ABSTRACT
The antimicrobial susceptibility pattern of Staphylococcus aureus collected from different private medical hospitals and laboratories was investigated in this study. A total of 50 of Staphylococcus aureus isolates from clinical specimens obtained from private medical hospitals and laboratories in Umuahia, were tested against 8 antimicrobial agents using the disc agar diffusion method. Resistance to Augumentin was 100% among strains isolated from clinical specimens. The clinical isolates also exhibited high rates of resistance to Ceftazidine (98%) and Cefuroxime, (98%), Ceftriazone (94%), Erythromycin (96%) and Cloacillin (98%).
Likewise, all (36%) and (46%) were resistant to gentamicin and cloxacillin, respectively. Isolates from nasal passages appeared to be less resistant to chloramphenicol (54.2%), gentamicin (43.4), streptomycin (31.3%) and tetracycline (51.8%).Ampicillin did not produce any zone of inhibition against 29 (96.7%) isolates from clinical specimens and only slightly inhibited one with zone of inhibition of 8mm. Nineteen of the isolates manifested low to high level of resistance to chloramphenicol with mean zone of inhibition ranging from 15. 8} 0.7 mm to 9.8} 2.0 mm. All the isolates were completely resistant to penicillin and cloxacillin with no zone of inhibition at all. In the case of gentamicin, 5 (16.7%) had intermediate susceptibility (mean zone of inhibition 14}0 mm), 12(40%) had mean inhibition zone of 9.6}2.9 mm and 6(20%) were not inhibited. This study shows that S. aureus strains isolated from clinical specimens and healthy students in Umuahia are highly resistant to common antibiotics. This may not be unconnected with indiscriminate use of antibiotics and calls for more control and rational use of antibiotics to minimize the rate of development of resistance to other antibiotics.
TABLE OF CONTENTS
Title Page i
Certification ii
Dedication iii
Acknowledgements iv
Table of Contents v
Lists of Tables vii
Abstract viii
CHAPTER ONE
1.0 INTRODUCTION 1
1.1 AIMS AND OBJECTIVES 3
1.2 OBJECTIVES
3
CHAPTER TWO
2.0 LITERATURE REVIEW 5
CHAPTER
THREE
3.0 MATERIALS
AND METHODS 13
3.1 SAMPLE
COLLECTION 13
3.2 MEDIA
USED 13
3.3
ISOLATION AND IDENTIFICATION OF BACTERIA 13
3.4 GRAM STAINING 13
3.5 BIOCHEMICAL TESTS 14
3.5.1 Catalase Test 14
3.5.2 Coagulase Test 14
3.6 DETERMINATION
OF ANTIMICROBIAL SUSCEPTIBILITY PATTERN 14
3.7 STATISTICAL ANALYSES 15
CHAPTER
FOUR
4.0 RESULTS 16
CHAPTER FIVE
5.0
DISCUSSION, CONCLUSION AND RECOMMENDATION 20
5.1 DISCUSSION
20
5.2 CONCLUSION 21
5.3 RECOMMENDATION 21
REFERENCES 22
LIST OF TABLES
Table Title Page
1:
Antibiotic
susceptibility profile of S. aureus
isolates
from
private hospitals and laboratories in umuhia 17
2: Age distribution of antibiotics
susceptibility from hospitals
and
laboratories 18
3:
Antibiotics
susceptibility profile among male and female from
S.
aureus isolates obtained from hospital and laboratories in umuahia 19
CHAPTER ONE
1.0
INTRODUCTION
Staphylococcus aureus
are Gram-positive cocci, catalase and coagulase positive bacterium belonging to
the Staphylococcaceae family (Parsek
and Sigh, 2003).They are approximately 0.5-1-5 nm in diameter, non-motile,
non-spore forming, facultative anaerobes (with the exception of S. aureus anaerobius) that usually form
in clusters. Staphylococcus aureus are
part of human flora, and are primarily found in the nose and skin. Many strains
of Staphylococcus aureus cause
disease through the production of enterotoxins or through direct invasion and
destruction of tissue. Infections caused by S.
aureus remain a significant cause of mortality and morbidity in tropical
countries (Parsek and Sigh, 2003).
Increased nasal colonization rates by Staphylococcus aureus have been noted in
insulin dependent diabetes individuals on haemodialysis, those on ambulatory
peritoneal dialysis, intravenous drug users and patients receiving routine
allergy injections (Jensen and Lyon, 2009).
It
has also been suggested that patients with symptomatic human immunodeficiency
virus infection have an increased colonization risks (Espedido and
Gosbell,2012).
Staphylococci
have a record of developing resistance quickly and successfully to antibiotics.
This defensive response is a consequence of the acquisition and transfer of
antibiotic resistance plasmids and the possession of intrinsic resistance
mechanisms (Esanet al., 2009). Three
species of clinical importance are Staphylococcus
aureus, Staphylococcus epidermidis and
Staphylococcus saprophyticus. Of all these, Staphylococcus aureus is the major pathogen for humans. Its
pathogenic effect is characterized by its ability to heomolyze blood, coagulate
plasma (a biochemical test that differentiates it from other non-pathogenic Staphylococcus), and produces a variety
of extracellular enzymes and toxins. Staphylococcus
aureus is present in the nasal passages and throat, on the hair and skin of
healthy individuals. Almost every person will have some type of Staphylococcus infection during a life
time, ranging from severity of food poisoning or minor skin infections to
severe life threatening infections.
The
importance of Staphylococcus aureus as
a persistent nosocomial and community acquired pathogen has become a global
health concern. It has a remarkable capability of evolving different mechanisms
of resistance to most antimicrobial agents (Shittu et al.,2009).
Staphylococcus
aureus has been recognized as a very important
virulent and frequently encountered pathogen in clinical practice. It is an
endogenous microorganism colonizing the nasal cavity, skin, gastrointestinal,
anus and vaginal vulvae of healthy women (Onanuga et al.,2005). The
capacity to produce human diseases had not diminished even with the
introduction of antibiotics (Onanuga et
al.,2005).
S.
aureus has been associated with different
clinical conditions. For instance, it is still one of the most frequently encountered
single bacterial species in hospitals and continues to be frequent cause of
burn and wounds sepsis. It produces pustules, carbuncles, boils and impetigo. It
frequently causes septicaemia, osteomyelitis, bacteraemia and otitis (Shittu et al., 2009). S. aureus exhibits
remarkable versatility in their behavior towards antibiotics (Parsek and Sigh,
2003).
Therefore,
the insight into the antibiotic susceptibility profile of clinical isolates in
any community is very imperative and desirable for effective management of the
clinical conditions considering the relative differences in the pattern of
susceptibility and resistance of S. aureus to antibiotics from one
locality to another. Also the susceptibility and resistance of S.aureus to
antibiotics is known to be altered at relatively higher temperatures. For
instance, Ako-Nai et al. (2002) observed that clinical
isolates of S. aureus which was resistant to streptomycin at 37oC
became sensitive when cultured at 44oC.
Reports
of high level of antimicrobial drug resistance of Staphylococcus aureus in
different parts of the world are generating serious public health concerns
(Zetola et al.,2005; Wang et al.,
2012; Caraciolo et al.,2012).
Staphylococcus aureus which is one of the most successful and
adaptable human pathogens that can exist as a commensal on human skin on one
hand and become a pathogen capable of causing serious infections in both healthcare
facilities and in the community (Delorme et al.,2009).
Staphylococcus aureus causes a plethora of human infections
ranging from minor pus forming skin infections such as boils, pustules,
impetigoto wound infections, furuncles, ulcers, burnsinfections and to serious,
sometimes life threatening infections like pleural empyema, pneumonia,
meningitis, osteomyelitis and septicaemia (Moore and Broome et al.,1994).
This organism is also frequently associated with surgical wound infections
(Caraciolo et al.,2012).
Antimicrobial agents have been used
extensively to combat S. aureus infections but the increasing level of
resistance of S. aureus to many antibiotics is complicating the treatment of serious
infections caused by this pathogen (Wang et al., 2012).
The knowledge of the antimicrobial
susceptibility profile of this versatile pathogen in a particular area is
important as this can contribute to rational choice and use of antimicrobial
agents.
1.2 AIMS AND OBJECTIVES
The
study is aimed at assessing the antibiotic susceptibility profile of Staphylococcus aureus isolated from
different medical laboratories and hospitals.
1.3 OBJECTIVES
1.
To determine the prevalence and antibiotic susceptibility profile of Staphylococcus aureus isolates from
different private laboratories and hospitals.
2.
To determine the antimicrobial susceptibility
profile of S. aureus isolates to various antimicrobial drugs.
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