Prevalence and antibiotic resistance patterns of coagulase-negative staphylococci isolated from hemodialysis patients

Document Type : Research Paper

Authors

1 Department of Biology, College of Education, University of Al-Qadisiyah, Al-Qadisiyah, Iraq.

2 Department of Medical and Basic Sciences, College of Nursing, University of Al-Qadisiyah, Al-Qadisiyah, Iraq

10.22103/jab.2025.25294.1716

Abstract

Objective
Coagulase-negative staphylococci (CoNS) have emerged as meaningful nosocomial pathogens, exclusively in immunocompromised populations like hemodialysis patients, due to their biofilm-forming capabilities and multidrug resistance. This investigation aimed to identify the prevalence and antibiotic resistance patterns of CoNS extracted from hemodialysis patients to inform targeted infection control strategies.
Materials and methods
Venous blood samples were gathered from 100 hemodialysis patients at AL-Diwaniyah General Hospital applying sterile syringes. Samples were cultured on mannitol salt agar and blood agar to isolate bacterial colonies. Isolates underwent Gram staining to affirm purity, morphology, and Gram-positive status. Coagulase-negative staphylococci (CoNS) were identified via coagulase testing, and species were affirmed by PCR amplification of the 16S rRNA gene applying primers 27F (5'-AGAGTTTGATCMTGGCTCAG-3') and 1492R (5'-TACGGYTACCTTGTTACGACTT-3'). Antibiotic susceptibility to amoxicillin, cefotaxime, ceftriaxone, gentamicin, levofloxacin, imipenem, meropenem, ciprofloxacin, and doxycycline was evaluateed applying the Kirby-Bauer disk diffusion method, following Clinical and Laboratory Standards Institute (CLSI) guidelines. Inhibition zone diameters were measured after 24-hour incubation at 37°C and interpreted per manufacturer standards.
Results
Of 100 clinical specimens from hemodialysis patients, 54% (54/100) tested positive for coagulase-negative staphylococci (CoNS). Staphylococcus epidermidis was the most prevalent species, constituting 51.85% (28/54) of isolates, followed by Staphylococcus saprophyticus (20.37%, 11/54), Staphylococcus hominis (16.67%, 9/54), and Staphylococcus haemolyticus (11.11%, 6/54). All S. epidermidis isolates exhibited 100% resistance to amoxicillin, with high resistance rates to gentamicin (89.28%), ceftriaxone (78.57%), cefotaxime (71.42%), levofloxacin (75%), imipenem (50%), and meropenem (50%). S. saprophyticus isolates showed lower resistance, with 72.72% resistant to amoxicillin, 54.54% to cefotaxime and ceftriaxone, 81.81% to gentamicin, and 63.63% to levofloxacin. S. hominis and S. haemolyticus demonstrated variable resistance patterns, with 66.67%–88.89% and 50%–83.33% resistance, respectively, across the tested antibiotics. Multidrug resistance (resistance to ≥3 antibiotic classes) was observed in 64.81% (35/54) of CoNS isolates.
Conclusions
These results necessitate the implementation of robust infection control measures, containing enhanced catheter care protocols, regular surveillance of resistance patterns, and antimicrobial stewardship programs to optimize antibiotic apply. Additionally, the variable resistance profiles of S. hominis and S. haemolyticus suggest the need for species-specific therapeutic approaches. Future research should centralize on elucidating the molecular mechanisms of resistance and exploring alternative treatments, like novel antimicrobials or biofilm-disrupting agents, to mitigate the risk of CoNS-related infections in clinical settings.

Keywords

References

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Agricultural Biotechnology Journal
Volume 17, Issue 3
August 2025
Pages 95-112

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