Abstract
Out of 260 strains isolated from the clinical specimens from different wards of hospital, 105 were identified as Methicillin resistant Staphylococcus aureus (MRSA). Minimum inhibitory concentrations (MIC) of vancomycin of these strains were determined by agar dilution method following CLSI guidelines. Sensitivity of different antibiotics was determined by Kirby Bauer disc diffusion method. Eight strains had MIC of vancomycin of 4 microgram /ml (µg/ml), 138 strains had MIC of 2 microgram /ml and 114 had MIC of 1 microgram/ml. All strains having MIC 4µg/ml were MRSA and were resistant to more than five antibiotics. Out of 138 strains having MIC of 2 µg/ml, 88 were MRSA and 50 were MSSA. Significant relation was found between increase in MIC of vancomycin and methicillin resistance. The most common risk factors associated with increased MIC of vancomycin were prior treatment of vancomycin and prolonged hospitalization .
Highlights
Multidrug resistant Staphylococcus aureus is a common cause of nosocomial infection
The condition has been further worsened by the emergence of Vancomycin intermediate sensitive Staphylococcus aureus (VISA) and Vancomycin resistant Staphylococcus aureus (VRSA) [2]
The present study was aimed to determine the risk factors associated with higher range of minimum inhibitory concentration of vancomycin, to identify different clinical settings or wards where the resistant strains of Staphylococcus aureus are more prevalent and to find out the different levels of minimum inhibitory concentration of vancomycin and oxacillin in a tertiary care hospital of a north Indian city
Summary
Multidrug resistant Staphylococcus aureus is a common cause of nosocomial infection. As per latest clinical and laboratory standard institute guidelines staphylococci with MIC of vancomycin ≤ 2 μg/ml is susceptible, while for which MIC is 4-8 μg/ml are intermediate and those with MIC ≥ 16 μg/ml are resistant [4]. The present study was aimed to determine the risk factors associated with higher range of minimum inhibitory concentration of vancomycin, to identify different clinical settings or wards where the resistant strains of Staphylococcus aureus are more prevalent and to find out the different levels of minimum inhibitory concentration of vancomycin and oxacillin in a tertiary care hospital of a north Indian city
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