Community associated- methicillin resistant staphylococcus aureus in skin and soft tissue infections

Introduction Methicillin-Resistant Staphylococcus aureus (MRSA) is well recognized as a major cause of nosocomial infections worldwide. Infections due to MRSA have become increasingly common among healthy members of the community with no other known risk factors for acquiring HA-MRSA infection. They are termed CA-MRSA and differ significantly from HAMRSA in their virulence and epidemiological properties. In this study, we detected the infections caused by CA-MRSA and studied their anti-biotic sensitivity pattern. Settings and Design: A prospective study which included 60 subjects attending the Surgery OPD with ailments like abscesses, carbuncles, osteomyelitis and skin infections in whom MRSA infection was newly identified in the microbiology laboratory and who fulfilled the inclusion & exclusion criteria for CA-MRSA. Materials and Methods: The specimens were cultured in the laboratory and identified as Staphylococcus aureus and subsequently, as MRSA using standard methods. Anti-biotic sensitivity pattern of these MRSA was studied using the modified Kirby Bauers disc diffusion method. Antibiotics used were Amoxyclav, Gentamicin, Netilmycin, Erythromycin, Trimethoprim + Sulfamethoxazole, Ciprofloxacin, Clindamycin, Linezolid and Vancomycin. Statistical Analysis was done using SPSS Version 11.5 and association was found by using chi square test. Results: A total of 60 CA-MRSA strains were isolated in Skin and Soft Tissue Infections (SSTIs), these strains were highly susceptible to Vancomycin (100%), Clindamycin (93.3%) and Linezolid (96.7%), moderately susceptible to Gentamicin (75%) and Netilmycin (90%) and a low susceptibility was recorded to Ciprofloxacin (18.3%) and Cotrimoxazole (31.7%), indicating the emergence of resistance to these valuable antibiotics. The results indicate that Vancomycin, Linezolid and Clindamycin, are to be used as 'Reserve Drugs' for resistant cases. Conclusion: A high proportion of resistance was found among CA-MRSA isolates. Susceptibility to Gentamicin, Ciprofloxacin and Cotrimoxazole was much lower than what was previously reported. This suggests that, the face of CA-MRSA has changed in both, epidemiological and microbiological features and calls for the formulation of specific treatment guidelines to prevent emergence of resistance to currently used drugs.