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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Surgical Site Infection by Methicillin Resistant Staphylococcus aureus- on Decline?
Susmita Bhattacharya1, Kuhu Pal2, Sonia Jain3
1Professor, Department of Microbiology, NRS Medical College , Kolkata, West Bengal, India .
Introduction:
Surgical Site Infection (SSI) is the most common healthcare associated infection that could be averted by antibiotics prophylaxis against the probable offending organisms. As Staphylococcus aureus has been playing a substantial role in the aetiology of SSIs, Methicillin Resistant Staphylococcus aureus (MRSA) happens to be a problem while dealing with the postoperative wound infection.
Aim:
To determine the prevalence of SSI caused by MRSA and the antibiotic sensitivity pattern of MRSA.
Materials And Methods:
A cross-sectional study was conducted at Nil Ratan Sircar Medical College, Kolkata, West Bengal from July 2009 to December 2012. A total of 19,359 surgical procedures were done of which 3003 culture positive SSIs have been documented. The clinical samples were collected from patients of both sexes and all ages suspected to be suffering from SSI from different specialities. Samples were processed according to CLSI, 2007 guidelines. The isolated strains of Staphylococcus aureus were screened for MRSA by detection of resistance to Cefoxitin disc (zone of inhibition was ≤21 mm) and slidex staph latex agglutination tests were done on cefoxitin resistant strains to spot phenotypic expression of mec A gene. Then PCR was performed for detection of mecA gene. Antibiotic sensitivity test was done following Kirby Bauer technique.
Results:
In this 3½ year study, 1049 Staphylococcus aureus (34.93%) were reported from 3003 cases of SSI followed by Escherichia coli (20.34%), Klebsiella spp. (18.08%), Pseudomonas spp. (7.99%), Acinetobacter spp. (7.49%) respectively. Among the Staphylococcus aureus, 267 strains were derived as MRSA (25.45%). MRSA were isolated from 167 (62.54%) male patients and 100 (37.45%) female patients having surgical site infections. Inpatients and outpatients distribution of MRSA were 235 (88.01%) and 32 (11.98%) respectively. Majority of the MRSA cases were reported from Surgery (12.49%) and Orthopaedics (11.85%) departments in the age group above 75 years (15.63%). The MRSA strains have been found to be 100% sensitive to linezolid and tigecycline followed by fucidin (92.51%), mupirocin (88.39%), levofloxacin (75.66%) and doxycycline (72.28%). No vancomycin resistant strains were detected, but 3 strains (1.12%) were found to be intermediately susceptible to it (VISA). Incidence of MRSA in SSI has been decreased by 15.17 % in 2012 in comparison to 2009. PCR revealed mecA gene was present in 96.25% of cefoxitin resistant Staphylococcus aureus strains.
Conclusion:
Staphylococcus aureus being the predominant organism causing SSIs, MRSA needs the attention for its resistance to commonly used antibiotics in the hospital like penicillin, cephalosporin group of drugs. Regular monitoring of the MRSA, involved in the SSI of a particular setup is the basic requirement to trim down the incidence of the postoperative wound infections by proper antibiotic prophylaxis.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of surgical site infections (SSIs). This study found MRSA prevalence and identified linezolid and tigecycline as effective treatments, highlighting the need for ongoing surveillance.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Surgical Site Infections (SSIs) are a major healthcare-associated infection.
- Staphylococcus aureus, particularly Methicillin-Resistant Staphylococcus aureus (MRSA), is a common cause of SSIs.
- Effective antibiotic prophylaxis is crucial for preventing SSIs.
Purpose of the Study:
- To determine the prevalence of SSIs caused by MRSA.
- To analyze the antibiotic sensitivity patterns of MRSA strains.
Main Methods:
- A 3.5-year cross-sectional study involving 19,359 surgical procedures.
- Culture and laboratory analysis of 3003 culture-positive SSIs.
- MRSA screening using cefoxitin disc diffusion, latex agglutination, and PCR for the mecA gene.
Main Results:
- Staphylococcus aureus was the most common pathogen (34.93%) in SSIs.
- MRSA accounted for 25.45% of Staphylococcus aureus isolates.
- MRSA strains showed 100% sensitivity to linezolid and tigecycline.
Conclusions:
- MRSA is a significant pathogen in SSIs, requiring attention due to resistance to common antibiotics.
- Regular monitoring of MRSA is essential for effective antibiotic prophylaxis and reducing SSI incidence.
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