Skin And Soft Tissue Infections Associated with Methicillin Resistant Staphylococcus Aureus, Esbl, Amp C And Metallo Β- Lactamase Producing Bacilli In A Tertiary Care Hospital

Dr. Jeevan Shetty
2017 IOSR Journal of Dental and Medical Sciences  
Skin and soft tissue infections (SSTI's) are commonly caused by both gram positive and gram negative bacteria. in this study. The isolates were identified by conventional microbiological methods and Antimicrobial susceptibility testing was done on Mueller Hinton Agar plate by Kirby Bauer's disc diffusion method. All the organisms suspected to be methicillin resistant Staphylococcus aureus (MRSA) among gram positive cocci and those gram negative bacilli producing ESBL were detected by phenotypic
more » ... confirmatory disc diffusion test (PCDDT) as per Clinical and Laboratory Standard Institute (CLSI) criteria. Amp C detection in gram negative bacilli was done by using Amp C Disc test while Metallo βlactamase production was detected by Imipenem-Ethylene Diamine Tetra Acetic acid (EDTA) combined disc test. Result: Out of the 263 clinical isolate tested, 162(61.6%) were gram positive cocci and 101 (38.4%) gram negative bacilli. MRSA accounted for 16 % of total isolates. Among gram negative bacilli, 22.8% were found to be pure ESBL producers by the PCDDT method and 23.8 % pure Amp C producers by Amp C Disc test.Metallo β-lactamases (MBL)accounted for 16.8 % of gram negative isolates. Co-expression of ESBL and AmpC was observed in 4.9% while in 8. 9% isolates AmpC production was associated with MBL production. ESBL production was predominantly noticed in Escherichia coli and Proteus mirabilis while Amp C production was most common in Klebsiella spp followed by Pseudomonas aeruginosa. One third of Acinetobacter isolates were found to be pure metallo β-lactamase producers. Conclusion: Since MRSA, ESBL's, Amp C and MBL producing gram negative bacilli are on a constant rise, it is very necessary to detect all the organisms isolated from cases of SSTI's for these mechanism of resistance. Regular detection of these bacteria in clinical microbiology laboratory helps in guiding the physicians regarding empirical use of antibiotics and also in incorporating strategies for control measures to prevent spread of drug resistant organisms.
doi:10.9790/0853-1606070814 fatcat:lp4r4ilvwfau5bhxh7bfizh2j4