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BMC Res Notes

Prevalence of methicillin resistant Staphylococcus aureus in Lumbini Medical College and Teaching Hospital, Palpa, Western Nepal.

Prevalence of methicillin resistant Staphylococcus aureus in Lumbini Medical College and Teaching Hospital, Palpa, Western Nepal.

BMC Res Notes. 2017 Jun 02;10(1):187

Authors: Raut S, Bajracharya K, Adhikari J, Pant SS, Adhikari B

Abstract
BACKGROUND: Multidrug resistant Staphylococcus aureus is common in both tertiary and primary health care settings. Emergence of methicillin resistance in S. aureus (MRSA) along with macrolide, lincosamide, streptogramin B (MLSB) has made treatment of Staphylococcal infection more challenging. The main objective of this study was to detect MRSA, MLSB (inducible; MLSBi and constitutive; MLSBc) resistant S. aureus using phenotypic methods and to determine their antibiogram.
METHODS: Various samples were collected from 1981 patients who attended Lumbini Medical College and Teaching Hospital (LMCTH) during the period of 6 months from September 2015 to February 2016. Out of a total of 1981 samples, 133 S. aureus were isolated. Cefoxitin was used to detect MRSA by the disk diffusion test. Inducible clindamycin resistance (MLSBi) was detected by the D-zone test. The antibiotic profile of all isolates was tested by a modified Kirby Bauer disk diffusion method.
RESULTS: Among 133 S. aureus, there were 58 (43.6%) MRSA, 34 (25.6%) MLSBi and 30 (22.6%) MLSBc. Of a total of 64 MLSB, a significant proportion (62.5%) was MRSA (p < 0.001). Among 11 different antibiotics that were tested for S. aureus, MRSA showed significant resistance to 9 (p < 0.05) with the exception of vancomycin and linezolid. All the isolates were 100% sensitive to linezolid. MLSBi organisms were 100% sensitive to vancomycin and linezolid. Both MLSBi and MLSBc showed a higher degree of resistance to multiple antibiotics (p < 0.05).
CONCLUSIONS: Isolation of MRSA, MLSBi and MLSBc were remarkably high. Routine use of simple and cost effective methods such as the disk diffusion test by cefoxitin for MRSA and the D-zone test for MLSBi organisms can easily identify these isolates. Antibiotic resistance profiles from this study can optimize the treatment of multi-drug resistant S. aureus.

PMID: 28577365 [PubMed – in process]

Bloodstream infections in patients with malignancies: implications for antibiotic treatment in a Ghanaian tertiary setting.

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Bloodstream infections in patients with malignancies: implications for antibiotic treatment in a Ghanaian tertiary setting.

BMC Res Notes. 2015;8(1):742

Authors: Obeng-Nkrumah N, Labi AK, Acquah ME, Donkor ES

Abstract
BACKGROUND: Bloodstream infections (BSI) remain a major cause of mortality in patients with malignancies. We present the first report on the microbiological profile of bacteraemia and fungaemia among cancer patients in Ghana.
METHODS: From January 2010 through December 2013, we retrospectively analyzed the spectrum of bloodstream pathogens in cancer patients from Korle-Bu Teaching Hospital, Ghana-focusing on multidrug resistant isolates (MDRs).
RESULTS: Overall BSI were confirmed in 22 % (n = 93/453) of total blood cultures. Our data highlights a co-dominance of Gram-negative (n = 49/93, 52.6 %) and Gram-positive (n = 40/93, 43.0 %) bacteria with the former less likely to infect children than adults [odds ratio (OR), 0.56; 95 % confidence interval (CI) 0.14-0.91; p value = 0.027]. Staphylococcus epidermidis was the most isolated bacteria (30.1 %; n = 28/93). About 61 % (n = 25/41) of Enterobacteriaceae isolates were resistant to cefotaxime; a majority (n = 24/25, 96 %) of which were MDRs and mostly susceptible to amikacin and levofloxacin. Four (80 %) penicillin resistant streptococci were found; 2 of which were MDRs and sensitive to erythromycin and cefuroxime. Methicillin resistant Staphylococcus aureus and vancomycin resistant enterococci were not identified. In multivariate analysis, the Enterobacteriaceae compared to other organisms were significantly associated with multidrug resistance (adjusted OR, 33.6; 95 % CI 6.41-88.73; p value 0.001).
CONCLUSION: MDRs, especially cefotaxime resistant Enterobacteriaceae, are common among patients with cancer in our institution but vary among different patient populations. The results show that empiric antibiotic treatment for cancer patients cannot be done effectively without regard for selective antimicrobial use based on local epidemiologic data.

PMID: 26628056 [PubMed – in process]