Investigation on Vancomycin Resistance (VRSA) among Methicillin Resistant S. aureus (MRSA) in Khartoum State, Sudan

Marwa Mohamed Osman^1, , Muataz Mohamed Osman², Nihal Abdulla Mohamed³, Samah Mohamed Osman⁴, Mamoun Magzoub⁵ and Suliman Mohamed El-Sanousi⁶

¹Department of Biotechnology, Africa city of Technology, Khartoum, Sudan

²Faculty of Medicine, Al-Zaiem Al-Azhari University, Khartoum, Sudan

³Faculty of Medical laboratory science, University for Sciences and Technology, Khartoum, Sudan

⁴Faculty of Medicine, Omdurman Islamic University, Khartoum, Sudan

⁵Faculty of Medicine, University of Kassala, Kassala, Sudan

⁶Faculty of Veterinary, University of Khartoum, Khartoum, Sudan

Cite this paper:
Marwa Mohamed Osman, Muataz Mohamed Osman, Nihal Abdulla Mohamed, Samah Mohamed Osman, Mamoun Magzoub and Suliman Mohamed El-Sanousi. Investigation on Vancomycin Resistance (VRSA) among Methicillin Resistant S. aureus (MRSA) in Khartoum State, Sudan. American Journal of Microbiological Research. 2016; 4(2):56-60. doi: 10.12691/ajmr-4-2-2

Abstract

Background: Staphylococcus aureus is one of the most important and frequent cause of nosocomial infections worldwide. This study was carried out to investigate the prevalence of Vacomycin-Resistant Staphylococcus aureus and antibiotic sensitivity pattern in clinical isolates in Khartoum. Methods: One hundred and thirty three various samples were collected from some hospitals in Khartoum over a period of 5 months. The samples were cultured on bacteriological media for the isolation of Staphylococcus aureus using standard methods of isolation and identification of bacteria. The Staphylococcus aureus were tested for Methicillin susceptibility using 5 μg Oxacillin disc and Oxacillin E-test, with Resistance defined as an MIC of ≥ 4µg/ ml. Results: In this study all MRSA isolates displayed an Oxacillin MIC of ≥256µg/ml. The MRSA strains were 41.0% while the Resistance to vancomycin was examined by vancomycin E-test, with resistance defined as an MIC of ≥16 µg ml. In this study all VSSA isolates displayed vancomycin MIC of ≤ 2µg/ml "except three intermediate resistant isolate MIC between 4-8 µg/ml". The percentage of the VISA strains was 12.0%. Discussion: The unprevalence of resistance to vancomycin may be related to the low usage of this antibiotic in this study area The majority MRSA isolates were multidrug-resistant (MDR) to different classes of antibiotics including; amoxicillin /clavulinic acid, ampicillin, tetracycline, erythromycin clindamycin and ciprofloxacin. Nitroforantoine exhibit no resistant pattern while 92% of MRSA isolates were susceptible to chloramphenicol. The unprevalence of resistance to Vancomycin may be related to the low usage of this antibiotic so Vancomycin might be used as a drug of choice for the treatment of MRSA infection.

Keywords:
prevalence MRSA VRSA Khartoum Sudan

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References:

[1]	Kluytmans J.A., Wertheim H.F. Nasal carriage of Staphylococcus aureus and prevention of nosocomial infections. Infection. 2005; 33: 3-8.
[2]	Tarai B, Das P, Kumar D. Recurrent Challenges for Clinicians: Emergence of Methicillin-Resistant Staphylococcus aureus, Vancomycin Resistance, and Current Treatment Options. Journal of Laboratory Physicians. 2013;5(2):71-78.
[3]	Kaur, H. et al. Susceptibility testing and resistance phenotypic detection in Staphylococcus aureus by conventional and molecular methods: Importance of automated (Vitek 2) system. International Journal of Engineering Research and Development. 2012; 3(10): 68.
[4]	Kheder, S.I et al. Prevalence and Antimicrobial Susceptibility Pattern of Methicillin Resistance Staphylococcus in a Sudanese Surgical Ward. Pharmacology & Pharmacy, 2012; 3: 103-108.
[5]	Jennie Finks, Eden Wells, Teri Lee Dyke, Nasir Husain, Linda Plizga, Renuka Heddurshetti, Melinda Wilkins, James Rudrik, Jeffrey Hageman, Jean Patel, and Corinne Miller, Vancomycin- Resistant Staphylococcus aureus, Michigan, USA, Emerg Infect Dis. 2009 Jun; 15(6): 943-945.
[6]	Centers for Disease Control and Prevention. Vancomycin-Resistant Staphylococcus aureus – Pennsylvania. Morbid. Mortal. Weekly Rep 2002; 51: 902.
[7]	Banerjee T., Anupurba S. (2012). Colonization with Vancomycin Intermediate Staphylococcus aureus Strains Containing the vanA Resistance Gene in a Tertiary-Care Center in North India. J. Clin. Microbiol. 50 (5): 1730-1732.
[8]	Neu, H.C. The Crisis in Antibiotic Resistance. Science 1992; 257: 1064-1072.
[9]	Cookson, B., A.C. Fluit and F.J. Schmitz. Introduction. In A.C. Fluit & F.J. Schmitz (Eds.), MRSA Current Perspectives (pp. 1-9). Norfolk, England: Caister Academic Press 2003 pp. 1-9.
[10]	Clinical Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement 2012; CLSI document M100-S22.32, 3:44-70
[11]	Kyaw B.M, arora S., Chu Sing Lim C.S. Bactericidal antibiotic- phytochemical combinations against methicillin resistant Staphylococcus aureus. Braz J Microbiol 2012; 43(3): 938-945.
[12]	C. P. KOLBERT, J. ARRUDA, P. VARGA-DELMORE, X. ZHENG, M. LEWIS, J. KOLBERG and D. H. PERSING. Branched-DNA Assay for Detection of the mecA Gene in Oxacillin-Resistant and Oxacillin-Sensitive Staphylococci. JOURNAL OF CLINICAL MICROBIOLOGY, 1998;36 (9): 2640-2644.
[13]	Solmaz D., Mohsen A., Elham J., and Reza S. Prevalence and antimicrobial resistance pattern of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from clinical specimens in Ardabil, Iran. Iran J Microbiol. 2014; 6 (3): 163-168.
[14]	Misk Elyamen A. E., Mogahid M. E., Omar B. A., B. and Elfadil E.O. Molecular Detection of Methicillin Resistant Staphylococcus aureus in Patients with Urinary Tract Infections in Khartoum State. Journal of Science and Technology 2014; 15(1): 1-8.
[15]	Kapil A. The challenge of antibiotic resistance: Need to contemplate. Indian J Med. 2005; 121: 83-91.
[16]	Torella J.P., Chait R., Kishony R. Optimal Drug Synergy in Antimicrobial Treatments. PLoS Comput Biol. 2010; 6(6): e1000796.