Methicillin and vancomycin resistance in coagulase-negative Staphylococci isolated from the nostrils of hospitalized patients

Abstract

Introduction: Nasal colonization by coagulase-negative Staphylococci (CoNS) play an important role in nosocomial infections. This study aims to determine antibiotics susceptibility pattern and molecular screening of methicillin- and vancomycin-resistant nasal CoNS among hospitalized patients.
 Methodology: Nasal swabs were collected from 202 inpatients at Prince Hamzah Hospital, Jordan. Swabs were processed according to standard microbiological procedures to isolate Staphylococci. Antibiotic susceptibility testing was performed using disk diffusion, E-test, microdilution, and Vitek 2. Molecular analysis was performed using PCR for the detection of mecA, vanA, and vanB genes.
 Results: Nasal Staphylococci was isolated in 64/202 (31.7%) samples. Thirty isolates (14.8%) were CoNS, including S. haemolyticus (n = 17, 8.4%), S. sciuri (n = 6, 3%), S. epidermidis (n = 2, 1%), S. warneri (n = 2, 1%), S. hominis (n = 2, 1%), and S. lentus (n = 1, 0.5%). Twenty-two (10.9%) isolates were MR-CoNS harboring mecA gene. CoNS and MR-CoNS isolates were highly resistant to benzylpenicillin, erythromycin, fosfomycin, and imipenem. All isolates were sensitive to vancomycin by E-test and microdilution test and were negative for vanA and vanB genes. Nasal CoNS colonization was associated with an increased number of family members living with the participant (P = 0.04) and with admission to the orthopedic department (P = 0.03), while MR-CoNS colonization was associated with smoking (P = 0.03).
 Conclusions: Nasal colonization by unusual CoNS species and mecA-positive MR-CoNS are common among hospitalized patients. Absence of vanA and vanB genes suggests little contribution of nasal CoNS to vancomycin resistance transmission.

First Report of Multi-drug Resistant Staphylococcus haemolyticus in Nosocomial Infections in North Western Saudi Arabia

“…Currently, vancomycin, linezolid and rifampicin are the treatment of choice for Staphylococcus haemolyticus infections 14, 21 , our results showed that resistance to vancomycin and linezolid do not exist, particularly with the absence of vanA gene (0% in this study) which in agreement with what reported worldwide, however, resistance to rifampicin exhibited by 30% of the isolates reported in this study is alarming, emerging Staphylococcus haemolyticus resistant to rifampicin have been reported 7 , Resistance to glycopeptides (vancomycin and teicoplanin) remains rarely detected in Staphylococcus haemolyticus 3, 6, 14, 16, 18 . Despite the total absence of vancomycin/teicoplanin, linezolid resistant isolates and the apparently low prevalence of rifampicin resistance among Staphylococcus haemolyticus reported in this study, wide surveillance of susceptibility patterns of these drugs among Staphylococcus haemolyticus of clinical origin is mandatory, since the development of resistance to these drugs may exist at low levels 17 .…”

“…In this study 90% of the Staphylococcus hameolyticus isolates exhibited multiple resistance (to three and more antimicrobial classes) (P <0.001, x 2 ). Multiple resistant Staphylococcus haemolyticus of clinical origin are increasingly encountered worldwide 3, 6, 8, 14, 15, 16, 18 . We observed that 100% and 95% of the isolates were resistant to benzylpenicillin and oxacillin respectively, this result was also supported by cefoxitin screening, which is widely accepted as a surrogate for the detection methicillin resistance in staphylococci 19 , as well as the detection of mecA gene by PCR in these isolates.…”

Vancomycin Resistance Among Clinical Isolates of Staphylococcus aureus Obtained from Selected Hospitals in Sokoto Metropolis

“…One limitation of this study is the absence of isolation of the Van A/Van B genes by Polymerase Chain Reaction (PCR). However, it was reported that these genes were absent in the VISA and VRSA strains isolated even in the presence of phenotypic resistance to vancomycin (Al-Tamimi et al, 2020). Hence, the presence or absence of the resistant van A/B genes does not necessarily rule out that strains are not VRSA.…”

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

“…Screening for MRSA among hospital staff is an important component of hospital infection control strategy. Similar to MRSA, nasal carriage constitutes a significant and a common reservoir of CoNS, which are associated with an increased risk of nosocomial infections 5 . However, little data is available for CoNS/MRCoNS colonization in hospital staff .…”