VANCOMYCIN SUSCEPTIBILITY STATUS AMONG CLINICAL MRSA ISOLATES AND DETECTION OF VISA, hVISA IN A TERTIARY CARE HOSPITAL
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 14
Abstract
BACKGROUND In the present scenario due to indiscriminate use of many antibiotics including vancomycin Staphylococcus aureus (S. aureus) demonstrates a reduced susceptibility to it. Reduced susceptibility to vancomycin is one of the bigger problems in the treatment of infections caused by S. aureus. METHODS To detect reduced susceptibility for vancomycin, vancomycin disk diffusion by Kirby-Bauer disk diffusion method, vancomycin agar screen by Hiramatsu et al (4 µg/ml of vancomycin) and CDC/CLSI (6 µg/ml of vancomycin) method and vancomycin minimum inhibitory concentration (MIC) were performed. MIC’s were determined by broth microdilution as well as ETEST. Simplified Population Analysis Profile (SPAP) was also performed for confirmation of h-VISA isolates. RESULTS MIC’s of 165 isolates was ≤2μg/ml by ETEST while 35 isolates had MIC’s >2µg/ml. Among these 35 isolates, two isolates had MIC of 4µg/ml and one had MIC of 6µg/ml and therefore, these three isolates may have been VISA as per CLSI guidelines. Using broth microdilution, all the isolates had MIC’s of ≤2μg/ml. Vancomycin agar screen was performed by cut using method followed by Hiramatsu et al (4 µg/ml of vancomycin) and CDC/CLSI (6µg/ml of vancomycin) method. By the former method, four isolates demonstrated growth at 4 µg/ml and 196 isolates had no growth. These four isolates were further confirmed by Simplified Population Analysis Profile (SPAP) and were confirmed as h-VISA (Heterogeneous – Vancomycin Intermediate Staphylococcus aureus) isolates with MIC’s 8 µg/ml. Using CDC/CLSI method, all 200 isolates did not grow at 6 µg/ml of vancomycin. CONCLUSIONS Detection of hVISA hetero-resistance phenotype is very difficult. The best method for detecting hVISA is controversial. Population Analysis Profile (PAP) is considered as the gold standard, but this method is time consuming, expensive and labour intensive. So, it can’t be routinely used in a large busy setup.
Authors and Affiliations
Sanjay Kumar, Anil Kumar Singh, Narendra Pal Singh
Keywords
Related Articles
- EP ID EP615939
- DOI 10.18410/jebmh/2019/240
- Views 95
- Downloads 0
BIZARRE PAROSTEAL OSTEOCHONDRAL PROLIFERATION OF METATARSAL IS RECONSTRUCTED BY FREE TRICORTICAL ILIAC BONE GRAFT: A CASE REPORT
Bizarre parosteal osteochondral proliferation (BPOP) is a rare variety tumour like bone lesion usually of small bones of hands and feet which has a strong tendency for recurrence. Clinico-radiologically solitary exostosi...
ISOMETRIC EXERCISE AND ITS EFFECT ON BLOOD PRESSURE AND HEART RATE, BEFORE AND AFTER TRAINING IN YOUNG HEALTHY MALES
INTRODUCTION: Isometric exercise is a normal part of everyday activities and many occupational tasks. Preventive services are important as they give physicians an opportunity and responsibility to promote regular physica...
DETERMINATION OF AGE FROM HISTOLOGY OF BONE
BACKGROUND Identification of human remains is a problem of great importance in crime investigation. Estimating age at death and finding sex of the individual from skeletal remains can be done with relative accuracy only...
EFFECT ON BONE METABOLISM IN PATIENTS WITH TYPE 2 DIABETES MELLITUS OF ORAL HYPOGLYCAEMIC AGENTS
BACKGROUND This study evaluated the effect of treatment of many oral hypoglycaemic agents on bone metabolism in patients with type 2 diabetes mellitus and occurrence of osteoporosis. MATERIALS AND METHODS This cross-sect...
HISTOPATHOLOGICAL PATTERNS OF MASSES IN THE NASAL CAVITY, PARANASAL SINUSES AND NASOPHARYNX
BACKGROUND Masses in the nasal cavity, paranasal sinuses and nasopharynx are common and can be classified into non-neoplastic or neoplastic lesions. OBJECTIVES To study the histopathological patterns of masses in the nas...