Methicillin, β-lactams, and clindamycin resistance profiles of Staphylococcus aureus strains isolated from patients with UTI in Bechar province (Algeria)

Abstract

Staphylococcus aureus is a bacterial pathogen responsible for many diseases. Multidrug resistance in S aureus has become common worldwide and is a serious clinical issue in the treatment and care of S. aureus-infected patients. S. aureus uropathogenic strains isolated from patients with UTI in Bechar province (Algeria) were phenotypically identified and evaluated for multiple drug resistance (MDR) patterns against recommended antimicrobial drugs. Through selective media, the uropathogenic S. aureus strains were isolated by analyzing a total of 211 urine samples, then subjected to various biochemical identification tests. Multidrug resistance pattern (MRSA, MLSB, and β-lactamase production) among Staphylococcus aureus uropathogenic strains was performed using phenotypic tests. A total of 50 S. aureus strains were isolated, i.e., 40,48% of all the isolated uropathogenic agents estimated at 126 isolates. More than 69% of the women had a urinary tract infection, i.e., a sex ratio (SR) of 0,43. The susceptibility test results showed that the isolated S. aureus strains were resistant to various antibiotics of the β-lactams class (penicillin, cefoxitin, and oxacillin) and were susceptible to gentamicin, chloramphenicol, co-trimoxazole, vancomycin, ofloxacin, and ciprofloxacin. Cefoxitin disk diffusion and agar screening tests showed that all the isolated S. aureus strains were qualified as MRSA at the rate of 100% (50/50), whereas a rate of 74% (37/50) was granted to MRSA using oxacillin disk diffusion test. The highest percentage of MDR-MRSA was observed in class three of antibiotics 12 (24%). The lowest percentage was observed in classes 8 and 9 of antibiotics 1 (2%). For MDR-MRSA, the MAR index ranged from 0,27 to 1,0. Penicillin disk diffusion (DD) and DDST (PI/PIT) tests showed a production rate of β-lactamase in the range of 94 and 80%, respectively. 85,1% (40/50) of penicillin-resistant strains were positive for DDST. Thus, the D-test among MRSA strains shows a rate of 38% (19/50) of cMLSB and no strain attributed to the iMLSB phenotype. This is an alarming rate, confirming the concern that is still being discussed within the medical teams of the national health sector as well as the Algerian antimicrobial resistance network, which requires prompt intervention to update a new strategy to fight antimicrobial resistance.