title: Minimum inhibitory concentration of vancomycin to methicillin resistant Staphylococcus aureus isolated from different clinical samples at a tertiary care hospital in Nepal.
abstract: BACKGROUND
  Methicillin resistant Staphylococcus aureus (MRSA) has evolved as a serious threat to public health. It has capability to cause infections not only in health care settings but also in community. Due to the multidrug resistance shown by MRSA, there are limited treatment options for the infections caused by this superbug. Vancomycin is used as the drug of choice for the treatment of infections caused by MRSA. Different studies from all around the world have documented the emergence of strains of S. aureus those are intermediate sensitive or resistant to vancomycin. And recently, there have been reports of reduced susceptibility of MRSA to vancomycin, from Nepal also. So the main purpose of this study was to determine the minimum inhibitory concentration (MIC) of vancomycin to methicillin resistant S. aureus isolated from different clinical specimens.
  
  
  METHODS
  Total 125 strains of S. aureus isolated from different clinical samples at KIST Medical College and Teaching Hospital, Lalitpur, Nepal from Nov 2012 to June 2013, were subjected to MRSA detection by cefoxitin disc diffusion method. The minimum inhibitory concentrations of vancomycin to confirmed MRSA strains were determined by agar dilution method. Yellow colored colonies in mannitol salt agar, which were gram positive cocci, catalase positive and coagulase positive were confirmed to be S. aureus.
  
  
  RESULTS
  Among, total 125 S. aureus strains isolated; 47(37.6%) were MRSA. Minimum inhibitory concentrations of vancomycin to the strains of MRSA ranged from 0.125 μg/ml to 1 μg/ml.
  
  
  CONCLUSIONS
  From our findings we concluded that the rate of isolation of MRSA among all the strains of S. aureus isolated from clinical samples was very high. However, none of the MRSA strains were found to be vancomycin intermediate-sensitive or vancomycin-resistant.
authors.affiliation: Department of Microbiology, Goldengate International College, Battisputali, Kathmandu, Nepal.
authors.forename: Arjun Ojha
authors.initials: AO
authors.lastname: Kshetry
authors.affiliation: Department of Microbiology, Grande International Hospital, Dhapasi, Kathmandu, Nepal.
authors.forename: Narayan Dutt
authors.initials: ND
authors.lastname: Pant
authors.affiliation: Department of Microbiology, Goldengate International College, Battisputali, Kathmandu, Nepal.
authors.forename: Raju
authors.initials: R
authors.lastname: Bhandari
authors.affiliation: Department of Microbiology, Goldengate International College, Battisputali, Kathmandu, Nepal.
authors.forename: Sabita
authors.initials: S
authors.lastname: Khatri
authors.affiliation: Department of Microbiology, Goldengate International College, Battisputali, Kathmandu, Nepal.
authors.forename: Krishma Laxmi
authors.initials: KL
authors.lastname: Shrestha
authors.affiliation: Department of Microbiology, Goldengate International College, Battisputali, Kathmandu, Nepal.
authors.forename: Shambhu Kumar
authors.initials: SK
authors.lastname: Upadhaya
authors.affiliation: Department of Microbiology, Goldengate International College, Battisputali, Kathmandu, Nepal.
authors.forename: Asia
authors.initials: A
authors.lastname: Poudel
authors.affiliation: Department of Microbiology, Goldengate International College, Battisputali, Kathmandu, Nepal.
authors.forename: Binod
authors.initials: B
authors.lastname: Lekhak
authors.affiliation: Department of Microbiology, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.
authors.forename: Bijendra R
authors.initials: BR
authors.lastname: Raghubanshi
keywords: MRSA; Nepal; S. aureus; VISA; VRSA