Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Kyiv Surgical Hospital (Ukraine)

Abstract

Objective — to determine the prevalence of methicillin-resistant strains of Staphylococcus aureus, isolated from patients different departments in Kyiv Surgical Hospital.
 Materials and methods. Between June 2015 and December 2015, a total of 128 S. aureus isolates were collected from the pus samples of the patients with SSI in a surgical hospital in Kyiv, Ukraine. The identification and antimicrobial susceptibility of the cultures were determined, using automated microbiology analyzer VITEK 2 Compact (bioMerieux, France). Susceptibility to antibiotics was determined using VITEK 2 AST-P580 card (bioMerieux, France), which included 20 antibiotics (benzylpenicillin, oxacyllin, cefoxitin, gentamycin, tobramycin, levofloxacin, moxifloxacin, erythromycin, clindamycin, linezolid, teicoplanin, vancomycin, tetracycline, tigecycline, fosfomicin, nitrofurantoin, fusidic acid, mupirocin, rifampicin, and trimethoprim/ sulphamethoxazole) and a cefoxitin test, designed for detection of staphylococci resistance to methicillin. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute (CLSI).
 Results and discussion. Based on antimicrobial susceptibility analysis, the most active antibiotics found in the study were linezolid, tigecycline, and mupirocin, showing growth inhibition of 100 % strains tested. Susceptibility to the other antimicrobials was also on a high level: 99 % of strains were found susceptible to nitrofurantoin and trimethoprim/sulphamethoxazole, 98 % — to fusidic acid, 97 % — to moxifloxacin, 96 % — to teicoplanin, 95 % — to vancomycin and fosfomicin, 93 % — to gentamycin, and 92 % — to tobramycin. Susceptibility to levofloxacin (89 %), tetracycline (88 %), rifampin (87 %), erythromycin (84 %), and clindamycin (79 %) was observed to be some lower. Research of MRSA prevalence in Kyiv Surgical Hospital (Ukraine) shown, that 11 % of staphylococci strains, isolated from patients having nosocomial infections (SSI), had multiple resistance to antibiotics. Resistance S. aureus to oxacyllin came up to 19 %. Further, 35.7 % of MRSA strains were resistant only to the group of beta-lactamic antibiotics, while the rest — also to the other classes of antibiotics.
 Conclusions. MRSA in surgical hospital, being a subject of the research is considered to be a serious therapeutic and epidemiologic problem. Total prevalence of MRSA in hospital was evaluated as 19 %, varying in every surgical department studied. Antibiotics revealed the most effective for treatment of MRSA infections were linezolid, mupirocin, tigecycline, vancomycine, teicoplanin, moxifloxacin, nitrofurantoin, fusidic acid, and trimethoprim/sulphamethoxazole. Taking into account the constant changes and significant differences of the S. aureus resistance levels observed in various regions, the constant monitoring of antibiotic resistance to antimicrobials in every in-patient medical institution is required and on the base of the local obtained results to elaborate the hospital record sheets. Antibiotics application tactics should be determined in accordance with the local data of resistance to them in each surgical inpatient institution. The system of epidemiologic surveillance over microbial resistance should be established on the local, regional, and national levels.