M Sreejisha, Mulki Shalini Shenoy, Shenoy Suchitra, Dhanashree Biranthabail, M Chakrapani, Bhat Gopalakrishna
Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 575001, India.
Department of Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 575001, India.
Infect Drug Resist. 2023 Jan 5;16:9-17. doi: 10.2147/IDR.S393415. eCollection 2023.
To study the infections caused by methicillin resistant (MRSA) with emphasis on heterogeneous vancomycin intermediate (hVISA) in diabetic and non-diabetic patients and their comparison.
strains isolated from diabetic and non-diabetic patients admitted in four tertiary care hospitals in Coastal Karnataka, South India, were tested for methicillin resistance and included in the present study. Demographic and clinical data of the patients were collected using structured proforma. Antimicrobial susceptibility testing was done using the Kirby-Bauer disc diffusion method, and MLS phenotypes were identified using the D-test. The minimum inhibitory concentration (MIC) of vancomycin was determined using agar dilution. MRSA isolates were tested for hVISA using vancomycin screen agar and population analysis profile - area under the curve (PAP-AUC) test. Statistical analysis of the results was done using the chi-square test. SPSS version 29.0 was used for this purpose.
Out of 665 strains of isolated, 220 (33.1%) were MRSA. Of these 220 MRSA strains, 122 (55.5%) and 98 (44.5%) were isolated from diabetic and non-diabetic patients, respectively. There was no significant difference in the antimicrobial resistance patterns of MRSA strains isolated from diabetic and non-diabetic patients. Foot infections and osteomyelitis caused by MRSA were significantly more among diabetic patients. Out of 220 strains of MRSA, 14 (6.4%) were hVISA. The rates of hVISA among MRSA isolated from diabetic and non-diabetic were 9.0% and 3.1%, respectively. This difference was statistically not significant.
The rate of hVISA among all MRSA isolates was 6.4%. The risk of hVISA infection was three times more in diabetic patients. The results emphasize the importance of the detection of hVISA among MRSA isolates especially from diabetic patients.
研究耐甲氧西林金黄色葡萄球菌（MRSA）引起的感染，重点关注糖尿病患者和非糖尿病患者中的异质性万古霉素中介金黄色葡萄球菌（hVISA）及其比较。
从印度南部卡纳塔克邦沿海地区四家三级护理医院收治的糖尿病患者和非糖尿病患者中分离出的菌株，进行耐甲氧西林检测，并纳入本研究。使用结构化表格收集患者的人口统计学和临床数据。采用 Kirby-Bauer 纸片扩散法进行抗菌药物敏感性试验，使用 D 试验鉴定 MLS 表型。采用琼脂稀释法测定万古霉素的最低抑菌浓度（MIC）。使用万古霉素筛选琼脂和群体分析谱-曲线下面积（PAP-AUC）试验对 MRSA 分离株进行 hVISA 检测。使用卡方检验对结果进行统计学分析。为此使用了 SPSS 29.0 版本。
在分离出的 665 株菌株中，220 株（33.1%）为 MRSA。在这 220 株 MRSA 菌株中，分别从糖尿病患者和非糖尿病患者中分离出 122 株（55.5%）和 98 株（44.5%）。从糖尿病患者和非糖尿病患者中分离出的 MRSA 菌株的抗菌耐药模式没有显著差异。糖尿病患者中由 MRSA 引起的足部感染和骨髓炎明显更多。在 220 株 MRSA 菌株中，14 株（6.4%）为 hVISA。从糖尿病患者和非糖尿病患者中分离出的 MRSA 中 hVISA 的发生率分别为 9.0%和 3.1%。这种差异在统计学上不显著。
所有 MRSA 分离株中 hVISA 的发生率为 6.4%。糖尿病患者发生 hVISA 感染的风险是其三倍。结果强调了在 MRSA 分离株中，尤其是从糖尿病患者中检测 hVISA 的重要性。
