Antimicrobial Resistance of Streptococci Sp. Isolated From Different Clinical Sources in Al-Muthanna Province
Abstract
Background: The genus Streptococcus includes Gram-positive organisms cocci shape and organized in chains. Streptococcus has spacious importance in medicine, different streptococci are significant as part of the commensals of humans; some can as well cause illnesses that may be subacute, acute or chronic. From the considerable human illnesses belong to streptococci are rheumatic heart disease, scarlet fever, pneumococcal pneumonia and glomerulonephritis. Antibiotic Resistance is a growing concern for public health and the main cause for the failure of streptococcal infections treatment is the increase resistance to antibiotics.
Aim: Determine the antimicrobial resistance of Streptococci sp .isolated from different clinical sources in Al- Muthanna Province.
Method: The study included the collection of (270) samples from different clinical source(Throat swabs,burns, wounds, abscess, pus, vagina swabs,teeth,ear,mouth and sputum ) from patients in different hospitals and clinics in Al-Muthanna Province, during the period from first of September to the mid December of 2022 .The patients were with different ages ranging from 1 day-80 year, and from both sexes. The identification of bacterial isolates were achieved by morphological characteristics of bacterial colonies on selective media, result of Bacitracin sensitivity test, Optochin sensitivity test, CAMP test, Gram stain, and biochemical tests and then confirmed the diagnosis by using Remel RapID™ STR System. The antibiotics sensitivity test was achieved for all isolates by disk diffusion method.
Results: A total of 50 (18.5 %) isolates were identified as Streptococcus spp. from (270) clinical samples that collected from different sources, that distributed by 16 (20.77% )from Throat Swab, 12 (33.33%) from sputum, 10(29.41%) from Tooth swab, 7 (13.20%) from Vaginal swab, 3 (10%) from Mouth swab, 2 (10%) from Ear swab, and No isolate detected from burns, wounds, abscess and pus samples. The Fifty isolates included 16(32%) of them were identified as S. pyogenes, 11(22%) were S.sanguins, 10(20%) were S.aglactiae, 9(18%) were S. mutans and 4(8%) were identified as S. pneumoniae
The antibiotic susceptibility of the bacterial isolates was achieved against 10 types of antibiotics; most S.pyogenes isolates have resistance to three or more antibiotics. The highest percentage of S. pyogenes resistance was (93.7%) to Ceftriaxone, 87% to Penicillin and Ampicillin, (62.5%) to Tetracycline, 50% to Chloramphenicol and Clindamycin. Whereas (81.25 of the isolates were sensitive to Levofloxacin, Vancomycin (75, Azithromycin (62.5%), erythromycin (56.25%), and Clindamycin (50%). All S. agalactiae isolates were resistance (100%) for ceftriaxone, tetracycline, Azithromycin, Chloramphenicol, clindamycin and erythromycin. On the other hand,the isolates were resistance to vancomycin and Levofloxacin with rate( 90%) and( 60%) respectively. While they were sensitive for Ampicillin and Penicillin with percentage (80%, 60%) respectively. Antibiotic susceptibility profile for Streptococcus mutans isolates revealed that all the isolates were resistant to Ampicillin and clindamycin, 77.77 % of them were resistant to penicillin, 66.66% isolates were resistant to Ceftriaxone. Whereas all isolates were sensitive to Azithromycin, erythromycin and Levofloxacin. While, the sensitivity to Chloramphenicol, vancomycin, ceftriaxone and Tetracyclin were (88.88 %, 77.77%, 33.33%,33.33%) respectively. Streptococcus pneumoniae isolates were resistant to penicillin, Ampicillin, Ceftriaxone, tetracycline, clindamycin and vancomycin (100,100.100,75,75,and 50) respectively. While, all isolates were sensitive to Azithromycin, Erythromycin, Levofloxacin, Chloramphenicol. S.sanguinis isolates were sensitive to clindamycin, Levofloxacin, Azithromycin and erythromycin (90.90%,81.81%,81.81%,63.63%)) respectively. and all the isolates were resistant to Ampicillin and Ceftriaxone, nine isolates were resistant to vancomycin and penicillin (81.81%) and six isolates were resistant to tetracycline (54.54%).
References
2. Kumar, S., Bansal, K., & Sethi, S. K. (2022). Phylo-taxonogenomic reconciliations of genus Streptococcus reveals the existence of sixteen novel genomospecies.
3. Sherman JM. (1937). The Streptococci. Bacteriol Rev 1:3–97.
4. Abranches, J., Zeng, L., Kajfasz, J. K., Palmer, S. R., Chakraborty, B., Wen, Z. T., ... & Lemos, J. A. (2018). Biology of oral streptococci. Microbiology spectrum, 6(5), 6-5.
5. Carapetis J. R., McDonald M., Wilson N. J. Acute rheumatic fever. Lancet. 2005;366(9480):155–168. .
6. Rohde, M., & Cleary, P. P. (2022). Adhesion and invasion of Streptococcus pyogenes into host cells and clinical relevance of intracellular streptococci.
7. Cunningham M. W. (2000)/ Pathogenesis of group A streptococcal infections. Clinical Microbiology Reviews;13(3):470–511.
8. Courtney H. S., Hasty D. L., Dale J. B.(2002). Molecular mechanisms of adhesion, colonization, and invasion of group A streptococci. Annals of Medicine;34(2):77–87.
9. Talay S. R. (2005). Gram-positive adhesins. Contributions to Microbiology;12:90–113. .
10. Nitsche-Schmitz D. P., Rohde M., Chhatwal G. S. (2007).Invasion mechanisms of gram-positive pathogenic cocci. Thrombosis and haemostasis;98(3):488–496.
11. Nobbs A. H., Lamont R. J., Jenkinson H. F.(2009). Streptococcus adherence and colonization. Microbiology and Molecular Biology Reviews;73(3):407–450. Table of Contents.
12. Rohde M., Chhatwal G. S.(2013). Adherence and invasion of streptococci to eukaryotic cells and their role in disease pathogenesis. Current Topics in Microbiology and Immunology;368:83–110.
13. Brouwer, S., Barnett, T. C., Rivera‐Hernandez, T., Rohde, M., & Walker, M. J. (2016). Streptococcus pyogenes adhesion and colonization. FEBS letters, 590(21), 3739-3757.
14. Rohde, M., & Cleary, P. P. (2022). Adhesion and invasion of Streptococcus pyogenes into host cells and clinical relevance of intracellular streptococci.
15. Siemens, N., Snäll, J., Svensson, M., & Norrby-Teglund, A. (2020). Pathogenic mechanisms of streptococcal necrotizing soft tissue infections. Necrotizing Soft Tissue Infections: Clinical and Pathogenic Aspects, 127-150.
16. Votsch, D., Willenborg, M., Weldearegay, Y. B., and Valentin-Weigand, P. (2018). Streptococcus suis The "Two Faces" of a pathobiont in the porcine respiratory tract. Front. Microbiol. 9, 480. doi: 10.3389/fmicb.2018.00480.
17. Steinert, M., Ramming, I., and Bergmann, S. (2020). Impact of von willebrand factor on bacterial pathogenesis. Front. Med. 7, 543. doi: 10.3389/fmed.2020.00543.
18. Palmer, C. S., and Kimmey, J. M. (2022). Neutrophil recruitment in Pneumococcal Pneumonia. Front. Cell. Infect. Microbiol. 12, 894644. doi: 10.3389/fcimb.2022.894644.
19. Armistead, B., Oler, E., Adams Waldorf, K., and Rajagopal, L. (2019). The double life of group b Streptococcus: asymptomatic colonizer and potent pathogen. J. Mol. Biol. 431, 2914-2931. doi: 10.1016/j.jmb.2019.01.03.
20. Reissmann, S., Friedrichs, C., Rajkumari, R., Itzek, A., Fulde, M., Rodloff, A. C., et al. (2010). Contribution of Streptococcus anginosus to infections caused by groups C and G streptococci, southern India. Emerg. Infect. Dis. 16, 656-663. doi: 10.3201/eid1604.090448.
21. Bergmann, S., Fulde, M., & Siemens, N. (2022). Streptococci in infectious diseases–pathogenic mechanisms and host immune responses. Frontiers in Microbiology, 13, 2863.
22. Ojha, A.K., Shah, N.P., Mishra, V.(2021). Conjugal transfer of antibiotic resistances in Lactobacillus spp. Curr. Microbiol. 1-11 https:// doi.org/10.1007/s00284-021- 02554-1 .
23. Sahib Russell Issam Ali,2019; Molecular study of some virulence factors among streptococcus pyogenes isolated from patients with pharyngitis; department of Microbiology-College of Medicine/ Babylon University.
24. Jose ,J.J.M.; Brahmadathan ,K. N.; Abraham, V.J.; Huang ,C.Y.; Morens , D.; Hoe,N.P.; Follmann ,D.A. and Krause, R.M. (2018).Streptococcal group A, C and G pharyngitis inschool children: a prospective cohort study in Southern India. Epidemiology and Infection146,848–853.
25. Ameen Hawzheen Mohammed. (2022). Evaluation of Some Immunological Parameters In Secondary Bacterial Infections among COVID-19 Patients In Kirkuk City . College of Education for Pure Sciences University of Kirkuk.
26. Linder, J.A.; Bates ,D.W. and Lee ,G.M. (2005).Antibiotic treatment of children with sore throat. JAMA;294:2354-6.
27. Cohen J, Bertille N, Cohen R, Chalumeau M.(2016). Rapid antigen detection test for group A streptococcus in children with pharyngitis. Cochrane Database of Systematic Reviews.
28. Aljadoa, H.H.(2019). Phenotypic and Genotypic Characterization of some bacterial causing pharyngeal Infections in Babylon Province.
29. Tamimi Zainab Amer Hatem .(2013). Bacteriological and hereditary study of Streptococcus pyogenes isolated from patients with tonsillitis in the city of Muqdadiya, Master Thesis, College of Education for Pure Sciences \ University of Diyala.
30. Alp, F., Findik, D., Dagi, H.T., Arslan, U., Pekin, A.T. and Yilmaz, S.A. (2016). Screening and genotyping of group B streptococcus in pregnant and non-pregnant women in Turkey.The Journal of Infection in Developing Countries, 10(03), pp.222-226.
31. Rasheed Taiseer Safaa Jwad. (2018 ). Molecular Study of Streptococcus agalactiae isolated from pregnant women in Babylon province, Doctor Thesis College of Medicine\ University of Babylon.
32. Bakhtiari, R., Dallal, M.S., Mehrabadi, J.F., Heidarzadeh, S. and Pourmand, M.R.,( 2012). Evaluation of culture and PCR methods for diagnosis of group B streptococcus carriage in Iranian pregnant women. Iranian journal of public health, 41(3), p.65.
33. Hamid, Z.O., Zaki, N.H. and Ali, M.R., (2015). Prevalence of macrolide resistance genes among Group B Streptococci in pregnant women. Int. J. Curr. Microbiol. App. Sci, 4(1), pp.419-436.
34. Abdul-Razzaq, M.S., Al-taee, S.S. and al-khalidi Saleem, A., (2013). Detection of Sortase Enzymes and Cyl operon A and B of Streptococcus Agalactiae by PCR. Medical Journal of Babylon, 10(4), pp.1013-1020.
35. Mashouf, R.Y., Mousavi, S.M., Rabiee, S., Alikhani, M.Y. and Arabestani, M.R. (2014). Direct identification of Streptococcus agalactiae in vaginal colonization in pregnant women using polymerase chain reaction. Journal of Comprehensive Pediatrics, 5(4).
36. Mohammed, H. H. (2022). Assist. Prof. Maitham Abas Makki (Doctoral dissertation, Ministry of Higher Education.
37. Srinivasan R, Karaoz U, Volegova M, MacKichan J, Kato-Maeda M, Miller S and Lynch S V .(2015). Use of16S rRNA gene for identification of a broad range of clinically relevant bacterial pathogens. PloS One 10(2), e0117617.
38. Ibrahim, Hadeel Jalil.(2018). Diagnostic and molecular study of Streptococcus spp isolated from oral and upper respiratory diseases in Baquba city , Master Thesis, Diyala University, College of Education for Pure Sciences Biology Department.
39. Torki Sumyah hasan .(2018).A Study on Streptococcus mutans bacteria isolated from Dental caries infection and comparing the effect of some plant extracts and antibiotics on this bacteria, Master Thesis, Diyala University College of Science.
40. Almasohode M.A.(2016) . Diagnostic study for Streptococcus pyogenes and molecular characterization for some virulence factor in tonsillitis patients .
41. Bose,S.C.; Kumar,V. and Raghavan.S. (2012).Qualitative Analysis of Amoxicillin, Ampicillin, Cephalexinby Quadrupole–Time of Flight (LCMS) Using Electrospray Ionization International .Journal of ChemTech Research CODEN( USA): 1151-1157.
42. Zhang, M., Liu, J., Pan, Y. C., Liu, H. L., Shu, J., Wu, X. M., & Yang, Y. (2023). Analysis of Pathogenic Bacteria and Drug Resistance Among Girls with Bacterial Vaginitis. Infection and Drug Resistance, 1849-1863 .
43. Brandon, M., & Dowzicky, M. J. (2013). Antimicrobial susceptibility among Gram-positive organisms collected from pediatric patients globally between 2004 and 2011: results from the Tigecycline Evaluation and Surveillance Trial. Journal of Clinical Microbiology, 51(7), 2371-2378.
44. ALNaayli Haneen Kadhum Abdul-Hamza.(2019).Assessment of Antagonistic effect of some nanoparticles against Biofilm, and Quorum Sensing Streptococcus agalactiae isolated from pregnant women in Al –Diwaniyah city, AL -Qadisiyah University ,College of Science.
45. Davidson, R.J.(2019). In vitro activity and pharmacodynamic/ pharmacokinetic parameters of clarithromycinand azithromycin: why they matter in thetreatment of respiratory tract infections. Infection and Drug Resistance .12 :585–596.
46. Varaldo, P.E., Montanari, M.P. and Giovanetti, E., (2009). Genetic elements responsible for erythromycin resistance in streptococci. Antimicrobial agents and chemotherapy, 53(2), pp.343-353.
47. Johnson A P .(2015). Surveillance of antibiotic resistance. Phil. Trans. R. Soc. B 370 (1670), 20140080.
48. Haenni , M.; Lupo ,A.; Madec,J-Y.( 2018). Antimicrobial Resistance in Streptococcus spp. ASM Journals/Microbiology Spectrum; Vol. 6, No. DOI: https://doi.org/10.1128/microbiolspec.ARBA-0008-2017.
