Prevalence and resistance pattern of methicillin-resistant coagulase negative Staphylococci among orthopaedic patients in a tertiary institution in North western Nigeria

SUMMARYDrug-resistant coagulase-negative staphylococci (DRCNS) in orthopaedic patients and ward staff were studied. A significant increase in the DRCNS carriage rate was observed among the 16 patients studied after 14 days of hospitalization with levels approaching that of the staff. Patients receiving dicloxacillin prophylaxis (n=9) were more likely to be colonized with methicillin-resistant CNS, while patients receiving no antibiotics (n= 7) became to a larger extent colonized with multiple DRCNS. The combined data from species determination, biochemical, plasmid, and antibiogram typing revealed a considerable diversity among DRCNS;64 types were distinguished among 112 DRCNS isolates selected for study after exclusion of apparently duplicate isolates. Plasmid plus antibiogram typing yielded almost as many types (61); whereas species determination plus antibiogram distinguished only 33 types. Although a novel computerized 96-reaction boityping method alone enabled differentiation of 17 biotypes, most DRCNS isolates belonged to one of three major biotypes limiting the usefulness of this method. Ten of the 64 (16%) DRCNS types identified comprised 50 of the 112 (45%) isolates. These were isolated from staff and from patients on day 14, suggesting a nosocomial origin.

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Staphylococci isolated from animals and food with phenotypically reduced susceptibility to β-lactamase-resistant β-lactam antibiotics

Acta Veterinaria Hungarica ◽

10.1556/avet.52.2004.1.2 ◽

2004 ◽

Vol 52 (1) ◽

pp. 7-17 ◽

Cited By ~ 18

Author(s):

Éva J. Kaszanyitzky ◽

Zsuzsanna Egyed ◽

Sz. Jánosi ◽

Judit Keserű ◽

Zsuzsanna Gál ◽

...

Keyword(s):

Inhibition Zone ◽

Disk Diffusion ◽

Diffusion Method ◽

Resistance Pattern ◽

Coagulase Negative Staphylococci ◽

Disk Diffusion Method ◽

Disk Diffusion Test ◽

Methicillin Resistant ◽

Zone Diameter ◽

Mrsa Strains

The antibiotic resistance pattern of 1921 Staphylococcus strains isolated from animals and food within the last two years were examined using diffusion tests. Among them there were only 35 strains of S. aureus having an inhibition zone diameter of 15 mm or less, and 4 strains of coagulase-negative staphylococci (CNS) having a zone diameter of 18 mm or less to 1-µg oxacillin disk. These 39 strains were examined also by E-test to oxacillin and for the detection of the mecA gene by PCR in order to determine whether they might be real methicillin-resistant staphylococci. Among the 39 strains there were only two that were susceptible to penicillin by disk diffusion method; however, further examination by the penicillinase test showed that they produced ß-lactamase. While 19 (15 S. aureus, 4 CNS) strains were resistant and 7 strains were intermediate to oxacillin in disk diffusion test, the E-test gave 8 resistant and 5 intermediate results. Six out of the 8 oxacillin-resistant strains examined by disk diffusion and E-test harboured the mecA gene. Thus only 6 out of the examined 1921 strains proved to be mecA positive. These methicillin-resistant, mecA-positive strains (5 of the S. aureus strains and 1 of the S. epidermidis) originated from two dairy herds. The results prove that methicillin-resistant S. aureus (MRSA) strains in animals are really rare in Hungary. Eighteen strains were chosen and screened for minimal inhibitory concentration (MIC) of oxacillin with or without clavulanic acid or sulbactam, and three of them produced methicillinase enzyme.

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Non-susceptibility trends among methicillin-resistant coagulase-negative staphylococci isolated from blood cultures

Archives of Biological Sciences ◽

10.2298/abs1401079p ◽

2014 ◽

Vol 66 (1) ◽

pp. 79-86 ◽

Cited By ~ 1

Author(s):

Anika Povazan ◽

Anka Vukelic ◽

Tatjana Kurucin ◽

Mirjana Hadnadjev ◽

Vesna Milosevic ◽

...

Keyword(s):

Diffusion Method ◽

Resistance Pattern ◽

Multiple Resistance ◽

Disc Diffusion ◽

Disc Diffusion Method ◽

Coagulase Negative Staphylococci ◽

Methicillin Resistant ◽

Resistant Strains ◽

Susceptibility Tests ◽

Hospital Acquired

Coagulase-negative staphylococci are a significant cause of hospital-acquired bacteremias. There is an increase of infections induced by methicillin-resistant strains, with growing resistance to other antibiotics. The aim of the study was to analyze the resistance of methicillin-resistant coagulase-negative staphylococci isolated from hemocultures in a five-year period. The study was carried out in the microbiology laboratory of the Institute for Pulmonary Diseases of Vojvodina, from 2008 to 2013. Coagulase-negative staphylococci were isolated from 196 hemocultures. Susceptibility tests were performed using the disc diffusion method. Of 196 coagulase-negative staphylococci, 122 (62.2%) were resistant to methicillin, of which 112 (91.8%), 105 (86.1%), 103 (84.4%), 88 (72.1%) were resistant to erythromycin, gentamicin, ciprofloxacin and clindamycin, respectively. All strains were susceptible to vancomycin and linezolid. Multiple resistance was registered in 100 (82%) strains. The most common resistance pattern was gentamicin-erythromycin-clindamycinciprofloxacin. Multiple resistance was established in a significant percentage of methicillin-resistant strains.

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Investigation of SCCmec types I–IV in clinical isolates of methicillin-resistant coagulase-negative staphylococci in Ahvaz, Southwest Iran

Bioscience Reports ◽

10.1042/bsr20200847 ◽

2020 ◽

Vol 40 (5) ◽

Cited By ~ 2

Author(s):

Effat Abbasi Montazeri ◽

Sakineh Seyed-Mohammadi ◽

Aram Asarehzadegan Dezfuli ◽

Azar Dokht Khosravi ◽

Maryam Dastoorpoor ◽

...

Keyword(s):

Multiplex Pcr ◽

Sccmec Type ◽

Meca Gene ◽

Clinical Isolates ◽

Resistance Pattern ◽

Type I ◽

Coagulase Negative Staphylococci ◽

Methicillin Resistant ◽

Drug Resistance Pattern ◽

Sccmec Types

Abstract Today methicillin resistant coagulase-negative staphylococci (MR-CoNS) are important in terms of causing significant nosocomial infections. Besides, MR-CoNS are confirmed as the reservoir of SCCmec elements that carry mecA (methicillin-resistant) gene. Hence, the present study was designed to evaluate the susceptibility pattern, prevalence and diversity of SCCmec types I, II, III, and IV in MR-CoNS strains. In this cross-sectional study, 44 clinical isolates of MR-CoNS were identified using the cefoxitin disc method and further confirmation by polymerase chain reaction (PCR) amplification of the mecA gene. Antimicrobial susceptibility of isolates was investigated by disc diffusion. The identification of CoNS was done by amplification and sequencing of the tuf gene. Multiplex PCR method was done for the determination of SCCmec types. In the present study, the Staphylococcus epidermidis and Staphylococcus haemolyticus were the most predominant isolates with a prevalence of 45.4%. The highest resistance rates were observed against erythromycin (84.1%) and clindamycin (75%). Multiplex PCR revealed the SCCmec type I as the predominant type in the present study. Our study showed that there was no significant relationship between the presence of different types of SCCmec elements and resistance to antibiotics. The present study highlighted a frequent prevalence of MR-CoNS harboring SCCmec type genes in Ahvaz, southwest of Iran. Thus, the molecular typing and periodical monitoring of their drug resistance pattern should be considered in national stewardship programs to designing useful antibiotic prescription strategies.

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Nasopharyngeal Carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) among Sickle Cell Disease (SCD) Children in the Pneumococcal Conjugate Vaccine Era

Infectious Disease Reports ◽

10.3390/idr13010022 ◽

2021 ◽

Vol 13 (1) ◽

pp. 191-204

Author(s):

Nicholas T. K. D. Dayie ◽

Deborah N. K. Sekoh ◽

Fleischer C. N. Kotey ◽

Beverly Egyir ◽

Patience B. Tetteh-Quarcoo ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Sickle Cell Disease ◽

Conjugate Vaccine ◽

Sickle Cell ◽

Pneumococcal Conjugate Vaccine ◽

Diffusion Method ◽

Nasopharyngeal Carriage ◽

Cell Disease ◽

Coagulase Negative Staphylococci ◽

Methicillin Resistant

The aim of this cross-sectional study was to investigate Staphylococcus aureus nasopharyngeal carriage epidemiology in relation to other nasopharyngeal bacterial colonizers among sickle cell disease (SCD) children about five years into pneumococcal conjugate vaccine 13 (PCV-13) introduction in Ghana. The study involved bacteriological culture of nasopharyngeal swabs obtained from 202 SCD children recruited from the Princess Marie Louise Children’s Hospital. S. aureus isolates were identified using standard methods and subjected to antimicrobial susceptibility testing using the Kirby-Bauer disc diffusion method. Cefoxitin-resistant S. aureus isolates were screened for carriage of the mecA, pvl, and tsst-1 genes using multiplex polymerase chain reaction. The carriage prevalence of S. aureus was 57.9% (n = 117), and that of methicillin-resistant S. aureus (MRSA) was 3.5% (n = 7). Carriage of the mecA, pvl, and tsst-1 genes were respectively demonstrated in 20.0% (n = 7), 85.7% (n = 30), and 11.4% (n = 4) of the cefoxitin-resistant S. aureus isolates. PCV-13 vaccination (OR = 0.356, p = 0.004) and colonization with coagulase-negative staphylococci (CoNS) (OR = 0.044, p < 0.0001) each protected against S. aureus carriage. However, none of these and other features of the participants emerged as a determinant of MRSA carriage. The following antimicrobial resistance rates were observed in MRSA compared to methicillin-sensitive S. aureus: clindamycin (28.6% vs. 4.3%), erythromycin (42.9% vs. 19.1%), tetracycline (100% vs. 42.6%), teicoplanin (14.3% vs. 2.6%), penicillin (100% vs. 99.1%), amoxiclav (28.6% vs. 3.5%), linezolid (14.3% vs. 0.0%), ciprofloxacin (42.9% vs. 13.9%), and gentamicin (42.9% vs. 13.0%). The proportion of S. aureus isolates that were multidrug resistant was 37.7% (n = 46). It is concluded that S. aureus was the predominant colonizer of the nasopharynx of the SCD children, warranting the continuous monitoring of this risk group for invasive S. aureus infections.

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In Vitro activity of a Novel Benzoquinolizine Antibiotic, Levonadifloxacin (WCK 771) against Blood Stream Gram-Positive Isolates from a Tertiary Care Hospital

Journal of Laboratory Physicians ◽

10.1055/s-0040-1720944 ◽

2020 ◽

Vol 12 (03) ◽

pp. 230-232

Author(s):

Dhruv Mamtora ◽

Sanjith Saseedharan ◽

Ritika Rampal ◽

Prashant Joshi ◽

Pallavi Bhalekar ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Blood Stream ◽

Tolerability Profile ◽

Care Hospital ◽

Coagulase Negative Staphylococci ◽

Gram Positive ◽

Methicillin Resistant

Abstract Background Blood stream infections (BSIs) due to Gram-positive pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) are associated with high mortality ranging from 10 to 60%. The current anti-MRSA agents have limitations with regards to safety and tolerability profile which limits their prolonged usage. Levonadifloxacin and its oral prodrug alalevonadifloxacin, a novel benzoquinolizine antibiotic, have recently been approved for acute bacterial skin and skin structure infections including diabetic foot infections and concurrent bacteremia in India. Methods The present study assessed the potency of levonadifloxacin, a novel benzoquinolizine antibiotic, against Gram-positive blood stream clinical isolates (n = 31) collected from January to June 2019 at a tertiary care hospital in Mumbai, India. The susceptibility of isolates to antibacterial agents was defined following the Clinical and Laboratory Standard Institute interpretive criteria (M100 E29). Results High prevalence of MRSA (62.5%), quinolone-resistant Staphylococcus aureus (QRSA) (87.5%), and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) (82.35%) were observed among bacteremic isolates. Levonadifloxacin demonstrated potent activity against MRSA, QRSA, and MR-CoNS strains with significantly lower minimum inhibitory concentration MIC50/90 values of 0.5/1 mg/L as compared with levofloxacin (8/32 mg/L) and moxifloxacin (2/8 mg/L). Conclusion Potent bactericidal activity coupled with low MICs support usage of levonadifloxacin for the management of BSIs caused by multidrug resistant Gram-positive bacteria.

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Methicillin-Resistant Staphylococcus aureus (MRSA) Infection of Diabetic Foot Ulcers at a Tertiary Care Hospital in Accra, Ghana

Pathogens ◽

10.3390/pathogens10080937 ◽

2021 ◽

Vol 10 (8) ◽

pp. 937

Author(s):

Ramzy B. Anafo ◽

Yacoba Atiase ◽

Nicholas T. K. D. Dayie ◽

Fleischer C. N. Kotey ◽

Patience B. Tetteh-Quarcoo ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Multidrug Resistance ◽

Teaching Hospital ◽

Diabetic Foot ◽

Foot Ulcer ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Coagulase Negative Staphylococci ◽

Methicillin Resistant ◽

Mrsa Infection

Aim: This study investigated the spectrum of bacteria infecting the ulcers of individuals with diabetes at the Korle Bu Teaching Hospital in Accra, Ghana, focusing on Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA), with respect to their prevalence, factors predisposing to their infection of the ulcers, and antimicrobial resistance patterns. Methodology: This cross-sectional study was conducted at The Ulcer Clinic, Department of Surgery, Korle Bu Teaching Hospital, involving 100 diabetic foot ulcer patients. The ulcer of each study participant was swabbed and cultured bacteriologically, following standard procedures. Antimicrobial susceptibility testing was done for all S. aureus isolated, using the Kirby-Bauer method. Results: In total, 96% of the participants had their ulcers infected—32.3% (n = 31) of these had their ulcers infected with one bacterium, 47.9% (n = 46) with two bacteria, 18.8% (n = 18) with three bacteria, and 1.0% (n = 1) with four bacteria. The prevalence of S. aureus and MRSA were 19% and 6%, respectively. The distribution of the other bacteria was as follows: coagulase-negative Staphylococci (CoNS) (54%), Escherichia coli (24%), Pseudomonas spp. (19%), Citrobacter koseri and Morganella morgana (12% each), Klebsiella oxytoca (11%), Proteus vulgaris (8%), Enterococcus spp. (6%), Klebsiella pneumoniae (5%), Proteus mirabilis and Enterobacter spp. (4%), Klebsiella spp. (2%), and Streptococcus spp. (1%). The resistance rates of S. aureus decreased across penicillin (100%, n = 19), tetracycline (47.4%, n = 9), cotrimoxazole (42.1%, n = 8), cefoxitin (31.6%, n = 6), erythromycin and clindamycin (26.3% each, n = 5), norfloxacin and gentamicin (15.8% each, n = 3), rifampicin (10.5%, n = 2), linezolid (5.3%, n = 1), and fusidic acid (0.0%, n = 0). The proportion of multidrug resistance was 47.4% (n = 9). Except for foot ulcer infection with coagulase-negative Staphylococci, which was protective of S. aureus infection of the ulcers (OR = 0.029, p = 0.001, 95% CI = 0.004–0.231), no predictor of S. aureus, MRSA, or polymicrobial ulcer infection was identified. Conclusions: The prevalence of S. aureus and MRSA infection of the diabetic foot ulcers were high, but lower than those of the predominant infector, coagulase-negative Staphylococci and the next highest infecting agent, E. coli. Diabetic foot ulcers’ infection with coagulase-negative Staphylococci protected against their infection with S. aureus. The prevalence of multidrug resistance was high, highlighting the need to further intensify antimicrobial stewardship programmes.

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Assessment of door handles as potential reservoirs of drug-resistant enterococci

Bulletin of the National Research Centre ◽

10.1186/s42269-020-00462-1 ◽

2020 ◽

Vol 44 (1) ◽

Author(s):

Kome Otokunefor ◽

Blessing O. Famakin ◽

Dorothy O. Douglas

Keyword(s):

Drug Susceptibility ◽

Resistance Pattern ◽

Human Pathogens ◽

Tertiary Institution ◽

Microbiological Methods ◽

Single Clone ◽

Source Contamination ◽

Rivers State ◽

Bacterial Groups ◽

Black Pigmentation

Abstract Background Fomites have long been known to play a key role in the spread of disease causing agents. Hospital-associated fomites in particular have been linked with transmission of members of the Enterococci sp which are key human pathogens. Few studies have explored the role non-hospital door handles might play as potential sources of these isolates. This study therefore set out to explore this role. Results A total of hundred toilet and office door handles in a tertiary institution in Rivers State, Nigeria, were sampled using the swab and rinse method. The presence and drug susceptibility of Enterococcus was determined using the selective bile esculin agar (BEA) and standard microbiological methods. Growth on BEA was observed in 71% of cases, with more growth (38/50, 76%) observed from toilet door handles. Only 35% of samples produced the characteristic black pigmentation associated with Enterococcus sp. Six different bacterial groups were identified from this subset with Enterococcus sp. making up only 14% (5/35) of the isolates. All (100%) Enterococci were isolated from toilet door handles. Antibiotic susceptibility testing revealed very high levels of resistance (80–100%) against 75% of the test antibiotics. An analysis of the antibiotic resistance pattern of each isolate revealed 11 unique antibiogram patterns. Only 2 of these patterns were associated with the enterococci, with majority (4/5) exhibiting resistance to Augmentin (AUG), Ceftazidime (CAZ), Ceftriaxone (CTR), Cefuroxime (CRX), Cloxacillin (CXC), Erythromycin (ERY), Gentamicin (GEN), Ofloxacin (OFL) (antibiogram of AUG–CAZ–CRX–CTR–CXC–ERY). None of the enterococci, however, was resistant to vancomycin. Conclusion This study reports low level contamination of door handles by enterococci. Identical antibiogram patterns linked with majority of the enterococci could however point at the occurrence of a single clone perhaps indicating single source contamination. Reports of high levels of ampicillin resistance among these isolates are problematic as ampicillin–gentamicin combination is the treatment of choice for nosocomial enterococci pathogens.

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