Epidemiology, risk factors and antimicrobial resistance of Escherichia coli bacteremia

Background: Escherichia coli is a common causative of blood stream infection having potentials to produce significant morbidity and mortality. This organism also has the ability to develop resistance against antimicrobial agents. Knowing its epidemiology, risk factors and antimicrobial resistance patterns can help preventing and managing bacteremia caused by this organism. Materials and methods: This was across sectional observational study carried out from February 2017 to February 2018 on 64 blood culture positive Escherichia coli infected patients admitted in Medicine inpatient of a medical college hospital. Age, sex, mode of acquisition of infection, history of prior empiric antibiotic treatment, duration of hospital stay, development of complication were observed and noted. Antibiotic susceptibility test for all isolates was performed by Kirby-Bauer disc diffusion method. Predesigned semi-structured data collection from was used and collected data were analyzed manually and expressed in descriptive statistical terms. Results: Of the 64 enrolled patients, 47(73.43%) were female. Average age of affection was 53.48±20.65 years and increased incidence rates (51.56%) was observed at age >60 years. Infection was communityacquired in 35.84% cases and urinary tract infection was the most frequent (46.3) risk factor. More than eighty seven percent of samples showed resistance to at least one antimicrobial agent and resistance to multiple drugs was associated with complications. Conclusion: Escherichia coli bacteremia has high incidence rates for antimicrobial resistance and mortality. Continuous surveillance and antibiotic susceptibility pattern monitoring is essential to develop regional antibiotic therapy protocols.

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Bio-activities of Tetracycline and Algae Food Supplement Algo-Bio® on Escherichia coli Antimicrobial Resistance Isolated from Piglet’s Intestinal Flora

Microbiology Research Journal International ◽

10.9734/mrji/2019/v29i330164 ◽

2019 ◽

pp. 1-8

Author(s):

Amine Naty Tadiogo Kone ◽

Baguy Mohamed Ouattara ◽

Bertin Tiekoura ◽

Fernique Kouadio Konan ◽

Eugène Koffi ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Antibiotic Susceptibility ◽

Intestinal Flora ◽

Susceptibility Test ◽

Diffusion Method ◽

Bacteriological Study ◽

Antibiotic Susceptibility Test ◽

Resistance Rates ◽

Study Laboratory

Aims: This study aimed at evaluating the effect of Algo-Bio® use on Escherichia coli resistance strains isolated from piglets intestinal flora. Study Design: Bacteriological study. Place and Duration of Study: Laboratory of the National Reference Center for antibiotics at Institute Pasteur Côte d’Ivoire, between March 2018 and June 2018. Methodology: A breeding of three batches of two piglets was carried out, then treatments with tetracycline and Algo-Bio® were administered to them. Enterobacteria was isolated on Mac Conkey medium added up with tetracycline and resistance rates were determined. Escherichia coli resistant strains have been identified and antibiotic susceptibility test was performed using disk diffusion method on Müller-Hinton agar. Results: Enterobacteria resistance rates increased ranging from 18.4% (D0) to 81.5% (D4) to tetracycline-treated piglets and respectively from 25.7% (D0) to 29% (D4) and from 22.3% (D0) to 24.5% (D4), in control piglets and those treated with Algo-Bio®. Antibiotic susceptibility test of Escherichia coli strains isolated from piglets treated with tetracycline showed high resistance to ceftazidime (83.3%), amoxicillin (76.9%) and tetracycline (92.3%) with 39.4% strains producing ESBL, 23.7% producing PHL and 5.2% of producing CHP on D4. Escherichia coli strains isolated from control piglets and Algo-Bio® treated piglets revealed a decrease of ESBL respectively from 17.6% (D0) to 13.7% (D4) and from 12.5% (D0) to 6.4% (D4). Conclusion: The study showed that the use of Algo-Bio® does not induce an evolution of antimicrobial resistance in Microbiota strains and consequently this dietary supplement can be used as a good alternative to antibiotics.

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Molecular characterisation of antimicrobial resistance and virulence genes in Escherichia coli strains isolated from diarrhoeic and healthy rabbits in Tunisia

World Rabbit Science ◽

10.4995/wrs.2020.10879 ◽

2020 ◽

Vol 28 (2) ◽

pp. 81

Author(s):

Raouia Ben Rhouma ◽

Ahlem Jouini ◽

Amira Klibi ◽

Safa Hamrouni ◽

Aziza Boubaker ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Virulence Genes ◽

Antimicrobial Agents ◽

Antibiotic Resistance Genes ◽

Virulence Gene ◽

Diffusion Method ◽

Class 1 Integron ◽

E Coli ◽

Class 1

The purpose of this study was to identify Escherichia coli isolates in diarrhoeic and healthy rabbits in Tunisia and characterise their virulence and antibiotic resistance genes. In the 2014-2015 period, 60 faecal samples from diarrhoeic and healthy rabbits were collected from different breeding farms in Tunisia. Susceptibility to 14 antimicrobial agents was tested by disc diffusion method and the mechanisms of gene resistance were evaluated using polymerase chain reaction and sequencing methods. Forty E. coli isolates were recovered in selective media. High frequency of resistance to tetracycline (95%) was detected, followed by different levels of resistance to sulphonamide (72.5%), streptomycin (62.5%), trimethoprim-sulfamethoxazole (60%), nalidixic acid (32.5%), ampicillin (37.5%) and ticarcillin (35%). E. coli strains were susceptible to cefotaxime, ceftazidime and imipenem. Different variants of blaTEM, tet, sul genes were detected in most of the strains resistant to ampicillin, tetracycline and sulphonamide, respectively. The presence of class 1 integron was studied in 29 sulphonamide-resistant E. coli strains from which 15 harboured class 1 integron with four different arrangements of gene cassettes, dfrA17+aadA5 (n=9), dfrA1 + aadA1 (n=4), dfrA12 + addA2 (n=1), dfrA12+orf+addA2 (n=1). The qnrB gene was detected in six strains out of 13 quinolone-resistant E. coli strains. Seventeen E. coli isolates from diarrhoeic rabbits harboured the enteropathogenic eae genes associated with different virulence genes tested (fimA, cnf1, aer), and affiliated to B2 (n=8) and D (n=9) phylogroups. Isolated E. coli strains from healthy rabbit were harbouring fim A and/or cnf1 genes and affiliated to A and B1 phylogroups. This study showed that E. coli strains from the intestinal tract of rabbits are resistant to the widely prescribed antibiotics in medicine. Therefore, they constitute a reservoir of antimicrobial-resistant genes, which may play a significant role in the spread of antimicrobial resistance. In addition, the eae virulence gene seemed to be implicated in diarrhoea in breeder rabbits in Tunisia.

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Detection of the Antiseptic Resistance Gene among Pseudomonas aeruginosa Isolates

Iraqi Journal of Science ◽

10.24996/ijs.2021.62.1.7 ◽

2021 ◽

pp. 75-82

Author(s):

اخلاص نعمة

Keyword(s):

Pseudomonas Aeruginosa ◽

Antibiotic Susceptibility ◽

Antimicrobial Agents ◽

Opportunistic Pathogen ◽

Susceptibility Test ◽

Diffusion Method ◽

Bacterial Isolates ◽

Disk Diffusion Method ◽

Antibiotic Susceptibility Test ◽

Antibiotics Susceptibility

Pseudomonas aeruginosa is an opportunistic pathogen that causes a number of infections in immunocompromised patients. This organism appears to improve resistance to many antimicrobial agents and a high percentage of clinical isolates of P. aeruginosa exhibit multidrug resistance (MDR) phenotype . The purpose of this study is to screen the antibiotic susceptibility patterns and the prevalence of qacE delta1 gene among bacterial isolates. Accordingly, 145 samples were collected from different clinical sources from patients who admitted to different hospitals in Baghdad city in a period ranged 23/8/2018-1/1/2019. The isolates were diagnosed as P. aeruginosa based on routine bacteriological methods and confirmed by a molecular method using 16SrRNA gene. The antibiotic susceptibility test was performed to all identified isolates by Kirby-Bauer Disk Diffusion method using ten types of antibiotics. The results of antibiotics susceptibility test revealed high levels of resistance toward Piperacillin (72.22%), Trimethoprim (68%), Ceftazidime (68%), Colistin (40.28%), and Levofloxacin (33.33%). And , the minimum inhibitory concentration (MIC) of Cetrimide was tested using different concentrations (2.048 to 0.004µg/100µl) and the results showed that MIC values ranged between 2.048 and 0.016) μg/100μL, and the concentration of 0.256 μg/100μl was more frequent . Finally, the prevalence of qacE delta1 gene among bacterial isolates was detected in percentage 63.88% among bacterial isolates .

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Antimicrobial resistance of non-clinical Escherichia coli strains from chicken in Nsukka, South-east Nigeria.

Nigerian Journal of Animal Production ◽

10.51791/njap.v30i1.1840 ◽

2021 ◽

Vol 30 (1) ◽

pp. 101-106

Author(s):

K. F. Chah ◽

S. C. Okafor ◽

S. I. Oboegbulem

Keyword(s):

Escherichia Coli ◽

Drug Resistance ◽

Antimicrobial Resistance ◽

Antimicrobial Agents ◽

Diffusion Method ◽

Disc Diffusion ◽

Disc Diffusion Method ◽

E Coli ◽

Sensitivity Tests ◽

Resistance Patterns

This study was carried out to determine resistance profiles of Escherichia coli strains isolated from clinically healthy chickens in Nsukka, southeast Nigeria. A total of 324 E. coli strains isolated from cloaca swabs from 390 chickens were tested against 16 antimicrobial agents using the disc diffusion method. The antibiotics used in the study were: ampicillin (25µg), amoxycillin-clavulanic acid (30µg), gentamicin (10µg), Streptomycin (30µg). cefuroxime (20µg), cephalexin (10µg), nalidixic acid (30µg), ciprofloxacin (5µg), norfloxacin (10µg), ofloxacin (5µg), pefloxacin (5µg), tetracycline (30µg), chloramphenicol (10µg), cotrimoxazole (50µg), colistin (25µg) and nitrofurantoin (100µg).The strains demonstrated high rates of resistance (34.6% 66.1%) to ampicillin, tetracycline, nitrofurantoin, cefuroxime and cotrimoxazole. None of the isolates was resistant to colistin, ofloxacin and pefloxacin. For each antimicrobial agent (except cephalexin), strains from the intensively reared chickens (layers and broilers) displayed higher resistance frequencies than those from the local birds. A total of 49 resistant patterns were recorded for the 228 strains resistant to at least one antimicrobial drug, with AmTeCoS and AmTeCfN being the predominant patterns. Because of the great variation in the drug resistance patterns of the Escherichia coli strains, use of antimicrobial agents in the management of E. coli infections in the study area should be based on results of sensitivity tests.

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Prevalence and antibiotic susceptibility pattern of pathogens from urinary tract infections (UTI) in a private diagnostic laboratory in Bangladesh

Asian Journal of Medical and Biological Research ◽

10.3329/ajmbr.v6i3.49809 ◽

2020 ◽

Vol 6 (3) ◽

pp. 564-569

Author(s):

Md Habibur Rahman ◽

Mushtaque Ahmed ◽

Dayanidhi Sarkar ◽

Md Asadur Rahman

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Antibiotic Susceptibility ◽

Antimicrobial Agents ◽

Urine Samples ◽

Gram Positive ◽

Diagnostic Laboratory ◽

Gram Negative ◽

Antibiotic Susceptibility Test ◽

Tract Infections

Urinary tract infection (UTI) is one of the commonest infections encountered by clinicians and despite the widespread availability of antimicrobial agents UTI has become difficult to treat because of appearance pathogens with increasing resistance to antimicrobial agents. The aim and objectives of this study were to determine the pathogens causing UTI and to determine the antibiotic sensitivity status among these isolates in a diagnostic laboratory in Dhaka city. A laboratory based cross sectional survey was conducted in Popular Diagnostic Centre Ltd. Dhanmondi, Dhaka-1205, Bangladesh from July 2016 to December 2016. A total of 553 freshly voided midstream urine samples (10-20 ml) were collected in a wide mouth sterile container from patients and processed in microbiology laboratory to isolate pathogens and antibiotic susceptibility test using standard procedure. Among 553 urine sample, the culture positivity in urine samples was found to be 158 (28.57%) of which 39 (24.70%) were isolated from male patients and 119 (75.30%) from female patients. Escherichia coli (43.67%) were found to be the predominant pathogen followed by Staphylococcus spp. (16.45%), Enterococcus spp. (13.39%), Klebsiella spp. (13.29%), Candida spp. (5.70%), Acinetobacter spp. (4.43%), Psudomonas spp. (3.80%) and Proteus spp. (1.27%). Carbapenem group (Imipenem, Meropenem) were the most effective antibiotic with resistance between 0 and 5.1% of the gram negative isolates and Linezolid and Vancomycin was most effective in gram positive isolates. Nitrofurantoin was most effective both gram negative and gram positive isolates. This study finding showed That Escherichia. coli isolates were the predominant pathogens and showed increasing pattern to the commonly prescribed drugs in private practice that in turn leaves the clinicians with very few alternative options in drug for the treatment of UTIs. Asian J. Med. Biol. Res. September 2020, 6(3): 564-569

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Bloodstream infections initiated by ESBL-producing Escherichia coli in neonates and infants at two hospitals in Yaoundé, Cameroon

International Journal of Biological and Chemical Sciences ◽

10.4314/ijbcs.v15i3.27 ◽

2021 ◽

Vol 15 (3) ◽

pp. 1222-1233

Author(s):

Carole Suzie Lacmago Titsamp ◽

Hortense Kamga Gonsu ◽

Simon Ngamli Fewou

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Bloodstream Infection ◽

Antibiotic Susceptibility ◽

Klebsiella Oxytoca ◽

Blood Cultures ◽

Susceptibility Test ◽

Coagulase Negative Staphylococci ◽

Antibiotic Susceptibility Test ◽

Neonates And Infants

Early diagnosis and probabilistic antibiotic therapy based on known bacterial ecology and antibiotic sensibility can reduce mortality and morbidity in pathologies caused by a bacterial infection. This study aimed at determining the prevalence and risk factors of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli isolated from blood cultures of neonates and infants population. We conducted a cross-sectional study during which pathogenic bloodstream isolates were identified. Antibiotic susceptibility test was performed on Escherichia coli isolates and phenotypic confirmation of ESBL production by Escherichia coli was performed by a double-disc synergy test. Over the course of this study, 298 blood cultures were performed and 129 (43.3%) positive cultures were obtained. Of the 129 bacterial isolates, 90 (69.7%) were Escherichia coli and 39 (30.2%) were other bacteria strains that included Klebsiella oxytoca, Streptococcus pneumonia, and Coagulase-negative staphylococci. Antibiotic susceptibility test indicated that Escherichia coli isolates were resistant to cephalosporin, penicillin, sulfonamide, and aminoglycoside antibiotic families. Further analysis indicated that 31 (34.4%) Escherichia coli strains were ESBL producers and risk factors for bloodstream infection by ESBL-producing Escherichia coli were prior to exposure to antibiotics and immune system depression. These findings clearly extend our understanding of the type of resistant initiated by ESBL-producing Escherichia coli in bloodstream infection of neonates, and infants and also provides useful information that can guide the establishment of an efficient therapeutic strategy for the community- and hospital-acquired bloodstream infection.

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Antibiotic susceptibility profile and extended spectrum β-lactamases production by uropathogenic Escherichia coli from tertiary care hospital of rural settings

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184901 ◽

2018 ◽

Vol 6 (12) ◽

pp. 4022

Author(s):

Mustafa Sofiur Rahman ◽

Ritu Garg ◽

Varsha A. Singh ◽

Dipankar Biswas

Keyword(s):

Escherichia Coli ◽

Drug Resistance ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Antibiotic Susceptibility ◽

Uropathogenic Escherichia Coli ◽

Diffusion Method ◽

Care Hospital ◽

Antibiotic Susceptibility Test ◽

Tract Infections

Background: Escherichia coli are the most common cause of urinary tract infections in community as well as hospital settings. Emergence of drug resistance in Escherichia coli due to various mechanisms makes the treatment options very limited. This study was undertaken to detect ESBLs in uropathogenic Escherichia coli isolates and to determine their antimicrobial susceptibility pattern in rural setting.Methods: A prospective study was done on 502 E. coli isolates from clinically suspected cases of urinary tract infections (UTI) patients of all age groups. All samples were inoculated on Cysteine Lactose Electrolyte Deficient Agar (CLED). Organisms grown in pure culture were identified by standard biochemical tests. Antibiotic susceptibility test was done by the Kirby Bauer Disc diffusion method on Muller Hinton agar. ESBL detection was done as per CLSI guidelines.Results: Of the 502 isolates of Escherichia coli, nitrofurantoin (82%) was found be most sensitive antimicrobial followed by amikacin (73%), gentamycin (71%) and imipenem (64%). Common empirically used antibiotics like fluroquinolones and Cotrimoxazole drugs showed alarming rate of resistance. 60% isolates were found to be multidrug resistant. ESBL production was detected in 31% isolates. ESBL producing strains were found to be more drug resistant than non ESBL producing strains.Conclusions: So, drug resistance due to production of ESBLs in Escherichia coli is a serious threat for clinicians. Strict infection control measures and early detection of beta lactamase producing isolates are the need of the hour to contain the emergence of this type of resistance.

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Biofilm production and its correlation with antibiogram among clinical isolates of uropathogenic Escherichia coli

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20182116 ◽

2018 ◽

Vol 5 (3) ◽

pp. 638

Author(s):

Monika Yadav ◽

Sulochana D. Khumanthem ◽

Mamta D. Kshetrimayum ◽

Shan Damrolien

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Health Problem ◽

Antimicrobial Agents ◽

Diffusion Method ◽

Isolation And Identification ◽

Biofilm Production ◽

Antibiotic Susceptibility Test

Background: Urinary tract infection (UTI) is one of the commonest health problem encountered in clinical practice. The biofilms play major role in decreasing the susceptibility to the antimicrobial agents. The present study aimed at isolation and identification of Escherichia coli from cases of urinary tract infection, and to find out production of biofilms by these isolates and to correlate it with antimicrobial resistance.Methods: This study was a cross sectional study. Urine specimen from patients suspected of UTIs were collected and processed by standard operative procedure, antibiotic susceptibility test was done by Kirby Bauer disc diffusion method. Biofilm production in isolates was done by Tissue culture plate (TCP) method, Christensen’s test tube (CTT) method, and Congo red agar (CRA) method.Results: Out of the total of 250 isolates 191 (76%) showed biofilm positive by TCP method, 180 (72%) showed biofilm positive by CTT method, 161 (64%) showed biofilm positive by CRA method. 90% of total extended spectrum beta lactamase (ESBL) producing Escherichia coli were biofilm producers. There is more resistance for each and every antibiotic among biofilm producers in comparision to biofilm non producers.Conclusions: The microbial biofilms may pose a public health problem, as the microorganisms in the biofilms are difficult to be treated with antimicrobial agents.

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Susceptibility and Multidrug Resistance Patterns of Escherichia coli Isolated from Cloacal Swabs of Live Broiler Chickens in Bangladesh

Pathogens ◽

10.3390/pathogens8030118 ◽

2019 ◽

Vol 8 (3) ◽

pp. 118 ◽

Cited By ~ 10

Author(s):

Muha. Ajijur Rahman Al Azad ◽

Md. Masudur Rahman ◽

Ruhul Amin ◽

Mst. Ismat Ara Begum ◽

Reinhard Fries ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Broiler Chickens ◽

Antimicrobial Agents ◽

Diffusion Method ◽

Multi Drug Resistance ◽

Major Health Problem ◽

E Coli ◽

Antimicrobial Resistance Gene ◽

Resistance Patterns

Antimicrobial resistance is a major health problem, particularly in developing countries like Bangladesh, where there is a paucity of information on resistance patterns and prevalence of antimicrobial determinants. Therefore, the aims of this study were to investigate the prevalence of resistance, including multi-drug resistance (MDR), and the associated genetic determinants in Escherichia coli isolates from cloacal swabs of live broiler chickens in Bangladesh. Altogether, 400 cloacal swabs (200 from Rajshahi and 200 from Dhaka divisions) were randomly collected from individual chickens in 50 broiler farms. E. coli was isolated and identified using conventional bacteriological culture and biochemical methods. The isolates were further confirmed using genus-specific 16S rRNAtargeted polymerase chain reaction (PCR) primers. Antimicrobial susceptibilities and MDR of the isolates against nine different antimicrobial agents (ampicillin, erythromycin, tetracycline, gentamicin, ciprofloxacin, levofloxacin, trimethoprim-sulfamethoxazole, colistin sulphate, and streptomycin) were determined using the Kirby-Bauer disc diffusion method. Resistance determinants of E. coli to ampicillin (blaTEM), streptomycin (aadA1), erythromycin [ere(A)], trimethoprim (dfrA1), and tetracycline [tet(A), tet(B)] were screened using PCR. Our results showed that all swab samples were positive for E. coli. The isolates were uniformly resistant to ampicillin, tetracycline, streptomycin, ciprofloxacin, erythromycin, and trimethoprim-sulphamethoxazole. The isolates exhibited highest susceptibility to colistin sulphate (73.5%), followed by gentamicin (49%), and levofloxacin (17%). All isolates were resistant to three classes of antibiotics, 204 isolates (51%) were resistant to four classes, and 56 isolates (14%) were resistant to five. The highest prevalence of antimicrobial resistance gene was recorded for tetracycline (tet(A):95.25%; tet(B):95.25%) followed by ampicillin (blaTEM:91.25%), streptomycin (aadA1:88.25%), erythromycin (ere(A):84.75%), and trimethoprim (dfrA1:65.5%). In conclusion, surveillance for MDR bacteria in poultry is a critical piece of knowledge, which would be useful for optimizing empiric antimicrobial treatments and exploring alternative antimicrobial agents.

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MACROLIDE-LINCOSAMIDE-STREPTOGRAMIN B RESISTANCE AMONG STAPHYLOCOCCUS AUREUS IN CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL, NEPAL

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i5.41012 ◽

2021 ◽

pp. 61-65

Author(s):

NAVIN KUMAR CHAUDHARY ◽

RUSAN PIYA

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Susceptibility ◽

Antimicrobial Agents ◽

Susceptibility Testing ◽

Clinical Specimen ◽

Significant Proportion ◽

College Teaching ◽

Diffusion Method ◽

Cross Sectional ◽

Antibiotic Susceptibility Test

Objectives: Staphylococcus aureus is often linked with human infection. Clindamycin is one of the key substitute antimicrobial agents in the treatment of S. aureus, especially in methicillin-resistant S. aureus (MRSA) infections. Inducible macrolide-lincosamide-streptogramin B (iMLS B) resistance is a crucial factor in antimicrobial susceptibility testing. The intention of the research was to identify S. aureus from distinct clinical specimens and investigate the prevalence of inducible clindamycin resistance among them and also study their association with MRSA. Methods: A descriptive cross-sectional study was accomplished in the Dept. of Microbiology CMC-TH, Nepal from January 2018 to December 2020 with 525 non-repeated S. aureus obtained from a different clinical specimen. Antibiotic susceptibility test was performed by Kirby–Bauer disc diffusion method. MRSA was detected using cefoxitin (30 μg) and results were interpreted as stated by CLSI. “D-Test” was done by applying erythromycin (15 μg) and clindamycin (2 μg) as per CLSI guidelines. Data were analyzed using SPSS IBM version 20. Results: Among 525 isolates, there were 315 (60.00%) MRSA. Results of D test analysis showed that 280 (53.33%) were MLSB sensitive while 245 (46.67%) were MLSB resistant; where 80 (15.24%) iMLSB with D zone, 100 (19.05%) constitutive MLSB (cMLSB) phenotype, and 65 (12.38%) MS phenotype. Of a total of 80 iMLSB, a significant proportion of 64 (80.00%) was MRSA (p<0.001). All the isolates were sensitive to vancomycin, teicoplanin, and linezolid. The prevalence of both iMLSB and cMLSB was high among MRSA. Conclusion: In this study, cMLSB phenotype was predominant (19.05%) followed by iMLSB phenotype (15.25%) and then MS phenotype (12.38%). Inducible iMLS B phenotypes, as well as cMLSB, are higher among MRSA. It is advisable to include “D-Test” as a part of regular antibiotic susceptibility testing to detect iMLSB resistance among S. aureus.

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