Prevalence and Antibiotic Susceptibility Pattern of Staphylococcus Aureus in Clinical Specimens

The present study was carried out to determine the prevalence of Staphylococcus aureus in clinical samples and their susceptibility pattern to antibiotics. Standard microbiological and biochemical methods were used to screen 155 clinical specimens comprising of sputum, wound, urine and high vaginal swabs for S .aureus. Twenty eight (28) isolates was obtained from these samples. Antibiotic susceptibility results shows high percentage of sensitivity to gentamicin (89%,) azithromycin (89%), pefloxacin (79%)  followed by erythromycin (68%) ciprofloxacin (61%) streptomycin (61%)and sparfloxacin (54%). A high resistance was recorded for cotrimaxazole (90%), amoxycillin (88%), ampicillin (73%), tetracycline (65%), cefuroxime and cephalexin (40%) each. Key words: Staphylococcus aureus, antibiotic susceptibility, prevalence, resistance

Accessory gene regulators and virulence genes associated with the pathogenicity of Staphylococcus aureus from clinical and community settings in Lagos, Nigeria

Staphylococcus aureus is a prominent pathogen that causes serious community and hospital-acquired infections globally. Its pathogenicity is attributed to a variety of secreted and cell surface associated proteins that are modulated by the quorum-sensing accessory gene regulator (agr) system. In this study, we investigated the presence of toxin genes and agr involved with S. aureus from clinical samples and apparently healthy individuals. Unequivocal identification of the isolates was obtained with the Vitek 2 system. We screened 70 clinical (CL) and 22 community (C) S. aureus strains for the methicillin resistance (mecA) gene, agr and superantigens (SAg) (enterotoxins and toxic shock syndrome toxin-1) using PCR techniques. A total of 12 clinical isolates were classified as methicillin-resistant S. aureus (MRSA); 89 isolates belonged to one of the four agr groups (agr1-4), and 3 isolates were non-typeable. Of the agr groups, agr1 was the most prominent and mostly consisted of isolates from pus/wounds. The methicillin-susceptible S. aureus (MSSA) isolates were distributed within the four agr groups while MRSA strains were restricted to agr1 and agr3. The most common enterotoxin gene, sei, was likewise more prevalent in MSSA strains than in MRSA strains, where sea predominated. The co-existence of two or more enterotoxins was confirmed in 40% of the isolates. sea occurred through all the agr groups except agr3 and sei was not found in agr1 and agr4. The toxic shock toxin (tst) gene was detected in six MSSA. These findings suggest that MSSA may cause more lethal infections than MRSA because of the increased frequency of toxic genotypes seen in MSSA strains. Significance: • Isolates in the agr1,3 groups had more SAg toxin genes, whereas isolates in the agr4 groups possessed more tst genes. • The MSSA isolates contained higher proportions of virulence genes than MRSA. • The clinical implications of this discovery include that MSSA may cause more lethal infections than MRSA due to the greater number of toxigenic genotypes discovered

CARRIAGE OF MULTIDRUG RESISTANT ENTEROCOCCUS FAECIUM AND ENTEROCOCCUS FAECALIS AMONG APPARENTLY HEALTHY HUMANS

Enterococci are indigenous flora of the gastro-intestinal tracts of animals and humans. The recent years have witnessed increased interest in two major species, E. faecium and E. faecalis, because of their ability to cause serious infections and their intrinsic resistance to antimicrobials. In this study, human faecal samples were processed to determine the frequency of occurrence of E. faecium and E. faecalis and evaluate the susceptibility of the isolates to antibiotics. One hundred faecal samples were collected from apparently healthy individuals and 73 Enterococcus were phenotypically identified using conventional methods. The susceptibility profiles of the isolates to 9 different antibiotics were determined using disk diffusion method and the results were interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Sixty-five isolates were differentiated into 36 (55.4%) E. faecium and 29 (44.6%) E. faecalis. No dual colonization by the two species was observed and isolation rate was independent of sex. Antimicrobial susceptibility testing revealed high occurrence of several different combinations of resistant patterns. The 65 isolates were resistant to ceftriaxone, cefuroxime and ceftizoxime. Enterococcus faecium exhibited resistance to erythromycin (88.9%), gentamicin (77.8%), amoxicillin-clavulanate (63.9%), ofloxacin (44.4%), teicoplanin (19.4%) and vancomycin (16.7%). Enterococcus faecalis showed the least resistance to vancomycin (13.8%) and teicoplanin (27.7%). The high prevalence of resistant strains in this study can be attributed to misuse of drugs. This can be curtailed by stopping the sale of antibiotics across the counter and creating awareness among the populace by Government and Health Agencies on the consequences of unregulated antibiotic use

Staphylococcal bacteraemia among human immunodeficiency virus positive patients at a screening center in Lagos, Nigeria

Bacteraemia due to Staphylococcus aureus in Human immunodeficiency virus (HIV) – positive patients is associated with increased mortality rate. The present study aimed at determining the species distribution and occurrence of staphylococcal bacteraemia in HIV – positive patients in Lagos, Nigeria. Staphylococcal blood stream infection in febrile HIV patients was investigated by culture technique. The antibiotic resistance pattern was investigated using the disk diffusion and methicillin resistance was confirmed by the salt agar methods. The genetic relatedness of S. aureus was determined using Pulsed Field Gel Electrophoresis (PFGE). Eighty-six patients comprising 47 (55%) female and 39 (45%) male, median aged 34 years took part in the study. Staphylococci were identified in 16 (18.6%) patients; 13 (15.1%) and 3 (3.5%) with single and dual Staphylococcus species respectively. The isolates consisted of S. aureus (7 patients), followed by S. haemolyticus (4 patients). Of the thirteen (13) antibiotics tested, isolates were resistant to ampicillin (AMP; 89.5%), tetracycline (TET; 68.4%), cloxacillin (CXC; 89.5%), oxacillin (OXA; 68.4%); chloramphenicol (CHL; 57.9%) and trimethoprim-sulphamethoxazole (SXT; 63.1%). The overall percentage of all the isolates resistant to gentamicin, erythromycin and amoxicillin-clavulanic acid was less than 50%. All the isolates were susceptible to ciprofloxacin and vancomycin and none was positive for methicillin resistance except a strain of S. haemolyticus. Significant genetic diversity was observed among the S. aureus isolates with a predominant pulsotype A. The two isolates with pulsotype A had identical resistotype (AMP, ERY, TET, CXC, SXT). Other PFGE patterns were represented by single isolates except pulsotype C which had a subtype. In these patients, the most frequent Staphylococcus species isolated was S. aureus and the results revealed that clonal dissemination of a virulent pulsotype of S. aureus among this population is plausible and should be a cause for concern