Resistant Coagulase-negative Staphylococci Research Articles

Bacteriological Profile and Antibiogram of Isolates Causing Bloodstream Infection in Children

Objective: (1) To identify and characterize bacterial isolates causing blood stream infection in children. (2) To determine the antibiotic sensitivity pattern of isolates obtained. Materials And Methods: Study design: Descriptive study. Study population: Blood samples collected from pediatric patients aged upto 12 years who are admitted in Government Medical College Kottayam, with clinical features of blood stream infection. Sampling methodology: The sample size of suspected blood stream infection is 345. All pediatric patients with clinical features suggestive of blood stream infection in the study period satisfying inclusion and exclusion criteria will be included in the study. The identification of bacterial pathogens and antimicrobial susceptibility tests were done by conventional and automated methods like VITEK system. Results: Out of 345 study sample population, 46 were culture positive, of which 21(45.7%) were Gram negative isolates and 20(43.4%) were Gram positive. Major isolates obtained were Klebsiella spp (15%), Methicillin Resistant Coagulase negative Staphylococci (15%), followed by Staphylococcus aureus (13%), Coagulase negative Staphylococci (8%) and Acinetobacter baumannii (8%). Klebsiella pneumoniae was resistant to most of the antibiotics tested except meropenem. All isolates of Coagulase negative Staphylococci and Staphylococcus aureus were susceptible to vancomycin and linezolid. Conclusion: Gram negative organisms were predominant pathogens in blood stream infections. Klebsiella pneumoniae, Coagulase negative Staphylococci, Staphylococcus aureus were the most commonly isolated pathogens. Amikacin along with the third generation cephalosporins should be used for empirical treatment of Gram negative sepsis. Vancomycin and linezolid can be used for Gram positive pathogens.

Distribution of Bacterial Species and Resistance Patterns in Surgical Site Infection after Prior Administration of Vancomycin and Tobramycin Intrawound Powdered Antibiotic Prophylaxis.

Evaluate the species distribution and resistance patterns of bacterial pathogens causing surgical site infection (SSI) after operative fracture repair, with and without the use of intrawound powdered antibiotic (IPA) prophylaxis during the index surgery. Retrospective cohort study. Academic, level 1 trauma center, 2018-2020. Fifty-nine deep SSIs were identified in a sample of 734 patients with 846 fractures (IPA [n = 320], control [n = 526]; open [n = 157], closed fractures [n = 689]) who underwent orthopaedic fracture care. Among SSIs, 28 (48%) patients received IPA prophylaxis and 25 (42%) of the fractures were open. Intrawound powdered vancomycin and tobramycin. Distribution of bacterial species and resistance patterns causing deep surgical site infections requiring operative debridement. Zero patients developed infections caused by resistant strains of streptococci, enterococci, gram-negative enterics, Pseudomonas , or Cutibacterium species. The only resistant strains isolated were methicillin resistance (19%) and oxacillin-resistant coagulase-negative staphylococci (16%). There was no associated statistical difference in the proportion of bacterial species isolated, their resistance profiles, or rate of polymicrobial infections between the IPA and control group. Most (93%) cases using IPAs included vancomycin and tobramycin powders. There were 59 SSIs; 28 (9%) in the IPA cohort and 31 (6%) in the control cohort ( P = 0.13). The use of local antibiotic prophylaxis resulted in no measurable increase in the proportion of infections caused by resistant bacterial pathogens after operative treatment of fractures. However, the small sample size and limited time frame of these preliminary data require continued investigation into their role as an adjunct to SSI prophylaxis. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

A retrospective study on bacteriological profile and antibiotics prescription practice in a tertiary level intensive care unit

BACKGROUND Antibiotics are the most commonly prescribed medicines in intensive care units (ICU). The irrational use of antibiotics leads to the development of multidrug-resistant organisms (MDR). The aim of the study is to determine the bacteriological profile of infections in our ICU and antibiotic prescription practice, before and after the culture results. METHODOLOGY This is a retrospective study conducted in a tertiary-level, 33-bedded ICU in Nepal to evaluate the bacteriological profile and antibiotic prescription practice. The patients who were admitted between a period of 3 months (January 2023 to March 2023) were enrolled. The data variables collected were; patients' details, culture samples sent (blood, urine, endotracheal (ET) aspirate, sputum, cerebrospinal fluid (CSF), wound swab, pleural fluid, ascitic fluid, tissue culture, and peritoneal fluid), gram stain results, culture sensitivity results, empirical antibiotics used, and change in antibiotics following culture results. RESULTS A total of 378 culture samples were obtained from 230 patients. A positive culture report was obtained for 165 (43.65%) of the 378 samples sent. Urine was the most common sample sent for microbiology (28%), followed by blood (25.3%) and sputum (22.75%). The percentage occurrence of gram-negative bacteria was 84%, while that of gram-positive bacteria was 16%. Methicillin- resistant coagulase-negative staphylococcus (MRCONS) was the most common gram-positive organism isolated (46.15%), and Klebsiella pneumoniae was the most common gram-negative organism (38.84%). Cephalosporin was the commonest group of empirical antibiotics used in our ICU, followed by carbapenem. Empirical antibiotic treatment was continued in 108 patients (47%), changed following the culture results in 92 patients (40%), and discontinued in 30 patients (13%). Escalation of antibiotics was done in 78 patients (85%) and de-escalation in 14 patients (15%). CONCLUSION Antimicrobial resistance and the irrational prescription of antibiotics can lead to a global economic burden. Hence, antibiotic stewardship programs are required to reduce the irrational prescribing patterns of antibiotics.

Antimicrobial Resistant Coagulase-Negative Staphylococci Carried by House Flies (Musca domestica) Captured in Swine and Poultry Farms.

House flies (Musca domestica) are very diffuse insects attracted by biological materials. They are abundantly present in farm environments and can frequently come in contact with animals, feed, manure, waste, surfaces, and fomites; consequently, these insects could be contaminated, carry, and disperse several microorganisms. The aim of this work was to evaluate the presence of antimicrobial-resistant staphylococci in house flies collected in poultry and swine farms. Thirty-five traps were placed in twenty-two farms; from each trap, 3 different kinds of samples were tested: attractant material present in the traps, the body surface of house flies and the body content of house flies. Staphylococci were detected in 72.72% of farms, 65.71% of traps and 43.81% of samples. Only coagulase-negative staphylococci (CoNS) were isolated, and 49 isolates were subjected to an antimicrobial susceptibility test. Most of the isolates were resistant to amikacin (65.31%), ampicillin (46.94%), rifampicin (44.90%), tetracycline (40.82%) and cefoxitin (40.82%). Minimum Inhibitory concentration assay allowed to confirm 11/49 (22.45%) staphylococci as methicillin-resistant; 4 of them (36.36%) carried the mecA gene. Furthermore, 53.06% of the isolates were classified as multidrug-resistant (MDR). Higher levels of resistance and multidrug resistance were detected in CoNS isolated from flies collected in poultry farms than in swine farms. Therefore, house flies could carry MDR and methicillin-resistant staphylococci, representing a possible source of infection for animals and humans.

In vitro elution characteristics of antibiotic-loaded polymethylmethacrylate cement and a calcium sulfate bone substitute using staphylococci isolated from orthopedic implant-associated infections.

Polymethylmethacrylate (PMMA) remains the gold standard antibiotic carrier in the management of osteomyelitis. However, biodegradable ceramic carriers may exhibit more efficient antibiotic elution properties. Through zone of inhibition (ZOI) testing and biofilm killing assays, we assessed the in vitro elution efficacy of vancomycin released from calcium sulfate (PG-CSH) and PMMA beads as carriers on clinical strains of Staphylococcus aureus and Staphylococcus epidermidis, which were isolated from sonication fluid of orthopedic implant-associated infections. Overall, vancomycin-loaded PMMA and PG-CSH beads showed potency (ZOI above 4cm2 ) for up to 14 days against ATCC and clinical strains. Vancomycin-loaded PG-CSH beads displayed higher rates, exhibited a more stable antibiotic elution, had greater impacts on bacterial colony-forming unit counts and produced higher ZOIs; additionally, statistically significant differences (Student's t test) were observed in different time sets during the experiment. In the biofilm killing assay, PG-CSH loaded with vancomycin resulted in more bacterial deaths. In conclusion, in the present study, both PG-CSH and PMMA beads acted as good carriers, but greater antimicrobial elution and biofilm bacterial killing were observed with PG-CSH than PMMA. Future in vitro research should focus on testing other difficult-to-treat clinical strains, including multidrug resistant coagulase-negative staphylococci and Gram-negative bacilli.

SG-APSIC1101: Virulence factors and antimicrobial resistance in coagulase-negative staphylococci isolated from blood of neonates

Objectives: To determine virulence genes and sensitivity to antibacterial drugs of Staphylococcus epidermidis isolated from blood cultures of newborns. Methods: A study of сoagulase-negative Staphylococcus (CoNS) from newborns with sepsis was conducted in the regional perinatal center in Karaganda, Kazakhstan. Blood-culture identification was performed using MALDI-TOF MS. Virulence factors were determined on primers (sdrG, sdrG, atl, lip, nuc, ebh, hlb, sspA, sspB, and gehD) with PCR (Bio-Rad CFX 96). Susceptibility to antibiotics determination was carried out using the disc-diffusion method. Testing with cefoxitin was used to detect methicillin resistance in staphylococci. Results: Overall, 18 Staphylococcus epidermidis isolates from blood cultures of newborns with sepsis were investigated from January to December 2021. The frequency of detection of virulence genes was distributed as follows: atl (94.5%), sspB (94.5%), sspA (89%), gehD (89%), ebh (89%), hlb (72%), sdrG (39%), sdrF (28%), nuc (28%), and lip (13%). Also, 10 isolates (55%) were resistant to cefoxitin (MRSE). Furthermore, 72% of S. epidermidis isolates showed resistance to azithromycin and 33% were resistant to clindamycin and gentamicin. Also, 39% of strains were resistant to fluorchinolones. All isolates were susceptible to vancomycin, linezolid, and fusidic acid. Conclusions:S. epidermidis strains isolated from blood cultures had high rates of exoenzymes sspB, sspA, gehD, autolysin (atl), β-hemolysin (hlb), and cell-wall–associated fibronectin-binding protein (ebh). Among 18 neonatal sepsis pathogens, 10 (55%) were MRSE, so it is necessary to pay attention to antibiotic therapy adjustment.

Molecular characterisation of antimicrobial resistance in coagulase negative staphylococci isolated from bovine subclinical mastitis

Coagulase negative staphylococci (CNS) are emerging as the most prevalent causative agent of bovine mastitis. They are resistant to many commonly used antibiotics due to the presence of antimicrobial resistance (AMR) genes. A study was conducted to evaluate the AMR profiling of CNS isolated from bovine subclinical mastitis.Coagulase negative staphylococci were isolated from 49 (44.95 per cent) of the subclinical mastitis samples. Disc diffusion assay revealed that highest resistance was shown against gentamicin (42.85 per cent) followed by methicillin (32.6 per cent), ceftriaxone – tazobactam (24.48 per cent), enrofloxacin (20.4 per cent), tetracycline (16.32 per cent) and least resistance to cotrimoxazole (4 per cent). Genotypic characterisation of AMR genes such as mecA, aacA-aphD and norA by PCR was done for determining resistance to methicillin, gentamicin and fluroquinolone resistance. The CNS carried aacA-aphD, norA and mecA in 44.89 per cent, 32.65 per cent and 14.28 per cent, respectively. Comparison of phenotypic and genotypic characterisation of AMR in CNS was carried out by McNemar test and it was found that there was significant difference between the presence of mecA gene and methicillin resistance. There was no significant difference noticed forcharacterisation of phenotypic and genotypic AMR of CNS for gentamicin and fluroquinolone resistance.

Pathogenicity and Antimicrobial Resistance in Coagulase-Negative Staphylococci

The coagulase-negative staphylococci (CoNS) group was considered saprophytic or rarely pathogenic for many years. Since the first case of septicemia caused by CoNS, there has been a progressive increase in the prevalence of healthcare-associated infections caused by CoNS. The CoNS group has emerged as one of the main causes of nosocomial infections related to vascular catheters and prostheses, especially among immunocompromised patients. This gradual increase in infections is due to the change in the relationship between patients and procedures since CoNS are closely related to devices implanted in the human body. CoNS are successful in colonizing the host because they have several virulence mechanisms, such as biofilm formation and production of enzymes and toxins, in addition to several mechanisms of resistance to antimicrobials. Despite their great clinical relevance, few studies have focused on CoNS’s pathogenicity and resistance to antimicrobials, which reveals the current need to better understand the factors by which this group became pathogenic to humans and other animals. This review aims to synthesize the aspects related to the pathogenicity and antimicrobial resistance in CoNS.

Antimicrobial susceptibility of coagulase-negative staphylococci isolated from red-tailed racers (Gonyosoma oxycephalum)

Antibiotic resistant Coagulase negative staphylococci CoNS have been reported around the world. Therefore, the aim of the study is to determine the antimicrobial susceptibility of CoNS isolated from red–tailed racers. Samples were swabbed from the oral cavity of 5 wild caught red–tailed racers, and were identified with biochemical test. The results obtained show that red–tailed racer 1 had S. sciuri and S. xylosus; red–tailed racer 2 had S. xylosus; red–tailed racer 3 had S. sciuri; red–tailed racer 4 had S. lentus; and red–tailed racer 5 had S. kloosii. The resistance test was done using the Kirby–Bauer disc diffusion test. And interpreted by referring to Clinical and Laboratory Standards Institute (CLS1 2013). The results for antibiotic resistance test of Staphylococcus xylosus, Staphylococcus sciuri, and Staphylococcus lentus show susceptibility to amoxicillin, gentamicin, erythromycin, bacitracin, vancomycin and oxacillin, but resistance towards penicillin G. One sample of Staphylococcus sciuri is intermediate towards erythromycin, and one sample of Staphylococcus kloosii shows susceptibility towards amoxicillin, gentamicin, bacitracin, penicillin G, vancomycin, and oxacillin, but is resistant towards erythromycin.
 Keywords:
 antimicrobial susceptibility, coagulase negative staphylococci, red–tailed racers, Gonyosoma oxycephalum

Chronic non-healing perianal ulcer as presenting sign of acquired immunodeficiency syndrome

A male in his forties presented with painful, persistent, nonhealing ulcers in the buttocks for two months with history of inadvertent weight loss and loss of appetite. History of highrisk sexual behavior including anal intercourse was present. On examination, the patient appeared cachexic with a body mass index of 15kg/m2. A shallow, tender, non-indurated, perianal ulcer of size around 10 x 7cm, with irregular margins, unhealthy granulation tissue and slough was noted. Multiple, skin-colored, umbillicated papules were also noted in bilateral buttocks (Figure 1). Multiple, non-tender, non-matted, inguinal lymph nodes were present bilaterally. A provisional diagnosis of chronic non-healing ulcer secondary to Herpes Simplex Virus with Molluscum contagiosum was considered. During workup, ELISA revealed antibodies to HIV-1 and was confirmed by Western blot test. His CD4 counts were 6.4% with absolute CD4 count of 113/µL. Blood culture revealed methicillin resistant coagulase negative staphylococci and pus culture reported growth of Enterobacter. His routine baseline investigations were normal. Rapid plasma reagin (RPR) test for syphilis and serology for hepatitis B and C virus were negative. The patient was started on tablet acyclovir 400mg thrice daily for 7 days and tablet linezolid 600 mg twice daily for 14 days along with topical antibiotic cream. The patient was then referred to the antiretroviral therapy (ART) centre. At 2 weeks’ follow-up, the ulcer showed complete re-epithelialization

Chronic non-healing perianal ulcer as presenting sign of acquired immunodeficiency syndrome

A male in his forties presented with painful, persistent, nonhealing ulcers in the buttocks for two months with history of inadvertent weight loss and loss of appetite. History of highrisk sexual behavior including anal intercourse was present. On examination, the patient appeared cachexic with a body mass index of 15kg/m2. A shallow, tender, non-indurated, perianal ulcer of size around 10 x 7cm, with irregular margins, unhealthy granulation tissue and slough was noted. Multiple, skin-colored, umbillicated papules were also noted in bilateral buttocks (Figure 1). Multiple, non-tender, non-matted, inguinal lymph nodes were present bilaterally. A provisional diagnosis of chronic non-healing ulcer secondary to Herpes Simplex Virus with Molluscum contagiosum was considered. During workup, ELISA revealed antibodies to HIV-1 and was confirmed by Western blot test. His CD4 counts were 6.4% with absolute CD4 count of 113/µL. Blood culture revealed methicillin resistant coagulase negative staphylococci and pus culture reported growth of Enterobacter. His routine baseline investigations were normal. Rapid plasma reagin (RPR) test for syphilis and serology for hepatitis B and C virus were negative. The patient was started on tablet acyclovir 400mg thrice daily for 7 days and tablet linezolid 600 mg twice daily for 14 days along with topical antibiotic cream. The patient was then referred to the antiretroviral therapy (ART) centre. At 2 weeks’ follow-up, the ulcer showed complete re-epithelialization

Prevalence, risk factors and antibiogram of bacteria isolated from skin of human having close contact with dairy cows in small-holder farms in Gatundu Sub-County, Kenya

Background: Antimicrobial resistance is a global health crisis which needs surveillance especially in people having close contact with animals.Methods: A total of 120 skin swabs from around the neck region were obtained from human respondents and subjected to bacteriological analyses. Antimicrobial susceptibility test was done using Kirby Bauer disk diffusion method and results were interpreted according to the Clinical and Laboratory Standard Institute guidelines.Results: The results showed that the skin was colonized by Staphylococcus aureus (49.4%), coagulase-negative staphylococci (CoNS) (16.9%), Pantoea spp. (13%), Serratia spp. (13%), Bukholderia cepacian (3%), Enterobacter spp. (3%), Yersinia enterocolitica (1.3%) and Pasteurella aerogenes (1.3%). The CoNS were mostly resistant to gentamycin (100%), clindamycin (84.6%), erythromycin (84.6%) and ciprofloxacin 84.6% and sensitive to sulphamethoxazole-trimethoprim (76.9%). For S. aureus, most isolates were resistant to gentamycin (86.8%), oxacillin (86.8%) and vancomycin (73.7%) but susceptible to amoxycillin-clavulanic acid (89.5%) amongst other antibiotics. The multiple antibiotic resistance index for S. aureus and CoNS was 0.92 and 0.92, respectively. Respondents aged more than 40 years had higher burden of AMR compared to the other respondents (p = 0.011, OD=1.745). Similarly, the AMR burden was higher in respondents who had previous history of using medication compared to those who had not (p=0.025, OD=0.204).Conclusions: The study showed a high prevalence of antibiotic resistance in CoNS and S. aureus isolates from skin of people having regular contacts with dairy cows in the study area. Interventions strategies to stem the emergence of AMR should be undertaken.

"Antibiogram of Methicillin Resistance Coagulase Negative Staphylococci from Nasal Carriage of Healthcare Workers in a Tertiary Care Hospital"

The commensal microflora like coagulase negative staphylococci (CoNS) is recently considered as emerging pathogen which are crucial for causing nosocomial, so studies on the distribution and pattern of antibiotic resistance along with its virulence properties for health care workers (HCWs) are important as they can be responsible for transmission of multi drug resistant bacteria to community .

Antibiotic sensitivity analysis of clinical coagulase-negative staphylococci

Background. The increasing role of coagulase-negative staphylococci in the occurrence of staphylococcal infections leads to the need for close attention to them. Special control is required over the sensitivity of bacteria to antibiotics and the spread of methicillin resistance, as a sign of multiple resistance to antibacterial drugs. It is also important to identify the virulence factors of coagulase-negative staphylococci, which determine their behavior in the environment.The aim. To evaluate the sensitivity of strains of coagulase-negative staphylococci to clinically significant antibiotics daptomycin, vancomycin, linezolid and oxacillin and lantibiotic warnerin.Methods. Determination of the minimal inhibitory concentrations of antibacterial compounds for clinical coagulase-negative staphylococci by standard methods of serial dilutions and disc diffusion. Identification of the phenomenon of decreased susceptibility of bacteria to vancomycin by population analysis and concentration gradient. Lipid analysis by thin layer chromatography. Results. High antibacterial activity of vancomycin, daptomycin and linezolid against clinical strains of coagulase-negative staphylococci was shown. The upper limit of the minimum inhibitory concentrations of vancomycin within the sensitive phenotype and the expansion of the ranges of the minimum inhibitory concentrations of daptomycin and warnerin towards an increase in oxacillin-resistant isolates were revealed. The heterogeneous nature of sensitivity to vancomycin of the cultures of the studied strains and the possibility of their rapid enrichment with subpopulations with reduced sensitivity to this antibiotic have been established. The selection of resistance of coagulase-negative staphylococci to vancomycin was accompanied by an increase in the synthesis of lysylphosphatidylglycerol and a decrease in their sensitivity to cationic peptide compounds.Conclusion. The revealed prevalence of the methicillin-resistant phenotype of clinical strains of coagulase-negative staphylococci, along with the presence in the lipid spectrum of the universal factor of resistance to cationic antibacterial compounds, lysylphosphatidylglycerol, entails the need for new methodological solutions for diagnosing infections caused by coagulase-negative staphylococci.

Evaluation and Susceptibility Pattern of Staphylococci Isolated From Clinical Specimens in POF Hospital, Wah Cantt.

Objective: To determine the frequency and antibiotic susceptibility pattern of Staphylococcus aureus and coagulase negative staphylococci isolated from clinical specimens as a result of culture and sensitivity.
 Materials & Methods: This cross sectional study was carried out in POF Hospital Microbiology laboratory from January 2019 to September 2020. One hundred and eighty four staphylococci isolated from clinical specimens were processed as per standard methodology.
 Results: Out of 148, methicillin resistant S.aureus and methicillin resistant coagulase negative staphylococci were 38.04% and13.04% respectively. Infections caused by Methicillin resistant staphylococcal isolates were higher among the age group 31-40 years (71.4%, OR=2.68). Out of thirty expired patients, 53.3% had been infected with methicillin resistant staphylococcal infections. The methicillin resistant staphylococci were most frequent in miscellaneous category of clinical specimens (80.0%, OR=4.63). The susceptibility analysis revealed that methicillin resistant staphylococci are 100% resistant to penicillin, meropenem and amoxycillin-clavulanate (p=0.000). A significant association of methicillin resistance was also noticed against amikacin (p=0.002), ciprofloxacin (p=0.001), clindamycin (p=0.005) and erythromycin (p=0.000). Moxifloxacin, linezolid and vancomycin are the most effective choice for infections caused by methicillin resistant staphylococci.
 Conclusions: The methicillin-resistant staphylococci are highly resistant to commonly prescribed oral as well as injectable antibiotics. Establishment and implementation of infection control policies are required to combat the grave situation of increasing antibiotic resistance.

High Prevalence of Nasal carriage of Methicillin Resistant Coagulase Negative Staphylococci among Medical Students in a Tertiary Care Institution in North India

Introduction: MBBS students during rotational clinical postings run the risk of being colonised by critical hospitalpathogens such as Methicillin-resistant staphylococci (MRSA and MRCoNS). Methods: This study was conducted on150 undergraduate MBBS students from August to September 2018 to determine prevalence of nasal colonization rates ofMRSA /MRCoNS in them. One sterile cotton tipped swab per student was used to collect specimen from the anterior nares.This was inoculated on 5 % Sheep Blood agar. Isolated suspected Staphylococci colonies were speciated and Methicillinresistance was determined by disc diffusion tests as per standard protocols. Overall prevalence of MRCoNS (22%) amongstudents was significantly higher compared to MRSA(4%). MRCoNS colonisation was also significantly higher in clinicgoing students. Conclusion: Compared to MRSA, little information is available on epidemiology of CoNS/MRCoNSamong healthcare workers as these bacteria are considered harmless commensals. Findings of this study suggest thatthose involved in patient care including medical students may be carriers of MRCoNS similar to MRSA and could bepotential sources of infection to vulnerable patients.

Incidence of multi drug resistant coagulase-negative Staphylococci from seafood samples, Veraval, Gujarat

Incidence of multi drug resistant coagulase-negative Staphylococci from seafood samples, Veraval, Gujarat

Mec-Positive Staphylococcus Healthcare-Associated Infections Presenting High Transmission Risks for Antimicrobial-Resistant Strains in an Equine Hospital.

Healthcare-associated infections caused by Staphylococcus, particularly Staphylococcus aureus, represent a high risk for human and animal health. Staphylococcus can be easily transmitted through direct contact with individual carriers or fomites, such as medical and non-medical equipment. The risk increases if S. aureus strains carry antibiotic resistance genes and show a phenotypic multidrug resistance behavior. The aim of the study was to identify and characterize methicillin resistant coagulase-positive staphylococci (MRSA) and coagulase-negative staphylococci (MRCoNS) in equine patients and environmental sources in an equine hospital to evaluate the genetic presence of multidrug resistance and to understand the dissemination risks within the hospital setting. We explored 978 samples for MRSA and MRCoNS using Oxacillin Screen Agar in an equine hospital for racehorses in Chile, which included monthly samples (n = 61–70) from equine patients (246) and hospital environments (732) in a one-year period. All isolates were PCR-assessed for the presence of methicillin resistance gene mecA and/or mecC. Additionally, we explored the epidemiological relatedness by Pulsed Field Gel Electrophoresis (PFGE) in MRSA isolates. Phenotypic antibiotic resistance was evaluated using the Kirby-Bauer disk diffusion method. We estimated the unadjusted and adjusted risk of acquiring drug-resistant Staphylococcus strains by employing logistic regression analyses. We identified 16 MRSA isolates and 36 MRCoNS isolates. For MRSA, we detected mecA and mecC in 100% and 87.5 % of the isolates, respectively. For MRCoNS, mecA was detected among 94% of the isolates and mecC among 86%. MRSA and MRCoNS were isolated from eight and 13 equine patients, respectively, either from colonized areas or compromised wounds. MRSA strains showed six different pulse types (i.e., A1–A3, B1–B2, C) isolated from different highly transited areas of the hospital, suggesting potential transmission risks for other patients and hospital staff. The risk of acquiring drug-resistant Staphylococcus species is considerably greater for patients from the surgery, equipment, and exterior areas posing higher transmission risks. Tackling antimicrobial resistance (AMR) using a One Health perspective should be advocated, including a wider control over antimicrobial consumption and reducing the exposure to AMR reservoirs in animals, to avoid cross-transmission of AMR Staphylococcus within equine hospitals.

Constitutive and Inducible Clindamycin Resistance Frequencies among Staphylococcus sp. Coagulase Negative Isolates in Al-Basrah Governorate, Iraq.

Antibiotics called macrolide, lincosamide and streptogramin B (MLSB) are being used to treat staphylococci infections. Multiple pathways that impart resistance to MLSB antibiotics have been confirmed to cause clinical failure. The present work aimed to determine the frequency of constitutive and inducible clindamycin resistant among coagulase-negative staphylococci (CoNS) isolates of different clinical samples in Al-Basrah governorate, Iraq. The 28 CoNS, traditional techniques and the Vitek®2 system were used to identify the isolates. The disk diffusion technique was used to detect methicillin resistance and antibiotic sensitivity patterns via cefoxitin, gentamicin, ciprofloxacin, amikacin, teicoplanin, linezolid, doxycycline and vancomycin disks. Erythromycin and clindamycin antibiotic disks was used to detect the inducible and constitutive clindamycin resistance as well as a D-test according to CLSI guidelines. Among 28 CoNS isolated, the Staphylococcus aureus 11(39.29%), Staphylococcus epidermidis 7(25 %), Staphylococcus haemolyticus 4(14.29%) and Staphylococcus saprophyticus 3 (10.71%) were predominant isolated species. Out of 28 CoNS isolates, 15(53.57%) were methicillin resistant coagulase-negative staphylococci (MRCoNS) isolates and 13(46.43%) were methicillin sensitive coagulase-negative staphylococci (MSCoNS) isolates. The 15(53.57%) isolates out of 28 CoNS, showed erythromycin resistance while 6(40%) isolates out of 15 CoNS, showed inducible macrolide-lincosamide-streptogramin B (iMLSB) and 2(13.3%) of CONS isolated showed constitutive macrolide-lincosamide-streptogramin B (cMLSB). In order to achive the best result in choosing the suitable treatment and avoiding the loses the money and time, it is better to use the D-test for inducible clindamycin resistance in the daily routine work of antibiotic susceptibility testing in hospital and private clinical laboratories.

Multidrug resistant coagulase-negative Staphylococcus spp. isolated from cases of chronic rhinosinusitis in humans. Study from Poland.

For many years, coagulase-negative staphylococci (CoNS) have been considered non-pathogenic bacteria. However, recently, CoNS are becoming more common bacteriological factors isolated from cases of chronic rhinosinusitis in humans. Moreover, most of them represent the multidrug-resistant or/and methicillin-resistant profile, which significantly increases the therapeutic difficulties. The aim of the study was to characterize profile of resistant coagulase-negative staphylococci isolated from cases of chronic rhinosinusitis in patients treated in a Medical Center in Warsaw in 2015-2016. The study material was derived from patients with diagnosed chronic rhinosinusitis treated at the MML Medical Center in Warsaw. The material was obtained intraoperatively from maxillary, frontal, and ethmoid sinuses. In total, 1,044 strains were isolated from the studied material. Coagulase-negative staphylococci were predominant, with the largest share of Staphylococcus epidermidis. Isolated CoNS were mainly resistant to macrolide, lincosamide, and tetracycline. Among the S. epidermidis strains, we also showed 35.6% of MDR and 34.7% of methicillin-resistant strains. The same values for other non-epidermidis species were 31.5% and 18.5%, respectively and the percentage of strains with MAR >0.2 was greater in S. epidermidis (32.6%) than S. non-epidermidis (23.9%). Although the percentage of strains resistant to tigecycline, glycopeptides, rifampicin and oxazolidinones was very small (2.3%, 1.9%, 1.4% and 0.7% respectively), single strains were reported in both groups. The study has shown a high proportion of MDR and methicillin-resistant CoNS strains, which indicates a large share of drug-resistant microorganisms in the process of persistence of chronic rhinosinusitis; therefore, isolation of this group of microorganisms from clinical cases using aseptic techniques should not be neglected.