Quarter-wise proportion and beta-lactam resistance rate of bovine mastitis associated- Staphylococcus aureus among infectious episodes in Ethiopia: Systematic review and meta-Analysis

BACKGROUND

Bovine mastitis, a condition with multifactorial etiology, imposes a significant economic burden on the dairy sector in Ethiopia, with Staphylococcus aureus (S. aureus) being one of the leading etiologic agents. The acquisition of a compiled source of information concerning S. aureus is imperative in order to enhance the control and prevention strategies, as well as to facilitate the successful implementation of the national action plan aimed at curbing antimicrobial resistance by the year 2025. Thus, the primary objective of this meta-analysis was to comprehensively summarize the estimates of the proportion and beta-lactam resistance profile of S. aureus in bovine mastitis in Ethiopia.

METHODS

electronic bibliographic data such as PubMed, Web of Science, HINARI, Google Scholar, and other databases were used to search articles and quality assessment was performed using the AMSTAR-2. The pooled proportion, the rate of beta-lactam resistance, and a 95% confidence interval were calculated with a random effects model using STATA 17 statistical software. Funnel plots, and Eggers were used to assess publication bias.

RESULTS

Twenty-six (26) cross-sectional studies were included in this meta-analysis. The overall pooled proportion of S.aureus was 35% (95% CI: 0.31 to 0.41). Considerable heterogeneity was observed in the included studies (I2 = 90.75%; P < 0.01). The subgroup analysis of the study region showed significant differences. The highest estimated regional pooled proportion of bovine mastitis-associated S.aureus was 40% in the Amhara and Tigray regions. Funnel plot and Eggers results showed no statistically significant publication bias (Eggers test: p = 0.5656) in estimating the proportion of S.aureus infections in association with bovine mastitis. A total of 14 articles were included to estimate beta-lactam antimicrobial resistance. The estimated pooled beta-lactam antimicrobial resistance rate of S.aureus was resistance to penicillin at 75%, followed by amoxicillin at 67%, ampicillin at 50% and cephalosporin at 57% were evaluated in the treatment of S. aureus. Therefore, the present meta-analysis has revealed that the prevalence of bovine-associated Staphylococcus aureus and its resistance to beta-lactam antibiotics are alarmingly high in the region of Ethiopia. This further emphasizes the vital necessity of implementing effective preventive measures to reduce the incidence and spread of this pathogen across the entire nation.

Comparison between Some Phenotypic and Genotypic Methods for Assessment of Antimicrobial Resistance Trend of Bovine Mastitis Staphylococcus aureus Isolates from Bulgaria

Simple Summary

The aim of the study was to assess the resistance of bovine mastitis Staphylococcus aureus isolates to antimicrobials by comparison of laboratory methods and statistical analysis. For this, 546 mastitis milk samples at 14 farms from 9 districts in Bulgaria were examined. A total of 92 Staphylococcus aureus strains were isolated and identified. The results showed high resistance to sulfadimethoxine (87%), followed by resistance to penicillin (33.7%), erythromycin (13%), streptomycin (8.7%), tetracycline (6.5%) and gentamicin (1.1%). The comparison of the methods demonstrated more than 90% agreement for 9 tested antimicrobial drugs, hence proving reliability of results from monitoring of resistance. Considering the detected discrepancies for some of isolates, an integral evaluation through standard and modern molecular methods for Staphylococcus aureus is recommended. The results from this study add to the microbiology laboratory experience and strategies for mastitis prevention and control programmes.

Abstract

The aim of this study was to assess the resistance of bovine mastitis S. aureus isolates from farms in Bulgaria to different classes of chemotherapeutic drugs by comparison of some phenotypic and genotypic methods by means of Cohen’s kappa statistics. The study comprised 546 milk samples from subclinical and clinical mastitis at 14 farms from 9 districts in the country. A total of 92 Staphylococcus aureus strains were isolated from tested samples and identified by nuc PCR. The results demonstrated high levels of resistance to sulfadimethoxine (87%), followed by resistance to penicillin (33.7%), erythromycin (13%), streptomycin (8.7%), tetracycline (6.5%) and gentamicin (1.1%). The comparison of both phenotypic tests with respect to 9 antimicrobials revealed strong agreement with kappa coefficient 0.836. An almost complete agreement was evidenced between phenotypic resistance to penicillin and blaZ gene presence, to methicillin with mecA gene, to tetracycline with tet genes, but the agreement between erythromycin resistance and erm genes presence was moderate. This study was the first to demonstrate discrepancy between the behaviour to cefoxitin in the disk diffusion test and oxacillin in the MIC test for an isolate shown to carry the mecA gene in the subsequent genetic analysis. Considering the detected discrepancies for some of isolates, an integral evaluation through phenotypic and molecular methods for monitoring of antimicrobial resistance of Staphylococcus aureus is recommended.

Antibiotic resistance and phylogenetic comparison of human, pet animals and raw milk Staphylococcus aureus isolates

The present study was conducted to compare the S. aureus isolates from different sources in the basis of resistance phenotypic and genotypic features and phylogenetic differences. Total of 70 S. aureus isolates (including 25 human, 25 raw milk and 20 pet animal isolates) were subjected to the antimicrobial susceptibility testing, polymerase chain reaction (PCR) detection of the resistance genes and DNA fingerprinting using random amplification of polymorphic DNA-PCR (RAPD-PCR) to survey the variability of the isolates. Among 70 S. aureus, 55 (78.5%) isolates were MRSA. The isolates showed the highest antibiotic resistance to methicillin, ampicillin and penicillin (78.5%) and showed the lowest resistance to ciprofloxacin (12.8%). ErmB and tetM resistance genes were present in all isolates and the vanA gene was not detected in any of the isolates. Thirteen distinct clusters were identified in RAPD-PCR fingerprinting. Statistical analysis showed that the isolates without resistance to antibiotics were significantly in associated with raw milk origin (P < 0.05). According to the results of the study, S. aureus strains with pets and raw milk origin are significant sources of antibiotic-resistant isolates such as MRSA. They are also carriers of resistance genes that can be transmit to human isolates and cause drug resistance in human infections. Identifying the source of these infections is possible with a reliable genotyping method such as RAPD-PCR.