The role of non-B-lactam antimicrobials and screening for vancomycin resistance in methicillin resistant Staphylococcus aureus

The study was carried out to determine the prevalence of MRSA, VRSA and their current antimicrobial susceptibility pattern to various non-B-lactam antimicrobial agents to record the current status of MRSA response to commonly used antistaphylococcal antibiotics in Aligarh, India for a period of two years. A total of 430 Staphylococcus aureus strains were isolated from various clinical samples. Two hundred ninety (67.44%) of S. aureus were isolated from pus and most of these were from orthopaedics 124 (28.85%) and surgery wards 99 (23.02%). One hundred thirty eight (32.09%) strains were confirmed to be methicillin resistant by both phenotypic and genotypic methods. More than 80% of MRSA strains were multidrug resistant. However, all were uniformly sensitive to vancomycin and linezolid. Levofloxacin was the drug found to be resistant in just 16.47% MRSA strains. Vancomycin is the drug of choice for MRSA treatment. However, regular screening should be done for vancomycin intermediate and vancomycin resistant strains of Staphylococcus aureus .We suggest the use of levofloxacin for MRSA treatment since overuse of vancomycin can lead to the development of vancomycin resistance and more importantly it is beyond the scope of poor patients in developing countries like India.