DefinePK

Abstract

The rise of antimicrobial resistance, particularly vancomycin-resistant Staphylococcus aureus (VRSA), is a significant public health concern worldwide. The high prevalence of surgical site infections and unregulated antibiotic use in developing countries like Pakistan creates a favorable environment for multidrug-resistant strains. There is a notable lack of local data on VRSA prevalence in regions of Pakistan, including the Kohat district. The primary objective of this study was to determine the prevalence of vancomycin-resistant S. aureus (VRSA) among isolates from surgical patients in the Kohat district and analyze their antimicrobial susceptibility profiles. This was a cross-sectional study conducted at the District Hospital (CMH), Kohat, from July to December 2022.  A total of 155 samples, including pus, tissue, and wound swabs, were collected from surgical patients with postoperative infections. S. aureus was identified using microscopic, macroscopic, and biochemical tests.  Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Vancomycin resistance was confirmed by the Minimum Inhibitory Concentration (MIC) test, with isolates having an MIC of ≥4μg/ml classified as resistant. Out of 155 samples collected, 80 isolates of S. aureus were identified. The prevalence of S. aureus was found to be 53.94% (n=82/152). Notably, 39% (n=32) of the isolates were Methicillin-Resistant S. aureus (MRSA)12. The study's main finding was that 11% (9 out of 80) of the S. aureus isolates showed resistance to vancomycin. The MIC values for these 9 isolates ranged from 4μg/ml to 8μg/ml. The findings indicate that VRSA is present in surgical patients in the Kohat district, a significant and alarming discovery given its previously rare reporting in Pakistan. This underscores a critical public health issue that necessitates immediate action to curb the spread of these pathogens. The study recommends implementing strict antibiotic stewardship, enhancing surveillance, and improving infection control measures in local healthcare facilities