Prevalence and Molecular Characterisation of Methicillin-Resistant Coagulase Negative Staphylococci (MR-CoNS) Isolated from Nasal Carriers of End Stage Renal Disease Patients- A Prospective Study
Published: May 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/40266.12888
Saravanan Murugesan, Nagaraj Perumal, Betsy Sowndarya Dass, Ramanathan Vijayakumar, Padma Krishnan
1. Lecturer, Microbiology Division, Department of Clinical Laboratory Services and Translational Research, Malabar Cancer Centre, Thalassery, Kannur, Kerala, India.
2. Scientist B, Department of Microbiology, State Virology Laboratory, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
3. Research Scholar, Department of Microbiology, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai, Tamil Nadu, India.
4. Chief Nephrologist, Department of Nephrology, Billroth Hospitals, Chennai, Tamil Nadu, India.
5. Assistant Professor (Retd), Department of Microbiology, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai, Tamil Nadu, India.
Correspondence
Dr. Padma Krishnan,
Assistant Professor (Retd), Department of Microbiology, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai-113, Tamil Nadu, India.
E-mail: padma.abpkn@gmail.com
Introduction: Patient-to-patient transmission of resistant strains has caused a rapid increase in the prevalence of antimicrobial resistance in recent years. Infection has become a major cause of morbidity and is the second most common cause of death in patients receiving haemodialysis. Compared to methicillin-resistant Staphylococcus aureus (MRSA) transmission, less is known regarding the epidemiology of methicillin-resistant coagulase-negative staphylococci (MR-CoNS) in health care facilities. Patients receiving haemodialysis are at particular risk for the development of invasive infections caused by MR-CoNS.
Aim: To detect the prevalence of antibiotic resistance genes among nasal carriage of MR-CoNS from End Stage Renal Disease (ESRD) patients and hospital personnel.
Materials and Methods: This cross-sectional prospective study was conducted over a period of two months (August-September 2013) at the nephrology unit of a tertiary care hospital, Chennai, Tamil Nadu, India. A total of 145 anterior nasal swabs were collected from 115 patients and 30 hospital personnel. Screening of methicillin resistance was done by using phenotypic and genotypic method. Speciation of MR-CoNS was done by conventional biochemical methods. Molecular detection of various antibiotic resistant genes and staphylococcal cassette chromosome mec (SCCmec) type (I-V) was determined by PCR based method.
Results: Among 79 MR-CoNS isolates, S.epidermidis was the predominant species and highest resistance was seen towards co-trimoxazole (29; 36.7%) followed by tetracycline (18; 23%), gentamycin (17; 21.5%), fusidic acid (14; 18%) and linezolid (2; 2.5%). Among the SCCmec types, type IV (n=27) was the predominant type followed by type I (n=18) and type V (n=15), while 17 isolates had two types including I+V (n=8), IV+III (n=6), II+V (n=3).
Conclusion: The findings of our study strongly suggest the need for the establishment of infection control program measures in order to prevent and reduce MR-CoNS infections in ESRD patients.
[
FULL TEXT ] | [ PDF]