Abstract
Problem statement: Methicillin-Resistant Staphylococcus aureus (MRSA) is responsible for an increasing number of serious hospital and community acquired infections. Increased emergence in MRSA resistance to antibiotics is a growing problem. Approach: The resistance of MRSA to 20 antibiotics agents were studied. Also comparison of antibiotics resistance of community and hospital acquired MRSA were performed. Meanwhile the profile of antibiotics resistance of different clinical specimens among community and hospital acquired MRSA were evaluated. The clinical specimens of wound, urine, diabetic foot, skin abscess and sputum were collected from 1189 patients from March 2008-2009 at Hawler, Maternity and Rizgary teaching hospitals in Erbil, Iraq, 377 of Staphylococcus aureus were isolated and identification by standard methods, 114 MRSA were detected by detection PBP2a. Antibiotics resistance for MRSA were determined by the agar dilution method according to CLSI and BSAC guidelines. Results: The percentages of resistance in all hospital acquired MRSA were higher than community acquired MRSA. Among community acquired MRSA, the highest percentage (73.33%) of wound specimens were resistance to tetracycline, erythromycin and azithromycin. About 14% of urine samples were resistance to tobramycin, levofloxacin, moxifloxacin and rifampicin, 12.5% of diabetic foot was resistance to tobramycin, moxifloxacin and rifampicin. The resistance to tobramycin and rifampicin among MRSA cause skin abscess were 10 and 75% of sputum specimens were resistance to azithromycin and ciprofloxacin. Among hospital acquired MRSA isolates, 92% of wound specimens were resistance to tetracycline, 85.71% of urine samples were resistance to erythromycin and azithromycin. All sputum specimens were resistance to erythromycin. Conclusion/Recommendations: The most antibiotics affected agents MRSA were gatifloxacin, moxifloxacin and rifampicin. Physicians should be aware about MRSA and order for diagnostic and antibiotics sensitivity test. The use of antibiotics on random scale without antibiotic sensitivity testing must be restricted.
Highlights
Antibiotics resistance among a variety of bacterial resistance is the major problem of global dimensions with a significant impact on morbidity, mortality and healthcare-associated costs (AL-Haj et al, 2010)
The spectrum of infections due to Methicillin-Resistant Staphylococcus aureus (MRSA) varies from mild skin infections to serious and invasive diseases such as surgical site infections, lower combined different resistance phenotypes were noted, the percentages of resistance in all hospital acquired MRSA were higher than community acquired MRSA, but statistically the different were not significant except respiratory tract infections, urinary tract infections and amikacin (P = 0.024)
The effects specimens including wound, urine, diabetic foot, skin of gentamicin, amikacin, tobramycin, erythromycin, abscess and sputum were collected from 1189 patients levofloxacin and moxifloxacin were significantly at Hawler, Maternity and Rizgary teaching hospitals in different on the clinical specimens
Summary
Antibiotics resistance among a variety of bacterial resistance is the major problem of global dimensions with a significant impact on morbidity, mortality and healthcare-associated costs (AL-Haj et al, 2010). Staphylococcus aureus is a leading cause of both resistant bacterial strains all over the world. Antibiotic hospital acquired and community acquired infections. Methicillin-Resistant Staphylococcus aureus (MRSA) infection is a significant cause of high mortality and morbidity worldwide. The infections were classified into the community and hospital acquired MRSA. The differentiation of MRSA strains from other and 58 hospital acquired) by detection of PBP2a by strains of Staphylococcus aureus has important PBP2a kit (Oxoid, Japan) was performed according to implications for the treatment and management of the manufacturer’s instructions using colonies from patients with Staphylococcus aureus infections (Grisold et al, 2002; Garau et al, 2009; Amsterdam et al, 2010). There is a marked difference between the resistances profiles of Methicillin-Sensitive Staphylococcus aureus compared to MRSA isolates (Kim, 2009; Gould et al, 2010).
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