Methicillin Resistant Staphylococcus aureus (MRSA) were noticed in 1961 and they developed into a Health-care associated organism throughout the world. Recently the appearance of endemic Community- acquired MRSA has been reported. Infections due to community acquired MRSA are recent world wide phenomenon. This study was undertaken to compare CA-MRSA and HA-MRSA isolates on the basis of their genotyping results, clinical presentations and antibiotic susceptibilitiy pattern.

Method

Study design:  Descriptive study.

Study Setting:   Central Microbiology laboratory, Govt. Medical College, Thiruvananthapuram.

Sample size:  161 isolates of Methicillin Resistant Staphylococcus aureus.

Study period:   1 year.   

Results: The proportion of HA-MRSA is 94(58%) and CA-MRSA 67(42%) among 161 MRSA isolates. A male preponderance is  observed in both types of MRSA. The commonest clinical presentation of  HA-MRSA is  cellulitis ie,32(34.04%) ,followed by post operative wound infection ie,27 (28.72%). The commonest clinical presentation of CA-MRSA is abscess ie,27(40%), followed by post traumatic wound infection ie,14 (21% ) . Extremes of age, history of recent hospitalization in past I year, history of surgery in the past and  Type 2 Diabetes Mellitus  are the risk factors  observed  in case of HA-MRSA. CA-MRSA isolates show lower resistance rate towards Trimethoprim –Sulfamethoxazole 15(22.3%) than 27,(28.72%) of HA-MRSA. Resistance rates of Gentamicin were high in both CA- MRSA and HA-MRSA, ie 92.5% and 93.6% respectively. CA-MRSA showed more resistance to Amikacin 28(41.79%) and HA-MRSA 0(21.27%).CA-MRSA showed resistance to Ciprofloxacin for 65 strains (97%)  and HA- MRSA to 62 strains (65.9%). Both types of MRSA showed a low and similar resistance rate of Tetracycline ie, 10.44% CA and 9.57% HA-MRSA respectively. Lower rate of Clindamycin resistance was shown by both CA-MRSA and HA-MRSA  ie, 1 (1.49%) and  6  (6.38%) respectively. All 94 isolates of HA-MRSA and 67 isolates of CA-MRSA were uniformly  sensitive to Vancomycin , Linezold  and Rifampicin.

Keywords:  CA-MRSA,HA-MRSA.

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Dr S.Manjusree

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