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OUTCOME OF IMPLEMENTATION OF HOSPITAL INFECTION CONTROL GUIDELINES ON THE ANTIBIOTIC RESISTANCE PATTERN IN STAPHYLOCOCCUS AUREUS ISOLATED FROM SKIN AND SOFT TISSUE INFECTIONS: A RETROSPECTIVE TWO TIME POINT STUDY

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Ramakrishna Pai Jakribettu, SurluVidya Rao, Ovine Loyster D’souza, Valerian Sudeep Pinto, Brincy Loyala D’souza, Laveena AgnisTellis, Manjeshwar Shrinath Baliga

 

 

ABSTRACT: BACKGROUND: Skin and soft tissue infections (SSTIs), by Staphylococcus aureus is a commonly observed phenomena. However, when the organism is methicillin-resistant S. aureus(MRSA) the morbidity is high and the organism can also lead to death of the individual if immunocompromised. Treatment of MRSA involves use of high end drugs that are extremely expensive and accompanied by side effects. METHODS: This is a retrospective study and the medical records for the year 2010 and 2015 for S aureus in SSTIs were accessed. The two time points were selected because in the beginning of the decade Hospital Infection control was upgraded and emphasized through rigorous sensitization and implementation audits. The incidence and drug resistance pattern for various clinicallyused antibiotics against S aureus at two time points were analyzed. RESULTS:The results indicated that there was a 23.24% decrease in the incidence of MRSA and was significant (p<0.019). However there was an increase in resistance of S aureus to fluoroquinolones and macrolides (p< 0.0001).CONCLUSIONS: The safety measures adopted has immense use in reducing hospital infection and be of use to public health. This study indicates that adoption of hospital infection control measures byregular practice of the stipulated guidelines is an important way in reducing the incidence of MRSA infection.

KEY WORDS: Staphylococcus aureus;MRSA; Hospital Infection Control; Skin and soft tissue infections

 

REFERENCE:

 

  1. Tognetti L, Martinelli C, Berti S, Hercogova J, Lotti T, Leoncini F, Moretti S. Bacterial skin and soft tissue infections: review of the epidemiology, microbiology, aetio-pathogenesis and treatment: a collaboration between dermatologists and infectivologists.JEurAcadDermatolVenereol.2012; 26:931-41.

  2. Oliveira DC, Tomasz A, deLencastre H. Secrets of success of a human pathogen: molecular evolution of pandemic clones of methicillin-resistant Staphylococcus aureus The Lancet Infectious Diseases. 2002; 2: 180-189.

  3. Stevens DL, Bisno AL, Chambers HF, et al; Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014; 59:e10-52.

  4. Nikaido H. Multidrug resistance in bacteria. Annual Review of Biochemistry.2009; 78:8.1-8.28.

  5. Lowy FD (2003). Antimicrobial resistance: the example of StaphylococcuS aureus J. Clin. Invest. 111:1265–1273.

  6. Cosgrove, S.E., et al. 2003. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcu-Saureus bacteremia: a meta-analysis. Clin. Infect. Dis. 36:53–59.

  7. Kumar M. Multidrug-Resistant Staphylococcus aureus, India, 2013-2015. Emerg Infect Dis. 2016; 22(9):1666-7.

  8. Gandra S, Mojica N, Klein EY, Ashok A, Nerurkar V, Kumari M, Ramesh U, Dey S, Vadwai V, Das BR, Laxminarayan R. Trends in antibiotic resistance among major bacterial pathogens isolated from blood cultures tested at a large private laboratory network in India, 2008-2014. Int J Infect Dis. 2016; 50:75-82.

  9. Neetu TJ, Murugan S. Genotyping of Methicillin Resistant StaphylococcuS aureus from Tertiary Care Hospitals in Coimbatore, South India. J Glob Infect Dis. 2016; 8:68-74.

  10. Jindal N, Malhotra R, Grover P, Singh S, Bansal R, Kaur S. Methicillin resistant StaphylococcuS aureus (MRSA) in Malwa region of Punjab (North-West India). Indian J Med Res. 2016; 143: 371-2.

  11. Bhat V, Gupta S, Kelkar R, Biswas S, Khattry N, Moiyadi A, Bhat P, Ambulkar R, Chavan P, Chiplunkar S, Kotekar A, Gupta T. Bacteriological profile and antibiotic susceptibility patterns of clinical isolates in atertiary care cancer center. Indian J Med PaediatrOncol. 2016; 37 (1): 204.

  12. Emilda JK, Shenoy SM, Chakrapani M, Kumar P, Bhat KG. Clinical spectrum and antimicrobial resistance pattern of skin and soft tissue infections caused by community acquired-methicillin resistant StaphylococcuS aureus.Indian J DermatolVenereolLeprol.2014; 80:539-40.

  13. Sahoo KC, Sahoo S, Marrone G, Pathak A, Lundborg CS, Tamhankar AJ. Climatic factors and community -associated methicillin-resistant StaphylococcuS aureus skin and soft-tissue infections - a time-series analysis study. Int J Environ Res Public Health. 2014; 11(9):8996-9007.doi: 10.3390/ijerph110908996.

  14. Indian Network for Surveillance of Antimicrobial Resistance (INSAR) group, India. Methicillin resistant StaphylococcuS aureus (MRSA) in India: prevalence & susceptibility pattern. Indian J Med Res. 2013;137(2):363-9.

  15. Loomba PS, Taneja J, Mishra B. Methicillin and Vancomycin ResistantS. aureus in Hospitalized Patients. J Glob Infect Dis. 2010 Sep;2(3):275-83.

  16. Shenoy MS, Bhat GK, Kishore A, Hassan MK. Significance of MRSA strains in community associated skin and soft tissue infections. Indian J Med Microbiol. 2010; 28(2):152-4.

  17. Angel MR, Balaji V, Prakash J, Brahmadathan KN, Mathews MS. Prevalence of inducible clindamycin resistance in gram positiveorganisms in a tertiary care centre. Indian J Med Microbiol. 2008; 26(3):262-4.

  18. Goering RV, Shawar RM, Scangarella NE, O'Hara FP, Amrine-Madsen H, West JM, Dalessandro M, Becker JA, Walsh SL, MillerLA, van Horn SF, Thomas ES, Twynholm ME. Molecular epidemiology of methicillin-resistant and methicillin-susceptible StaphylococcuS aureus isolates from global clinical trials. J ClinMicrobiol. 2008; 46(9):2842-7.

  19. Sajna AM, Kuruvilla M, Shenoy S, Bhat GK. Methicillin resistant StaphylococcuS aureus (MRSA) in skin isolates from hospital acquired infections. Indian J DermatolVenereolLeprol. 1999; 65(5):222-4.

  20. Anonymous (2016). Prevention of the spread of MRSA.http://www.cdc.gov/mrsa/healthcare/clinicians/prevention/ (accessed June 1st2016)

  21. Coia JE, Duckworth GJ, Edwards DI, Farrington M, Fry C, Humphreys H, Mallaghan C, Tucker DR; Joint Working Party of the British Society of Antimicrobial Chemotherapy; Hospital Infection Society; Infection ControlNurses Association. Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect. 2006; 63 Suppl 1:S1-44.

  22. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fifth Informational Supplement. CLSI document M100-S25. Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2015.

  23. Daum RS. Skin and Soft-Tissue Infections Caused by Methicillin-Resistant Staphy-lococcuSaureus N Engl J Med 2007; 357:380-390

  24. Dryden M, Andrasevic AT, Bassetti M, Bouza E, Chastre J, Cornaglia G, Esposito S, French G, Giamarellou H, Gyssens IC, Nathwani D, Unal S, Voss A. A European survey of antibiotic management of methicillin-resistant StaphylococcuS aureus infection: current clinical opinion and practice. ClinMicrobiol Infect. 2010; 16 Suppl 1:3-30.

  25. Tinelli M, Monaco M, Vimercati M, Ceraminiello A, Pantosti A. Methicillin-susceptible StaphylococcuS aureus in skin and soft tissue infections, Northern Italy. Emerg Infect Dis. 2009; 15:250-7.

  26. Freitas FI, Guedes-Stehling E, Siqueira-Júnior JP.Resistance to gentamicin and related aminoglycosides in StaphylococcuS aureus isolated in Brazil.Lett ApplMicrobiol.1999; 29:197-201.

  27.  Chandrakanth K, Raju S, Patil SA. Aminoglycoside-Resistance Mechanisms in Multidrug-Resistant StaphylococcuS aureus Clinical Isolates. CurrMicrobiol (2008) 56: 558. doi:10.1007/s00284-008-9123-y

  28. Bouchami O, Achour W, Ben Hassen A (2007). Prevalence and mechanisms of macrolide resistance among Staphylococcus epidermidisisolates from neutropenic patients in Tunisia. Clinical Microbiology and Infection, 13(1): 86-90.

  29. Hauschild T, Sacha P, Wieczorek P, Zalewska M, Kaczyñska K, Tryniszewska E. Aminoglycosides resistance in clinical isolates of StaphylococcuSaureus from a University Hospital in Bialystok, Poland. FoliaHistochemicaet Cytobiologica. Vol. 46, No. 2, 2008. 225-228

  30. Moreillon P, Que YA, Glauser MP. StaphylococcuS aureus (including staphy-lococcal toxic shock). In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Vol 2. 6th ed. Philadelphia, Pa: Elsevier;2005:2321-235

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