DETECTION AND EFFICACY OF DAPTOMYCIN VERSUS VANCOMYCIN OF BLOOD STREAM INFECTIONS BY METHICILLIN - RESISTANCE Staphylococcus aureus WITH HIGH VANCOMYCIN MINIMUM INHIBITORY CONCENTRATION

DEEPALI DESAI¹*, SAVITA JADHAV², CHANDA VYAWAHARE³, SHAHZAD BEG MIRZA⁴, R.N. MISRA^5
1Department of Microbiology, Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India
²Department of Microbiology, Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India
³Department of Microbiology, Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India
⁴Department of Microbiology, Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India
⁵Department of Microbiology, Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India
* Corresponding Author : patilsv78@gmail.com

Received : 27-06-2018     Accepted : 15-07-2018     Published : 30-07-2018
Volume : 10     Issue : 7       Pages : 1295 - 1298
Int J Microbiol Res 10.7 (2018):1295-1298

Keywords : Daptomycin, Vancomycin
Conflict of Interest : None declared
Acknowledgements/Funding : Author thankful to Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India
Author Contribution : All author equally contributed

Blood stream infections (BSI) caused by Methicillin-resistance S. aureus (MRSA) is a common disease with high risk of mortality and complications. Prevalence of MRSA with high vancomycin Minimum inhibitory concentrations (MICs) have been increased and usually associated with prolonged bacteraemia and increased mortality. Recent consensus guidelines recommend that clinicians consider using alternative agents for MRSA infection when the vancomycin MIC is greater than 1 mcg/ml. Recent reports comparing daptomycin and vancomycin in treatment of BSI by MRSA with high vancomycin MIC demonstrated that daptomycin presented improved outcome, both in terms of rates of clinical success and mortality, compared to vancomycin. The aim of our study to compare the in-vitro susceptibility of daptomycin verses vancomycin susceptibility by E-test in MRSA BSIs isolates. Materials and Methods: In this pilot study, 100 MRSA BSIs isolates were collected over a period of one year. Antimicrobial susceptibility testing was performed by Kirby Bauer disc diffusion method. The inducible Clindamycin resistance was performed by D- zone test. Dual MRSA Detection EZY MIC Strip EM063 [Hi - media] for detection of Oxacillin and vancomycin by E-test. Daptomycin E test Daptomycin was performed by Ezy MIC TM Strip (DAP) (0.016-256 mcg/ml) EM088 [Hi- Media]. Results and Observations: all strains were susceptible for vancomycin and tigecycline by Kirby- Bauer Disc diffusion method. 96% MRSA strains were susceptible with linezolid, 86% MRSA strains were susceptible to TMP-SMX, 70% susceptibility to gentamycin while 56 % MRSA strains were resistant to erythromycin and subjected for detection of inducible clindamycin resistant [ ICR] test. Of which 20 % strains were positive for ICR. All 100 MRSA BSIs strains were shown susceptibility by Daptomycin Ezy MIC strip test. Conclusion: These results supports the practice of switching early from vancomycin to daptomycin for the treatment of BSIs by MRSA when the vancomycin MIC is >1 mcg/ml.

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