Dhungel Sajina, Rijal Komal Raj, Yadav Bindeshwar, Dhungel Binod, Adhikari Nabaraj, Shrestha Upendra Thapa, Adhikari Bipin, Banjara Megha Raj, Ghimire Prakash
Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
Shaid Gangalal Heart Center, Banbasari, Kathmandu, Nepal.
Infect Dis (Auckl). 2021 Sep 1;14:11786337211037355. doi: 10.1177/11786337211037355. eCollection 2021.
Methicillin Resistant (MRSA) is a significant human pathogen associated with nosocomial infections. A in the is a marker of MRSA. The main objective of this study was to detect A and genes conferring resistance in among cardiac patients attending Sahid Gangalal National Heart Centre (SGNHC), Kathmandu, Nepal between May and November 2019.
A total of 524 clinical samples (blood, urine, sputum) were collected and processed. Bacterial isolates were tested for antimicrobial susceptibility test (AST) and screening for MRSA was carried out by cefoxitin disc diffusion method. Minimum inhibitory concentration (MIC) of vancomycin for MRSA was established by agar dilution method and chromosomal DNA was extracted and used in polymerase chain reaction targeting the A A genes.
Out of 524 specimens, 27.5% (144/524) showed bacterial growth. Among 144 culture positive isolates, (27.1%; 39/144) was the predominant bacteria. Among 39 isolates, all isolates were found resistant to penicillin followed by erythromycin (94.9%; 37/39), gentamicin (94.9%; 37/39) and cefoxitin (87.2%; 34/39). Out of 39 , 87.2% (34/39) were MRSA. Among 34 MRSA, 8.8% (3/34) were vancomycin intermediate (VISA). None of the MRSA was resistant to vancomycin. All of the 3 VISA isolates were obtained from inpatients. Of 39 , 82.1% (32/39) harbored gene. Similarly, the entire VISA isolates and 94.1% (32/34) of the MRSA isolates were tested positive for gene.
High prevalence of MRSA among the cardiac patients indicates the increasing burden of drug resistance among bacterial isolates. Since infection control is the crucial step in coping with the burgeoning antimicrobial resistance in the country, augmentation of diagnostic facilities with routine monitoring of drug resistance is recommended.
耐甲氧西林金黄色葡萄球菌（MRSA）是一种与医院感染相关的重要人类病原体。A是MRSA的一个标志物。本研究的主要目的是在2019年5月至11月期间，检测尼泊尔加德满都萨希德·甘加拉尔国家心脏中心（SGNHC）的心脏病患者中赋予耐药性的A和基因。
共收集并处理了524份临床样本（血液、尿液、痰液）。对细菌分离株进行抗菌药敏试验（AST），并通过头孢西丁纸片扩散法进行MRSA筛查。采用琼脂稀释法确定万古霉素对MRSA的最低抑菌浓度（MIC），提取染色体DNA并用于靶向A A基因的聚合酶链反应。
在524份标本中，27.5%（144/524）显示有细菌生长。在144株培养阳性分离株中，（27.1%；39/144）是主要细菌。在39株分离株中，所有分离株均对青霉素耐药，其次是红霉素（94.9%；37/39）、庆大霉素（94.9%；37/39）和头孢西丁（87.2%；34/39）。在39株中，87.2%（34/39）为MRSA。在34株MRSA中，8.8%（3/34）为万古霉素中介（VISA）。没有MRSA对万古霉素耐药。所有3株VISA分离株均来自住院患者。在39株中，82.1%（32/39）携带基因。同样，所有VISA分离株和94.1%（32/34）的MRSA分离株基因检测均为阳性。
心脏病患者中MRSA的高流行表明细菌分离株的耐药负担在增加。由于感染控制是应对该国迅速增长的抗菌药物耐药性的关键步骤，建议加强诊断设施并对耐药性进行常规监测。
