AiM  Vol.3 No.6 , October 2013
Incidence of Methicillin Resistant Staphylococcus aureus in Burn Patients Admitted to Burn Unit, Dhaka Medical
Staphylococcus aureus infection remains an increasing problem for higher morbidity and mortality in burn patients. We sought to determine the frequency of methicillin-resistant S. aureus (MRSA) in burn wound patients and study their drug resistance genes. Samples were collected (August 2010 to October 2011) from burn unit of Dhaka Medical College Hospital (DMCH), Bangladesh. MRSA was identified by conventional culture based methods. S. aureus was confirmed in 44.44% burn wound samples and 22.5% of the isolates were oxacillin resistant. All the S. aureus isolates were resistant to commonly used drugs like amoxicillin, azactam, erythromycin, azithromycin etc. and were sensitive to imipenem. The isolates were devoid of plasmid and the gene mecA, femA and IS431 were detected in their chromosomal DNA. Computational analysis of mecA gene sequence showed homology to S. aureus “penicillin binding protein 2a” (PBP-2a). The higher association of MRSA is in burn unit of DMCH, Bangladesh is alarming and with inappropriate antibiotic use, and the situation gets even complicated to treat. Therefore, the detection system and control practices for MRSA in DMCH should be improved in the hospital settings.


Cite this paper
M. Islam, M. Ahmed and S. Rahman, "Incidence of Methicillin Resistant Staphylococcus aureus in Burn Patients Admitted to Burn Unit, Dhaka Medical," Advances in Microbiology, Vol. 3 No. 6, 2013, pp. 498-503. doi: 10.4236/aim.2013.36066.
[1]   Health Bulletin, “Ministry of Health and Family Welfare (MOHFW),” Dhaka Medical College Hospital, 2012, P. 7. []

[2]   R. Kaushik, S. Kumar, R. Sharma and P. Lal, “Bacteriology of Burn Wounds—The First Three Years in a New Burn Unit at the Medical College Chandigarh,” Burns, Vol. 27, No. 6, 2001, pp. 595-597.

[3]   T. H. Wong, B. H. Tan, M. L. Ling and C. Song, “Multi-Resistant Acinetobacter baumannii on a Burns Unit—Clinical Risk Factors and Prognosis,” Burns, Vol. 28, No. 4, 2002, pp. 349-357.

[4]   S. Nasser, A. Mabrouk and A. Maher, “Colonization of Burn Wounds in Ain Shams University Burn Unit,” Burns, Vol. 29, No. 3, 2003, pp. 229-233.

[5]   N. P. Singh, R. Goyal, V. Manchanda, S. Das, I. Kaur and V. Talwar, “Changing Trends in Bacteriology of Burns in the Burns Unit, Delhi, India,” Burns, Vol. 29, No. 2, 2003, pp. 129-132.

[6]   M. C. Enright, D. A. Robinson, G. Randle, E. J. Feil, H. Grundmann and B. G. Spratt, “The Evolutionary History of Methicillin-Resistant Staphylococcus aureus (MRSA),” Proceedings of the National Academy of Sciences of the United States of America, Vol. 99, No. 11, 2002, pp. 7687-7692.

[7]   F. D. Lowy, “Staphylococcus aureus Infections,” The New England Journal of Medicine, Vol. 339, No. 8, 1998, pp. 520-532.

[8]   G. J. Moran, A. Krishnadasan, R. J. Gorwitz, G. E. Fosheim, L. K. McDougal, R. B. Carey and D. A. Talan, “Methicillin-Resistant S. aureus Infections among Patients in the Emergency Department,” The New England Journal of Medicine, Vol. 355, No. 7, 2006, pp. 666-674.

[9]   B. Capitano, O. A. Leshem, C. H. Nightingale and D. P. Nicolau, “Cost Effect of Managing Methicillin-Resistant Staphylococcus aureus in a Long-Term Care Facility,” Journal of the American Geriatrics Society, Vol. 51, No. 1, 2003, pp. 10-16.

[10]   L. A. Selvey, M. Whitby and B. Johnson, “Nosocomial Methicillin-Resistant Staphylococcus aureus bacteremia: Is It Any Worse than Nosocomial Methicillin-Sensitive Staphylococcus aureus Bacteremia?” Infection Control and Hospital Epidemiology, Vol. 21, No. 10, 2000, pp. 645-648.

[11]   S. I. Blot, K. H. Vandewoude, E. A. Hoste and F. A. Colardyn, “Outcome and Attributable Mortality in Critically Ill Patients with Bacteremia Involving Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus,” Archives of Internal Medicine, Vol. 162, No. 19, 2002, pp. 2229-2235.

[12]   National Nosocomial Infections Surveillance (NNIS) “System Report, Data Summary from January 1992 through June 2004, Issued October 2004,” American Journal of Infection Control, Vol. 32, No. 8, 2004, pp. 470-485.

[13]   K. B. Anand, P. Agrawal, S. Kumar and K. Kapila, “Comparison of Cefoxitin Disc Diffusion Test, Oxacillin Screen Agar, and PCR for mecA Gene for Detection of MRSA,” Indian Journal of Medical Microbiology, Vol. 27, No. 1, 2009, pp. 27-29.

[14]   H. F. Chambers. “Methicillin Resistance in Staphylococci: Molecular and Biochemical Basis and Clinical Implications,” Clinical Microbiology Reviews, Vol. 10, No. 4, 1997, pp. 781-791.

[15]   S. Boyle-Vavra and R. S. Daum, “Community-Acquired Methicillin Resistant Staphylococcus aureus: The Role of Panton-Valentine Eukocidin,” Laboratory Investigation, Vol. 87, No. 1, 2007, pp. 3-9.

[16]   S. Unal, J. Hoskins, J. E. Flokowitsch, C. Y. E. Wu, D. A. Preston and P. L. Skatrud, “Detection of Methicillin-Re-sistant Staphylococci by Using the Polymerase Chain Reaction,” Journal of Clinical Microbiology, Vol. 30, No. 7, 1992, pp. 1685-1691.

[17]   L. Barberis-Maino, B. Berger-Bachi, H. Weber, W. D. Beck and F. H. Kayser, “IS431, a Staphylococcal Insertion Sequence-Like Element Related to IS26 from Proteus Vulgaris,” Gene, Vol. 59, No. 1, 1987, pp. 107-113.

[18]   L. K. McDougal and C. Thornsberry, “The Role of Beta-Lactamase in Staphylococcal Resistance to Penicillinase-Resistant Penicillins and Cephalosporins,” Journal of Clinical Microbiology, Vol. 23, No. 5, 1986, pp. 832-839.

[19]   C. Thornsberry and L. K. McDougal, “Successful Use of Broth Microdilution in Susceptibility Tests for Methicillin-Resistant (Heteroresistant) Staphylococci,” Journal of Clinical Microbiology, Vol. 18, No. 5, 1983, pp. 1084-1091.

[20]   European Committee on Antimicrobial Susceptibility Testing, “Clinical Breakpoint Table v. 1.3,” 2011.

[21]   C. I. Kado and S. T. Liu, “Rapid Procedure for Detection and Isolation of Large and Small Plasmids,” Journal of Bacteriology, Vol. 145, No. 3, 1981, pp. 1365-1373.

[22]   P. Vannuffel, J. Gigi, H. Ezzedine, B. Vandercam, M. Delmee, G. Wauters and J. L. Gala, “Specific Detection of Methicillin-Resistant Staphylococcus Species by Multiplex PCR,” Journal of Clinical Microbiology, Vol. 33, No. 11, 1985, pp. 2864-2867.

[23]   F. C. Tenover, “Mechanisms of Anti Microbial Resistance in Bacteria,” The American Journal of Medicine, Vol. 119, No. 6, 2006, pp. S3-S10.

[24]   S. Afroz, N. Kobayashi, S. Nagashima, M. M. Alam, A. B. Hossain, M. A. Rahman, M. R. Islam, A. B. Lutfor, N. Muazzam, M. A. Khan, S. K. Paul, A. K. Shamsuzzaman, M. C. Mahmud, A. K. Musa and M. A. Hossain, “Genetic Characterization of Staphylococcus aureus Isolates Carrying Panton-Valentine Leukocidin Genes in Bangladesh,” Japanese Journal of Infectious Diseases, Vol. 61, No. 5, 2008, pp. 393-396.

[25]   J. C. Seguin, R. D. Walker, J. P. Caron, W. E. Kloos, C. G. George, R. J. Hollis, R. N. Jones and M. A. Pfaller, “Methicillin-Resistant Staphylococcus aureus Outbreak in a Veterinary Teaching Hospital: Potential Human-to-Animal Transmission,” Journal of Clinical Microbiology, Vol. 37, No. 5, 1999, pp. 1459-1463.

[26]   J. H. Lee, “Methicillin (Oxacillin)-Resistant Staphylococcus aureus Strains Isolated from Major Food Animals and Their Potential Transmission to Humans,” Applied and Environmental Microbiology, Vol. 69, No. 11, 2003, pp. 6489-6494.

[27]   H. F. Chambers and F. R. DeLeo, “Waves of Resistance: Staphylococcus aureus in the Antibiotic Era,” Nature Reviews Microbiology, Vol. 7, No. 9, 2009, pp. 629-641.

[28]   M. Gelmi, I. Foresti, G. Ravizzola, C. Bonfanti, R. Verardi, A. Caruso and A. Turano, “Antibiotic Resistances and Plasmids in Staphylococcus aureus from Italian Hospitals,” Journal of Medical Microbiology, Vol. 23, No. 2, 1987, pp. 111-118.

[29]   J. E. Coia, I. Noor-Hussain and D. J. Platt, “Plasmid Profiles and Restriction Enzyme Fragmentation Patterns of Plasmids of Methicillin-Sensitive and Methicillin-Resistant Isolates of Staphylococcus aureus from Hospital and the Community,” Journal of Medical Microbiology, Vol. 27, No. 4, 1988, pp. 271-276.

[30]   S. R. Mashreky, A. Rahman, S. M. Chowdhury, T. F. Khan, L. Svanstrom, F. Rahman, “Non-Fatal Burn Is a Major Cause of Illness: Findings from the Largest Community-Based National Survey in Bangladesh,” Injury Prevention, Vol. 15, No. 6, 2009, pp. 397-402.