ABSTRACT
This study determined the antibiotic sensitivity of Staphylococcus aureus isolated from wounds samples in patients attending General Hospital (GH), Minna and IBB Specialist Hospital, Minna, Niger State. Wounds samples from two hundred (200) patients were collected and analyzed for Staphylococcus aureus. The resistance pattern of the S. aureus isolates for vancomycin using disc diffusion techniques was also determined. Out of the 200 samples collected from both hospitals, 97 (48.50 %) were positive for S. aureus. GH Minna had higher occurrence of S. aureus 76 (50.70 %) than IBB specialist Minna with 21 (42.00 %). Wounds samples from male had higher frequency of occurrence 65 (67.00%) compared to female 32 (33.00 %). In these findings, it was observed that S. aureus had a high resistance rate of vancomycin and also resistance to other antibiotics such as; Amoxicillin, Ampicillin, Oxacillin and Erythromycin, although resistance to Erythromycin was very low in this study. The molecular characterization identified the VRSA isolates to be S. aureus strain GSI17, S. aureus strain GSI36, S. aureus strain GSI93, S. aureus strain GSI112 and S. aureus strain GSI114. vanA, van B and vanXY from the isolates were resistant genes detected in the isolates with band size approximately 713 bp, 430 bp and 550 bp respectively. This study established the active circulation of vanA, vanB and vanXY resistant genes among S. aureus in the study area.
CHAPTER ONE
1.0 INTRODUCTION
1.1 Background to the Study
Staphylococcus aureus is a Gram-positive, non-spore-forming spherical bacterium that belongs to the Staphylococcus genus. This class is subdivided into 32 species and subspecies. S. aureus is widely found in the atmosphere (soil and water), and is also found in the nose and on the skin of humans (Montville and Matthews, 2008; Food and Drug Administration (FDA), 2012). S. aureus is the most pathogenic specie of the genus Staphylococcus, being involved in both community-acquired and nosocomial contaminations (Costa et al., 2013). Despite constant improvement in patient care, S. aureus infections remain associated with considerable morbidity and mortality, both in hospitals and in the community (Rasigade et al., 2014).
It has been estimated that about 20-30 % of the population are permanently colonized by this bacterium, while other 30 % are transient carriers (Wertheim et al., 2005). This colonization represents an increased risk of infection by providing a reservoir from which bacteria are introduced when the host defense is compromised (Costa et al., 2013). Due to the importance of S. aureus infections and the increasing prevalence of antibiotic- resistant strains, this bacterium has become the most studied staphylococcal species (Costa et al., 2013).
Skin diseases are the highly popular type of S. aureus infection (Tong et al., 2015). This may manifest itself in a variety of ways, including folliculitis, impetigo, cellulitis, and other serious, obtrusive soft-tissue diseases. People with atopic dermatitis, also known as skin inflammation, have a great prevalence of S. aureus (Tong et al., 2015).
S. aureus may also manifest itself in one of three ways: osteomyelitis, septic joint pain, or contamination after a replacement joint operation (Rasmussen et al., 2011; Tong et al., 2015).
Methicillin-resistant Staphylococcus aureus (MRSA) is an infection caused by Staphylococcus bacteria. This type of bacteria is resistant to many different antibiotics (Lights, 2019). MRSA is responsible for several difficult-to-treat infections in humans. MRSA is any strain of S. aureus that has developed (through natural selection) or acquired (through horizontal gene transfer) a multiple drug resistance to beta-lactam antibiotics (Gurusamy et al., 2013).
Methicillin-resistant S. aureus (MRSA) is one of a number of greatly feared strains of S. aureus which have become resistant to most β-lactam antibiotics. For this reason, vancomycin, a glycopeptide antibiotic, is commonly used to combat MRSA. Vancomycin inhibits the synthesis of peptidoglycan, but unlike β-lactam antibiotics, glycopeptide antibiotics target and bind to amino acids in the cell wall, preventing peptidoglycan cross- linkages from forming. MRSA strains are most often found associated with institutions such as hospitals, but are becoming increasingly prevalent in community-acquired infections (Bonomo et al., 2007).
Vancomycin-resistant S. aureus (VRSA) is a strain of S. aureus that has established resistance to glycopeptides. In 1996, Japan defined the primary cause of vancomycin- intermediate S. aureus (VISA). However, it existed only in 2002 that the initial instance of S. aureus that was actually resistant to glycopeptide antibiotics stayed identified (Chang et al., 2003). As of 2005, three circumstances of VRSA contamination had remained reported within the United States (Menichetti, 2005). Antimicrobial tolerance around S. aureus can be deduced from its capability to adjust in the tiniest of ways.
Different two-component flag transduction pathways aid S. aureus in acquiring unique qualities needed to survive antimicrobial stress (Sengupta et al., 2012).
1.2 Statement of the Research Problems
The management of wound infection has continued to be a challenging issue in the clinical setting due to the globally growing problem of antibiotic resistance, particularly in Staphylococcus aureus.
The infection caused by methicillin-resistant Staphylococcus aureus (MRSA) is a global threat to public health. Vancomycin remains one of the first-line drugs for the treatment of MRSA infections. However, S. aureus isolates with complete resistance to vancomycin have emerged in recent years (Cong et al., 2020).
This study was carried out to know whether there exist strains of Vancomycin-resistant
S. aureus in Minna, Niger State, Nigeria.
1.3 Justification for the Study
The trajectory nature of antibiotic resistance requires an immediate concerted effort to avail the next pandemic of untreatable bacterial infection. S. aureus that is vancomycin- resistant is also multi-drug resistant to a wide range of currently available antimicrobial agents, limiting treatment options and raising the risk of insufficient antimicrobial therapy, as well as an increase in morbidity and mortality (Tarai et al., 2013). In recent years, the advent of VRSA has added to the therapeutic challenge created by the existence of multi-drug resistant species (Loomba et al., 2010).
1.4 Aim and Objectives of the Study
The aim of this research was to isolate and characterize vancomycin resistant Staphylococcus aureus from wound infection of patients attending selected hospitals in Minna, Niger State, Nigeria
The objectives of the study were to;
i. isolate and characterize Staphylococcus aureus from wound infection in the study population
ii. determine the antibiotic susceptibility profile of S. aureus isolates
iii. detect vancomycin resistant genes in the S. aureus isolated
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ISOLATION AND CHARACTERIZATION OF VANCOMYCIN RESISTANT STAPHYLOCOCCUS AUREUS FROM WOUND INFECTIONS IN PATIENTS ATTENDING SELECTED HOSPITALS IN MINNA, NIGER STATE, NIGERIA
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