Macrolide resistance in Staphylococcus from COVID-19 patients in Santander
DOI:
https://doi.org/10.15649/cuidarte.4924Keywords:
Co-infection, COVID-19, Macrolides, Antibiotic ResistanceAbstract
Highlights
- High prevalence of macrolide-resistant Staphylococcus aureus and Staphylococcus epidermidis in hospitalized COVID-19 patients in Santander, Colombia.
- Predominant identification of ermB and ermT resistance genes, highlighting their relevance in macrolide resistance among Gram-positive cocci.
- S. epidermidis, typically not associated with respiratory infections, was detected in co-infections, suggesting an opportunistic role in hospital environments.
- Findings support the urgent need to implement antibiotic stewardship practices in high vulnerability healthcare settings.
Introduction: Intensive use of macrolides, such as azithromycin, during the COVID-19 pandemic has facilitated the development of antimicrobial resistance in Gram-positive bacteria through multiple resistance mechanisms, including ribosomal RNA modification, efflux pumps, and enzymatic inactivation. Objective: To describe the prevalence of resistance genes in bacteria isolated from COVID-19 patients in Santander, Colombia. Materials and Methods: A descriptive study was conducted on 112 stored samples from nasopharyngeal and oropharyngeal swabs and tracheal aspirates collected from hospitalized COVID-19 patients in 2020, from which 48 Gram-positive strains were isolated. Macrolide resistance and the presence of the ermA, ermB, ermT, and mef(A/E) genes were evaluated through phenotypic and molecular tests. Results: Staphylococcus aureus was the most prevalent species at 58.33% (28), followed by Staphylococcus epidermidis at 31.25% (15). A total of 47.92% (23) of the strains showed phenotypic resistance to azithromycin, and 81.25% (39) displayed genotypic resistance, with ermB being the most prevalent at 58.33% (28) and ermT at 45.83% (22), with no detection of mef(A/E). Discussion: These findings reveal a high prevalence of macrolide resistance, which may be related to the extensive use of these antibiotics during the pandemic. Conclusions: The increase in macrolide resistance among Gram-positive bacteria represents a critical public health challenge, especially in the context of pandemics. These results underscore the urgent need to implement control measures in antibiotic use.
How to cite this article: Santos-Angarita Michael J, Arias Guerrero Monica Y, Parada-Diaz Andrea J; Bravo Granados Natalia A, Alfonso Vargas Nadia C, Trejos-Suárez Juanita. Macrolide resistance in Staphylococcus from COVID-19 patients in Santander. Revista Cuidarte. 2025;16(3):e4924. https://doi.org/10.15649/cuidarte.4924
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