Methicillin and inducible clindamycin resistance in clinical Staphylococcus aureus isolates: a cross-sectional study from Northwest Ethiopia

BackgroundStaphylococcus aureus is a major pathogenic bacterium associated with high morbidity and mortality worldwide. It exhibits resistance to multiple antibiotics, complicating treatment options. Despite its clinical significance, there is limited data on the prevalence of S. aureus infections a...

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Main Authors: Zemen Addis, Yibeltal Aschale, Abebe Fenta, Zigale Hibstu Teffera, Abateneh Melkamu, Abeba Tigab, Tebelay Dilnessa
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fmicb.2025.1569242/full
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author Zemen Addis
Zemen Addis
Yibeltal Aschale
Abebe Fenta
Zigale Hibstu Teffera
Abateneh Melkamu
Abeba Tigab
Tebelay Dilnessa
author_facet Zemen Addis
Zemen Addis
Yibeltal Aschale
Abebe Fenta
Zigale Hibstu Teffera
Abateneh Melkamu
Abeba Tigab
Tebelay Dilnessa
author_sort Zemen Addis
collection DOAJ
description BackgroundStaphylococcus aureus is a major pathogenic bacterium associated with high morbidity and mortality worldwide. It exhibits resistance to multiple antibiotics, complicating treatment options. Despite its clinical significance, there is limited data on the prevalence of S. aureus infections and the patterns of methicillin and inducible clindamycin resistance, particularly in Ethiopia. Understanding these resistance trends is essential for guiding appropriate therapy and improving patient outcomes.ObjectiveTo assess the prevalence of S. aureus, methicillin and inducible clindamycin resistance patterns, and associated factors among patients with suspected bacterial infection at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.MethodA hospital-based cross-sectional study was conducted among patients suspected of bacterial infections from 10 June 2023 to 28 February 2024. Blood, wound swab, cerebrospinal fluid, urine, eye swab, synovial fluid, ear swab, and pleural fluid were collected aseptically and inoculated onto appropriate media. S. aureus was identified based on colony morphology, Gram staining, DNase test and biochemical tests. Antimicrobial susceptibility testing was performed on the isolates using the disk diffusion and the D-test techniques based on CLSI guideline. Data were entered into SPSS version 26 for analysis. Logistic regression was applied to assess the relationship between predictors and the outcome variable. A P-value of ≤ 0.05 with a 95% CI was considered statistically significant.ResultsAmong the 339 study participants, 38 (11.2%) (95% CI: 8–15) tested positive for S. aureus. Of these isolates, 14/38 (36.9%) were resistant to methicillin, 5/38 (13.1%) isolates were resistance to clindamycin by routine disk diffusion test whereas 10/38 (26.3%) isolates exhibited inducible clindamycin resistance using the D-test. The level of multidrug resistance was noted in 10/38 (26.3%) of the isolates. Significant factors associated with S. aureus infection included illiteracy (AOR = 13.51; 95% CI: 3.56–21.90; P = 0.018), having larger family size (AOR = 12.14; 95% CI: 2.38–20.43; P = 0.024), and income level of less than 3,000 ETB (AOR = 6.20; 95% CI: 1.03–30.09; P = 0.046).ConclusionThe study revealed an 11.2% occurrence of S. aureus among the study participants, with a substantial proportion exhibiting methicillin resistance (36.9%) and inducible clindamycin resistance (26.3%). These findings highlight a higher burden of clindamycin resistance in MRSA, underscoring the need for routine D-test screening to guide appropriate antibiotic therapy. Additionally, factors such illiteracy, low income and residing in rural areas were associated with S. aureus infection. Targeted health education initiatives should be implemented, especially in rural areas and among populations with low literacy levels, to improve hygiene practices and reduce transmission.
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spelling doaj-art-d25d08eec1144c099adc3ee364b73bef2025-08-20T03:25:42ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2025-06-011610.3389/fmicb.2025.15692421569242Methicillin and inducible clindamycin resistance in clinical Staphylococcus aureus isolates: a cross-sectional study from Northwest EthiopiaZemen Addis0Zemen Addis1Yibeltal Aschale2Abebe Fenta3Zigale Hibstu Teffera4Abateneh Melkamu5Abeba Tigab6Tebelay Dilnessa7Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, EthiopiaDepartment of Medical Laboratory Sciences, College of Health Sciences, Debark University, Debark, EthiopiaDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, EthiopiaDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, EthiopiaDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, EthiopiaDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, EthiopiaMedical Microbiology Laboratory Team, Debre Markos Comprehensive Specialized Hospital, Debre Markos, EthiopiaDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, EthiopiaBackgroundStaphylococcus aureus is a major pathogenic bacterium associated with high morbidity and mortality worldwide. It exhibits resistance to multiple antibiotics, complicating treatment options. Despite its clinical significance, there is limited data on the prevalence of S. aureus infections and the patterns of methicillin and inducible clindamycin resistance, particularly in Ethiopia. Understanding these resistance trends is essential for guiding appropriate therapy and improving patient outcomes.ObjectiveTo assess the prevalence of S. aureus, methicillin and inducible clindamycin resistance patterns, and associated factors among patients with suspected bacterial infection at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.MethodA hospital-based cross-sectional study was conducted among patients suspected of bacterial infections from 10 June 2023 to 28 February 2024. Blood, wound swab, cerebrospinal fluid, urine, eye swab, synovial fluid, ear swab, and pleural fluid were collected aseptically and inoculated onto appropriate media. S. aureus was identified based on colony morphology, Gram staining, DNase test and biochemical tests. Antimicrobial susceptibility testing was performed on the isolates using the disk diffusion and the D-test techniques based on CLSI guideline. Data were entered into SPSS version 26 for analysis. Logistic regression was applied to assess the relationship between predictors and the outcome variable. A P-value of ≤ 0.05 with a 95% CI was considered statistically significant.ResultsAmong the 339 study participants, 38 (11.2%) (95% CI: 8–15) tested positive for S. aureus. Of these isolates, 14/38 (36.9%) were resistant to methicillin, 5/38 (13.1%) isolates were resistance to clindamycin by routine disk diffusion test whereas 10/38 (26.3%) isolates exhibited inducible clindamycin resistance using the D-test. The level of multidrug resistance was noted in 10/38 (26.3%) of the isolates. Significant factors associated with S. aureus infection included illiteracy (AOR = 13.51; 95% CI: 3.56–21.90; P = 0.018), having larger family size (AOR = 12.14; 95% CI: 2.38–20.43; P = 0.024), and income level of less than 3,000 ETB (AOR = 6.20; 95% CI: 1.03–30.09; P = 0.046).ConclusionThe study revealed an 11.2% occurrence of S. aureus among the study participants, with a substantial proportion exhibiting methicillin resistance (36.9%) and inducible clindamycin resistance (26.3%). These findings highlight a higher burden of clindamycin resistance in MRSA, underscoring the need for routine D-test screening to guide appropriate antibiotic therapy. Additionally, factors such illiteracy, low income and residing in rural areas were associated with S. aureus infection. Targeted health education initiatives should be implemented, especially in rural areas and among populations with low literacy levels, to improve hygiene practices and reduce transmission.https://www.frontiersin.org/articles/10.3389/fmicb.2025.1569242/fullantimicrobial resistanceprevalenceS. aureusmethicillin resistanceinducible clindamycin resistanceEthiopia
spellingShingle Zemen Addis
Zemen Addis
Yibeltal Aschale
Abebe Fenta
Zigale Hibstu Teffera
Abateneh Melkamu
Abeba Tigab
Tebelay Dilnessa
Methicillin and inducible clindamycin resistance in clinical Staphylococcus aureus isolates: a cross-sectional study from Northwest Ethiopia
Frontiers in Microbiology
antimicrobial resistance
prevalence
S. aureus
methicillin resistance
inducible clindamycin resistance
Ethiopia
title Methicillin and inducible clindamycin resistance in clinical Staphylococcus aureus isolates: a cross-sectional study from Northwest Ethiopia
title_full Methicillin and inducible clindamycin resistance in clinical Staphylococcus aureus isolates: a cross-sectional study from Northwest Ethiopia
title_fullStr Methicillin and inducible clindamycin resistance in clinical Staphylococcus aureus isolates: a cross-sectional study from Northwest Ethiopia
title_full_unstemmed Methicillin and inducible clindamycin resistance in clinical Staphylococcus aureus isolates: a cross-sectional study from Northwest Ethiopia
title_short Methicillin and inducible clindamycin resistance in clinical Staphylococcus aureus isolates: a cross-sectional study from Northwest Ethiopia
title_sort methicillin and inducible clindamycin resistance in clinical staphylococcus aureus isolates a cross sectional study from northwest ethiopia
topic antimicrobial resistance
prevalence
S. aureus
methicillin resistance
inducible clindamycin resistance
Ethiopia
url https://www.frontiersin.org/articles/10.3389/fmicb.2025.1569242/full
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