Abstract
Staphylococcus aureus is an important healthcare-associated bacterium that causes a multitude of infections in humans such as superficial skin and soft tissue infections, necrotizing pneumonia, foodborne illnesses and postsurgical infections. Treatment of S. aureus infections has become more complicated due to the emergence of Methicillin-Resistant Staphylococcus aureus (MRSA), some of which are multidrug resistant. The present study aimed to characterize S. aureus isolates from a tertiary care hospital in the Rawalpindi district of Pakistan. Staphylococci were isolated from 300 clinical samples collected from January 2018 to January 2019 and S. aureus isolates were tested for antimicrobial susceptibility and analyzed using Pulsed-Field Gel Electrophoresis (PFGE), Multi-Locus Sequence Typing (MLST), staphylococcal cassette chromosome mec (SCCmec) and spa typing. Approximately 25.3% (76/300) of the clinical samples were positive for S. aureus; of those, 88.2% (67/76) were mecA+ (MRSA). In addition to the β-lactam antibiotics, high levels of resistance were also found to the fluoroquinolones (ciprofloxacin, gatifloxacin and levofloxacin (73.7% each)). Of the 23 different spa types identified, the majority of isolates belonged to spa type t632 and t657 (9/66; 13.6% each spa type). ST772-t657 (Bengal Bay clone) was the most commonly identified clone in this study although other clones circulating around different regions of the world were also found indicating the diversity in MRSA isolates from this area of Pakistan. This study emphasizes the need to monitor MRSA in the clinical setting for improved infection control and treatment options.
Highlights
The aim of the present study was to characterize clinical S. aureus isolates from a tertiary care hospital in Rawalpindi city of Pakistan
Moderate frequencies of antibiotic resistance ranging from 30% to 60% were found against tetracycline (50%), erythromycin (46.1%), gentamicin (42.1%) and ceftriaxone (32.9%)
The results of the current study present an alarming situation as frequency of Methicillin-Resistant Staphylococcus aureus (MRSA) was very high among the S. aureus isolated
Summary
Staphylococcus aureus is a well-known commensal found on different parts of the human body such as skin, skin glands, nose and gut mucus membranes [1]. S. aureus is a major cause of skin diseases and invasive infections, such as endocarditis, pneumonia and osteomyelitis, in both healthcare and community settings. It has been estimated that 20% of humans are persistent nasal carriers for S. aureus, while 30% are intermittent and 50% are non-carriers for S. aureus [2]. Persistent and intermittent colonization increases the opportunity for infection, which is primarily caused by the same strains present as a commensal on an individuals’ body [3–5].
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