Vancomycin resistant coagulase-negative Staphylococcal isolates from HIV positive patients in the Limpopo Province, South Africa

Iweriebor, C.

doi:10.5897/jma11.090

Cited by 3 publications

(6 citation statements)

References 38 publications

(37 reference statements)

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“…Pathogenic CoNS are usually associated with clinical environments and found in immunocompromised patients and patients with indwelling metallic or polymer devices, such as orthopedic prostheses, peripheral venous catheters, and artificial pacemakers; however, they are less commonly involved in community-associated diseases [ 3 , 4 , 5 , 6 ]. CoNS are the most common pathogens implicated in nosocomial bloodstream infections, responsible for 30–40% of these infections [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Multidrug-Resistant Coagulase-Negative Staphylococci Isolated from Bloodstream in the uMgungundlovu District of KwaZulu-Natal Province in South Africa: Emerging Pathogens

et al. 2021

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Coagulase-negative staphylococci (CoNS) are increasingly associated with nosocomial infections, especially among the immunocompromised and those with invasive medical devices, posing a significant concern. We report on clinical multidrug-resistant CoNS from the uMgungundlovu District, KwaZulu-Natal Province, South Africa, as emerging pathogens. One hundred and thirty presumptive CoNS were obtained from blood cultures. Culture, biochemical tests, and the Staphaurex™ Latex Agglutination Test were used for the initial identification of CoNS isolates; confirmation and speciation were undertaken by the VITEK 2 system. Susceptibilities of isolates against a panel of 20 antibiotics were determined using the Kirby-Bauer disk diffusion method, and the multiple antibiotic resistance (MAR) indices of the isolates were determined. The polymerase chain reaction (PCR) was used to amplify the mecA gene to confirm methicillin resistance. Overall, 89/130 presumptive CoNS isolates were confirmed as CoNS by the VITEK 2 system. Of these, 68 (76.4%) isolates were putatively methicillin-resistant by the phenotypic cefoxitin screen test and 63 (92.6%) were mecA positive. Staphylococcus epidermidis (19.1%), S. hominis ssp hominis (15.7%), and S. haemolyticus (16.9%) were the most common CoNS species. Isolates showed high percentage resistance against penicillin (100.0%), erythromycin (74.2%), and azithromycin (74.2%) while displaying high susceptibilities to linezolid (95.5%), gentamicin (95.5%), and tigecycline (94.4%). Multidrug resistance (MDR) was observed in 76.4% of isolates. MAR index calculation revealed 71.9% of isolates with MAR index >0.2 and 20.2% >0.5. Isolates with the highest MAR indices (0.7 and 0.8) were recovered from the neonatal intensive care unit. Fifty-one MDR antibiograms were observed. The high prevalence of methicillin resistance and multidrug resistance in several species of CoNS necessitates surveillance of this emerging pathogen, currently considered a contaminant of microbial cultures.

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Section: Introductionmentioning

confidence: 99%

Multidrug-Resistant Coagulase-Negative Staphylococci Isolated from Bloodstream in the uMgungundlovu District of KwaZulu-Natal Province in South Africa: Emerging Pathogens

et al. 2021

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“…40 The difficulty in determining the pathogenicity of most CoNS samples, including clinical samples, is due partly to poorly defined virulence factors in these strains even though the possession of some genetic markers could prove important in distinguishing between potentially virulent and saprophytic/contaminating strains of CoNS. 19 The possession for example of virulence factors, such as Panton-Valentine leukocidin or toxic shock syndrome toxin 1 and enterotoxins could be associated with increased pathogenicity of CoNS. 41 The CoNS do not possess as many virulence factors as S. aureus, reflected in the different spectra of diseases they respectively cause.…”

Section: Epidemiology and Clinical Relevancementioning

confidence: 99%

“…18 Since then, glycopeptide-resistant CoNS in patients on prolonged vancomycin treatment have been variously reported, thus limiting therapeutic options. 19 CoNS have a particularly high resistance against methicillin (70%-80%) as indicated by various reports in the Canada, United States, and Latin America. 20,21 CoNS possess a wide range of multidrug-resistant determinants mostly on plasmids that mediate resistance to some major antibiotics and can be transferred between different staphylococcal species such as S. intermedius and S. aureus.…”

Section: Introductionmentioning

confidence: 99%

“…20,21 CoNS possess a wide range of multidrug-resistant determinants mostly on plasmids that mediate resistance to some major antibiotics and can be transferred between different staphylococcal species such as S. intermedius and S. aureus. 19 For instance, horizontal transmission of the mecA gene (which mediates methicillin resistance and is carried by the mobile genetic element SCCmec) to other staphylococcal species has been suggested to be a common occurrence. 22 As at 2018, there were 54 species and 28 subspecies comprising the genus staphylococcus, 23 whereas 41 CoNS species have been documented as of July 2018.…”

Section: Introductionmentioning

confidence: 99%

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Review of Clinically and Epidemiologically Relevant Coagulase-Negative Staphylococci in Africa

Asante

Amoako

Abia

et al. 2020

Microbial Drug Resistance

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Coagulase-negative staphylococci (CoNS) have engendered substantial interest in recent years as pathogenic causes of infections in both human and veterinary medicine, especially in the immunocompromised, critically ill, long-term hospitalized and in those harboring invasive medical devices such as catheters. They have been implicated in infections such as urinary tract infections, bloodstream infections, and invasive device-related infections, and are responsible for substantial economic losses in livestock production. The advancement of diagnostic techniques has increased our understanding of their molecular mechanisms of pathogenicity, even though distinguishing between innocuousness and pathogenicity is still challenging. The incidence of CoNS varied across the continent in humans and animals (mainly cattle), ranging from 6% to 68% in suspected human infections and from 3% to 61.7% in suspected animal infections, distributed across different geographic locations. Furthermore, there were varying antibiotic resistance patterns observed in CoNS isolates, with high methicillin resistance in some cases, leading to crossresistance against many antibiotics. Staphylococcus epidermidis, Staphylococcus haemolyticus, and Staphylococcus xylosus were most commonly reported in studies herein reviewed, while the enterotoxin C gene, atl E gene, ica gene, and hemolysin virulence factors were linked with enhanced pathogenicity. Advancement in identification and typing methods, including whole genome sequencing, virulence screening, and the assessment of the immune status of subjects in studies will help to thoroughly assess the true pathogenic potential of isolated CoNS species in developing countries. Careful antibiotic stewardship guidelines should be followed due to the ability of CoNS to develop multidrug resistance.

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“…In 1987, Schwalbe and colleagues reported the first clinical isolate of vancomycinresistant CoNS (13). Since then, many vancomycin-resistant or other glycopeptide-resistant CoNS isolated from clinical samples have been documented in different countries (14)(15)(16)(17)(18). Additionally, the emergence of resistance to teicoplanin has been reported (15).…”

Section: Introductionmentioning

confidence: 99%

Investigation of Glycopeptide Susceptibility of Coagulase-Negative Staphylococci (CoNS) From a Tertiary Care Hospital in Gorgan, Northern Iran

Mehri

Jahanbakhsh

Shakeri

et al. 2016

Arch Pediatr Infect Dis

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Background: Coagulase-negative staphylococci (CoNS) are clinically important, especially in nosocomial and neonatal infections. The increasing emergence of glycopeptide-resistant CoNS has made these agents therapeutically challenging. Objectives: We aimed to investigate the susceptibility patterns of CoNS to teicoplanin and vancomycin in Gorgan, northern Iran. Materials and Methods: A total of 100 clinical samples were obtained from different wards of a hospital and screened for CoNS with standard microbiological and biochemical tests. Antibiogram testing was carried out for the detection of vancomycin-, teicoplanin-, and multidrug-resistant (MDR) species. The minimum inhibitory concentration (MIC) of vancomycin was determined using E-test strips. The presence of the vanA gene was investigated with PCR. Results: Only 1% of CoNS (Staphylococcus haominis) showed resistance to vancomycin and 15% of these were intermediate-resistant to teicoplanin on the disc diffusion agar test. In addition, all isolates (100%) were negative for vanA on PCR and sensitive with E-test

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Vancomycin resistant coagulase-negative Staphylococcal isolates from HIV positive patients in the Limpopo Province, South Africa

Abstract: Coagulase-negative staphylococci (CNS) are a major cause of nosocomial infection, especially in critically ill and immunocompromised patients. CNS is usually a multi-drug

Cited by 3 publications

References 38 publications

Multidrug-Resistant Coagulase-Negative Staphylococci Isolated from Bloodstream in the uMgungundlovu District of KwaZulu-Natal Province in South Africa: Emerging Pathogens

Multidrug-Resistant Coagulase-Negative Staphylococci Isolated from Bloodstream in the uMgungundlovu District of KwaZulu-Natal Province in South Africa: Emerging Pathogens

Review of Clinically and Epidemiologically Relevant Coagulase-Negative Staphylococci in Africa

Investigation of Glycopeptide Susceptibility of Coagulase-Negative Staphylococci (CoNS) From a Tertiary Care Hospital in Gorgan, Northern Iran

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