Detection and Antibiotic Resistance Pattern of Multidrug Resistant Staphylococccus aureus from Wound Infection at Tertiary Hospital in Yenagoa, Nigeria

Main Article Content

Ifeoma Vivian Anyiam
Douye Victor Zige

Abstract

Multidrug resistant Staphylococcus aureus is increasingly prevalent worldwide, albeit with significant regional variations. The development of bacterial resistance to various antibacterial agents coupled with its virulence factors have significantly contributed to its pathogenicity. This investigation aimed to identify multidrug resistant S. aureus in wound infections. A total of 40 specimens from burn and cut wound specimens were examined utilizing culture, Gram staining, biochemical analysis, Kirby Bauer disc diffusion technique using ten multidisc antibiotics and plasmid profiling. Descriptive analysis was employed to determine the prevalence of S. aureus in specimens collected from individuals with open wounds, comprising 18 (45%) males and 22 (55%) females. Antibiogram profiles were used to determine the antibiotic resistance of the isolates. A total number of 19 (48%) S. aureus isolates were obtained in this study. Among patients with burn wounds, 12 (63.5%) exhibited the highest number of isolates, while those with cut wounds accounted for 7 (36.8%) representing the lowest count. The number of males with burn wounds was 7 (58.3%), higher than that of females 5 (41.7%). Females had a greater number of cut wounds with 5 (71.4%) compared to males with 2 (28.6%). The age group 16-25 years exhibited the highest number of isolates at 7 (37%), while the lowest was observed in the age group 66-75 years, with 1 (5%). Notably, these age intervals showed a statistically significant difference with P<0.05. The highest occurrence of isolate was recorded in males within the age group 16-25 years, totalling 5 (24%). In contrast, for females, the most prevalent isolate was found in the age 26-35 years, amounting to 3 (16%). The susceptibility profile of S. aureus revealed sensitivity to gentamycin 7 (36.8%) and levofloxacin 11 (57.9%), while resistance to norfloxacin, chloramphenicol, erythromycin, amoxil and ampiclox was 100%. Plasmid profiling identified multiple plasmid bands in the obtained multidrug resistant S. aureus, with a molecular weight of 9466kbp. The susceptibility pattern of the multidrug S. aureus both before and after plasmid curing indicated that previously resisted antibiotics became susceptible after curing except for amoxicillin-clavulanic acid and cefpodoxime. Cefotaxime, with a 25 mm zone of inhibition, was the most sensitive antibiotic after the plasmid curing. The discovery of plasmid in this study may prove valuable for the effective monitoring of antibiotic resistance patterns in bacteria from wound infections and clinical settings.

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References

Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP), 2019. Methicillin Resistant Staphylococcus aureus. [online] Available at: https://www.cdc.gov/mrsa/ index.html.

Ezeh, C.K., Eze, C.N., Dibua, M.E.U. and Emencheta, S.C., 2023. A meta-analysis on the prevalence of resistance of Staphylococcus aureus to different antibiotics in Nigeria. Antimicrobial Resistance and Infection Control, 12(1), https://doi.org/10.1186/s13756-023-01243-x.

World Health Organization, 2019. Antibiotic Resistance. Geneva: World Health Organization.

Ahmad, M. and Khan, A.U., 2019. Global economic impact of antibiotic resistance: a review. Journal of Global Antimicrobial Resistance, 19, 313-316.

O’Neill, J., 2014. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations. Geneva: World Health Organization.

Byrd, A.L., Belkaid, Y. and Segre, J.A., 2018. The human skin microbiome. Nature Reviews Microbiology, 16, 143-155.

Tong, S.Y.C., Davis, J.S., Eichenberger, E., Holland, T.L. and Fowler Jr., V.G., 2015. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clinical Microbiology Reviews, 28(3), 603-661.

Frank, D.N., Feazel, L.M., Bessesen, M.T., Price, C.S., Janoff, E.N. and Pace, N.R., 2010. The human nasal microbiota and Staphylococcus aureus carriage. PloS One, 5(5), https://doi.org/10.1371/journal.pone.0010598.

Braga, E.D.V., Aguiar-Alves, F., de Freitas, M.D.F.N., Silva, M.O.D., Correa, T.V., Snyder, R.E., de Araujo, V.A., Marlow, M.A., Riley, L.W., Setúbal, S., Silva, L.E. and Cardoso, C.A.A., 2014. High prevalence of Staphylococcus aureus and methicillin-resistant S-aureus colonization among healthy children attending public daycare centers in informal settlements in a large urban center in Brazil. BMC Infectious Diseases, 14, https://doi.org/10.1186/1471-2334-14-538.

Turner, N.A., Sharma-Kuinkel, B.K., Maskarinec, S.A., Eichenberger, E.M., Shah, P.P., Carugti, M.C., Holland, T.L. and Fowler Jr., V.G., 2019. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nature Reviews Microbiology 17(4), 203-218.

Mascaro, V., Capano, M.S., Iona, T., Nobile, C.G.A., Ammendolia, A. and Pavia, M., 2019. Prevalence of Staphylococcus aureus carriage and pattern of antibiotic resistance, including methicillin resistance, among contact sport athletes in Italy. Infection and Drug Resistance 12, 1161-1170.

Jiménez-Truque, N., Saye, E.J., Soper, N., Saville, B.R., Thomsen, I., Edwards, K.M. and Creech, C.B., 2017. Association between contact sports and colonization with Staphylococcus aureus in a prospective cohort of collegiate athletes. Sports Medicine, 47(5), 1011-1019.

Brancaccio, M., Mennitti, C., Laneri, S., Franco, A., De Biasi, M.G., Cesaro, A., Fimiani, F., Moscarella, E., Gragnano, F., Mazzaccara, C., Limongelli, G., Frisso, G., Lombardo, B., Pagliuca, C., Colicchio, R., Salvatore, P., Calabrò, P., Pero, R. and Scudiero, O., 2020. Methicillin-resistant Staphylococcus aureus: risk for general infection and endocarditis amongst athletes. Antibiotics, 9(6), https://doi.org/10.3390/antibiotics9060332.

Kejela, T. and Bacha, K., 2013. Prevalence and antibiotic susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) among primary school children and prisoners in Jimma Town, Southwest Ethiopia. Annals of Clinical Microbiology and Antimicrobials, 12, https://doi.org/10.1186/1476-0711-12-11.

Mason, A., Findlay-Cooper, K., Holden, G., Nevin, W., Ross, D. and Lamb, L., 2021. Facilitating future research and policy in PVL-associated Staphylococcus aureus in military cohorts. BMJ Military Health, 169(2), 105-107.

Blomfeldt, A., Jørgensen, S.B., Helmersen, K., Eskonsipo, P.K.J. and Aamot, H.V., 2021. Is increased Staphylococcus aureus colonization during military service caused by specific genotypes? Molecular examination of long-term carriage in a prospective cohort study? APMIS, 129(4), 170-177.

Gupta, S., Mishra, B., Thakur, A., Dogra, V., Loomba, P.S., Jain, M. and Bhargava, A., 2018. Risk factors associated with MRSA. Southern African Journal of Infectious Diseases, 33(3), 76-79.

Ismail, H.Y., Bello, H.S., Mustafa, A. and Adamu, A., 2015. Multidrug resistance pattern of Staphylococcus aureus isolates in Maiduguri Metropolis. Scientific Review, 1(2), 16-20.

Onanuga, A. and Temedie, T.C., 2011. Multidrug-resistant intestinal Staphylococcus aureus among self-medicated healthy adults in Amassoma, South-South, Nigeria. Journal of Health Population and Nutrition, 29(5), 446-453.

Choo, E.J. and Chambers, H.F., 2016. Treatment of methicillin-resistant Staphylococcus aureus bacteremia. Infection and Chemotherapy, 48(4), 267-273.

Nigussie, D., Makonnen, E., Legesse, B.A., Fekadu, A. and Davey, G., 2022. Antimicrobial susceptibility of bacteria isolated from the infected wounds of patients with lymphoedema in East Wollega, Ethiopia. Transactions of the Royal Society of Tropical Medicine and Hygiene, 114(12), 962-973.

Nobel, F.A., Islam, S., Babu, G., Akter, S., Jebin, R.A., Sarker, T.C., Islam, A. and Islam, M.J., 2022. Isolation of multidrug resistance bacteria from the patients with wound infection and their antibiotics susceptibility patterns: A cross-sectional study. Annals of Medicine and Surgery, 84, https://doi.org/10.1016/j.amsu.2022.104895.

Roy, S., Ahmed, M.U., Uddin, B.M.M., Ratan, Z.A., Rajawat, M., Mehta, V. and Zaman, S.B., 2017. Evaluation of antibiotic susceptibility in wound infections: A pilot study from Bangladesh. F1000Research, 6, https://doi.org/10.12688/f1000research.12887.1.

Omoyibo, E.E., Oladele, A.O., Ibrahim, M.H. and Adekunle, O.T., 2018. Antibiotic susceptibility of wound swab isolates in a tertiary hospital in Southwest Nigeria. Annals of African Medicine, 17(3), 110-116.

Adewuyi, T.O., Idoro, G.I. and Ikpo, I.J, 2014. Empirical evaluation of construction material waste generated on sites in Nigeria. Civil Engineering Dimension, 16(2), 96-103.

Adamu, B., Tansey, K. and Ogutu, B., 2016. An investigation into the factors influencing the detectability of oil spills using spectral indices in an oil-polluted environment. International Journal of Remote Sensing, 37(10), 2338-2357.

Cross, H.H., 2014. Obtaining a wound swab culture specimen. Nursing, 44(7), 68-69.

Rondas, A.A.L.M., Halfens, R.J.G., Schols, J.M.G.A., Thiesen, K.P.T., Trienekens, T.A.M. and Stobberingh, E.E., 2015. Is a wound swab for microbiological analysis supportive in the clinical assessment of infection of a chronic wound? Future Microbiology, 10(11), 1815-1824.

Dilnessa, T. and Bitew, A., 2016. Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus isolated from clinical samples at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia. BMC Infectious Diseases 16, https://doi.org/10.1186/s12879-016-1742-5.

Karmakar, A., Dua, P. and Ghosh, C., 2016. Biochemical and molecular analysis of Staphylococcus aureus clinical isolates from hospitalized patients. Canadian Journal of Infectious Diseases and Medical Microbiology, 2016, https://doi.org/10.1155/2016/9041636.

Clinical and Laboratory Standard Institute, 2014. Analysis and Presentation of CumulativeAntimicrobial Susceptibiltiy Test Data; Approved Guideline. [online] Available at: https://www.nih.org.pk/wp-content/uploads/2021/02/CLSI-M39A4E-Antibiogram.pdf.

Clinical and Laboratory Standard Institute, 2020. Performance Standard for Antimicrobial Susceptibility Testing. [online] Available at: https://clsi.org/media/3481/m100ed30_sample.pdf.

Zhou, C., Yang, Y. and Jong, A.Y, 1990. Mini-prep in ten minutes. Biotechniques, 8 (2), 172–176.

Biadglegne, F., Abera, B., Alem, A. and Anagaw, B., 2009. Bacterial isolates from wound infection and their antimicrobial susceptibility pattern in Felege Hiwot Referral Hospital North West Ethiopia. Ethiopian Journal of Health Sciences, 19(3), 173-177.

Upreti, N., Rayamajhee, B., Sherchan, P.S., Choudhai, M.K. and Banjara, M.B., 2018. Prevalence of methicillin resistant Staphylococcus aureus, multidrug resistant and extended spectrum β-lactamase producing gram negative bacilli causing wound infections at a tertiary care hospital of Nepal. Antimicrobial Resistance and Infection Control, 7, https://doi.org/10.1186/s13756-018-0408-z.

Guo, Y., Song, G., Sun, M., Wang, J. and Wang, Y., 2020. Prevalence and therapies of antibiotic-resistance in Staphylococcus aureus. Frontiers in Cellular and Infection Microbiology, 10, https://doi.org/10.3389/fcimb.2020.00107.

Zorgani, A., Zaidi, M., Ranka, R. and Shahen A., 2002. The pattern and outcome of septicemia in a burns intensive care unit. Annals of Burns and Fire Disasters,15, 179-182.

Alebachew, T., Yismaw, G., Derabe, A. and Sisay, Z., 2012. Staphylococcus aureus burn wound infection among patients attending yekatit 12 hospital burn unit, addis ababa, ethiopia. Ethiopian Journal of Health Sciences, 22(3), 209-213.

McClelland, E.E. and Smith, J.M., 2011. Gender specific differences in the immune response to infection. Archivum Immunologiae et Therapiae Experimentalis, 59(3), 203-213.

Sørensen, L.T., Hemmingsen, U., Kallehave, F., Wille-Jørgensen, P., Kjaergaard, J., Møller, N.L. and Jørgensen, T., 2005. Risk factors for tissue and wound complications in gastrointestinal surgery. Annals of Surgery, 241(4), 654-658.

Onwubiko, N.E. and Sadiq, N.M., 2011. Antibiotic sensitivity pattern of Staphylococcus aureus from clinical isolates in a tertiary health institution in Kano, Northwestern Nigeria. Pan African Medical Journal, 8(1), https://doi.org/10.4314/pamj.v8i1.71050.

Yusuf, I., Arzai, A.H., Haruna, M., Sharif, A.A. and Getso, M.I., 2014. Detection of multi drug resistant bacteria in major hospitals in Kano, North-West, Nigeria. Brazilian Journal of Microbiology, 45(3), https://doi.org/10.1590/s1517-83822014000300005.

Ozumba, U.C., 2005. Antimicrobial resistance problems in a university hospital. Journal of the National Medical Association, 97(12), 1714-1718.

Wolters, M., Frickmann, H., Christner, M., Both, A., Rohde, H., Oppong, K., Akenten, C.W., May, J. and Dekker, D. 2020. Molecular characterization of Staphylococcus aureus isolated from chronic infected wounds in rural Ghana. Microorganisms, 8(12), https://doi.org/10.3390/microorganisms8122052.

Haaber, J., Penadés, J.R. and Ingmer, H., 2017. Transfer of antibiotic resistance in Staphylococcus aureus. Trends in Microbiology, 25(11), 893-905.

Ramsay, S., Cowan, L., Davidson, J.M., Nanney, L. and Schultz, G., 2016. Wound samples: moving towards a standardized method of collection and analysis. International Wound Journal, 13(5), 880-891.

Poirel, L., Madec, J.-Y., Lupo, A., Schink, A.-K., Kieffer, N., Nordmann, P. and Schwarz, S., 2018. Antimicrobial resistance in Escherichia coli. Microbiology Spectrum, 6(4), https://doi.org/10.1128/microbiolspec.arba-0026-2017.

Okoye, E.L., Kemakolam, C., Ugwuoji, E.T. and Ogbonna, I., 2022. Multidrug resistance tracing by plasmid profile analysis and the curing of bacteria from different clinical specimens. Advanced Gut and Microbiome Research, 2022, https://doi.org/10.1155/2022/3170342.

Gurung, R.R., Maharjan, P. and Chhetri, G.G., 2020. Antibiotic resistance pattern of Staphylococcus aureus with reference to MRSA isolates from pediatric patients. Future Science OA, 6(4), https://www.future-science.com/doi/10.2144/fsoa-2019-0122.