Abstract
Background: Staphylococcal infections are managed by hygiene measures and usage of antibiotics. The first-line treatment refers to beta-lactamins. However, the emergence of beta-lactamin resistant staphylococcal strains has been reported, as demonstrated by a study conducted in Lomé University Teaching Hospital, Bacteriology Laboratory (2001) on 742 Staphylococcus aureus strains which revealed 67.00% of them where methicillin resistant. In this setting of emergent methicillin-resistant strains, the second-line treatments are prescribed by clinicians without antibiograms. Fluoroquinolones are the first preference molecules used for second-line treatment because of their efficacy and affordability. We want to contribute to setting monitoring and alert-making tools for drug prescribers. Thus we conducted this study, aiming to determine the frequency of S. aureus and coagulase-negative staphylococci (CNS) strains isolation in different types of biologic samples, and to investigate the link between methicillin resistance and ciprofloxacin resistance. Methods: We conducted this study from January 2006 through Jun 2010. The Microbiology Laboratory Service collected and analyzed samples for diagnostic purpose from inpatients and outpatients consulted in the hospital. We collected and analyzed de-identified data on these patients to form laboratory records. Bacteriological analyses in which ciprofloxacin have not been tested were excluded. Results: Over the 1108 staphylococal strains isolated from various biological samples processed, 751 were Staphylococcus aureus and 357 were coagulase-negative staphylococci. The strains sensitivity profile is for all isolates. The majority of germs were S. aureus and 20% of them were ciprofloxacin-resistant. The probability of a patient who has an infection caused by S. aureus increases his stay in high-risk settings such as intensive care unit, surgical intervention, extended hospitalization, use of a catheter. The use of broad-spectrum antibiotics increases the risk of multidrug-resistant strains. Conclusion: This study highlights the recurring issue of over consumption of antibiotics in nowadays medical treatments. There is a need to raise awareness about the rational use of antibiotics in general and fluoroquinolones particularly.
Highlights
Staphylococci are ubiquitous germs part of the human and animal cutaneous-mucous flora
Over a total of 1108 staphylococcus strains isolated during the study period, 751 (68%) were S. aureus and 357 (32%) were coagulase-negative staphylococci (CNS).The majority (53%) of staphylococci strains were isolated from inpatients versus outpatients (43%)
Several studies show that methicillin-resistant Staphylococcus aureus (MRSA) are being important bacterial pathogens in hospital setting, but our result (37.38%) is much higher: 6.64% in the United States (2010), 5.97% in Canada (1999) and 0.8% in Japan (2003) [8]-[10]
Summary
Staphylococci are ubiquitous germs part of the human and animal cutaneous-mucous flora. They can be spread by a healthy carrier. Staphylococcus can persist endemically and lead to a high rate of nosocomial infections. The seriousness of these infections is linked to symptoms severity and to the therapeutic difficulties because of the multi resistance to antibiotics [1] [2]. In the setting of emerging methicillin-resistant strains, second-line treatments are prescribed. These treatments are prescribed in our health services by clinicians without antibiogram evidences. We conducted this study to assess ciprofloxacin resistance (Cipro-R) of staphylococcal isolates in our settings
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