PREVALENCE OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS AT A PRIVATE HOSPITAL IN SANA'A, YEMEN

Abstract

Objective: Methicillin resistant Staphylococcus aureus (MRSA) strains are common causes of nosocomial infections and are associated with increased morbidity and mortality. In addition, the antibiotic resistance for MRSA is a major concern in clinical practice.  To study the prevalence and the antimicrobial susceptibility pattern of MRSA isolates from patients in a private hospital.

Methods: The study was performed at a private hospital in Sana’a, Yemen. All the patients' samples from January, 2017 to December, 2017 were included. All isolates from inpatients’ clinical specimens (mainly respiratory secretion, pus, urine, and blood) were collected and standard isolation procedures were applied to all the samples. The records were taken from the microbiology department. Antibiotic susceptibility testing was done by Kirby Bauer's Disc diffusion technique, following the national committee for clinical laboratory standards. The antimicrobial susceptibility patterns of all the MRSA strains were studied against several antibiotics.

Results:  A total of 2079 samples were gathered during the study period. Among them, 199 strains of Staphylococcus aureus were isolated. A majority of Staphylococcus aureus isolates were from pus specimen (n=81/199; 40.7%). MRSA prevalence among the patients was 17.6 % (n=35/199; 17.6). Highest proportion of MRSA was in ICU and surgical departments about 29% of all MRSA isolates. A majority of MRSA isolates were from sputum specimen (n=18/35; 51.4%). The study findings showed that MRSA isolates had the highest frequency of resistant (100%) to levofloxacin and amoxicillin/ clavulinic acid, followed by ciprofloxacin 97%, gentamicin and ampicillin/ sulbactam 94 %, cefuroxime 91 %, moxifloxacin 76%, erythromycin 71.5%, clindamycin 70.5%, and imipenem 55%. The highest frequency of sensitivity (100%) was observed with linezolide, vancomycin, and trimethoprim/ sulfamethoxazole.

Conclusion: In conclusion, MRSA isolates were highly susceptible to newer drugs such as linezolid and to vancomycin which is not a commonly prescribed drug due to the higher nephrotoxic antibiotic. A more careful monitoring for use of broad-spectrum antibiotics should be instituted.

Peer Review History:

Received 7 April 2018; Revised 12 May; Accepted 14 June; Available online 15 July 2018

Received file:        Reviewer's Comments:

Average Peer review marks at initial stage: 6/10

Average Peer review marks at publication stage: 8/10

Reviewer(s) detail:

Dr. Mahmoud S. Abdallah, University of Sadat city, Egypt, dr_samy777@yahoo.com

Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com