Antibiotic Resistance Pattern of Staphylococcus aureus and Associated Risk Factors in the Adamaoua and Far North Regions of Cameroon

Abstract

Background: Infections due to Staphylococcus aureus (S. aureus) have been recognized as an important public health problem worldwide. Resistant S. aureus strains emerged and its prevalence has been on the rise. Many risk factors were identified as comorbidities and impact seriously the health state of infected individual by resistant Staphylococcus aureus. We focus our study on two of these risk factors (HIV-infection and diabetes) which may constitute high potential health conditions for emergence of resistant S. aureus strains. 
 Methods: A Cross sectional study was conducted during 19 months in five laboratories in the northern Cameroon. Collection of clinical samples from nine different types of specimens and first identifications were conducted in the various sites of study. Selected strains were transported in Yaoundé using standard procedure. Identification and drug susceptibility testing was performed using the disk diffusion method. Questionnaires were submitted to all the participants after an approved written and oral consent. HIV and Glycemia test were carried out on each patient in case their status was not known. During the study, 380 strains of Staphylococcus aureus were identified. Antimicrobial test was achieved using 16 different antibiotics.
 Results: Result showed that 202/380 (53.2 %) of Staphylococcus aureus were resistant to at least three antibiotics (multiresistant) from three different families. Multiresistant strains displayed high resistance to cotrimoxal (76.7 %) followed by penicillin (66.8 %), tetracyclin (57.4 %) and oxacillin (51.5%). While high rate of sensitivity were obtained for rifampicin (78.7 %), fusidic acid (65.8 %), lincomycin (60.5 %) and minocyclin (58.9 %). Few participants 8.9 % were tested HIV positive and 7.9% were living with diabetes. Strains isolated from participants living with these diseases presented higher rate of resistance to antibiotics.
 Conclusion: The rate of multiresistant Staphylococcus aureus are constantly in progress in northern Cameroon, most of the strains originated from community. These strains exhibited high resistance level to cotrimoxazol while displaying high sensitivity to rifampicine. People living with chronic diseases presented high resistance to antibiotic recommended for S. aureus infection treatment.

Methicillin-Resistant Staphylococcus aureus (MRSA): A major concern in the Northern Cameroon

“…Moreover, in our study, pus recorded the highest cases of resistance, similar to Dilnessa's findings in Ethiopia (2016) [35] and Wangai in Kenya (2019) [6]. We suggest that the observed resistance of Staphylococcus aureus might be due to the selection pressure resulting from years of exposure to antibiotics used to kill germs in routine hospital sanitization which was responsible of high rate of multiresistant S. aureus observed in this same area (53.2%) [28]. In our questionnaire, participant information about antibiotic consumption right before sample collection was noted.…”

“…Previous investigations in North Cameroon region showed: an important antibiotics misuse in human and livestock for Staphyloccocci infections [27] and a high frequency of multiresistant S. aureus. (53,2%) were reported [28]. Besides, few studies in Cameroon have been conducted to assess the problem of S. aureus resistance to penicillin which is the first line prescribe antibiotic when S. aureus infection is diagnosed [29].…”

Prevalence and Antimicrobial Resistance Pattern of Community Acquired Staphylococcus aureus in Patients Received at the Traumatology Unit of a Secondary Referral Health Setting in the Western Cameroon

“…[9] and Mohamadou et al [28] obtained greater MRSA prevalence of 58.62% and 51.5% respectively in Yaoundé and in the Adamawa and Far North regions of Cameroon. This difference could be justified by the sample size, which was larger in their studies.…”

“…However, Tigist et al [11] and Mendem et al [4] observed increased resistance of S. aureus to penicillin of 95.5% and 97.5% respectively. Other studies have reported considerable resistance to Erythromycin and Ampicillin [33] or Rifampicin and Cotrimoxazole [28]. This variability in resistance to a wide range of antibiotics reveals the limited possibilities and therapeutic choices applicable in emergency circumstances or in a syndromic approach in facilities with limited resources.…”