Kandel Shesh Narayan, Adhikari Nabaraj, Dhungel Binod, Shrestha Upendra Thapa, Angbuhang Khadga Bikram, Karki Gayatri, Adhikari Bipin, Banjara Megha Raj, Rijal Komal Raj, Ghimire Prakash
Kantipur College of Medical Sciences, Tribhuvan University, Sitapaila, Kathmandu, Nepal.
Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
Microbiol Insights. 2020 Nov 11;13:1178636120972695. doi: 10.1177/1178636120972695. eCollection 2020.
Methicillin resistant (MRSA) is a major human pathogen associated with nosocomial and community infections. A gene is considered one of the important virulence factors of responsible for acquiring resistance against methicillin. The main objective of this study was to explore the prevalence, antibiotic susceptibility pattern, and A gene.
A total of 39 isolates of were isolated from 954 clinical specimens processed in Microbiology laboratory of Himal Hospital, Kathmandu. Antimicrobial susceptibility test (AST) was performed by Kirby-Bauer disc diffusion method using cefoxitin, and performed Polymerase Chain Reaction (PCR) for amplification of gene in MRSA isolates.
Out of 954 clinical samples, (16.2%; 153/954) samples had bacterial growth. Among 153 culture positive isolates, 25.5% (39/153) were positive for Among 39 (61.5%; 24/39) were multiple drug resistant (MDR). On AST, amoxicillin was detected as the least effective while vancomycin was the most effective. The prevalence of methicillin resistance was 46% (18/39) of which 72.2% (13/18) were positive for gene in PCR assay.
One in 4 culture positive isolates from the clinical specimens were , of which almost two-thirds were MDR. Around half of the MDR showed MRSA and significant proportion of them were positive for gene. This study concludes that the gene is solely dependent for methicillin resistance in but the presence of gene is not obligatory. PCR detection of the A gene is reliable, valid and can be suggested for the routine use in diagnostic laboratories.
耐甲氧西林金黄色葡萄球菌（MRSA）是一种与医院感染和社区感染相关的主要人类病原体。一种基因被认为是导致对甲氧西林产生耐药性的重要毒力因子之一。本研究的主要目的是探讨其流行情况、抗生素敏感性模式以及该基因。
从加德满都喜马拉雅医院微生物实验室处理的954份临床标本中总共分离出39株金黄色葡萄球菌。采用头孢西丁通过 Kirby-Bauer 纸片扩散法进行药敏试验（AST），并对MRSA分离株进行聚合酶链反应（PCR）以扩增该基因。
在954份临床样本中，有153份（16.2%；153/954）样本有细菌生长。在153株培养阳性分离株中，25.5%（39/153）为金黄色葡萄球菌阳性。在39株金黄色葡萄球菌中，61.5%（即24/39）为多重耐药（MDR）。在药敏试验中，阿莫西林被检测为最无效，而万古霉素最有效。耐甲氧西林的流行率为46%（18/39），其中72.2%（13/18）在PCR检测中该基因呈阳性。
临床标本中每4株培养阳性分离株就有1株是金黄色葡萄球菌，其中近三分之二为多重耐药。大约一半的多重耐药菌表现为MRSA，且其中相当一部分该基因呈阳性。本研究得出结论，该基因是金黄色葡萄球菌耐甲氧西林的唯一决定因素，但该基因的存在并非必需。该基因的PCR检测可靠、有效，可建议在诊断实验室常规使用。
