Methicillin Resistant Staphylococcus aureus (MRSA) in Maharat Nakhon Ratchasima Hospital: Prevalence and Susceptibility Patterns.
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Abstract
Methicillin resistant S. aureus (MRSA) is a gram-positive coccus resistant to many antibiotics. Currently, there is trend to increase drug resistance, leading to limited choice of antibiotics. This study was aimed to verify the prevalence and antimicrobial susceptibility patterns of MRSA. A retrospective study of bacterial cultures from the clinical microbiology division, Department of Clinical Medical Technology, Maharat Nakhon Ratchasima Hospital from 2010 to 2014 was performed. The 2,853 isolates of MRSA were found from 12,540 isolates of S. aureus (23.06%). The incidence rate diminished of 12.5% from 2010 to 2014. The rates of resistance during 2010 to 2014 were 29.03%, 24.84%, 21.7%, 21.01%, 16.53% respectively. In 2014, 7 isolates of MRSA were firstly found at OPD. The most common site of MRSA infection was respiratory tract, around 60.85%. The main sources of MRSA infection were the general wards around 60.32% in 2014 and it was around three times more than that of ICU, 16.27% and the rate of infection in general ward was increased every year. Mostly MSSA were sensitive to cephazolin, cefdinir, amoxicillin/ clavulanic acid, gentamicin, trimethoprim-sulfamethoxazole, fosfomycin up to 98%, and to erythromycin and clindamycin in the range of 93-97%. MRSA was 100% resistant to cephazolin, cefdinir, amoxicillin/ clavulanic acid and nearly all resistant to erythromycin, clindamycin and gentamicin. MRSA had gradually increased trend of susceptibility to trimethoprim-sulfamethoxazole, 27%, 61%, 63%, 82%, 78% from 2010 to 2014, respectively. The drug to which MRSA was 99% susceptible was linezolid. The resistance to vancomycin was found to increase, viz., vancomycin intermediate S. aureus (VISA) was 6.25% in 2013 and it was necessary to carefully monitor the use of vancomycin in MRSA because of the increased occurrence of the slight resistance. However there was no report of vancomycin resistant S. aureus (VRSA) in the hospital, so far. These antibiograms may be useful for choosing the appropriate antimicrobial therapy leading to reduce the hospital stay day and the mortality due to MRSA infection.
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