PREVALENCE OF MRSA BACTERAEMIA AND THE ASSOCIATED RESISTANCE PATTERN IN CHILDREN AT A TERTIARY CARE PAEDIATRIC HOSPITAL

Dr. Gaurav Salunke

Abstract


Introduction:

Severe metastatic or complicated infections are associated with Staphylococcus aureus (S. aureus) bacteraemia. Multidrug resistant (MDR) strains of S. aureus, particularly Methicillin Resistant S. aureus (MRSA) cause hard to treat infections, thus making the first line drugs ineffective.

Methodology:

Retrospective data was collected from all MRSA bacteraemia events in children (0- 16 years) from Jan 2019 to June 2019 at Bai Jerbai Wadia Hospital, a tertiary care pediatric hospital in Mumbai.

Results:

The overall prevalence of methicillin resistance during the study period was 79.55 %. The overall prevalence of methicillin resistance during the study period was 79.55 %.  No isolates were found to be resistant to Vancomycin, Teicoplanin, Linezolid or Tigecycline.

 

Conclusion:

The study showed alarmingly high level of bacteraemia, due to MRSA in the pediatric population. Multiple-non-β-lactam agents have also become ineffective against the newer strains isolated.

 


Keywords


MRSA, bacteraemia

Full Text:

PDF

References


Lowy FD. Staphylococcus aureus infections. N Engl J Med. 1998;339:520–532.

Beigelman PM, Rantz LA. Clinical importance of coagulase – positive, penicillin-resistant Staphylococcus aureus. N Engl J Med. 1950;242:353–358.

Barber M. Staphylococcal infections due to penicillin-resistant strains. Br Med J. 1947;2:863–865.

Jevons PM. Celbenin-resistant staphylococci. Br Med J. 1961;1:124. 8. Barber M. Methicillin-resistant staphylococci. J Clin Pathol. 1961;14:385–393

Baba T, Takeuchi F, Kuroda M, et al. Genome and virulence determinants of high virulence community-acquired MRSA. Lancet. 2002;359:1819–1827.

Okuma K, Iwakawa K, Turnidge JD, et al. Dissemination of new methicillin-resistant Staphylococcus aureus clones in the community. J Clin Microbiol. 2002;40:4289–4294.

Shanson DC. Antibiotic-resistant Staphylococcus aureus. J Hosp Infect. 1981;2:11–36.

Collopy BT, Dalton MF, Wright C, et al. Comparison of the clinical significance of methicillin-resistant and methicillin-sensitive Staphylococcus aureus isolates. Med J Aust. 1984;140:211–214.

Smith JT, Amyes SGB. Bacterial resistance to antifolate chemotherapeutic agents mediated by plasmids. Br Med J. 1984;40:42–46.

Patel AK, Patel KK, Patel KR, Shah S, Dileep P. Time trends in the epidemiology of microbial infections at a tertiary care center in west India over last 5 years. J Assoc Physicians India 2010; 58 (Suppl): 37-40.

Gopalakrishnan R, Sureshkumar D. Changing trends in antimicrobial susceptibility and hospital acquired infections over an 8 year period in a tertiary care hospital in relation to introduction of an infection control programme. J Assoc Physicians India 2010; 58 (Suppl): 25-31.

The changing epidemiology of Staphylococcus aureus bloodstream infection: a multinational population-based surveillance study. Laupland KB, Lyytikäinen O, Søgaard M, Kennedy KJ, Knudsen JD, Ostergaard C, Galbraith JC, Valiquette L, Jacobsson G, Collignon P, Schønheyder HC, International Bacteremia Surveillance Collaborative. Clin Microbiol Infect. 2013 May; 19(5):465-71.

Tiwari HK, Das AK, Sapkota D, Sivarajan K, Pahwa VK. Methicillin resistant Staphylococcus aureus: Prevalence and antibiogram in a tertiary care hospital in western Nepal. J Infect Dev Ctries. 2009;3:681–4.

Rajaduraipandi K, Mani KR, Panneerselvam K, Mani M, Bhaskar M, Manikandan M. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus: A multicentre study. Indian J Med Microbiol. 2006;24:34–8.

Menezes GA, Harish BN, Sujatha S, Vinothini K, Parija SC. Emergence of vancomycin-intermediate Staphylococcus species in southern India. J Med Microbiol. 2008;57:911–2

Tiwari HK, Sen MR. Emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India. BMC Infect Dis. 2006;6:156.

Shilpa Arora, Pushpa Devi, Usha Arora, Bimla Devi. Prevalence of Methicillin-resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Hospital in Northern India. J Lab Physicians. 2010 Jul-Dec; 2(2): 78–81.

Majumder D, Bordoloi JS, Phukan AC, Mahanta J. Antimicrobial susceptibility pattern among methicillin resistant staphylococcus isolates in Assam. Indian J Med Microbiol. 2001;19:138–40

Vidhani S, Mehndiratta PL, Mathur MD. Study of methicillin resistant Staphylococcus aureus isolates from high risk patients. Indian J Med Microbiol. 2001;19:87–90

Han JH, Edelstein PH, Lautenbach E. Reduced vancomycin susceptibility and staphylococcal cassette chromosome mec (SCCmec) type distribution in methicillin-resistant Staphylococcus aureus bacteraemia. J Antimicrob Chemother. 2012;67:2346–9.

Moore CL, Osaki-Kiyan P, Haque NZ, Perri MB, Donabedian S, Zervos MJ. Daptomycin versus vancomycin for bloodstream infections due to methicillin-resistant Staphylococcus aureus with a high vancomycin minimum inhibitory concentration: a case-control study. Clin Infect Dis. 2012;54:51–8.

Moise PA, Amodio-Groton M, Rashid M, Lamp KC, Hoffman-Roberts HL, Sakoulas G, et al. Multicenter evaluation of the clinical outcomes of daptomycin with and without concomitant beta-lactams in patients with Staphylococcus aureus bacteremia and mild to moderate renal impairment. Antimicrob Agents Chemother. 2013;57:1192–200.

Holland TL, Arnold C, Fowler Jr VG. Clinical management of Staphylococcus aureus bacteremia: a review. JAMA. 2014;312:1330–41

Zasowski EJ, Trinh TD, Claeys KC, Casapao AM, Sabagha N, Lagnf AM, et al. Multicenter observational study of ceftaroline fosamil for methicillin-resistant Staphylococcus aureus bloodstream infections. Antimicrob Agents Chemother. 2017;61(2). doi:10.1128/AAC.02015-16.

Park HJ, Kim SH, Kim MJ, Lee YM, Park SY, Moon SM, et al. Efficacy of linezolid-based salvage therapy compared with glycopeptide-based therapy in patients with persistent methicillin-resistant Staphylococcus aureus bacteremia. J Infect. 2012;65:505–12.

Sander A, Beiderlinden M, Schmid EN, Peters J. Clinical experience with quinupristin-dalfopristin as rescue treatment of critically ill patients infected with methicillin-resistant staphylococci. Intensive Care Med. 2002;28:1157–60.

Paul M, Bishara J, Yahav D, Goldberg E, Neuberger A, Ghanem-Zoubi N, et al. Trimethoprim-sulfamethoxazole versus vancomycin for severe infections caused by meticillin resistant Staphylococcus aureus: randomised controlled trial. BMJ. 2015;350:h2219

Davis JS, Sud A, O'Sullivan MVN, Robinson JO, Ferguson PE, Foo H, et al. Combination of vancomycin and beta-lactam therapy for methicillin-resistant Staphylococcus aureus bacteremia: a pilot multicenter randomized controlled trial. Clin Infect Dis. 2016;62:173–80.

Shafiq I, Bulman ZP, Spitznogle SL, Osorio JE, Reilly IS, Lesse AJ, et al. A combination of ceftaroline and daptomycin has synergistic and bactericidal activity in vitro against daptomycin nonsusceptible methicillin-resistant Staphylococcus aureus (MRSA). Infect Dis (Lond). 2017;49:410–6.


Refbacks

  • There are currently no refbacks.