Antibiotic resistance trends and species distribution of coagulase negative Staphylococci in a tertiary hospital setting

Authors

  • Rasika D. Alone Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
  • Seema Khetan Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India
  • Sunanda Shrikhande Department of Microbiology, Government Medical College, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253951

Keywords:

Coagulase-negative Staphylococci, VITEK 2, Biofilm, Inducible clindamycin resistance, Antibiotic susceptibility, MRCoNS

Abstract

Background: Coagulase-negative Staphylococci (CoNS) have emerged as significant opportunistic pathogens, especially in nosocomial settings. Their increasing resistance to commonly used antibiotics has heightened the need for species-level identification and susceptibility profiling. Aim of this study was to speciate clinical isolates of CoNS, determine their antibiogram and study biofilm formation.

Methods: In this cross-sectional study, 84 clinically significant CoNS isolates were identified by Standard biochemical tests and VITEK 2 system. Antibiotic susceptibility was determined by Kirby-Bauer disc diffusion method following CLSI (Clinical and laboratory standards institute) guidelines. Biofilm formation was assessed by tissue culture plate (TCP) method.

Results: A total 84 clinically significant CoNS isolates were identified from blood, pus, urine, sterile body fluids and catheter tips.  Out of 84 isolates, S. epidermidis (46.43%) was the most common species, followed by S. haemolyticus (22.61%) and S. saprophyticus (10.71%). Majority of CoNS were isolated from blood culture (57.15%) followed by pus (21.42%) and urine (14.29%). High resistance was observed against penicillin (92.9%), followed by gentamicin (63.1%), and cotrimoxazole (61.9%). The 54.8% isolates were MRCoNS (Methicillin resistant coagulase negative Staphylococci), with 21.42% showing inducible clindamycin resistance (ICR) among the 84 CoNS. All MRCoNS were sensitive to vancomycin and linezolid. Biofilm production was noted in 61.90% of isolates.

Conclusions: Species-level identification and antibiotic resistance profiling of CoNS is crucial in clinical settings to avoid treatment failures. The high prevalence of MRCoNS and biofilm producers necessitates strict infection control and antibiotic stewardship.

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References

Roopa C, Biradar S. Incidence and speciation of coagulase negative Staphylococcus isolates from clinically relevant specimens with their antibiotic susceptibility patterns. Int J Curr Microbiol App Sci. 2015;4(9):975-80.

Singh S, Dhawan B, Kapil A, Kabra SK, Suri A, Sreenivas V, et al. Coagulase-negative Staphylococci causing blood stream infection at an Indian tertiary care hospital: prevalence, antimicrobial resistance and molecular characterisation. Indian J Med Microbiol. 2016;34(4):500-5 DOI: https://doi.org/10.4103/0255-0857.195374

Koksal F, Yasar H, Samasti M. Antibiotic resistance patterns of coagulase-negative Staphylococcus strains isolated from blood cultures of septicemic patients in Turkey. Microbiological Res. 2009;164(4):404-10. DOI: https://doi.org/10.1016/j.micres.2007.03.004

Sangwan J, Kumari S. Isolation, Identification and Antibiogram of Coagulase Negative Staphylococcus (CoNS) Isolated from Various Clinical Samples at a Tertiary Care Teaching Hospital, Jaipur, India. Int J Curr Microbiol App Sci. 2018;7(1):3048-59. DOI: https://doi.org/10.20546/ijcmas.2018.701.362

Chikkaraddi U, Nandihal NW. Clinico-bacteriological profile and antibiogram of Staphylococcus epidermidis with special emphasis on Methicillin resistance and hospital acquired infections in a tertiary care center south India. Indian J Microbiol Res 2022;9(1):34-40 DOI: https://doi.org/10.18231/j.ijmr.2022.006

Usha MG, Shwetha DC, Vishwanath G. Speciation of coagulase negative Staphylococcal isolates from clinically significant specimens and their antibiogram. Indian J Pathol Microbiol. 2013;56:258-60 DOI: https://doi.org/10.4103/0377-4929.120383

Singh NH, Singh R, Chongtham U. Speciation and Antibiotic Susceptibility Pattern of Coagulase Negative Staphylococci in a Tertiary Care Hospital of Manipur, India. J Clin Diagnostic Res. 2022;16:3. DOI: https://doi.org/10.7860/JCDR/2022/55012.16132

Koneman E, Allen S, Janda W. Gram Positive Cocci Part 1: Staphylococci and related Gram-Positive Cocci. In: Koneman's colour atlas and textbook of diagnostic microbiology. 6th ed. Philadelphia: Lippincott Williams and Wilkins. 2006;623-73.

BioMérieux. VITEK® 2: Healthcare. 2024.

CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 32nd ed. CLSI supplement M100. Clinical and Laboratory Standards Institute. 2022.

Paiva RM, Machado AB, Zavascki AP, Barth AL. Vancomycin MIC for methicillin-resistant coagulase-negative Staphylococcus isolates: evaluation of the broth microdilution and test methods. J Clin Microbiol. 2010;48(12):4652-54. DOI: https://doi.org/10.1128/JCM.01182-10

Christensen GD, Simpson WA, Younger JA. Adherence of cogulase negative Staphylococci to plastic tissue cultures: a quantitative model for the adherence of Staphylococci to medical devices. J Clin Microbiol. 1985;22:996-1006. DOI: https://doi.org/10.1128/jcm.22.6.996-1006.1985

Abdel Halim RM, Kassem NN, Mahmoud BS. Detection of Biofilm Producing Staphylococci among Different Clinical Isolates and Its Relation to Methicillin Susceptibility. Open Access Maced J Med Sci. 2018;6(8):1335-41. DOI: https://doi.org/10.3889/oamjms.2018.246

Weinstein MP, Mirrett S, Van Pelt L, McKinnon M, Zimmer BL, Kloos W, et al. Clinical importance of identifying coagulase-negative Staphylococci isolated from blood cultures: Evaluation of microscan rapid and dried overnight gram-positive panels versus a conventional reference method. J Clin Microbiol. 1998;36(7):2089-92. DOI: https://doi.org/10.1128/JCM.36.7.2089-2092.1998

Chavan SP, Jalgaonkar SV, Raut SS, Khadse RK. Clinical and antimicrobial profile of coagulase negative Staphylococci in a tertiary care hospital. Int J Res Med Sci. 2017;5:3420-5. DOI: https://doi.org/10.18203/2320-6012.ijrms20173533

Bora P, Datta P, Gupta V, Singhal L, Chander J. Characterization and antimicrobial susceptibility of coagulase-negative Staphylococci isolated from clinical samples. J Lab Phys. 2018;10(04):414-9. DOI: https://doi.org/10.4103/JLP.JLP_55_18

Kavitha Y, Mohiddin Shaik K. Speciation and Antibiogram of Clinically Significant Coagulase Negative Staphylococci. Int J Health Sci Res. 2014;4(12):157-61.

Raina D, Chandola I, Negi N, Kataria V, Roy R. Prevalence of Coagulase Negative Staphylococcus and their Antibiotic Sensitivity Pattern from Various Clinical Samples. J Pure Appl Microbiol. 2020;14(2):1255-62. DOI: https://doi.org/10.22207/JPAM.14.2.20

Shrestha LB, Bhattarai NR, Khanal B. Comparative evaluation of methods for the detection of biofilm formation in coagulase-negative Staphylococci and correlation with antibiogram. Infect Drug Resist. 2018;11:607-613. DOI: https://doi.org/10.2147/IDR.S159764

Dilip DS, Menon AR. Speciation, Detection of Virulence Factors and Antibiotic Susceptibility of Coagulase Negative Staphylococci. Int J Scientific Res Dental Med Sci. 2021;3(3):122-32.

Mathur P, Singh S. Multidrug resistance in bacteria: a serious patient safety challenge for India. J Lab Physicians. 2013;5(01):05-10. DOI: https://doi.org/10.4103/0974-2727.115898

Oliveira A, Cunha MD. Comparison of methods for the detection of biofilm production in coagulase-negative Staphylococci. BMC Res Notes. 2010;3:1-8. DOI: https://doi.org/10.1186/1756-0500-3-260

Meriem L, Hassaine H, Kaotar N, Bellifa S, M'hamedi I, Ibtissem K, et al. Detection of biofilm formation, icaADBC gene and investigation of toxin genes in Staphylococcus spp. strain from dental unit waterlines, University Hospital Center (UHC) Tlemcen Algeria. Afr J Microbiol Res. 2014;8:559-65. DOI: https://doi.org/10.5897/AJMR2013.6101

Manandhar S, Singh A, Varma A, Pandey S, Shrivastava N. Phenotypic and genotypic characterization of biofilm producing clinical coagulase negative Staphylococci from Nepal and their antibiotic susceptibility pattern. Ann Clin Microbiol Antimicrob. 2021;20:1-1. DOI: https://doi.org/10.1186/s12941-021-00447-6

Raina M, Pandotra P, Salgotra RK, Ali S, Mir ZA, Bhat JA, et al. Genetic engineering and environmental risk. In book Modern age environmental problems and their remediation. 2018;69-82. DOI: https://doi.org/10.1007/978-3-319-64501-8_4

Golia S, Telsang DB, Kamath BAS, Tiwari D. Speciation of clinically significant coagulase negative Staphylococci and their antibiotic resistant patterns in a tertiary care hospital. Int J Res Med Sci. 2015;3:1242-6. DOI: https://doi.org/10.5455/2320-6012.ijrms20150537

Kashid RA, Raghuraman K. Speciation and antimicrobial susceptibility of coagulase negative Staphylococci, isolated from the anterior nares of health care workers, in a tertiary care hospital in South India, with special reference to methicillin resistance. Int J Contemporary Med Res. 2016;3(8):2329-33.

Al-Janabi F, Arif H, Jalal P. A Microbiological Study on Clinical Isolates of Coagulase-Negative Staphylococci (CoNS) from Sulaimaniyah Hospitals. J Zankoy Sulaimani-Part A. 2022;24(1):14-26. DOI: https://doi.org/10.17656/jzs.10866

Nasaj M, Saeidi Z, Asghari B, Ghodratollah R, Mohammad RA. Identification of hemolysin encoding genes and their association with antimicrobial resistance pattern among clinical isolates of coagulase-negative Staphylococci. BMC Res Notes. 2020;13(1):68. DOI: https://doi.org/10.1186/s13104-020-4938-0

Tupakula G, Rao RK, Ravindranadh G, Varshith GV. Prevalence, speciation and antibiotic resistance profiles of coagulase negative Staphylococci isolates from clinical samples. J Evolut Med Dental Sci. 2017;6(26):2134-7. DOI: https://doi.org/10.14260/Jemds/2017/463

Thapa S, Bahadur LB. Prevalence of inducible clindamycin resistance in erythromycin resistant clinical isolates of Staphylococcus aureus and CoNS at tertiary care hospital. JCMS Nepal. 2016;12(3):83-88. DOI: https://doi.org/10.3126/jcmsn.v12i3.16011

Yilmaz G, Aydin K, Iskender S, Caylan R, Koksal I. Detection and prevalence of inducible clindamycin resistance in Staphylococci. J Med Microbiol. 2007;56:342-5. DOI: https://doi.org/10.1099/jmm.0.46761-0

Kalbhor P, Wanjare V, Shrikhande S. Species distribution and antimicrobial resistance pattern of coagulase-negative Staphylococci with special reference to inducible clindamycin resistance. Int J Sci Res. 2019;8(3):73-6.

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Published

2025-11-28

How to Cite

Alone, R. D., Khetan, S., & Shrikhande, S. (2025). Antibiotic resistance trends and species distribution of coagulase negative Staphylococci in a tertiary hospital setting. International Journal of Research in Medical Sciences, 13(12), 5286–5292. https://doi.org/10.18203/2320-6012.ijrms20253951

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Original Research Articles