Resistance Pattern and Virulence Factors of CoNS Isolates from Sepsis Associated Acute Kidney Injury

Document Type : New and original researches in the field of Microbiology.

Authors

1 Medical Microbiology & Immunology Department, Faculty of Medicine, Damietta University

2 Mansoura Faculty of Medicine, Mansoura University, Damietta, Egypt

3 Urology and Nephrology Center, Mansoura University – Mansoura, Egypt.

4 Internal Medicine Department, New Mansoura General Hospital

5 Mansoura Nephrology and Hemodialysis Unit, Mansoura University, Mansoura, Egypt

Abstract

Background: Acute kidney injury (AKI) is among the most frequent complications of sepsis. Objectives: This study evaluated the antibiotic resistance pattern and virulence factors; slime production and staphylococcal enterotoxins genes of CoNS isolates recovered from blood of sepsis patients with AKI. Methodology: Blood samples were collected from patients diagnosed as sepsis and AKI from October 2018 to September 2020 in Mansoura University Main and New Generalized Hospitals. Blood cultures were done and the isolates were identified by MALDI-TOF Biotyper™. Antibiotic testing was done by the disc diffusion test for CoNS isolates. Slime production and staphylococcal enterotoxins, toxic shock syndrome toxin (tsst) and mec A genes were evaluated. Results: A total of 73 patients diagnosed as sepsis with AKI were enrolled in this research; 21 had positive blood cultures, with 66.7% Gram positive bacteria. All cases with Gram-negative bacterial blood culture were significantly complicated with chronic kidney disease compared to 42.9% of Gram-positive bacterial blood cultures (p = 0.01). Eleven out of 14 Gram-positive bacterial blood cultures were CoNS strains; seven S. haemolyticus, three S. epidermidis and one S. hominis strains. All CoNS isolates were sensitive to vancomycin and linezolid. Eight (72.7%) CoNS isolates had mecA gene. About 63.6% of CoNS strains were slime producers. Enterotoxin gene sec was the predominant among the isolates of CoNS (36.4%). Conclusion: S. haemolyticus was the most frequent isolated species from blood of patients with sepsis associated AKI. Majority of CoNS strains had mecA gene and were slime producers. Sec gene was the most often detected enterotoxin gene.

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