Multidrug and vancomycin resistance among clinical isolates of Staphylococcus aureus from different teaching hospitals in Nigeria

Backgrounds: Staphylococcus aureus has emerged as a major public health concern because of the occurrence of multi-drug resistant strains. This study aimed at investigating the multi-drug and vancomycin resistance profile of S. aureus from different infection sites in some teaching hospitals in Nigeria.

Methods: Swabs were collected from different infection sites from out-patients in three teaching hospitals from October 2015 to May, 2016. The antibiotic-susceptibility test was carried out with selected antibiotics usually administered anti-microbials in the treatment of infections in these hospitals. The prevalence of multi-drug and vancomycin resistance strains of S. aureus from clinical samples was determined using disk diffusion and agar dilution methods respectively.

Results: The result showed (165)82.5% of the isolates were resistant to ≥3 antibiotics tested. They were highly resistant to ceftazidime 180(90%), cloxacillin 171(85.6%) and augmentin 167(83.3%), but susceptible to ofloxacin 150(75%), gentamicin 142(71.7%), erythromycin 122(61.1%), ceftriaxone 111(55.6%) and cefuroxime 103(51.7%). All the isolates from the HVS were all multidrug resistant strains. While (56)90.16% were multidrug resistant (MDR) in urine samples, followed by (8)88.89% MDR strains in sputum, (37)88.81% MDR strains in semen, (49)71.64% MDR strains in wounds and (6)60% MDR strains in ear swabs samples. Although (147)73.5% of the isolates were vancomycin susceptible S. aureus (VSSA), (30)15% were vancomycin intermediate resistant S. aureus (VISA) and (89)44.5% of the isolates were considered vancomycin resistant S. aureus (VRSA).

Conclusions: The high percentage of the VRSA could have resulted from compromising treatment options and inadequate antimicrobial therapy. The implication, infections caused by VRSA would be difficult to treat with vancomycin and other effective antibiotics of clinical importance. Ensuring proper monitoring of drug administration will, therefore, enhance the legitimate role of vancomycin as an empiric choice for both prophylaxis against and treatment of staphylococcal infections.

Keywords: Bacterial resistance, vancomycin resistant S. aureus, susceptibility studies, agar dilution

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