Future Trends in the Treatment of MRSA in Pakistan

  • Muhammad Noorulamin Noorulamin Rawalpindi Institute of Cardiology
  • Dr. Zarafshan Badar Zarafsah Foundation University Medical College, Islamabad
  • Dr. Ayesha Janjua Foundation University Medical College, Islamabad
  • Azhar Iqbal Holy Family Hospital
  • Dr. Sobia Humerah Isra University, Islamabad
  • Dr. Pakeeza Arzoo Shaiq PMAS. ARID Agriculture University, Rawalpindi
Keywords: Antibiotics, MRSA, Vancomycin, Chloramphenicol

Abstract

 

Background: The Methicillin resistant Staphylococcus aureus (MRSA) is accountable for community and hospital acquired infections. Due to over and misuse of antibiotics, MRSA isolates are becoming multidrug resistant even with linezolid and vancomycin. The objective of this study was to determine recent antimicrobial profile of MRSA, isolated from different clinical samples and current treatment options for MRSA, other than vancomycin and Linezolid.

Methodology: This cross-sectional study was conducted at Foundation university medical college from Jan 2019 to Dec 2020. Total 918 samples of blood, pus swab, throat swab, tracheal swab, wound swab, endotracheal tube (ETT) tips, Catheter tips, axillary swab and suction tips received by using aseptic techniques, for culture and sensitivity in different hospitals of Rawalpindi and Islamabad, were taken. Isolated pathogens were identified using standard protocols and susceptibility testing was done by Kirby-Bauer disc diffusion method.

Results: Out of 918 samples, MRSA was isolated in 96 (10.4%) samples and most frequently observed in 27% (n=26) blood samples. The mean age of enrolled patients was 52.02 (SD±16.1) years, the infection was largely seen in age group 46-55(24%) and in 57% (n=52) male population. MRSA showed higher resistance to levofloxacin 78.1% (n=75), ciprofloxacin 75% (n=72), erythromycin 70.8% (n=68) and gentamycin 62.5% (n=60).  The susceptibility of older drug chloramphenicol and Trimethoprim-sulfamethoxazole was found 61% & 49% respectively. MRSA isolates were highly susceptible to vancomycin (96.8%), linezolid (89.5%) and teicoplanin (70.85%). Alarmingly, 2.1% (n=2) MRSA isolates showed resistance to vancomycin.

Conclusion:Vancomycin resistant MRSA is a matter of great concern, because of unawareness among health administrative departments and public, self-medication, lack of surveillance system and non-availability of antibiotic policy.  

Keywords: Antibiotics, MRSA, Vancomycin, Chloramphenicol

 

Author Biographies

Muhammad Noorulamin Noorulamin, Rawalpindi Institute of Cardiology

Medical Technologist, Department of Pathology, Rawal Institute of Cardiology, Rawalpindi

Dr. Zarafshan Badar Zarafsah, Foundation University Medical College, Islamabad

Associate Professor, Pharmacology Department, Foundation University Medical College, Islamabad

Dr. Ayesha Janjua, Foundation University Medical College, Islamabad

Associate Professor, Pharmacology Department, Foundation University Medical College, Islamabad

Azhar Iqbal, Holy Family Hospital

Senior Lab Technician, Department of Pathology, Holy Family Hospital

Dr. Sobia Humerah, Isra University, Islamabad

Assistant Professor, AL- Nafees Medical College, Islamabad

Dr. Pakeeza Arzoo Shaiq, PMAS. ARID Agriculture University, Rawalpindi

Assistant Professor, University Institute of Biochemistry & Biotechnology

Published
2022-06-30
Section
Original Articles