Sains Malaysiana 51(3)(2022): 865-872

http://doi.org/10.17576/jsm-2022-5103-20

Antibiotic Resistance Patterns of Coagulase-Negative Staphylococcus (CoNS) Isolates from a Major Teaching Hospital in Kuala Lumpur, Malaysia

(Corak Kerintangan Antibiotik Staphylococcus Koagulase-Negatif (CoNS) Dipencilkan daripadaHospital Pengajar Utama di Kuala Lumpur, Malaysia)

ASIF SUKRI^1,2, HAIFA HANANI MOHAMAD ZAKI² & NORAZIAH MOHAMAD ZIN^2,*

¹Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), 42300 UiTM Puncak Alam, Selangor Darul Ehsan, Malaysia

  ²Center for Diagnostic, Therapeutic and Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Federal Territory, Malaysia

Received: 1 April 2021/Accepted: 29 July 2021

Abstract

Coagulase-negative Staphylococcus (CoNS) species is a leading cause of nosocomial infection in patients with indwelling medical devices and immunocompromised patients. This study was conducted to determine the antibiotic resistance pattern of CoNS isolated from a major teaching hospital in Malaysia. A total of 43 CoNS isolates were collected from August to October 2018 at Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia. Speciation of CoNS species was conducted by 16S rRNA sequencing. Antibiotic susceptibility test was performed using a standard procedure, and detection of staphylococcal cassette chromosome mec (SCCmec) elements and antibiotic resistance genes were conducted via multiplex polymerase chain reaction (PCR). Comparison of 16S rRNA sequences showed that 67.44% of the isolates were identified as S. epidermidis, followed by S. haemolyticus (11.63%), S. hominis (9.3%), S. capitis (4.65%), and other Staphylococcus sp. (6.98%).  All the CoNS isolates were susceptible to linezolid and tedizolid, while most of them were resistant towards penicillin (86.05%), cefoxitin (69.77%), erythromycin (72.02%), and 88.37% of them were resistant to at least 3 antibiotics. The majority of CoNS harboured nontypeable SCCmec elements. AacA-D (95.5%) and ermC (78.6%) were the most commonly detected antibiotic resistance genes while no detection of tetK, tetM and ermA genes were observed. This study showed a high prevalence of multidrug-resistant CoNS in HCTM healthcare settings. Understanding CoNS resistance mechanism is warranted for intervention strategy.

Keywords: Coagulase-negative Staphylococcus; multi-drug resistance; SCCmec typing

Abstrak

Spesies Staphylococcus koagulase-negatif (CoNS) merupakan penyebab utama jangkitan nosokomium dalam kalangan pesakit yang menggunakan peralatan perubatan dan pesakit yang terimunokompromi. Penyelidikan ini telah dijalankan untuk menentukan corak kerintangan antibiotik dalam CoNS yang dipencilkan daripada hospital pengajar utama di Malaysia. Sejumlah 43 pencilan CoNS telah diambil daripada Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia daripada Ogos sehingga Oktober 2018. Penentuan spesies CoNS telah dijalankan menggunakan penjujukan 16S rRNA. Ujian kerentanan antibiotik telah dijalankan menggunakan prosedur piawai manakala pengesanan kromosom kaset mec stafilokokus (SCCmec) dan gen rintangan antibiotik dijalankan menggunakan tindak balas berantai polimerase multipleks(PCR). Perbandingan penjujukan 16S rRNA menunjukkan 67.44% pencilan CoNS adalah S. epidermidis, diikuti S. haemolyticus (11.63%), S. hominis (9.3%), S. capitis (4.65%) dan Staphylococcus sp. yang lain (6.98%). Semua CoNS rentan terhadap Linezolid and Tedizolid, manakala hampir semua rintang terhadap Penisilin (86.05%), Cefoksitin (69.77%), Eritromisin (72.02%) dan 88.37% adalah rintang terhadap sekurang-kurangnya 3 antibiotik. Majoriti CoNS mempunyai unsur SCCmec yang tidak dapat ditentukan. AacA-D (95.5%) dan ermC (78.6%) merupakan gen kerintangan yang paling kerap dijumpai manakala gen tetK, tetM dan ermA tidak ditemui. Kajian ini menunjukkan prevalens CoNS rintang terhadap pelbagai antibiotik adalah tinggi dalam persekitaran HCTM. Pemahaman mekanisme kerintangan CoNS adalah penting untuk strategi intervensi.

Kata kunci: Kerintangan pelbagai antibiotik; pengetipan SCCmec; Staphylococcus koagulase-negatif

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^*Corresponding author; email: noraziah.zin@ukm.edu.my