PMID- 26500902 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20151027 LR - 20220408 IS - 2249-782X (Print) IS - 0973-709X (Electronic) IS - 0973-709X (Linking) VI - 9 IP - 9 DP - 2015 Sep TI - Evaluation of Multidrug Resistant Staphylococcus aureus and their Association with Biofilm Production in a Tertiary Care Hospital, Tripura, Northeast India. PG - DC01-4 LID - 10.7860/JCDR/2015/13965.6417 [doi] AB - BACKGROUND: High morbidity and mortality rates are associated with Methicillin-resistant Staphylococcus aureus (MRSA) because of development of multidrug resistance. Staphylococcus aureus (S. aureus) has the ability to colonize and form biofilms on biomaterials which is causing resistance towards antimicrobials and thus making them difficult to eradicate from the infected hosts. MATERIALS AND METHODS: Culture isolation, identification was done following standard protocol and antibiogram of the isolates were done. The detection of MRSA, Macrolide-Lincosamide-Streptogramin B resistance (MLSB), vancomycin resistance phenotypes were done by using cefoxitin disc diffusion test, D zone test and vancomycin E test. Biofilm was detected by Congo red agar method. RESULTS: A total of 100 (31.7%) S. aureus strains were isolated from 315 clinical specimens. The prevalence of MRSA was 47% (47/100) with 85.1% were homogeneous MRSA and 14.9% were heterogeneous. Out of 47 MRSA strains, 63.8% were Hospital acquired-MRSA (HA-MRSA) infections whereas rests 36.2% were caused by Community acquired-MRSA (CA-MRSA) strains. Maximum number of MRSA isolates belonged to group A biotype (34%). A 14.9% isolates were of nontypeable group. Out of 100 S. aureus isolates, the prevalence of Vancomycin resistant S. aureus (VRSA) was found to be 3%. The MLSB phenotypes showed that the rates of inducible MLSB (iMLSB), constitutive MLSB (cMLSB) and Macrolide-Streptogramin B (MSB) in case of MRSA to be 19.1%, 31.9% and 12.8%. Prevalence of low-level (MUP(L)) and high-level mupirocin resistance (MUP(H)) among MRSA was 19.1% and 6.4%. Biofilm production was found in 55% strains of S. aureus. Out of 47 MRSA strains 76.6%were producing biofilm in comparison to 38.8% in methicillin-sensitive S. aureus (MSSA). Higher degree of antibiotic resistance in biofilm producers was seen especially in case of ciprofloxacin, co-trimoxazole, rifampicin, kanamycin, erythromycin and clindamycin whereas gentamycin, tetracycline and penicillin resistance was more in non-biofilm producers. CONCLUSION: This study shows high rate of circulating MRSA with a majority of these isolates are multi-drug resistant of which mostly are biofilm producers in our hospital setup. Development of antimicrobial stewardship program based on the local epidemiological data and national guidelines is the need of the hour. FAU - Bhattacharya, Sibabrata AU - Bhattacharya S AD - Assistant Professor, Department of Microbiology, Agartala Government Medical College , Kunjavan, Agartala, Tripura, India . FAU - Bir, Raunak AU - Bir R AD - Junior Resident, Department of Microbiology, Agartala Government Medical College , Kunjavan, Agartala, Tripura, India . FAU - Majumdar, Tapan AU - Majumdar T AD - Associate Professor, Department of Microbiology, Agartala Government Medical College , Kunjavan, Agartala, Tripura, India . LA - eng PT - Journal Article DEP - 20150901 PL - India TA - J Clin Diagn Res JT - Journal of clinical and diagnostic research : JCDR JID - 101488993 PMC - PMC4606231 OTO - NOTNLM OT - Congo red agar method OT - Methicillin resistant Staphylcoccus aureus OT - Vancomycin resistant Staphylcoccus aureus EDAT- 2015/10/27 06:00 MHDA- 2015/10/27 06:01 PMCR- 2015/11/01 CRDT- 2015/10/27 06:00 PHST- 2015/03/12 00:00 [received] PHST- 2015/06/09 00:00 [accepted] PHST- 2015/10/27 06:00 [entrez] PHST- 2015/10/27 06:00 [pubmed] PHST- 2015/10/27 06:01 [medline] PHST- 2015/11/01 00:00 [pmc-release] AID - 10.7860/JCDR/2015/13965.6417 [doi] PST - ppublish SO - J Clin Diagn Res. 2015 Sep;9(9):DC01-4. doi: 10.7860/JCDR/2015/13965.6417. Epub 2015 Sep 1.