Shah Sweta, Rampal Ritika, Thakkar Pooja, Poojary Sushima, Ladi Shweta
Department of Laboratory Medicine, Kokilaben Dhirubhai Ambani Hospital and Research Institute, Mumbai, Maharashtra, India.
Department of Medical Affairs, Wockhardt Limited, Mumbai, Maharashtra, India.
J Lab Physicians. 2021 Jul 2;14(2):109-114. doi: 10.1055/s-0041-1731136. eCollection 2022 Jun.
The growing resistance pattern of the gram-positive pathogens along with a steady increase in minimum inhibitory concentration of the currently available antibiotics have led to an increase in morbidity and mortality rates in India. This study aims to access the shifting antibiotic susceptibility paradigm of the gram-positive pathogens in various infections at a tertiary care center. This is a 3-year retrospective observational study which was performed from January 2016 to December 2018 at a tertiary care hospital in Mumbai. All clinically significant gram-positive cocci isolated from a variety of clinical specimens were studied for their prevalence and antimicrobial susceptibility. Out of 4,428 gram-positive isolates, (35.3%) was the commonly encountered pathogen, followed by spp. (32.1%) and coagulase-negative (CoNS) (25.7%). was majorly isolated from skin and soft tissue infections (60.3%), followed by patients with respiratory tract infections (18.2%) and blood stream infections (13%). Among , particularly methicillin-resistant (MRSA), prevalence increased from 29.5% in 2016 to 35.1% in 2018, with an overall prevalence of 33.6%. All isolates were 100% sensitive toward vancomycin, linezolid, tigecycline, and teicoplanin. However, the CoNS isolates showed a higher resistance rate with reduced susceptibility toward linezolid and teicoplanin. High prevalence of resistance was observed across gram-positive isolates with commonly used antibiotics such as ciprofloxacin, levofloxacin, and erythromycin. While the prevalence of linezolid-resistant enterococcus (LRE) was 3.6%, vancomycin (VRE) and teicoplanin resistance among the enterococcus species was as high as 7.7% and 7.5%, respectively. Rising methicillin resistance among the species (MRSA and MR-CoNS) along with reduced susceptibility toward currently available anti-MRSA agents is a matter of serious concern as it limits the therapeutic options for treating multidrug resistant (MDR) gram-positive infections.
革兰氏阳性病原体耐药模式的不断变化，以及现有抗生素最低抑菌浓度的稳步上升，导致印度的发病率和死亡率增加。本研究旨在了解一家三级护理中心各种感染中革兰氏阳性病原体不断变化的抗生素敏感性模式。
这是一项为期3年的回顾性观察研究，于2016年1月至2018年12月在孟买的一家三级护理医院进行。对从各种临床标本中分离出的所有具有临床意义的革兰氏阳性球菌进行了流行率和抗菌药敏性研究。
在4428株革兰氏阳性分离株中， （35.3%）是最常见的病原体，其次是 属（32.1%）和凝固酶阴性葡萄球菌（CoNS）（25.7%）。 主要从皮肤和软组织感染中分离出来（60.3%），其次是呼吸道感染患者（18.2%）和血流感染患者（13%）。在 中，特别是耐甲氧西林金黄色葡萄球菌（MRSA），其流行率从2016年的29.5%上升到2018年的35.1%，总体流行率为33.6%。所有 分离株对万古霉素、利奈唑胺、替加环素和替考拉宁均100%敏感。然而，CoNS分离株显示出较高的耐药率，对利奈唑胺和替考拉宁的敏感性降低。在革兰氏阳性分离株中，观察到对常用抗生素如环丙沙星、左氧氟沙星和红霉素的高耐药率。虽然耐利奈唑胺肠球菌（LRE）的流行率为3.6%，但肠球菌属中万古霉素（VRE）和替考拉宁耐药率分别高达7.7%和7.5%。
属（MRSA和MR-CoNS）中耐甲氧西林耐药性的上升以及对现有抗MRSA药物敏感性的降低是一个严重问题，因为它限制了治疗多重耐药（MDR）革兰氏阳性感染的治疗选择。
