Abstract：
BACKGROUND: Methicillin resistance, inducible clindamycin resistance (ICR), biofilm production, and increased minimum inhibitory concentration (MIC) of vancomycin in Staphylococcus aureus are major causes of antibiotic treatment failure and increased morbidity and mortality. The surveillance of such isolates and the study of their antimicrobial pattern are essential in managing the infections caused by these isolates. This study aimed to determine methicillin resistance, biofilm production, and ICR in S. aureus isolates from a tertiary care hospital in Kathmandu, Nepal.
METHODS: A total of 217 S. aureus isolated from different samples were processed following standard laboratory procedures. Antibiotic susceptibility testing was performed by the Kirby-Bauer disk diffusion technique. Methicillin-resistant S. aureus (MRSA) were identified by the cefoxitin disk diffusion test, and biofilm producers were examined using the microtiter plate technique. D-test and E-test were performed to determine inducible clindamycin resistance and minimum inhibitory concentration of vancomycin, respectively.
RESULTS: Among the 217 S. aureus isolates, 78.3% were multidrug-resistant (MDR), 47.0% were MRSA, 62.2% were biofilm producers, and 50.7% showed ICR. All MRSA isolates exhibited MIC levels of vancomycin within the susceptible range. Biofilm producers and MRSA isolates showed elevated antimicrobial resistance. MRSA was significantly associated with MDR. Biofilm-producing and multidrug-resistant MRSA isolates showed significantly higher MIC levels of vancomycin (p = 0.0013 and < 0.0001, respectively), while ICR was significantly higher in MDR (p = 0.0001) isolates.
CONCLUSIONS: High multidrug resistance, MRSA, and ICR in this study call for routine evaluation of antibiotic susceptibility patterns of S. aureus. Vancomycin can be used to treat serious staphylococcal infections. Clindamycin should be prescribed only after performing the D-test. Drugs like teicoplanin, chloramphenicol, doxycycline, amikacin, and levofloxacin can treat MRSA infections.
METHODS: A total of 217 S. aureus isolated from different samples were processed following standard laboratory procedures. Antibiotic susceptibility testing was performed by the Kirby-Bauer disk diffusion technique. Methicillin-resistant S. aureus (MRSA) were identified by the cefoxitin disk diffusion test, and biofilm producers were examined using the microtiter plate technique. D-test and E-test were performed to determine inducible clindamycin resistance and minimum inhibitory concentration of vancomycin, respectively.
RESULTS: Among the 217 S. aureus isolates, 78.3% were multidrug-resistant (MDR), 47.0% were MRSA, 62.2% were biofilm producers, and 50.7% showed ICR. All MRSA isolates exhibited MIC levels of vancomycin within the susceptible range. Biofilm producers and MRSA isolates showed elevated antimicrobial resistance. MRSA was significantly associated with MDR. Biofilm-producing and multidrug-resistant MRSA isolates showed significantly higher MIC levels of vancomycin (p = 0.0013 and < 0.0001, respectively), while ICR was significantly higher in MDR (p = 0.0001) isolates.
CONCLUSIONS: High multidrug resistance, MRSA, and ICR in this study call for routine evaluation of antibiotic susceptibility patterns of S. aureus. Vancomycin can be used to treat serious staphylococcal infections. Clindamycin should be prescribed only after performing the D-test. Drugs like teicoplanin, chloramphenicol, doxycycline, amikacin, and levofloxacin can treat MRSA infections.
摘要：
背景：甲氧西林耐药，诱导型克林霉素抗性（ICR），生物膜生产，万古霉素在金黄色葡萄球菌中的最低抑菌浓度（MIC）增加是抗生素治疗失败和发病率和死亡率增加的主要原因。对此类分离株的监测和对其抗菌模式的研究对于管理由这些分离株引起的感染至关重要。本研究旨在确定甲氧西林耐药性，生物膜生产，和来自加德满都三级医院的金黄色葡萄球菌分离株的ICR，尼泊尔。
方法:按照标准实验室程序处理从不同样品分离的总共217个金黄色葡萄球菌。通过Kirby-Bauer圆盘扩散技术进行抗生素敏感性测试。通过头孢西丁纸片扩散试验鉴定耐甲氧西林金黄色葡萄球菌（MRSA），和生物膜生产者使用微量滴定板技术进行检查。进行D检验和E检验以确定诱导型克林霉素抗性和万古霉素的最低抑制浓度。分别。
结果：在217株金黄色葡萄球菌中，78.3%为多重耐药(MDR),47.0%为MRSA，62.2%是生物膜生产者，50.7%显示ICR。所有MRSA分离物表现出在敏感范围内的万古霉素的MIC水平。生物膜生产者和MRSA分离株显示出升高的抗微生物耐药性。MRSA与MDR显著相关。生物膜产生和多重耐药的MRSA分离株显示出显著较高的万古霉素MIC水平（分别为p=0.0013和<0.0001），而ICR在MDR中显著较高(p=0.0001)。
结论：多药耐药性高，MRSA,和ICR在这项研究中要求对金黄色葡萄球菌的抗生素敏感性模式进行常规评估。万古霉素可用于治疗严重的葡萄球菌感染。克林霉素应仅在进行D测试后才处方。像替考拉宁这样的药物，氯霉素,多西环素,阿米卡星，和左氧氟沙星可以治疗MRSA感染。
方法:按照标准实验室程序处理从不同样品分离的总共217个金黄色葡萄球菌。通过Kirby-Bauer圆盘扩散技术进行抗生素敏感性测试。通过头孢西丁纸片扩散试验鉴定耐甲氧西林金黄色葡萄球菌（MRSA），和生物膜生产者使用微量滴定板技术进行检查。进行D检验和E检验以确定诱导型克林霉素抗性和万古霉素的最低抑制浓度。分别。
结果：在217株金黄色葡萄球菌中，78.3%为多重耐药(MDR),47.0%为MRSA，62.2%是生物膜生产者，50.7%显示ICR。所有MRSA分离物表现出在敏感范围内的万古霉素的MIC水平。生物膜生产者和MRSA分离株显示出升高的抗微生物耐药性。MRSA与MDR显著相关。生物膜产生和多重耐药的MRSA分离株显示出显著较高的万古霉素MIC水平（分别为p=0.0013和<0.0001），而ICR在MDR中显著较高(p=0.0001)。
结论：多药耐药性高，MRSA,和ICR在这项研究中要求对金黄色葡萄球菌的抗生素敏感性模式进行常规评估。万古霉素可用于治疗严重的葡萄球菌感染。克林霉素应仅在进行D测试后才处方。像替考拉宁这样的药物，氯霉素,多西环素,阿米卡星，和左氧氟沙星可以治疗MRSA感染。
