Phenotypic and genotypic detection of macrolide resistance among clinical isolates of Staphylococci, Zagazig University Hospitals, Egypt

Esmaeel, Noura E; Gebriel, Manar G; Yahia, Shymaa; Hosny, Thoraya; Mohammed, Sherif Yehia; Gerges, Marian Asaad

doi:10.21608/mid.2024.321004.2218

	Phenotypic and genotypic detection of macrolide resistance among clinical isolates of Staphylococci, Zagazig University Hospitals, Egypt
Microbes and Infectious Diseases
Article 20, Volume 6, Issue 1, February 2025, Page 213-225 PDF (706.66 K)
Document Type: Original Article
DOI: 10.21608/mid.2024.321004.2218
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Authors
Noura E Esmaeel¹; Manar G Gebriel ¹; Shymaa Yahia¹; Thoraya Hosny²; Sherif Yehia Mohammed²; Marian Asaad Gerges ¹
¹Department of Medical Microbiology and Immunology, Faculty of Medicine, ,Zagazig University, Egypt
²Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Abstract
Background: Macrolide resistance has increased worldwide among Gram-positive cocci including staphylococci, particularly after the irrational use of macrolides during the COVID-19 pandemic. Scarce data exists about the situation in Zagazig University Hospitals. Aim: To detect different macrolide resistance phenotypes and genotypes among staphylococcal clinical isolates in Zagazig University Hospitals, one of the tertiary hospitals in Egypt. Methods: Antibiotic susceptibility of ninety-two staphylococcal isolates collected from various clinical specimens, was carried out against erythromycin, azithromycin, and clindamycin by disc diffusion method. The D-test was applied to detect inducible macrolide, lincosamides, and streptogramin type B resistance phenotype (iMLS_B). Molecular detection of major genes coding for macrolide resistance, including erythromycin ribosomal methylase (ermA, ermB, and ermC), and macrolide-streptogramin resistance gene (msrA) was performed using PCR. Results: Out of 92 staphylococcal isolates, 37 isolates (40.2%) showed macrolide resistance. The iMLS_B phenotype was identified in 32.4% of the resistant isolates with a rate of 43.7% among methicillin-resistant Staphylococcus aureus (MRSA), meanwhile, constitutive resistance was detected in 43.2%. The investigated resistance genes were detected in a total of 89.2% of resistant isolates where the ermC was the most frequent (54.1%), followed by the msrA gene (45.9%), the ermA gene (16.2%), and the ermB (5.4%). However, none of the examined genes showed a statistically significant relationship with the resistance phenotypes (P > 0.05). Conclusion: Our finding revealed increased macrolide resistance, particularly the inducible phenotype among MRSA isolates with wide dissemination of macrolide resistance genes, necessitating continuous monitoring.
Keywords
Staphylococci; Macrolide resistance; cMLSB phenotype; iMLSB phenotype


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