Abstract
We report in this study for the first time the prevalence of multiple resistant Staphylococcus haemolyticus in clinical settings in Saudi Arabia. A total of 1060 clinical specimens of hospitalized patients were screened for the presence of S. haemolyticus in the period between September and December 2020. Primary identification of the isolates was carried out by colonial characteristics on mannitol salt agar and clumping factor test, confirmation of presumptive isolates and antimicrobial susceptibility testing was performed by Vitek® 2, while PCR was employed to detect mecA and vanA genes. A total of 20 S. haemolyticus isolates were recovered from 20 samples (blood cultures, urine, nasal swab, wound swab, groin swab, and axilla swab), 90% (P <0.001, x2) of the isolates were multiple resistant to three antimicrobial agents and more. Resistance to oxacillin was exhibited in 95% of the isolates, while none of the isolates were resistant to vancomycin and linezolid, yet resistance to rifampicin was observed in 30 % of the isolates. The findings of this study highlights the emerging trends of Staphylococcus haemolyticus as potential drug resistant pathogen in hospital settings in Saudi Arabia, which requires in depth investigation on molecular understanding on antimicrobial resistance and virulence traits of the strains.
Highlights
IntroductionStaphylococcus haemolyticus is a coagulase-negative common inhabitant of the human skin microbiota that has been recognized as an emerging important opportunistic pathogen[1]
Staphylococcus haemolyticus is a coagulase-negative common inhabitant of the human skin microbiota that has been recognized as an emerging important opportunistic pathogen[1].Staphylococcus haemolyticus has been commonly and frequently reported in various nosocomial infections, catheter-associated bacteremia[2], urinary tract infection[3], diabetic foot ulcer[4], device-associated meningitis[5] and wound infections[6].What makes Staphylococcus haemolyticus frequently encountered in clinical settings is perhaps its ability to from biofilm and more importantly its acquisition of multiple resistance to wide range of antimicrobial drug classes including glycopeptides[1]
Multiple resistance was observed in 18 isolates, while one isolate from urine was resistant to benzylpenicillin and showed intermediate resistance to erythromycin, likewise one isolate obtained from groin swabs exhibited resistance to benzylpenicillin, oxacillin and tetracycline only (Table 2)
Summary
Staphylococcus haemolyticus is a coagulase-negative common inhabitant of the human skin microbiota that has been recognized as an emerging important opportunistic pathogen[1]. What makes Staphylococcus haemolyticus frequently encountered in clinical settings is perhaps its ability to from biofilm and more importantly its acquisition of multiple resistance to wide range of antimicrobial drug classes including glycopeptides[1]. Resistance to methicillin/oxacillin has been commonly reported in Staphylococcus haemolyticus of clinical origin, and this suggests the bacterium is able to acquire and re-transfer (reservoir) the SCCmec cassette to other staphylococci 7, 6. Resistance to two or more classes of antimicrobial agents such as penicillins, tetracyclines, aminoglycosides, cephalosporins, quinolones, macrolides and glycopeptides among Staphylococcus haemolyticus of clinical importance have been frequently reported in different parts of the world[8, 9, 10].
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