Research Article

Multi-Drug Resistant Efflux Pumps among Clinical Isolates of Staphylococcus aureus

1 Department of Medical Laboratory Science, Nnamdi Azikiwe University, Nnewi Campus Nnewi, Anambra State, Nigeria.
2 Department of Medical Microbiology, Edo University, Iyamho, Edo State, Nigeria.
* Corresponding author: agbakobanr@nsmjournal.org.ng
Published: Jun, 2020
Pages: 4904-4910

Abstract

Against the background of high level antimicrobial resistance observed in isolates of Staphylococcus aureus, this study was conducted to determine the prevalence of multidrug resistant (MDR) efflux pumps among clinical isolates from University of Benin Teaching Hospital, Benin city. A total of 198 clinical isolates of Staphylococcus aureus obtained from various clinical specimens were used for the study. Disc susceptibility test, detection of MDR efflux pump among representative multidrug Staphylococcus aureus isolates as well as curing experiments on the positive efflux pump isolates were performed using standard techniques. The most active antibacterial agent was imipenem with a susceptibility profile of 32.32%. A total of 64(32.32%) of the 198 isolates of Staphylococcus aureus were MDR. Forty-seven (47) isolates of Staphylococcus aureus (23.74%) were recovered from urine samples. Compared to isolates from other specimens, the prevalence of MDR isolates was significantly higher (63.83%) in the urine specimens (P˂ 0.0001). The prevalence of MDR efflux pump was 9.09% (18/198) with a significant prevalence among isolates from urine (P=0.0032). All 18 Staphylococcus aureus isolates harbored resistant plasmids to the drugs that were used as substrates for efflux as well as to other drugs. Curing experiment revealed the loss of antibacterial resistance in some of the isolates after exposure to rifampicin. In conclusion, the isolates of Staphylococcus aureus used for this study were multidrug resistant with few plasmid-mediated; consequently had a multiple antibiotic resistant index (MARI) ≥ 0.2. Prudent use of antimicrobial agents is advocated to stem the tide of high bacterial resistance.

References

  1. Akinjogunla, O. J., Ajayi, A.O., Ekei, N.O (2014). Virulence factors and antibiotic resistant Staphylococcus aureus: an Update. Journal of Open Microbiology 7: 59–71.
  2. Akujobi, C.N., Ezeanya, C.C., Emeka-Okafor, K.M., Ebenebe, J.C. (2013). A study on applicable bacteriuria among children attending the outpatient clinic of a university teaching hospital, Nigeria. International Journal of Microbiology Research 5 (4): 448-451.
  3. Ambe, J.P., Gasi, I.S., Mava, Y. (2007). Review of neonatal infections in University of Maiduguri Teaching Hospital: common bacterial pathogens seen. Nigerian Journal of Clinical Practice 10:290-293.
  4. British Society for Antimicrobial Chemotherapy (2013). Disc diffusion method for antimicrobial susceptibility testing. British Society for Antimicrobial Chemotherapy 2: 1-46.
  5. Chamber, H.F. (2005). Community-associated MRSA-resistance and virulence converge. New England Journal of Medicine 352: 1485-1487.
  6. Costa, S.S., Viveiros, M., Leonard Amaral, L., Couto, I. (2013) Multidrug Efflux Pumps in Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management Clinical Microbiology Reviews 28(3): 603–661.
  7. Ehinmidu, J.O. (2003). Antibiotic susceptibility patterns of urine isolates in Zaria Nigeria. Staphylococcus spp from the anterior nares of apparently healthy undergraduate students in Uyo. American Journal of Research Communication 2:11.
  8. Esebelahie, O.N., Omoregie, R., Airegbionmen, U.E., Ibeh, I.N., Mordi, R.M., Garcia-Rodiguez, J.A. (1999). Efflux pump mediated quinolone resistance in Staphylococcus aureus wild type for gyrA, gyrB, and norA. Antimicrobial Agents and Chemotherapy 43(2): 354-356
  9. Mckeegan, K.S. (2001). The structure and function of drug pumps. Trends in Microbiology 2:71-79.
  10. McNeil, J.C (2014) Staphylococcus aureus – antimicrobial resistance and the immune-compromised child, Infection and Drug Resistance. 7: 117–127.
  11. Mofolorunsho, K.C., Ocheni, M., Omatola, C. A., Ageni, G.A. (2015). Staphylococcus aureus prevalence and antibiotic susceptibility profile in Anyigba North Central Nigeria. American Journal of Infectious Diseases 11(4): 93-97.
  12. Munoz-Bellido, J.L., Alonzo, M., Martinez, J.A., Gutierrez, M.N., Ortiz, G., Segovia, M., Nantanda, R., Hildenwall, H., Peterson, S., Kaddu-Mulindwa, D., Kalye-Subula, I, Tumwine, J. K. (2008). Bacterial aetiology and outcome in children with severe pneumonia in Uganda. Annals of Tropical Pediarics 28: 253-260.
  13. Nickerson, E.K., West, T.E., Day, N.P., Peacock, J. (2009). Staphylococcus aureus disease and resistance in resource limited countries in South and East Asia. Lancet Infectious Diseases 9: 130-135.
  14. Ogbolu, D.O. (2013). Impact of ESBLs and CREs – the Nigerian experience. APUA News Letter 31 (2): 15 – 16.
  15. Okon, K.O., Shittu, A.O., usman, H., Adamu, N., Balogun, S. T. (2013). Epidemiology and antimicrobial susceptibility pattern of Methicillin-resistant Staphylococcus aureus recovered from tertiary hospital in North Eastern Nigeria. Journal of
  16. Omoregie, R., Erabor, J.O., Akhokhai, I.I., Isibor, O. J., Ogefere, H.O. (2008). Observed changes in the prevalence of uropathogens in Benin City, Nigeria. New Zealand Journal of Medical Laboratory Science 62:29-31.
  17. Piddock, L. J. (2006). Clinically relevant chromosomally encoded multidrug resistance efflux pumps in bacteria. Clinical Microbiology Reviews 19: 382-402
  18. Ribera, A., Ruiz, J., Jimenez de Anta, T. (2002). Effect of an efflux pump inhibitor on the MIC of nalidixic acid for Acinetobacter baumannii and Stenotrophomonas maltophilia clinical isolates. Journal of Antimicrobial Chemotherapy, 49: 697–702.
  19. Tong, Y.C.S., Davis, J.S., Eichenberger, E., Holland, T.L., Fowler Jr., V.G. (2015). Clinically relevant epidemiology and evidence of persistent MRSA colonisation. Tropical Journal of Pharmaceutical Research 2:223-228.
  20. Utsalo, S.J. (2006). Effect of exposure to rifampicin on multi-resistant bacteria isolates from diabetic and non-diabetic wounds. Journal of Medical Laboratory Science 15(1): 33-36.
How to Cite

R., A. N., I., I. E., & C, E. C. (2020). Multi-Drug Resistant Efflux Pumps among Clinical Isolates of Staphylococcus aureus. Nigerian Journal of Microbiology, 34(1), 4904-4910. https://doi.org/10.67614/njm.2020.3usq7stu

A. N. R., I. E. I., and E. C. C, "Multi-Drug Resistant Efflux Pumps among Clinical Isolates of Staphylococcus aureus," Nigerian Journal of Microbiology, vol. 34, no. 1, pp. 4904-4910, June 2020. doi: 10.67614/njm.2020.3usq7stu

Share this article:
Facebook X / Twitter LinkedIn