Antibiotic Resistance Patterns and Virulence Factors of Coagulase Negative Staphylococcus Associated with Urinary Tract Infections in Bulawayo Province, Zimbabwe

Aims: To determine the antibiotic resistance patterns and virulence factors of coagulase negative Staphylococcus (CoNS) associated with urinary tract infections (UTIs). The virulence factors assayed for were the atl E and ica AB genes. The prevalence of the antibiotic resistance gene, mec A, was also determined.

Place and Duration of Study: Southern Pathology Clinical Laboratories and the National University of Science and Technology microbiology department, between December 2012 and March 2015.

Methods: A total of 754 urine samples were analyzed for bacteria by standard procedures. From these, 126 isolates were positively identified as CoNS. Antimicrobial susceptibility testing of the isolated CoNS was done using the disc diffusion method.The polymerase chain reaction (PCR) was also carried out to detect the presence of the mec A, ica AB and atl E genes.

Results: Antibiogram profiles showed that CoNS had high prevalences of resistance to nalidixic acid (88.1%), cotrimoxazole (72.2%) and oxacillin (69.8%).There were however high prevalences of sensitivity to nitrofurantoin (79.4%) and gentamycin (68.3%). A total of 106 (84%) isolates were resistant to three or more antibiotics and 12 multi-drug resistance patterns were observed. The most common pattern (resistance to nalidixic acid, ampicillin, oxacillin, tetracycline and cotrimoxazole) was exhibited by 33 isolates. A total of 40 CoNS isolates were then used to determine the prevalence of the mec A, ica AB and atl E genes. PCR results showed that most isolates 25/40 (62.5%) were positive for the mec A gene. The ica AB and atl E were detected in 32.5% and 25% of the isolates respectively. All isolates which were positive for both the mec A and ica AB genes showed resistance to multiple antibiotics.

Conclusion: There is emerging antibiotic resistance in CoNS that cause UTI’s. The occurrence of both the mec A and ica AB genes in CoNS isolates may lead to an increase in antibiotic resistance.