soft tissue infections (SSTIs) some of which are severe and can be lifethreatening. There are currently 74 species under the genus Streptococcus. Streptococcus pyogenes is the most pathogenic bacterium in the genus Streptococcus. We wanted to assess pyogenic potential of different species Streptococcus and their drug susceptibility patterns. METHODS This is a retrospective descriptive study done from Jan 2017 to Nov 2017. Total enrolled pus samples were 3300. The samples were processed conventionally and antibiotic sensitivity testing (AST) of all isolates was performed by Kirby Bauer’s disc diffusion method as per CLSI guidelines. RESULTS 4.63 % were culture positive for streptococcal isolates. Among streptococcal isolates, 128/153 (83.66%) were Enterococcus species, 12/153 (7.84%) were Streptococcus pyogenes and 10/153 (6.53%) were Streptococcus agalactiae and 3/153 (1.96%) were Streptococcus pneumoniae. For all Streptococcal isolates (153), 64% (102/160) were male patients and 36% (58/160) were female patients. Drug resistance is increasing for all the streptococcal species, and resistance to even high-end drugs like vancomycin was seen to be around 7.5% in Enterococcus spp. Almost one third of the isolates of Streptococcus pyogenes were resistant to Erythromycin and Gentamicin. No resistance was seen to Linezolid in any of the Streptococcal isolates. CONCLUSIONS Streptococcus species such as S. pyogenes, S. agalactiae and Streptococcus pneumoniae are seen to be increasing in SSTIs. Bacterial isolates exhibited high to moderate levels of resistance against different classes of antibiotics. A continuous inspection should be carried out to monitor the susceptibility of these pathogens and chose appropriate regimens both for prophylaxis and treatment of surgical wound infections. There is a need to create a viable antibiotic policy and draft guidelines to prevent or reduce undirected use of antibiotics, and conserve their effectiveness for better patient management. Consistent dialogue between the microbiology department and the surgeons is required for management of such cases.
Authors and Affiliations
Bhawna Sharma, Rushika Saksena, Manisha Jain, Rajni Gaind
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