Determination of antimicrobial resistance profile and inducible clindamycin resistance of coagulase negative staphylococci in pediatric patients: the first report from Iran

Background:Currently,coagulase negative staphylococci(CoNS)have got much attention as a serious health problem especially in neonates and children.High incidence of antibiotic resistance,in particular methicillin resistance,has complicated the treatment of these organisms.The aim of this study is to determine the susceptibility to different antimicrobial agents and the prevalence of macrolides-lincosamides-streptogramins B(MLS_(B))resistance in CoNS isolates obtained from pediatric patients.Methods:Totally 157 CoNS isolates from various clinical samples were examined for antibiotic resistance using disk diffusion and E-test methods.Double-disk test was applied to detect constitutive and inducible MLSB resistance(cMLS_(B)and iMLS_(B))phenotypes.Results:Resistance to methicillin was seen in 98(62.4%)isolates.All isolates were susceptible to vancomycin and linezolid.The prevalence of resistance to antibiotics tested was as follows:fusidic acid(n=58,36.9%),gentamicin(n=73,46.5%),ciprofloxacin(n=81,51.6%),clindamycin(n=112,71.3%),erythromycin(n=129,82.2%)and trimethoprim/sulfamethoxazole(n=133,84.7%).iMLS_(B)phenotype was seen in 14(8.9%)isolates,and 18(11.5%)and 98(62.4%)isolates showed MS and cMLS_(B)phenotypes,respectively.We observed that high overall antibiotic resistance rates were associated significantly with methicillin resistance.Conversely,iMLS_(B)phenotype was correlated neither with methicillin resistance nor with invasiveness.Conclusion:Given the similarity observed between the prevalence of iMLS_(B)and MS phenotypes,the performance of disk diffusion induction test is strongly recommended in our region.

Diversity and Distribution of Staphylococcal Chromosomal Cassettes Mec (SCCmec) Types I, II and III in Coagulase-Negative Staphylococcal Strains Isolated from Surfaces and Medico-Technical Materials of the University Hospital of Abomey-Calavi/Sô-Ava

The coagulase-negative staphylococci (CoNS) have long been considered to be low pathogenicity. The possibility of a horizontal transfer of resistance and virulence genes from S. aureus to CoNS could increase the pathogenicity of these bacteria. The objective of this work is to contribute to a better knowledge of the pathogenicity of (CoNS) strains isolated from surfaces and medico-technical materials of the University Hospital of Abomey-Calavi/Sô-Ava. Seventy strains of CoNS isolated from surfaces and medico-technical materials of the University Hospital of Abomey-Calavi were tested for methicillin resistance. The resistance to methicillin was evaluated phenotypically by the resistance of the strains to cefoxitin and then confirmed by the search for the mecA gene using PCR. The genes encoding staphylococcal chromosomal cassette (SCCmec) types I, II and III originally found in S. aureus were tested in CoNS by multiplex PCR using specific primers. All the strains studied showed resistance to methicillin. However, only 28.5% (20/70) carried the mecA gene. SCCmec was identified in only 17.14% (12/70) of these strains. Four strains carried mecA gene as well as one of the three types of SCCmec searched. SCCmec types I, II and III were identified in CoNS strains studied. SCCmec type I was the most frequent chromosomal cassette in mecA+ strains, only or in association with another SCCmec. The study also revealed methicillin-resistant strains carrying SCCmec lacking the mecA gene. Finally, 60% (12/20) of the strains were found to be non-typeable. Our results show that CoNS strains present a high resistance to methicillin and the source of this resistance in the CoNS of our study is not only the mecA gene. There is also a high diversity of SCCmec, justified by a large number of non-typeable CoNS strains. The mecA− SCCmec+ methicillin-resistant strains deserve to be sequenced for further studies.