Investigation of Resistance to Aminoglycosides and Tetracyclines among Methicillin-Resistant and -Sensitive Staphylococcus isolates in Shiraz, Southwestern Iran

Background: Methicillin-resistant staphylococci (MRS) are regarded as a global public health threat. Physicians are restricted in their treatment options due to resistance to aminoglycosides and tetracycline derivatives. This study investigated aminoglycoside and tetracycline derivative resistance among Staphylococcus isolates in Shiraz, southwestern Iran. Materials & Methods: Totally, ۱۱۳ staphylococcal isolates were recovered from different clinical samples in Nemazee Teaching Hospital from October ۲۰۱۹ to January ۲۰۲۰. Kirby-Bauer disc diffusion method was performed to assess the antimicrobial susceptibility of the isolates against aminoglycoside and tetracycline antibiotics. Aminoglycoside-modifying enzymes (AMEs) and tet genes were investigated among staphylococci isolates using polymerase chain reactions (PCR). Findings: MRS prevalence among Staphylococcus isolates was ۶۱% (۶۹ of ۱۱۳). The majority of MRS isolates were obtained from blood (۳۹.۱%; ۲۷ of ۶۹) and urine (۱۷.۴%; ۱۲ of ۶۹). The highest prevalence of MRS isolates was among emergency room patients (۳۴.۸%; ۲۴ of ۶۹). The highest resistance of MRS isolates was against tobramycin (۵۹.۴%; ۴۱ of ۶۹) and tetracycline (۵۵.۱%; ۳۸ of ۶۹). The prevalence of tetM and aac (۶')-Ie-aph (۲'') genes was significantly higher among MRS compared with methicillin-sensitive staphylococci (MSS) (۸۷.۵% vs ۱۲.۵% and ۹۵.۶% vs ۶.۴%, respectively) (p= .۰۰۱). Conclusion: The prevalence of MRS isolates, including methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MRCoNS), was remarkable in Shiraz as the center of medical services in the southwest of Iran. Furthermore, these MRS isolates were highly resistant to aminoglycosides and tetracyclines. Therefore, antimicrobial stewardship is necessary to address health conditions.

Keywords:

Staphylococcus aureus , Methicillin resistance , Coagulase-negative Staphylococcus , Tetracycline resistance