Macrolide and lincosamide resistance in staphylococcal clinical isolates in Nablus, Palestine

Abstract

Background/aim: Macrolide and lincosamide antibiotics are used for the treatment of staphylococcal infections, especially for penicillin-allergic patients. In the present study, we evaluate the prevalence of resistance to macrolide and lincosamide antibiotics among staphylococci isolates. Materials and methods:A total of 200 staphylococcal clinical isolates were collected from January 2012 to April 2013. Minimal inhibitory concentrations of erythromycin and clindamycin were determined by agar dilution method. An erythromycin-clindamycin induction test was performed for isolates that were only resistant to erythromycin. Representative erythromycin-resistant isolates were examined for erythromycin resistance genes using PCR.Results: Among staphylococci isolates, resistance frequencies of erythromycin and clindamycin were 65.5% and 20.5%, respectively. Erythromycin resistance was found to be mediated by putative efflux (50.4%) and target site modification (49.6%). Inducible target site modification resistance was detected in 19.1% of erythromycin-resistant isolates. Among the examined 36 staphylococci isolates, msr(A), erm(C), erm(A), and mef(A/E) genes were detected in 55.6%, 30.6%, 25%, and 0%, respectively. Conclusion:Results of the current study indicate the presence of high rates of macrolide resistance and inducible phenotypes among staphylococcal isolates. It is also essential to keep in mind variations of resistance rates among various age groups and specimen types.

Resistance profiles and biofilm formation of coagulase negative staphylococci isolated from clinical specimens in a tertiary care hospital in Palestine

“…In contrast, no resistance of CoNS isolate was detected to rifampicin, vancomycin, teicoplanin, nitrofurantoin, linezolid and mupirocin, and very low resistance was detected to tigecycline and moxifloxacin (3.7%, 8.4% respectively). Our findings are in agreement with many studies that showed full activity of most of these aforementioned antimicrobials against clinical CoNS isolates [8,11,13,15].Conversely, many reports from around the world showed different percentage of resistance to vancomycin, teicoplanin and linezolid ranging from 0.8% to 13% [4,12,39]. We think that this zero resistance in this study to glycopeptides and linezolid may be due to its limited prescription and use in Gaza Strip hospitals.…”

“…MDR phenotype was detected in 88.9% of CoNS isolates. This high level of MDR in our CoNS collection is similar to many studies conducted in different countries around the world as from China [4], Australia [5], Nigeria [8], Saudi Arabia [10], Jordan [11], Pakistan [12], India [13], West Bank of Palestine [15] and Turkey [40].…”

“…In this study, the resistance profile of all CoNS isolates showed complete to high resistance to most of the antibiotics tested. This pattern of resistance was shown in previous studies in different countries around the world [4,8,[10][11][12][13]15]. High resistance to the aforementioned antibiotics could be mainly due to excessive use, misuse, and great prescription of these medication in Gaza for both hospital and community acquired infections and also in agriculture and animal feeding.…”

“…Data regarding CoNS and MR-CoNSin Palestine are insufficient, with only one report from Nablus, Palestine [15]. Previous reports from Gaza Strip and West Bank of Palestine have mostly focused on epidemiology of S. aureus and MRSA both in hospital and community settings [23][24][25][26][27].…”

“…Epidemiological data about CoNS in Palestine are either scarce or insufficient [15]. To the best of our knowledge, this is the first report describing clinical CoNS infection within the Gaza Strip hospitals.…”