Genotypically Confirmed Vancomycin-Resistant With Gene Among Clinical Isolates in Kathmandu.

Purpose: Methicillin-resistant , a common bacterial pathogen causes various infections. The acquisition of various antimicrobial-resistant genes in has led to the transformation of this bacterium into a superbug. Vancomycin resistance among MRSA isolates is an emerging threat in empirical therapy of various infections. The study was hence aimed to find out the susceptibility status of isolates toward vancomycin and detect , and genes among the isolates.

Methods: A total of 1245 clinical samples from the participants attending a tertiary care hospital in Kathmandu were processed. isolated from the samples were subjected to antibiotic susceptibility patterns using the modified Kirby-Bauer disk diffusion method. Agar dilution method was used to determine the minimum inhibitory concentration of vancomycin. The antibiotic-resistant genes such as , and among isolates were screened by a conventional polymerase chain reaction.

Results: Of 1245 samples, 80 were identified. Out of which, 47.5% (38/80) were phenotypically confirmed MRSA isolates. A gene was detected in 84.2% (32/38) of MRSA isolates. 10.5% (4/38) were confirmed as vancomycin-intermediate (VISA) by MIC determination. None of the isolates was positive for gene; however, 2 isolates were found to possess the gene. The 2 isolates have vancomycin MIC breakpoints of 4 to 8 μg/mL.

Conclusion: There might be a spreading of vancomycin resistance among , creating serious public health problems. Therefore, measures to limit vancomycin resistance should be considered in healthcare facilities as immediately as possible.