Prevalence and antimicrobial susceptibility pattern of coagulase-negative staphylococci (CoNS) isolated from clinical specimens in Northern of Jordan
Abstract
Background: Coagulase negative Staphylococci (CoNS) are one of the most common bacteria found on human skin and on mucous membranes as a component of normal flora. The presence of CoNS in clinical specimens is frequently associated with an infectious aetiology or contamination.
Objectives: We aimed to evaluate CoNS species distribution and susceptibility patterns in specimens obtained from clinics and hospitals in the Northern area of Jordan.
Methods: Standard identification methods showed the presence of CoNS in 223 specimens at different local hospitals. Susceptibility testing was performed using 18 antibiotics in accordance with the Clinical and Laboratory Standards Institute (CLSI) recommendations.
Results: Staphylococcus epidermidis and S. haemolyticus were found to be the most common species isolated from all spec- imens representing 122 (54.7%) and 52 (23.4%) of all CoNS species, respectively. Antibiotic susceptibility testing of CoNS species revealed their sensitivity to vancomycin, linozolid, rifampin and nitrofurantin, while showing a highly resistant pattern to ampicillin, penicillin, ceftriaxone, cefazolin, amoxicillin-clavulanic acid and erythromycin. Some variation of the susceptibility pattern of CoNS species were identified in specimens isolated from the ICU and paediatric hospital wards as well as from clinical specimens of urine, blood and catheter tips.
Conclusion: The most common CoNS isolates were found to be S. epidermidis and S. haemolyticus with variable percentag- es according to the specimen source. Moreover, a high susceptibility CoNS to vancomycin, rifampin, and linezolid showed resistance to amoxicillin and penicillin.
Javadpour S KE, Karmostaji A. Frequency and anti- biogram pattern of coagulase negative Staphylococcus in clinical specimens of Shahid Mohammadi Hospital in patients Bandar-Abbas, Iran. Afric J Microbiol Res 2010;4:1581-1583.
Couto I, Pereira S, Miragaia M, Sanches IS, de Lencas- tre H. Identification of clinical staphylococcal isolates from humans by internal transcribed spacer PCR. J Clin Microbiol 2001;39:3099-3103.
Malik M RK. Significance of coagulase negative Staphylococcus species in blood culture. J Clin Diagn Res 2012;6:632-635.
Nzeako B AS, Neilson F, Albalkhair A. Type of bac- teria on some medical devices used in sultan qaboos university hospital wards. Middle-East J Scientific Res 2010;5:449-53.
Sharma V, Jindal N, Devi P. Prevalence of methicillin resistant coagulase negative staphylococci in a tertiary care hospital. Iran J Microbiol 2010;2:185-188.
Sarathbabu R RN, Ramani M TV. Characterization of coagulase negative staphylococci isolated from urine, pus, sputum and blood samples. Int J Pharma Sci Inv 2013;2:37-46.
Bouchami O AW, Ben Hassen A. Species distribution and antibiotic sensitivity pattern of coagulase-negative Staphylococci other than Staphylococcus epidermidis isolated from various clinical specimens. Afri Jf Micro- biol Res 2011;5:298-1305.
Nowak T, Balcerczak E, Mirowski M, Szewczyk EM.Detection of methicillin resistance in hospital environ- mental strains of coagulase-negative staphylococci. P J Microbiol 2006;55:339-343.
Longauerova A. Coagulase negative staphylococci and their participation in pathogenesis of human infections.Bratisl Lek Listy 2006;107:448-52.
Mert G KA, Bedir O, Basustaoglu A. Clinical signif- icance and staphylococcal cassette chromosome mec (SCCmec) characterization of coagulase-negative staphylococci isolated from blood cultures. Turk J Med Sci 2011;41::859-865.
Jain A, Agarwal A, Verma RK, Awasthi S, Singh KP.Intravenous device associated blood stream staphylo- coccal infection in paediatric patients. Indian J Med Res 2011;134:193-199.
Agbede O KO, Ogunleye V, Adegoke A. Incidence of novobiocin resistant coagulase negative staphylococ- cus saprophyticus in urinary tract infection in UITH, ilorin, nigeria. E3 J Med Res 2012;1:44-51.
Javed I HR, Zubair M, Anwar MS, Tayyib M, Husnain S. Microbiological surveillance of operation theatres and ICUs of a tertiary care hospital, Lahore. Afric J Biotechnol 2008;7:3535-3539.
Bhamare S KA, Dohe V, Rajput AG, Bhardwaj R, Ka- gal A. Study of sources of coagulase negative staph- ylococci infection from NICU environment. Int J of Healthcare & Biomed Res 2013;1:26-31.
Vackova M HI, Smetana J, Chlibek R, Bostikova V, Splino M. Microbial air load at the transplant intensive care unit. Mil Med Sci Lett 2011;80:52-57.
Gheibi S KM, Ilkhanizadeh B, AsghariSana F, Mah- moodzadeh H. Coagulase negative Staphylococcus; the most common cause of neonatal septicemia in urmia, Iran. Iran J Pediatr 2008;18:237-43.
El Kholy A BH, Hall GS, Procop GW, Longworth DL.Antimicrobial resistance in Cairo, Egypt 1999-2000:A survey of five hospitals. J Antimicrobial Chemother 2003;51:625-30.
El Kholy A, Baseem H, Hall GS, Procop GW, Long- worth DL. Antimicrobial resistance in Cairo, Egypt 1999-2000: a survey of five hospitals. J Antimicrobial Chemother 2003;51:625-630.
Goyal R, Singh NP, Kumar A, Kaur I, Singh M, Sunita N, et al. Simple and economical method for specia- tion and resist typing of clinically significant coagu- lase negative staphylococci. Indian J Med Microbiol 2006;24:201-204.
Tiwari HK SD, Sen MR. Evaluation of different tests for detection of Staphylococcus aureus using coagulase (coa) gene PCR as the gold standard. Nepal Med Coll J 2008;10:129-31.
Clinical and Laboratory Standards Institute. Perfor- mance standards for antimicrobia susceptibility test- ing: Nineteenth informational supplement. CLSI doc- ument no M100-S19 2009;CLSI.
Shin JH, Jung HJ, Lee HR, Kim JH, Kim HR, Lee JN.Prevalence, identification, and antimicrobial suscepti- bility of Staphylococcus lugdunensis from various clin-ical specimens in Korea. Jpn J Infect Dis 2007;60:312-313.
Krause R, Haberl R, Wolfler A, Daxbock F, Auner HW, Krejs GJ, et al. Molecular typing of coagulase-negative staphylococcal blood and skin culture isolates to dif- ferentiate between bacteremia and contamination. Eur J Clin Microbiol Infect Dis 2003;22:760-763.
Akpaka PE, Christian N, Bodonaik NC, Smikle MF.Epidemiology of coagulase-negative staphylococci isolated from clinical blood specimens at the Univer- sity Hospital of the West Indies. West Indian Med J 2006;55:170-173.
Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006;19:788-802.
Findik UY, Otkun MT, Erkan T, Sut N. Evaluation of handwashing behaviors and analysis of hand flora of in- tensive care unit nurses. Asian Nursing Res 2011;5:99-107.
Agvald-Ohman C LB, Edlund C. Multiresistant coag- ulase-negative staphylococci disseminate frequently between intubated patients in a multidisciplinary in- tensive care unit. Crit Care Med 2004;8:R42-47.
Singhal R, Dhawan S, Mohanty S, Sood S, Dhawan B, Das B, et al. Species distribution & antimicrobial susceptibility of coagulase negative Staphylococci in a tertiary care hospital. Indian J Med Res 2006;123:569-570.
Akinkunmi E OA, Lamikanra A. Species distribution and antibiotic resistance in coagulase-negative staphy- lococci colonizing the gastrointestinal tract of children in ile-ife, nigeria. Trop J Pharm Res 2010;9:35-43.
Cuevas O, Cercenado E, Vindel A, Guinea J, San- chez-Conde M, Sanchez-Somolinos M, et al. Evolution of the antimicrobial resistance of Staphylococcus spp.in Spain: five nationwide prevalence studies, 1986 to 2002. Antimicrob Agents Chemother 2004;48:4240-4245.
de Oliveira A, Sanches P, Lyra JC, Bentlin MR, Rugolo LM, de Lourdes Ribeiro de Souza da Cunha M. Risk factors for infection with coagulase-negative staphylo- cocci in newborns from the neonatal unit of a brazilian university hospital. Clin Med Insights Pediatr 2012;6:1-9.
Sheikh A MM. Identification and determination of coagulase-negativeStaphylococci species and antimi- crobial susceptibility pattern of isolates from clinical specimens. Afric J Microbiol Res 2012;6:1669-74.
Perez-Gonzalez LF, Ruiz-Gonzalez JM, Noyola DE.Nosocomial bacteremia in children: a 15-year expe- rience at a general hospital in Mexico. Infect Control Hosp Epidemiol 2007;28:418-22.
Cimolai N, Carter JE. Clinical validation for oxacillin susceptibility testing of coagulase negative staphylo- cocci. Arch Dis Child 2002;86:446-447.
Khadri H AM. Prevalence and antibiotic susceptibility pattern of methicillin-resistant and coagulase-negative staphylococci in a tertiary care hospital in India. Int J Med Medical Sci 2010;2:116-20.
Huang SY, Tang RB, Chen SJ, Chung RL. Coagu- lase-negative staphylococcal bacteremia in critically ill children: risk factors and antimicrobial susceptibility. J Microbiol Immunol Infect 2003;36(1):51-5.
Jean-Baptiste N, Benjamin DK, Cohen-Wolkowiez M, Fowler VG, Laughon M, Clark RH, et al. Coagu- lase-negative staphylococcal infections in the neona- tal intensive care unit. Infect Control Hosp pidemiol 2011;32:679-686.
Files | ||
Issue | Vol 7 No 6 (2015) | |
Section | Articles | |
Keywords | ||
CoNS Antibiotic Hospital Intensive Care Units Hospital Wards Nosocomial Infection |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |