Prevalence of methicillin resistance and macrolide–lincosamide–streptogramin B resistance in Staphylococcus haemolyticus among clinical strains at a tertiary-care hospital in Thailand

Abstract

Staphylococcus spp. is a major cause of nosocomial infection and sepsis. However, increasing drug resistance is becoming a challenge to microbiologists. The purpose of this study was to identify and determine antimicrobial resistance phenotypes and drug resistance genes of clinical coagulase-negative staphylococci (CoNS) isolates at Mae Sot Hospital in Tak province, Thailand. A total of 229 CoNS isolates were collected from clinical specimens during two periods in 2014 and in 2015. Staphylococcus haemolyticus was the most prevalent species (37.55%), followed by S. epidermidis (21.83%), S. saprophyticus (11.79%) and S. hominis (11.35%) respectively. The remaining 17.48% of the organisms comprised S. capitis, S. arlettae, S. cohnii, S. equorum, S. xylosus, S. warneri, S. sciuri, S. pettenkoferi, S. kloosii and S. lugdunensis. Methicillin-resistant CoNS (MRCoNS), containing the mecA gene, were detected in 145 of 229 isolates, mostly found in S. haemolyticus and S. epidermidis. In addition, the differentiation of their macrolide–lincosamide–streptogramin B (MLSB) resistance phenotypes was determined by the D-test and corresponding resistance genes. Among 125 erythromycin-resistant CoNS, the prevalence of constitutive type of MLSB, inducible clindamycin resistance and macrolide–streptogramin B resistance phenotypes were 72, 13.60 and 14.40% respectively. These phenotypes were expressed in 80% of MRCoNS strains. In addition, the ermC gene (79.20%) was found to be more prevalent than the ermA gene (22.40%), especially among MRCoNS. These results indicate that CoNS may play an important role in spreading of drug resistance genes. More attention to these organisms in surveillance and monitoring programs is needed.

Distribution of Staphylococcus haemolyticus as the most dominant species among Staphylococcal infections at the Zainoel Abidin Hospital in Aceh, Indonesia

“…This finding is aligned with previous investigation demonstrating that there were increasing occurrences of coagulase negative-Staphylococcus in blood samples of patients from the hospital in US (Monsen et al 2005) and Thailand (Teeraputon et al 2017). Furthermore, coagulasenegative Staphylococcus isolates were also frequently found in samples detected in the blood samples of patients suffering from bacteremia in East Java, Indonesia (Dzen et al 2013).…”

“…The high frequency of these MRSH isolates is aligned with previous research suggesting the high prevalence (77.5%) of oxacillin-resistant S. haemolyticus among coagulasenegative Staphylococcus-related infections (Pereira et al 2014). Moreover, other studies also reported the high prevalence of MRSH, not only in humans (Teeraputon et al 2017), but also in animals (Lloyd 2007;Ruzauskas et al 2014;Sidhu et al 2007). Additionally, due to their acquired multi-resistance, the MRSH isolates have a crucial role in the transmission of the corresponding resistance genes leading to the widespread of more virulent pathogens, including S. aureus, in the clinical settings (Cavanagh et al 2014).…”

“…Based on the types of clinical samples, MRSH isolates were predominantly detected in the blood specimens in the present study. Similar findings were also reported by Teeraputon et al (2017) The results revealed that out of total isolates 81.9 % of the isolates in the blood samples were S. haemolyticus which highlighting the clinical importance of the bacterial isolates in the blood infections (Hitzenbichler et al 2017). The high prevalence of MRSH isolates within the blood samples might be associated with their pathogenicity since they play a significant role for bacteremia related to colonization during the application of intravascular catheter (Daniel et al 2014).…”

Multidrug-resistant Staphylococcus pettenkoferi isolated from cat in India

“…In DDST, the test inoculum with 0.5 McFarland turbidity was streaked into MHA; HiMedia, India and disks of CTX, CAZ, ATZ, cefepime, and cefpodoxime (30 µg each) were manually placed at 20 mm distance center to center surrounding a disk of amoxicillin-clavulanate (AMC; 20/10 µg). Following overnight incubation at 37°C, the test isolate was considered positive, if its zone of inhibition against any of the peripheral disk was enhanced toward AMC [ 10 ]. In case of CDM, an increase of 5 mm or more in zone diameter for CAZ/CTX in combination with clavulanic acid (CA) than that of the corresponding cephalosporin disk was interpreted as ESBL positive.…”

Clindamycin Resistance among Methicillin Resistant <i>Staphylococcus aureus</i> Isolated from Human and Respective Household Swine in Greater Kabale Region—South Western Uganda

“…Clindamycin is the most preferred agent because of exceptional pharmacokinetic characteristics [6] and is regularly used in the management of severe infections, caused by macrolide resistant S. aureus infections including MRSA [7]. However, increasing resistance to clindamycin among MRSA strains and other Staphylococcus is a serious challenge [8]. The expression of clindamycin resistance in Staphylococcus species can be constitutive or inducible [9] [10] through erm genes which codes for ribosomal methylases [11].…”