Abstract
Staphylococcus epidermidis, especially methicillin-resistant strains, may be the source of surgical site infections and may be a reservoir of staphylococcal cassette chromosome mec (SCCmec) for S. aureus. The aim of this study was to investigate the prevalence of methicillin-resistant S. epidermidis (MRSE) on the abdominal skin of females before laparotomy and determine the molecular characteristics and antimicrobial susceptibility patterns of these isolates. MRSE was found in 54 of 157 isolates based on mecA gene detection, and there was no difference in icaA gene carriage rate between MRSE and methicillin-susceptible S. epidermidis (MSSE) isolates. Antimicrobial susceptibility profiles were determined by broth microdilution antimicrobial susceptibility testing according to the latest CLSI manuals. All MRSE isolates had unfavorable antimicrobial susceptibility patterns. Twenty-three MRSE strains (42.6%) were multi-drug resistant. SCCmec typing and pulsed field gel electrophoresis (PFGE) typing was performed. Thirty-nine (72.2%) had a single SCCmec type, whereas 1.9% had two types. Fourteen strains (25.9%) were non-typeable (NT). The most frequent MRSE genotype was SCCmec type IVa. High diversity with PFGE patterns was obtained for MRSE, and there were no isolates exhibiting identical pulsotype. The results confirm that methicillin-resistant strains are frequently present among S. epidermidis on the abdominal skin of females before laparotomy. Moreover, resistance profiles seem to have no association with the SCCmec types or PFGE types for most common antibiotics.
Highlights
Surgical interventions are common in the day-to-day practice of obstetrics and gynecology, and surgical site infections (SSIs) are frequent complications of abdominal gynecological operations
Fifty-four isolates were positive for mecA and were classified as methicillin-resistant S. epidermidis (MRSE) (34.4%), 13 isolates were positive for icaA (8.28%), and no difference was observed in icaA positive rates between MRSE and methicillin-susceptible S. epidermidis (MSSE) isolates
The results indicate that resistance profiles seem to have no association with the staphylococcal cassette chromosome mec (SCCmec) types for most common antibiotics
Summary
Surgical interventions are common in the day-to-day practice of obstetrics and gynecology, and surgical site infections (SSIs) are frequent complications of abdominal gynecological operations. Postoperative wound infections can increase the costs and hospital stay. They lead to higher morbidity and lower life quality of surgical patients. For most gynecological SSIs, the source of pathogens is the endogenous flora of the patient’s skin or vagina [4]. S. epidermidis is the most prevalent and persistent species found on the human skin and mucous membranes, constituting 65% to 90% of all staphylococci isolated from these environments [5], and it may act as a source of later bacteremia and surgical site infections. In one study by Martens et al [9], 64% infected wounds after cesarean delivery had positive bacterial cultures, with S. epidermidis (29%) being the most frequent isolates
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