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Comparative evaluation of different methods for the detection of methicillin resistant staphylococcus aureus (mrsa) and its antibiotic susceptibility pattern

Author: 
Ramprasad B. Pal, Rashmi Joshi and Upasana Pathak
Subject Area: 
Health Sciences
Abstract: 

Background& Objectives: Methicillin resistant Staphylococcus aureus (MRSA) is majorly responsible for a variety of infections in healthcare setting and in general community. These infections range from mild skin boils or pimples to severe life threatening infection of deep tissues, lungs etc. MRSA is of concern not only because of its resistance to methicillin but also because it is generally resistant to many other chemotherapeutic agents like cephalosporin, macrolides and aminoglycosides. MRSA must be detected and treated aggressively to prevent secondary infections. This study will help to determine the simple, most specific and sensitive method for the detection of MRSA, which could be carried out in routine microbiology laboratory. Methods: Strains of Staphylococcus aureus isolated from different clinical specimens were included in the study, which were screened for methicillin resistance. Screening with oxacillin and cefoxitin antibiotic discs, oxacillin MIC using commercial E test strip and detection of mecA gene product PBP2a using Latex agglutination test was carried out. Antibiotic susceptibility test for all MRSA strains was carried out by Kirby Bauer Disc diffusion method as per CLSI guidelines to determine their sensitivity pattern against an array of antibiotics. Multiplex PCR of confirmed MRSA strains was carried out to study resistance genes. Results: In the present study 70 (74.468 %) S.aureus isolates were found to be methicillin resistant by AST with oxacillin (1μg) as well as cefoxitin (30μg), latex agglutination test identified 89 (94.680 %) as MRSA, whereas by oxacillin MIC by E-test only 55 (58.510 %) isolates were found to be MRSA and 74 (78.723%) carried the mecA gene which was determined by the PCR. Interpretation and Conclusion: Results of AST with both Oxacillin (1μg) and cefoxitin (30μg) were somewhat similar to that of PCR results, which is considered as gold standard for detection of methicillin resistance genes. The other investigated methods like latex agglutination, oxacillin E-test may not be appropriate because of the relatively lower levels of concordance with PCR results.

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