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Molecular Confirmation of Vancomycin-Resistant Staphylococcus aureus with vanA Gene from a Hospital in Kathmandu

Meera Maharjan1, Anil Kumar Sah2, Susil Pyakurel3

  • 1Department of Microbiology, Kantipur College of Medical Science, Sitapaila, Kathmandu, Nepal.

International Journal of Microbiology
|December 13, 2021
PubMed

Insights

Methicillin-resistant Staphylococcus aureus (MRSA) is a major health concern. This study found a significant rate of vancomycin-resistant S. aureus (VRSA) and identified the vanA gene in some isolates, highlighting the need for surveillance.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Staphylococcus aureus is a common cause of nosocomial infections.
  • Methicillin-resistant S. aureus (MRSA) poses a significant global health threat.
  • Vancomycin is the primary treatment for MRSA, but resistance is emerging.

Purpose of the Study:

  • To determine the prevalence of vancomycin-resistant S. aureus (VRSA).
  • To detect vancomycin resistance genes (vanA and vanB) in S. aureus isolates.
  • To assess antibiotic susceptibility patterns in a hospital setting in Nepal.

Main Methods:

  • Hospital-based cross-sectional study conducted from July to December 2018.
  • Isolation and identification of S. aureus from clinical samples.
  • Antibiotic susceptibility testing using Kirby-Bauer disc diffusion and MIC.
  • MRSA screening via CLSI guidelines and VRSA confirmation using E-test strips.
  • Detection of vanA and vanB genes by conventional polymerase chain reaction (PCR).

Main Results:

  • A total of 74 S. aureus isolates were obtained, with 60.81% identified as MRSA.
  • Five isolates (11.11%) were confirmed as VRSA.
  • Two VRSA isolates (40%) tested positive for the vanA gene.
  • Linezolid demonstrated effectiveness, while 89.2% of isolates were resistant to penicillin.
  • The majority of S. aureus isolates (93.2%) exhibited a multidrug resistance (MAR) index > 0.2.

Conclusions:

  • The study highlights a significant prevalence of MRSA and a concerning rate of VRSA in the studied hospital.
  • The presence of the vanA gene in VRSA isolates warrants attention.
  • Routine surveillance for MRSA and VRSA is recommended in hospital settings to guide empirical therapy.

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