Antibiotic Susceptibility Pattern of Staphylococcus aureus Isolates from Different Clinical Samples from Patients at Specialist Hospital Sokoto

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The emergence of multidrug resistance in this organism has left physicians with limited therapeutic options to treat these infections, thus making antimicrobial surveillance very essential. Therefore, this study aimed to determine the antibiotic susceptibility pattern of S. aureus in the Specialist Hospital Sokoto (SHS) in order to provide updated data that were missing from previous limited research works in this community. Methods: This study determined the antibiotic susceptibility patterns of Staphylococcus aureus strains isolated from clinical samples at SHS. A total of 86 clinical samples were collected and processed via standard microbiological techniques, and antibiotic susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines via the Kirby-Bauer disc diffusion method. The data obtained were analyzed via the Statistical Package for Social Sciences (SPSS) Windows version 20. Results: The overall prevalence of S. aureus was 22.1%. The highest prevalence was recorded in wounds (6.98%), followed by urine (4.70%). Children aged 0-10 years had the highest infection rate (9.3%). The S. aureus isolates presented the highest sensitivity to ceftriaxone and streptomycin (63.2% each), ciprofloxacin and rifampicin (57.9% each). Resistance was most pronounced against norfloxacin (89.5%), cefuroxime (73.7%) and amoxicillin (68.4%). Conclusion: This study demonstrated the presence of potential S. aureus isolates in this research setting that were highly resistant to several frequently used first-line antibiotics and some relatively effective options for empirical therapy. Therefore, this study highlights the need for continuous antimicrobial resistance surveillance to help guide effective therapeutic strategies, manage patients with ongoing infections and prevent further spread among people. Staphylococcus aureus antibiotic susceptibility clinical isolates multidrug resistance Nigeria 1.0 Background Staphylococcus species are gram-positive, nonspore-forming bacteria that can grow and survive under aerobic and anaerobic conditions [1]. The Staphylococcus genus comprises more than 47 species and 23 subspecies classified into coagulase-positive and coagulase-negative groups. In the coagulase-positive group, Staphylococcus aureus ( S. aureus ) is known for causing food-borne infections in humans, urinary tract infections (UTIs), soft tissue infections and pneumonia with over one million deaths in 2019 [2, 3]. Coagulase-negative speciessuch as Staphylococcus epidermidis and Staphylococcus haemolyticus also contribute to hospital-associated infections [4]. The transition of Staphylococcus aureus from a harmless commensal to a highly pathogenic organism that causes serious infections reflects its ability for a wide range of diversity [5]. Infections by S. aureus generally progress through several stages, such as colonization, local infection, and systemic spread. Certain factors such as extended hospitalization, immune suppression, and the presence of invasive medical devices—can cause the transition of S. aureus from colonization to active infection even in conditions where the carriers of S. aureus infections are asymptomatic [6, 7]. The pathogenicity of S. aureus can be attributed to its ability to spread both locally and systemically [8]. Localized infections can lead to diseases such cellulitis and abscesses, whereas systemic infections can cause sepsis and serious complications that can affect various organs [9, 10]. Moreover, S. aureus can release extracellular toxins that are associated with gastroenteritis and toxic shock syndrome, thus complicating patient outcomes. Because of the increase in the number of antibiotic-resistant cases, the treatment of infectious diseases has become a major global problem [11]. Multidrug resistance (MDR) can be described as the nonsusceptibility of organism to at least one agent in three or more antimicrobial groups, extreme drug resistance (XDR) is characterized by nonsusceptibility to at least one agent in all but two or fewer antimicrobial categories, and pandrug resistance (PDR) is characterized by nonsusceptibility to all agents in all antimicrobial categories [12]. Multidrug-resistant Staphylococcus aureus (MDRSA) is a global public health challenge. In the last two decades, more efforts have been made globally to address the incessant increase in antibiotic resistance through several methods, including monitoring the use of antibiotics in hospitals [13-15], a well-designed quantitative system for the surveillance of the spread of antimicrobial resistance [16]. This surveillance helps to control changes in microbial populations, allows early detection of any resistant strains of public health concern, and supports the immediate warning and investigation of outbreaks [17]. The emergence of antibiotic resistance in methicillin resistant Staphylococcus aureus (MRSA) strains coupled with the lack of available therapeutic options for managing the MRSA infections remain a grave concern in the healthcare system [18]. Increasing drug resistance in S. aureus and the development of resistance to several drugs such as penicillins, tetracyclines, macrolides and aminoglycosides are now becoming a matter of serious global challenges [19, 20]. Many studies have identified MRSA as one of the major risk pathogens involved in the development of antimicrobial resistance [21]. MRSA is described as a strain of S. aureus that is resistant to a large group of antibiotics called B-lactams which include penicillin and cephalosporin [22]. MRSA is seriously alarming, because it has led to increased rates of morbidity and mortality, including increased healthcare costs [23, 24]. Vancomycin was once seen as a primary remedy for MRSA, but recently, resistance has diminished its efficacy. MRSA has complex mechanisms for developing resistance, including changes in penicillin-binding proteins (PBPs), which prevent methicillin and other β-lactam antibiotics from effectively binding. Additionally, MRSA can acquire resistance genes through horizontal gene transfer. Furthermore, MRSA can upregulate efflux pumps that expel antibiotics from its cells, thus allowing its survival even when the patient is taking the right antimicrobial agents [25, 26]. These changes foster greater demands for innovative treatment approaches. Chemical alterations to existing medications and the investigation of combination therapies have been seen as recent progress in antibiotic development aimed at targeting various bacterial pathways [27-29]. Promising opportunities for addressing the prevalence of MDRSA can be achieved through drug repurposing and the creation of novel classes of antibiotics [30, 27]. Given the clinical relevance of S. aureus and its evolving resistance mechanisms, there is an urgent need to generate local epidemiological data to inform clinical decision-making. Without evidence-based knowledge of current susceptibility patterns, clinicians are left to manage life-threatening infections with increasingly ineffective empirical therapies. 1.1 STATEMENT OF RESEARCH PROBLEM: Antimicrobial resistance (AMR) has been reported to have a worldwide destructive impact on both developing and developed countries worldwide. It is evaluated that AMR infections cause approximately 1.27 million annual deaths [31]. Furthermore, AMR delays disease healing, worsens mortality, and imposes a considerable economic burden as a result of the unexpected additional costs related to prolonged treatment and hospitalization [32]. In developing countries, the impact of AMR is particularly severe because of limited access to second-line drugs, accurate and precise diagnostics, and robust healthcare systems [33]. The main cause of antibiotic resistance in bacteria is prolonged exposure of bacteria to antibiotics; as such, drugs that can synergistically improve antibiotic efficiency are needed [34]. Similarly, the ability to develop resistance to antibiotics rapidly is a major problem encountered in the cure of infections caused by S. aureus in humans. The mechanisms of developing this resistance may involve mobile genetic elements such as plasmids, transposons, bacteriophages, pathogenicity islands, and staphylococcal cassette chromosomes that act as the major process by which genetic information is interchanged among bacteria via horizontal gene transfer [35]. Strains of S. aureus isolated from different clinical settings usually show significant genetic variation, which is the cause of strain variation in physiology and stress response [36]. This involves the emergence of multiple drug-resistant S. aureus strains in hospitals and communities that constitute the basis for hospital-acquired MRSA and community-acquired MRSA infections. The emergence of multidrug resistant (MDR) strains of S . aureus has become a very important global health threat since it has made the treatment of these bacterial infections a great challenge. They are also considered a serious risk in healthcare settings and in community-acquired infections [31]. Since the emergence of MRSA in the 1960s, it has been spread globally and has become a primary cause of bacterial infections in both healthcare and community settings [32]. In Nigeria, the situation is very alarming. Current research studies show increasing rates of MDRSA and MRSA strains in various hospitals across the country, thus contributing to delayed hospital stays, therapeutic inefficiencies, and increased mortality risks [37, 38]. Although some data have evolved from Sokoto State (with a few from Specialist Hospital Sokoto), but the data in this study community are limited and they typically focus on a limited number of isolates, narrow antibiotic coverage, and few sample types, thus making it difficult to draw comprehensive conclusions about local resistance trends [39]. 1.2 JUSTIFICATION OF THE STUDY : Similar studies, although very limited, have been carried out in this research setting and Sokoto state at large; however, unlike these studies, which used limited sample types and few antibiotic panels, our study examined a broader range of samples and antibiotics (some of which were not incorporated in some previous studies) in order to provide a more comprehensive data. Our final results are very crucial as they indicate significant resistance rates to several commonly used first-line drugs in this region and other available options which are very important for facilitating accurate stewardship efforts and empirical therapy in this resource-limited setting. 2.0 MATERIALS AND METHODS 2.1 AIM OF THE STUDY To determine the antibiotic susceptibility pattern of Staphylococcus aureus strains isolated from different clinical samples obtained at Specialist Hospital Sokoto. 2.2 OBJECTIVES OF THE STUDY To determine the prevalence of S. aureus inclinical samples. To isolate and identify S. aureus from different clinical samples. To determine the distribution of S. aureus isolates on the basis of the site of infection, age and sex. To evaluate the antibiotic susceptibility patterns of S. aureus isolates . 2.3 STUDY AREA This study was conducted at Specialist Hospital Sokoto, which is located in Sokoto South Local Government Area of Sokoto State. Sokoto State is in the northwestern geopolitical zone of Nigeria and was carved out of the defunct northwestern state on 3rd February 1976. According to the National Population Commission (2010), population figures stand at 3,702,676 persons spread over an area of 33,776.89 square kilometers of land [37]. 2.4 STUDY POPULATION The study population comprised both inpatients and outpatients attending Specialist Hospital Sokoto. 2.5 STUDY DESIGN An observational cross-sectional study design was used. 2.6 SAMPLE SIZE DETERMINATION The sample size for this study was determined on the basis of the standard formula for prevalence studies [38], with a 95% confidence interval, a prevalence (p) of 95% from a previous study [39], and a 5% margin of error. The minimum sample size calculated was 74, which was later adjusted to 81 to account for a 10% attrition rate. A total of 86 different clinical samples were analysed. 2.7 SAMPLE COLLECTION Clinical samples including urine, blood (blood culture), wound swabs, ear swabs, nasal swabs, high vaginal swabs (HVS), endocervical swabs (ECSs) and cerebrospinal fluid (CSF) were collected from different patients at Specialist Hospital Sokoto and transported to the research laboratory immediately for processing. Relevant demographic and clinical data (age, sex, patient status and diagnosis) were all collected from the laboratory request forms of those patients. 2.8 BACTERIOLOGICAL ANALYSIS All media used in this study were prepared according to the manufacturer's instructions. All collected samples were cultured on blood agar and mannitol salt agar (Oxoid, UK), and then incubated for 16 - 18hrs at 37°C. Standard microbiological techniques such as Gram staining, catalase tests, coagulase tests and mannitol fermentation, were all used for the identification of S. aureus [40]. 2.9 ANTIBIOTIC SUSCEPTIBILITY TESTING Following guidelines set by the Clinical and Laboratory Standards Institute (CLSI), antimicrobial susceptibility was assessed via the Kirby-Bauer disk diffusion method on Mueller - Hinton agar. The inoculum was standardized to the 0.5 McFarland standard (1 - 2×10° CFU/ml). For visual comparison, the inoculum tube and the 0.5 McFarland standards were examined against a card with a white background and contrasting black lines [41]. The antibiotic disks tested in this work included Ceftriaxone, Cotrimoxazole, pefloxacin, levofloxacin, ampicillin + cloxacillin, cefuroxime, amoxicillin, norfloxacin, rifampicin, ciprofloxacin, streptomycin, erythromycin, gentamycin and chloramphenicol. The results of the disk diffusion antibiotic susceptibility test were validated via the results obtained from the control organism ( Staphylococcus aureus ATCC 25923 ) [42]. 2.10 DATA ANALYSIS The results obtained are summarized as frequencies and percentages in the tables. The SPSS Windows version 20 was used to analyse the data. With statistical significance set at p < 0.05, the chi-square (X 2 ) test was used to test associations between variables. 2.11 Ethical considerations Ethical approval for this study was obtained from the Sokoto State Health Research Ethics Committee under the Sokoto State Ministry of Health (Approval No: SMH/1580/V. IV) 2.12 Assisted Writing In some parts of this manuscript, some preliminary text suggestions and phrasing were generated with the assistance of ChatGPT (Large Language Model). All final contents were critically reviewed and fully revised by the authors to reflect the original analysis and interpretation. 3.0 Results In this study, a total of 86 clinical samples were collected from patients attending SHS. The distribution of samples is shown in Table 1 , with wound swabs accounting for the greatest percentage (19.8%), followed by ear swabs (18.6%). Overall, S. aureus was isolated in 19 patients (22.1%), with a higher prevalence rate among males (14.0%) than females (8.1%), but the difference was not statistically significant (X²=7.182, p = 0.304) (Table 2 ). The highest frequency of S. aureus isolates occurred in the 0–10-year age group (9.3%), whereas no isolate was found in patients in the 41–50-year age group or in patients aged 61 years and above; the difference was not statistically significant (X²=8.154, p = 0.773) (Table 3 ). The highest number of isolates was obtained from the wound swabs (6.98%) followed by the urine samples 4(4.7%) (Table 4 ). CLSI interpretations of the susceptibility patterns of S. aureus to antimicrobial agents are shown in Table 5 . Antibiotic susceptibility testing revealed that S. aureus isolates were most sensitive to Ceftriaxone and Streptomycin (63.2% each), followed by Ciprofloxacin and Rifampicin (57.9% each). The highest resistance rates were observed against norfloxacin (89.5%), cefuroxime (73.7%) and amoxicillin (68.4%) (Table 6 ). Table 1 Distribution of clinical samples collected from patients at Specialist Hospital Sokoto Biological Samples Frequency n (%) Urine 13 (15.1) HVS 9 (10.5) ECS 11 (12.8) Wound Swab 17 (19.8) Ear Swab 16 (18.6) Blood Culture 4 (4.7) Nose Swab 8 (9.3) CSF 8 (9.3) Total 86 (100) a Footnote : a Percentages are calculated on the basis of the total number of samples (n = 86) Table 2 Sex distribution of patients with S. aureus infections Sex No. of samples Examined (%) Staph. Aureus Isolates n (%) *X 2 ** p value Male 44 (51.2) 12 (14.0) 7.182 0.304 Female 42 (48.8) 7 (8.1) Total 86 (100) a 19 (22.1) b Footnote : a Percentages are calculated on the basis of the total number of samples (n = 86) b Percentages are calculated based on the S. aureus isolates (n = 19) * chi-square test ** p > 0.05, not statistically significant Table 3 Age distribution of patients with S. aureus infections Age group (years) No. of samples Examined Frequency of isolates n (%) * X 2 ** p value 0–10 18 8 (9.30) 11–20 25 4 (4.70) 21–30 19 3 (3.50) 31–40 11 2 (2.33) 8.154 0.773 41–50 4 0 (0.0) 51–60 8 2 (2.33) 61 and above 1 0 (0.0) Total 86 19 (22.1) a Footnote : a Percentages are calculated based on the S. aureus isolates (n = 19) * chi-square test ** p > 0.05, not statistically significant Table 4 Distribution of S. aureus isolates by specimen type Clinical isolates Frequency n (%) Urine 4 (4.70) HVS 1 (1.20) Blood culture 2 (2.33) Wound swab 6 (6.98) ECS 3 (3.50) Nose swab 2 (2.33) Ear swab 1 (1.20) Total 19 (22.1) a Footnote : a Percentages are calculated based on the S. aureus isolates (n = 19) Table 5 CLSI Interpretation of susceptibility patterns to antimicrobial agents Disc Used Antibiotic Class Sensitive Intermediate Resistant Pefloxacin Fluoroquinolones ≥ 18 15–17 ≤ 14 Gentamycin Aminoglycosides ≥ 15 13–14 ≤ 12 Ampicillin + Cloxacillin Penicillin ≥ 15 12–14 ≤ 11 Cefuroxime Cephalosporin ≥ 18 15–17 ≤14 Amoxicillin Penicillin ≥ 20 16–18 ≤ 19 Ceftriaxone Cephalosporin ≥ 18 15–17 ≤14 Ciprofloxacin Fluoroquinolones ≥21 16–20 ≤ 15 Streptomycin Aminoglycosides ≥ 15 12–14 ≤ 11 Cotrimoxazole Sulfonamides ≥ 15 12–14 ≤ 11 Erythromycin Macrolides ≥ 23 14–22 ≤ 13 Norfloxacin Fluoroquinolones ≥ 17 13–16 ≤ 12 Rifampicin Ansamycins ≥ 20 17–19 ≤ 16 Chloramphenicol Phenicol ≥ 18 13–17 ≤ 12 Levofloxacin Fluoroquinolones ≥ 19 16–18 ≤ 15 Table 6 Antibiotic sensitivity and resistance patterns of Staphylococcus aureus isolates Antibiotic a Sensitive n (%) b Resistant n (%) Pefloxacin Gentamycin Ampicillin + Cloxacillin 8 (42.1) 8 (42.1) 7 (36.8) 11 (57.9) 11 (57.9) 12 (63.2) Cefuroxime 5 (26.3) 14 (73.7) Amoxicillin 5 (26.3) 13 (68.4) Ceftriaxone 12 (63.2) 6 (31.5) Ciprofloxacin 11 (57.9) 8 (42.1) Streptomycin 12 (63.2) 7 (36.8) Cotrimoxazole 10 (52.6) 9 (47.4) Erythromycin 10 (52.6) 9 (47.4) Norfloxacin 2 (10.5) 17 (89.5) Rifampicin 11 (57.9) 8 (42.1) Chloramphenicol 6 (31.5) 12 (63.2) Levofloxacin 10 (52.6) 9 (47.4) Footnote : a Percentages of sensitivity are calculated on the basis of the S. aureus isolates (n = 19) b Percentages of resistance were calculated based on the S. aureus isolates (n = 19). 4.0 Discussion The global increase in antibiotic resistance is increasing rapidly than the development of new drugs, which poses a serious global health threat. The prolonged, inappropriate, and unregulated use of antibiotics is one of the major contributors to the emergence of resistant pathogens rendering some treatments involving these microbial agents ineffective [ 43 ]. S. aureus , is an opportunistic pathogen associated with life-threatening infections leading to prolonged hospitalization, increased antibiotic use, increased healthcare-associated bills, and high morbidity and mortality [ 44 ]. There are numerous reports on the prevalence and antibiotic resistance of S. aureus published in recent years, reflecting the ability of pathogen to resist routinely used antibiotics [ 43 ]. In this study, a total of 86 different clinical samples were collected at Specialist Hospital Sokoto, and the overall prevalence rate was 22.1%. This finding is consistent with other studies in Nigeria, which reported rates of 21.3% [ 45 ] and 21.9% [ 46 ]. Other reports from outside Nigeria also show comparable results such as 28.9% in Cameroon [ 47 ], 23.6% in Ethiopia [ 48 ], and 26.7% in Tanzania [ 49 ]. Although this study reported a relatively lower prevalence than other studies did, this pathogen remains an important clinical and public health concern in Sokoto, particularly in the study community. This variation observed across different studies may be attributed to differences in sample type, study population, diagnostic techniques or local epidemiology. The highest isolation rate of S. aureus in this study (6.98%) was recorded in wound samples, which agrees with findings from studies in Nigeria by Akpudo et al. [ 50 ], who reported the highest prevalence (54.5%) in wound samples and Musa et al. [ 43 ], who reported (26.7%). In contrast, Gaire et al. [ 51 ] reported the highest prevalence (41.8%) in urine samples. The high prevalence rate of this pathogen in wound samples may be explained by the organism’s natural colonization of human mucosa, skin and other body sites, from which it can easily get access to open wounds through direct contact, shared items or poor hygiene practices [ 52 ]. By age-specific analysis, it was observed that children in the 0–10 age group had the highest frequency of S. aureus infections (9.3%). This agrees with the reports from Niger state, Nigeria [ 46 ], where the highest prevalence (25.9%) was also observed in younger age groups (0–17). Conversely, no cases were observed among patients aged 41 years and above, similar to [ 46 ], who also reported a lower prevalence among older adults. The high prevalence observed in this lower age group could be due to their underdeveloped immunity and greater exposure to contaminated surfaces through play activities [ 53 ]. Sex-specific analysis revealed that males accounted for a greater percentage (14.0%) than females did. This finding agrees with that of Kumurya [ 54 ] but contrasts with findings from Minna [ 46 ], Abia [ 55 ] and Zaria [ 50 ], where a higher prevalence was reported in female subjects. These discrepancies may be attributed to the differences in study duration, sample size, and local risk factors [ 50 ]. It is also possible that greater exposure of males to stress, alcohol consumption and accidents may also increase their susceptibility to S. aureus infections [ 53 ]. The development of resistance by S. aureus is very rapid to different antimicrobial agents for quite a period of time. In this study, the S. aureus isolates presented the highest sensitivity to ceftriaxone and streptomycin (63.2% each), followed by ciprofloxacin and rifampicin (57.9% each). This is contrary to the work of Umar et al. [ 56 ], who reported 78.6% resistance to ciprofloxacin and 81.0% susceptibility to rifampicin. However, these results partially agree with those of Bunza et al. [ 57 ], who reported ciprofloxacin as one of the most potent antibiotics that tested susceptible (64.0%) to S. aureus isolates in Sokoto. The highest resistance in this study was observed against norfloxacin (89.5%), followed by cefuroxime (73.7%), then amoxicillin (68.4%), ampicillin + cloxacillin and chloramphenicol (63.2% each). However, similar resistance rates were reported in Abakaliki [ 58 ] and Kenya [ 59 ], where resistance to amoxicillin and penicillin exceeded 90%. The low sensitivity of S. aureus to chloramphenicol, penicillin and fluoroquinolones observed in this study is consistent with earlier reports [ 59 ]. The high prevalence of resistant S. aureus observed in this study may be linked to factors such as self-medication, poor compliance and unregulated access to antibiotics. The use of outdated susceptibility profiles to guide empirical therapy contributes to the persistence of multidrug-resistant S. aureus , which consequently has implications for clinical care and public health, contributing to treatment failure and prolonged hospital stays. The potency of ceftriaxone, streptomycin, ciprofloxacin and rifampicin observed in this study suggests that they should be used as first-line treatment options by physicians for S. aureus infections in this study community. Frequent up-to-date data on MDRSA are very important for promoting and strengthening antimicrobial stewardship, promoting rational prescription practices and implementing continuous local surveillance, which is essential to reduce further escalation. This study has several limitations. Molecular techniques were not employed to detect resistance genes, and the sample size was relatively small, thus making it difficult to generalize these data to all patient populations in this region or beyond. This was due to the nonavailability of funds from any organization, the short timeframe needed to complete the research and the need to increase data availability in this region. Nevertheless, this study provides valuable baseline data in this region, battling the limited up-to-date data needed to inform empirical treatment and highlight the need for multicenter studies incorporating molecular methods in the future. 5.0 Conclusion A prevalence rate of 22.1% among various clinical samples collected at Specialist Hospital Sokoto was demonstrated in this study. This signifies the role of S. aureus as a significant public health threat. Therefore, the best way to regulate S. aureus infections is by performing regular monitoring of antibiotic resistance profiles to help formulate antibiotic policies and effective infection control practices. This study highlights the need for continuous surveillance of antibiotic susceptibility pattern of S. aureus with the goal of selecting appropriate therapies. The results obtained showed that ceftriaxone, streptomycin, ciprofloxacin and rifampicin are recommended as first-line antibiotics which can be used for the management of Staphylococcus aureus infections in this environment. To limit the spread of antibiotic-resistant S. aureus , ongoing surveillance and stricter regulation of antimicrobial distribution should be given a critical consideration. Abbreviations AMR = Antimicrobial resistance CLSI = Clinical and Laboratory Standards Institute CSF = cerebrospinal fluid ECS = Endocervical Swab HVS = High Vagina Swab MDR = Multidrug resistance MDRSA = Multidrug-Resistant Staphylococcus aureus MRSA = Methicillin-resistant Staphylococcus aureus PBPs = penicillin-binding proteins PDR = Pan Drug Resistance SHS = Specialist Hospital Sokoto SPSS = Statistical Package for Social Science UTI = Urinary tract infection XDR = Extreme drug resistance Declarations Funding The authors did not receive support from any organization for the submitted work. Competing Interests The authors declare that they have no competing interests. Ethical Statement and Consent to Participate This study was performed in accordance with the principles of the Declaration of Helsinki. Approval was obtained from the Sokoto State Health Research Ethics Committee - Sokoto State Ministry of Health, Sokoto State, Nigeria (Approval Ref. No. SMH/1580/V. IV, dated 29 April 2021). Written informed consent was obtained from all participants prior to the sample collection. Consent for Publication Not applicable Availability of Data and Materials All datasets generated and analysed during this study are included in this published article. Additional details are available from the corresponding author upon reasonable request. Author Contribution . Conceptualization, supervision and review of the manuscript were carried out by OFA Methodology, data collection, analysis and manuscript writing were equally contributed by MS and SM. All the authors read and approved the final manuscript. Acknowledgement Not applicable References Dugan PR. Bacteria. In: Kreier J. (ed.) Infection, resistance, and immunity, 2nd ed. New York: Routledge; 2022. p. 283–318. Ikuta KS, Swetschinski LR, Aguilar GR, Sharata F, Mestrovic T, Gray AP, et al. 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[Internet]. Research Gate; 2010. Available from: https://www.researchgate.net/publication/216834367_ Escalona A, Hayashi E, Evans M, van Bakel H, Alburquerque B, Dupper AC, et al. Polymicrobial methicillin-resistant Staphylococcus aureus bloodstream infections. Microbiol. Spectr. 2024;12(11); e0108124. doi: 10.1128/spectrum.01081-24. Pal N, Sharma P, Kumawat M, Singh S, Verma V, Tiwari RR, et al. Phage therapy: an alternative treatment modality for MDR bacterial infections. Infect Dis. 2024;56(10): 785-817. doi: 10.1080/23744235.2024.2379492. Sher EK, Džidić-Krivić A, Sesar A, Farhat EK, Čeliković A, Beća-Zećo M, et al. Current state and novel outlook on prevention and treatment of rising antibiotic resistance in urinary tract infections. Pharmacol Ther. 2024;261: 108688. doi: 10.1016/j.pharmthera.2024.108688 Enam G, Sitohy MZ, Awadallah S, Mohammed N. Inhibition of antibiotics-resistant bacteria by naturally modified proteins. Bull Fac Sci. 2024; 2024(3):57-69. doi: 10.21608/BFSZU.2024.250166.1340. Gopikrishnan M, Haryini S. Emerging strategies and therapeutic innovations for combating drug resistance in Staphylococcus aureus strains: a comprehensive review. J. Basic Microbiol. 2024;64(5): e2300579. doi: 10.1002/jobm.202300579. Morales-Durán N, León-Buitimea A, Morones-Ramírez JR. Unravelling resistance mechanisms in combination therapy: a comprehensive review of recent advances and future directions. Heliyon. 2024;10(6): e27984. doi: 10.1016/j.heliyon. 2024.e27984. Olatunji AO, Olaboye JA, Maha CC, Kolawole TO, Abdul S. Next-generation strategies to combat antimicrobial resistance: integrating genomics, CRISPR, and novel therapeutics for effective treatment. Eng Sci Technol J. 2024;5(7): 2284-303. doi: 10.51594/estj. v5i7.1344. Liu Y, Tong Z, Shi J, Li R, Upton M, Wang Z. Drug repurposing for next-generation combination therapies against multidrug-resistant bacteria. Theranostics. 2021;11 (10): 4910-28. doi: 10.7150/thno.56205. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet. 2022;399: 629–55. doi: org/10.1016/ S0140-6736(21)02724-0. Pulingam T, Parumasivam T, Gazzali AM, Sulaiman AM, Chee JY, Lakshmanan M, et al. antimicrobial resistance: Prevalence, economic burden, mechanisms of resistance and strategies to overcome. Eur J Pharm Sci. 2022; 170:106103. doi: 10.1016/j.ejps.2021.106103. Estany-Gestal A, Salgado-Barreira A, Vmvjmazquez-Lago JM. Antibiotic use and antimicrobial resistance: a global public health crisis. Antibiotics (Basel). 2024;13(9): 900 doi: 10.3390/antibiotics13090900 Dusane DH, Kyrouac D, Petersen I, Bushrow L, Calhoun JH, Granger JF, et al. Targeting intracellular Staphylococcus aureus to lower recurrence of orthopedic infection. J Orthop Res. 2018;36(4):1086-92. doi: 10.1002/jor.23723. McGuinness WA, Malachowa N, DeLeo FR. Vancomycin resistance in Staphylococcus aureus . Yale J Biol Med. 2017;90(2):269-81. Sabirova JS, Xavier BB, Hernalsteens JP, De Greve H, Ieven M, Goossens H, et al. Complete genome sequences of two prolific biofilm-forming Staphylococcus aureus isolates belonging to USA300 and EMRSA-15 clonal lineages. Genome Announc. 2014;2(3). doi: 10.1128/genomeA.00610-14. United Nations fund for Population Activities (UNFPA). Population projection and health care services in Sokoto State, Nigeria. 2023 Cochran WG. Sampling Techniques. 3rd Ed. John Wiley & Sons: London; 1999; p. 72-82. Joseph E, Sowniya GE, Olalekan B. Isolation, identification and antimicrobial testing of bacteria from wounds of diabetic patients. Int J curr Microbiol Appl Sci. 2013;2(11): 72-77. Available from: http://www.ijcmas.com Cheesbrough, M. District laboratory practice in tropical countries. Part 2. 2nd ed. Cambridge, Cambridge University Press. 2009. p: 62-70; 105-14. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing, 9th Edition. Determination of minimal inhibitory concentration of anaerobic bacteria by agar dilution and broth micro dilution. CLSI Document M07-A9. Wayne, PA: CLSI; 2012. Clinical and Laboratory Standards Institute. Performance standards of antimicrobial susceptibility testing; twenty-fourth informational supplement. CLSI Document M100-S24. Wayne, PA: CLSI; 2014. p.71. Musa I, Saadu M, Jibril F. Antibiogram and detection of mecA gene among MRSA at Specialist Hospital Sokoto. Microbes Infect Dis. 2022;4(3): 800-08. doi: 10.21608/mid.2022.150608.1350. Akhtar Danesh L, Saiedi-Nejad Z, Sarmadian H, Fooladvand S, van Belkum A, Ghaznavi-Rad E. Elimination of Staphylococcus aureus nasal carriage in intensive care patients lowers infection rates. Eur J Clin Microbiol Infect Dis. 2019;39(2):333-38. doi:10.1007/s10096-019-03729-2. Sunday EA, Ngwai YB, Abimiku RH, Nkene IH, Ibrahim Y, Envuladu EY, et al. antimicrobial resistance profile and quinolone resistance genes in Staphylococcus aureus from patients attending Federal Medical Centre Keffi, Nigeria. Asian J Biochem, Genet Mol Biol. 2020;6(3):15. doi:10.9734/ajbgmb/2020/v6i330151. Mamman GP, Angulu CN, Musa G, Angulu S. Identification and antibiotic susceptibility profile of methicillin and erythromycin resistance genes in clinical and environmental strains of Staphylococcus aureus in Minna. Bayero J Pure Appl Sci. 2022;15(1):195 - 201. doi:10.4314/bajopas. v15i1.28. Bissong M, Wirgham T, Enekegbe M, Niba P, Foka F. Prevalence and antibiotic susceptibility patterns of methicillin resistant Staphylococcus aureus in patients attending the Laquininie hospital Douala, Cameroon. Eur J Clin Biomed Sci. 2016;2(6):92-6. doi: 10.11648/j.ejcbs.20160206.16. Godebo G, Kibu G, Tassew H. Multi drug resistant bacterial isolates in infected wounds at Jimma University specialized hospital, Ethiopia. Ann Clin Microbiol antimicrob. 2013;12(17):1- 7. doi: 10.1186/1476-0711-12-17. Mshana SE, Kanugisha E, Mirambo M, Chalya P, Rambau P. Prevalence of clindamycin-inducible resistance among methicillin-resistant Staphylococcus aureus at Bugando Medical Centre, Mwanza, Tanzania. J Health Res. 2009;11(2): 59-64. doi: 10.4314/thrb. v11i2.45197. Akpudo MO, Jimoh O, Adeshina GO, Olayinka BO. Biofilm formation and antimicrobial susceptibility pattern of Staphylococcus aureus clinical isolates from two healthcare facilities in Zaria. Nig J Pharm Res. 2023;19(1):59-70. doi: 10.4314/njpr. v19i1.6. Gaire U, Thapa Shrestha U, Adhikari S, Adhikari N, Bastola A, Rijal KR. Antibiotic susceptibility, biofilm production, and detection of mecA gene among Staphylococcus aureus isolates from different clinical specimens. Diseases. 2021;9(4):80. doi:10.3390/diseases9040080. Kanaga EL. Antimicrobial susceptibility of bacteria that cause wound sepsis in the pediatric surgical patients at Kenyatta National Hospital. J Health Care Res. 2014; 20(2): 230-40. Available from: http://erepository.uonbi.ac.ke./handle/11295/95412. Emmanuel ON, Magaji SN. Antibiotic sensitivity pattern of Staphylococcus aureus from clinical isolates in a tertiary health institution in Kano, Northwestern Nigeria. The Pan Afr Med J. 2011;8(1):4. doi: 10.4314/pamj. v8i1.71050. Kumurya AS. In vitro activities of 6 antimicrobial agents against bacterial isolates from cases of neonatal meningitis in Kano, Nigeria. UMYU J Microbiol Res. 2017;2(1): 228-31. doi: 10.47430/ujmr.1721.033. Ifediora AC, Nwabueze RN, Amadi ES, Chikwendu CI. Methicillin and inducible clindamycin-resistant Staphylococcus aureus isolates from clinical samples in Abia State. Microbiol Res J Int. 2019; 29(4): 1-9. doi: 10.9734/mrji/2019/v29i430167. Asiya UI, Shuaibu MB, Aliyu BS, Ahmad UF, Yusuf A. Phenotypic identification and distribution of methicillin resistant Staphylococcus aureus from clinical samples in some selected hospital laboratories in Sokoto, Sokoto State, Nigeria. UMYU Scientifica. 2022;1(2):173–9. doi:10.56919/usci.1222.021. Bunza NM, Isah AA, Hafsat MD, Asiya UI. Antibiotic susceptibility pattern of Staphylococcus aureus isolated from clinical samples in Specialist Hospital, Sokoto. South Asian J Res Microbiol. 2019; 3(3): 1-6. doi: 10.9734/sajrm/2019/v3i330085. Ariom TO, Iroha IR, Moses IB, Iroha CS, Ude UI, Kalu AC. Detection and phenotypic characterization of methicillin resistant Staphylococcus aureus from clinical and community samples in Abakaliki, Ebonyi State, Nigeria. Afr health sci. 2019;19(2): 2026-35. doi: 10.4314/ahs. v19i2.26. Wilfred G, Moses M, Tituz M. Antimicrobial susceptibility pattern of Staphylococcus aureus from clinical specimens at Kenyatta National Hospital. BCR Notes. 2018;11(1):226. doi10.1186/s13104-018-2227-2. 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Background","content":"\u003cp\u003e\u003cem\u003eStaphylococcus\u003c/em\u003e species are gram-positive, nonspore-forming bacteria that can grow and survive under aerobic and anaerobic conditions [1]. \u0026nbsp; The \u003cem\u003eStaphylococcus genus\u0026nbsp;\u003c/em\u003ecomprises more than 47 species and 23 subspecies classified into coagulase-positive and coagulase-negative groups. In the coagulase-positive group, \u003cem\u003eStaphylococcus aureus\u003c/em\u003e (\u003cem\u003eS. aureus\u003c/em\u003e) is known for causing food-borne infections in humans, urinary tract infections (UTIs), soft tissue infections and pneumonia with over one million deaths in 2019 [2, 3]. Coagulase-negative speciessuch as\u003cem\u003e\u0026nbsp;Staphylococcus epidermidis\u003c/em\u003e and \u003cem\u003eStaphylococcus haemolyticus\u003c/em\u003e also contribute to hospital-associated infections [4]. The transition of \u003cem\u003eStaphylococcus\u003c/em\u003e aureus from a harmless commensal to a highly pathogenic organism that causes serious infections reflects its ability for a wide range of diversity [5].\u003c/p\u003e\n\u003cp\u003eInfections by \u003cem\u003eS. aureus\u003c/em\u003e generally progress through several stages, such as colonization, local infection, and systemic spread. Certain factors such as extended hospitalization, immune suppression, and the presence of invasive medical devices\u0026mdash;can cause the transition \u003cem\u003eof S. aureus\u003c/em\u003e from colonization to active infection even in conditions where the carriers of \u003cem\u003eS. aureus\u003c/em\u003e infections are asymptomatic [6, 7]. The pathogenicity of \u003cem\u003eS. aureus\u003c/em\u003e can be attributed to its ability to spread both locally and systemically [8]. Localized infections can lead to diseases such cellulitis and abscesses, whereas systemic infections can cause sepsis and serious complications that can affect various organs [9, 10]. Moreover, \u003cem\u003eS. aureus\u003c/em\u003e can release extracellular toxins that are associated with gastroenteritis and toxic shock syndrome, thus complicating patient outcomes.\u003c/p\u003e\n\u003cp\u003eBecause of the increase in the number of antibiotic-resistant cases, the treatment of infectious diseases has become a major global problem [11]. Multidrug resistance (MDR) can be described as the nonsusceptibility of organism to at least one agent in three or more antimicrobial groups, extreme drug resistance (XDR) is characterized by nonsusceptibility to at least one agent in all but two or fewer antimicrobial categories, and pandrug resistance (PDR) is characterized by nonsusceptibility to all agents in all antimicrobial categories [12].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMultidrug-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e (MDRSA) is a global public health challenge. In the last two decades, more efforts have been made globally to address the incessant increase in antibiotic resistance through several methods, including monitoring the use of antibiotics in hospitals [13-15], a well-designed quantitative system for the surveillance of the spread of antimicrobial resistance [16]. This surveillance helps to control changes in microbial populations, allows early detection of any resistant strains of public health concern, and supports the immediate warning and investigation of outbreaks [17].\u003c/p\u003e\n\u003cp\u003eThe emergence of antibiotic resistance in methicillin resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e (MRSA) strains coupled with the lack of available therapeutic options for managing the MRSA infections remain a grave concern in the healthcare system [18]. Increasing drug resistance in \u003cem\u003eS. aureus\u003c/em\u003e and the development of resistance to several drugs such as penicillins, tetracyclines, macrolides and aminoglycosides are now becoming a matter of serious global challenges [19, 20].\u003c/p\u003e\n\u003cp\u003eMany studies have identified MRSA as one of the major risk pathogens involved in the development of antimicrobial resistance [21]. MRSA is described as a strain of \u003cem\u003eS. aureus\u003c/em\u003e that is resistant to a large group of antibiotics called B-lactams which include penicillin and cephalosporin [22].\u003c/p\u003e\n\u003cp\u003eMRSA is seriously alarming, because it has led to increased rates of morbidity and mortality, including increased healthcare costs [23, 24]. Vancomycin was once seen as a primary remedy for MRSA, but recently, resistance has diminished its efficacy. MRSA has complex mechanisms for developing resistance, including changes in penicillin-binding proteins (PBPs), which prevent methicillin and other \u0026beta;-lactam antibiotics from effectively binding. Additionally, MRSA can acquire resistance genes through horizontal gene transfer. Furthermore, MRSA can upregulate efflux pumps that expel antibiotics from its cells, thus allowing its survival even when the patient is taking the right antimicrobial agents [25, 26]. These changes foster greater demands for innovative treatment approaches. Chemical alterations to existing medications and the investigation of combination therapies have been seen as recent progress in antibiotic development aimed at targeting various bacterial pathways [27-29]. Promising opportunities for addressing the prevalence of MDRSA can be achieved through drug repurposing and the creation of novel classes of antibiotics [30, 27]. Given the clinical relevance of \u003cem\u003eS. aureus\u003c/em\u003e and its evolving resistance mechanisms, there is an urgent need to generate local epidemiological data to inform clinical decision-making. Without evidence-based knowledge of current susceptibility patterns, clinicians are left to manage life-threatening infections with increasingly ineffective empirical therapies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.1\u0026nbsp; \u0026nbsp;\u0026nbsp;STATEMENT OF RESEARCH PROBLEM:\u0026nbsp;\u003c/strong\u003eAntimicrobial resistance (AMR) has been reported to have a worldwide destructive impact on both developing and developed countries worldwide. It is evaluated that AMR infections cause approximately 1.27 million annual deaths [31]. Furthermore, AMR delays disease healing, worsens mortality, and imposes a considerable economic burden as a result of the unexpected additional costs related to prolonged treatment and hospitalization [32]. In developing countries, the impact of AMR is particularly severe because of limited access to second-line drugs, accurate and precise diagnostics, and robust healthcare systems [33]. The main cause of antibiotic resistance in bacteria is prolonged exposure of bacteria to antibiotics; as such, drugs that can synergistically improve antibiotic efficiency are needed [34]. Similarly, the ability to develop resistance to antibiotics rapidly is a major problem encountered in the cure of infections caused by \u003cem\u003eS. aureus\u003c/em\u003e in humans. The mechanisms of developing this resistance may involve mobile genetic elements such as plasmids, transposons, bacteriophages, pathogenicity islands, and staphylococcal cassette chromosomes that act as the major process by which genetic information is interchanged among bacteria via horizontal gene transfer [35]. Strains of \u003cem\u003eS. aureus\u003c/em\u003e isolated from different clinical settings usually show significant genetic variation, which is the cause of strain variation in physiology and stress response [36]. This involves the emergence of multiple drug-resistant \u003cem\u003eS. aureus\u0026nbsp;\u003c/em\u003estrains in hospitals and communities that constitute the basis for hospital-acquired MRSA and community-acquired MRSA infections. The emergence of multidrug resistant (MDR) strains of\u003cem\u003e\u0026nbsp;S\u003c/em\u003e. \u003cem\u003eaureus\u003c/em\u003e has become a very important global health threat since it has made the treatment of these bacterial infections a great challenge. They are also considered a serious risk in healthcare settings and in community-acquired infections [31]. Since the emergence of MRSA in the 1960s, it has been spread globally and has become a primary cause of bacterial infections in both healthcare and community settings [32].\u003c/p\u003e\n\u003cp\u003eIn Nigeria, the situation is very alarming. Current research studies show increasing rates of MDRSA and MRSA strains in various hospitals across the country, thus contributing to delayed hospital stays, therapeutic inefficiencies, and increased mortality risks [37, 38]. Although some data have evolved from Sokoto State (with a few from Specialist Hospital Sokoto), but the data in this study community are limited and they typically focus on a limited number of isolates, narrow antibiotic coverage, and few sample types, thus making it difficult to draw comprehensive conclusions about local resistance trends [39].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.2 JUSTIFICATION OF THE STUDY\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eSimilar studies, although very limited, have been carried out in this research setting and Sokoto state at large; however, unlike these studies, which used limited sample types and few antibiotic panels, our study examined a broader range of samples and antibiotics (some of which were not incorporated in some previous studies) in order to provide a more comprehensive data. Our final results are very crucial as they indicate significant resistance rates to several commonly used first-line drugs in this region and other available options which are very important for facilitating accurate stewardship efforts and empirical therapy in this resource-limited setting.\u003c/p\u003e"},{"header":"2.0 MATERIALS AND METHODS","content":"\u003cp\u003e\u003cstrong\u003e2.1 AIM OF THE STUDY\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo determine the antibiotic susceptibility pattern of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e strains isolated from different clinical samples obtained at Specialist Hospital Sokoto.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 OBJECTIVES OF THE STUDY\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eTo determine the prevalence of \u003cem\u003eS. aureus\u003c/em\u003e inclinical samples.\u003c/li\u003e\n \u003cli\u003eTo isolate and identify \u003cem\u003eS. aureus\u003c/em\u003e from different clinical samples.\u003c/li\u003e\n \u003cli\u003eTo determine the distribution of\u003cem\u003e\u0026nbsp;S. aureus\u003c/em\u003e isolates on the basis of the site of infection, age and sex.\u003c/li\u003e\n \u003cli\u003eTo evaluate the antibiotic susceptibility patterns of \u003cem\u003eS. aureus\u0026nbsp;\u003c/em\u003eisolates\u003cem\u003e.\u003c/em\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp id=\"_Toc83398823\"\u003e\u003cstrong\u003e2.3 STUDY AREA\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted at Specialist Hospital Sokoto, which is located in Sokoto South Local Government Area of Sokoto State. Sokoto State is in the northwestern geopolitical zone of Nigeria and was carved out of the defunct northwestern state on 3rd February 1976. According to the National Population Commission (2010), population figures stand at 3,702,676 persons spread over an area of 33,776.89 square kilometers of land [37].\u003c/p\u003e\n\u003cp id=\"_Toc83398824\"\u003e\u003cstrong\u003e2.4 \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSTUDY POPULATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population comprised both inpatients and outpatients attending Specialist Hospital Sokoto.\u003c/p\u003e\n\u003cp id=\"_Toc83398825\"\u003e\u003cstrong\u003e2.5 \u0026nbsp; \u0026nbsp;STUDY DESIGN\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn observational cross-sectional study design was used.\u003c/p\u003e\n\u003cp id=\"_Toc83398826\"\u003e\u003cstrong\u003e2.6\u0026nbsp; \u0026nbsp;\u0026nbsp;SAMPLE SIZE DETERMINATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size for this study was determined on the basis of the standard formula for prevalence studies [38], with a 95% confidence interval, a prevalence (p) of 95% from a previous study [39], and a 5% margin of error. The minimum sample size calculated was 74, which was later adjusted to 81 to account for a 10% attrition rate. A total of 86 different clinical samples were analysed. \u0026nbsp;\u003c/p\u003e\n\u003cp id=\"_Toc83398831\"\u003e\u003cstrong\u003e2.7 SAMPLE COLLECTION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical samples including urine, blood (blood culture), wound swabs, ear swabs, nasal swabs, high vaginal swabs (HVS), endocervical swabs (ECSs) and cerebrospinal fluid (CSF) were collected from different patients at Specialist Hospital Sokoto and transported to the research laboratory immediately for processing. Relevant demographic and clinical data (age, sex, patient status and diagnosis) were all collected from the laboratory request forms of those patients.\u003c/p\u003e\n\u003cp id=\"_Toc83398832\"\u003e\u003cstrong\u003e2.8 BACTERIOLOGICAL ANALYSIS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll media used in this study were prepared according to the manufacturer\u0026apos;s instructions. All collected samples were cultured on blood agar and mannitol salt agar (Oxoid, UK), and then incubated for 16 - 18hrs at 37\u0026deg;C.\u003c/p\u003e\n\u003cp\u003eStandard microbiological techniques such as Gram staining, catalase tests, coagulase tests and mannitol fermentation, were all used for the identification of \u003cem\u003eS. aureus\u0026nbsp;\u003c/em\u003e[40].\u003c/p\u003e\n\u003cp id=\"_Toc83398837\"\u003e\u003cstrong\u003e2.9 ANTIBIOTIC SUSCEPTIBILITY TESTING\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFollowing guidelines set by the Clinical and Laboratory Standards Institute (CLSI), antimicrobial susceptibility was assessed via the Kirby-Bauer disk diffusion method on Mueller - Hinton agar. The inoculum was standardized to the 0.5 McFarland standard (1 - 2\u0026times;10\u0026deg; CFU/ml). For visual comparison, the inoculum tube and the 0.5 McFarland standards were examined against a card with a white background and contrasting black lines [41]. The antibiotic disks tested in this work included Ceftriaxone, Cotrimoxazole, pefloxacin, levofloxacin, ampicillin + cloxacillin, cefuroxime, amoxicillin, norfloxacin, rifampicin, ciprofloxacin, streptomycin, erythromycin, gentamycin and chloramphenicol. The results of the disk diffusion antibiotic susceptibility test were validated via the results obtained from the control organism (\u003cem\u003eStaphylococcus aureus\u0026nbsp;\u003c/em\u003eATCC 25923\u003cem\u003e)\u003c/em\u003e [42].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.10 \u0026nbsp; \u0026nbsp; DATA ANALYSIS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results obtained are summarized as frequencies and percentages in the tables. The SPSS Windows version 20 was used to analyse the data. With statistical significance set at p \u0026lt; 0.05, the chi-square (X\u003csup\u003e2\u003c/sup\u003e) test was used to test associations between variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.11 Ethical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the\u0026nbsp;Sokoto State Health Research Ethics Committee under the Sokoto State Ministry of Health (Approval No: SMH/1580/V. IV)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.12 Assisted Writing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn some parts of this manuscript, some preliminary text suggestions and phrasing were generated with the assistance of ChatGPT (Large Language Model). All final contents were critically reviewed and fully revised by the authors to reflect the original analysis and interpretation.\u003c/p\u003e"},{"header":"3.0 Results","content":"\u003cp\u003eIn this study, a total of 86 clinical samples were collected from patients attending SHS. The distribution of samples is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, with wound swabs accounting for the greatest percentage (19.8%), followed by ear swabs (18.6%). Overall, \u003cem\u003eS. aureus\u003c/em\u003e was isolated in 19 patients (22.1%), with a higher prevalence rate among males (14.0%) than females (8.1%), but the difference was not statistically significant (X\u0026sup2;=7.182, p\u0026thinsp;=\u0026thinsp;0.304) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The highest frequency of \u003cem\u003eS. aureus isolates\u003c/em\u003e occurred in the 0\u0026ndash;10-year age group (9.3%), whereas no isolate was found in patients in the 41\u0026ndash;50-year age group or in patients aged 61 years and above; the difference was not statistically significant (X\u0026sup2;=8.154, p\u0026thinsp;=\u0026thinsp;0.773) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The highest number of isolates was obtained from the wound swabs (6.98%) followed by the urine samples 4(4.7%) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). CLSI interpretations of the susceptibility patterns of \u003cem\u003eS. aureus\u003c/em\u003e to antimicrobial agents are shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. \u003cem\u003eAntibiotic susceptibility testing revealed that S. aureus isolates were most sensitive to\u003c/em\u003e Ceftriaxone and Streptomycin (63.2% each), followed by Ciprofloxacin and Rifampicin (57.9% each). The highest resistance rates were observed against norfloxacin (89.5%), cefuroxime (73.7%) and amoxicillin (68.4%) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of clinical samples collected from patients at Specialist Hospital Sokoto\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBiological Samples\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency n (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13 (15.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHVS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9 (10.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eECS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 (12.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWound Swab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17 (19.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEar Swab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 (18.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlood Culture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4 (4.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNose Swab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (9.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCSF\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 (9.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e86 (100)\u003c/b\u003e \u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003e\u003cb\u003eFootnote\u003c/b\u003e:\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003e\u003csup\u003ea\u003c/sup\u003e Percentages are calculated on the basis of the total number of samples (n\u0026thinsp;=\u0026thinsp;86)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSex distribution of patients with \u003cem\u003eS. aureus\u003c/em\u003e infections\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo. of samples Examined (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eStaph. Aureus\u003c/em\u003e Isolates n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003e*X\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003e** p\u003c/em\u003e value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44 (51.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (14.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.182\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.304\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42 (48.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (8.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e86 (100)\u003c/b\u003e \u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e19 (22.1)\u003c/b\u003e \u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003eFootnote\u003c/b\u003e:\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003ea\u003c/sup\u003e Percentages are calculated on the basis of the total number of samples (n\u0026thinsp;=\u0026thinsp;86)\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eb\u003c/sup\u003e Percentages are calculated based on the \u003cem\u003eS. aureus\u003c/em\u003e isolates (n\u0026thinsp;=\u0026thinsp;19)\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003e*\u003c/sup\u003e chi-square test\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e** \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05, not statistically significant\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAge distribution of patients with \u003cem\u003eS. aureus\u003c/em\u003e infections\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge group (years)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo. of samples Examined\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency of isolates n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e* \u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003e** p\u003c/em\u003e value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e0\u0026ndash;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (9.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u0026ndash;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (4.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e21\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (3.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e31\u0026ndash;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (2.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.154\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.773\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e41\u0026ndash;50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e51\u0026ndash;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (2.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e61 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e86\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e19 (22.1)\u003c/b\u003e \u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003eFootnote\u003c/b\u003e:\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003ea\u003c/sup\u003e Percentages are calculated based on the \u003cem\u003eS. aureus\u003c/em\u003e isolates (n\u0026thinsp;=\u0026thinsp;19)\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003e*\u003c/sup\u003e chi-square test\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e** \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05, not statistically significant\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of \u003cem\u003eS. aureus\u003c/em\u003e isolates by specimen type\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eClinical isolates\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency n (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4 (4.70)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHVS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 (1.20)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBlood culture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (2.33)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWound swab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 (6.98)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eECS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 (3.50)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNose swab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2 (2.33)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEar swab\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 (1.20)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e19 (22.1)\u003c/b\u003e \u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003e\u003cb\u003eFootnote\u003c/b\u003e:\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003e\u003csup\u003ea\u003c/sup\u003e Percentages are calculated based on the \u003cem\u003eS. aureus\u003c/em\u003e isolates (n\u0026thinsp;=\u0026thinsp;19)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCLSI Interpretation of susceptibility patterns to antimicrobial agents\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDisc Used\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAntibiotic Class\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSensitive\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIntermediate\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eResistant\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePefloxacin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFluoroquinolones\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;18\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u0026ndash;17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGentamycin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAminoglycosides\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13\u0026ndash;14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;12\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAmpicillin\u0026thinsp;+\u0026thinsp;Cloxacillin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePenicillin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12\u0026ndash;14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCefuroxime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCephalosporin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u0026ndash;17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;14\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAmoxicillin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePenicillin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16\u0026ndash;18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;19\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCeftriaxone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCephalosporin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u0026ndash;17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;14\u003c/p\u003e \u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCiprofloxacin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFluoroquinolones\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;21\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16\u0026ndash;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStreptomycin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAminoglycosides\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12\u0026ndash;14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCotrimoxazole\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSulfonamides\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;15\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12\u0026ndash;14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eErythromycin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMacrolides\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;23\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14\u0026ndash;22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;13\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNorfloxacin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFluoroquinolones\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;17\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13\u0026ndash;16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;12\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRifampicin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAnsamycins\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17\u0026ndash;19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;16\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChloramphenicol\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhenicol\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;18\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13\u0026ndash;17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;12\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLevofloxacin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFluoroquinolones\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;19\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16\u0026ndash;18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAntibiotic sensitivity and resistance patterns of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolates\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAntibiotic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Sensitive n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e Resistant n (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePefloxacin\u003c/p\u003e\u003cp\u003eGentamycin\u003c/p\u003e\u003cp\u003eAmpicillin\u0026thinsp;+\u0026thinsp;Cloxacillin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (42.1)\u003c/p\u003e\u003cp\u003e8 (42.1)\u003c/p\u003e\u003cp\u003e7 (36.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e11 (57.9)\u003c/p\u003e\u003cp\u003e11 (57.9)\u003c/p\u003e\u003cp\u003e12 (63.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCefuroxime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (26.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e14 (73.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAmoxicillin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (26.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e13 (68.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCeftriaxone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (63.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e6 (31.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCiprofloxacin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 (57.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e8 (42.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStreptomycin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (63.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e7 (36.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCotrimoxazole\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (52.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9 (47.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eErythromycin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (52.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9 (47.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNorfloxacin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e17 (89.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRifampicin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 (57.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e8 (42.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChloramphenicol\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (31.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e12 (63.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLevofloxacin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (52.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e9 (47.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003eFootnote\u003c/b\u003e:\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003ea\u003c/sup\u003e Percentages of sensitivity are calculated on the basis of the \u003cem\u003eS. aureus\u003c/em\u003e isolates (n\u0026thinsp;=\u0026thinsp;19)\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e Percentages of resistance were calculated based on the \u003cem\u003eS. aureus\u003c/em\u003e isolates (n\u0026thinsp;=\u0026thinsp;19).\u003c/p\u003e"},{"header":"4.0 Discussion","content":"\u003cp\u003eThe global increase in antibiotic resistance is increasing rapidly than the development of new drugs, which poses a serious global health threat. The prolonged, inappropriate, and unregulated use of antibiotics is one of the major contributors to the emergence of resistant pathogens rendering some treatments involving these microbial agents ineffective [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cem\u003eS. aureus\u003c/em\u003e, is an opportunistic pathogen associated with life-threatening infections leading to prolonged hospitalization, increased antibiotic use, increased healthcare-associated bills, and high morbidity and mortality [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. There are numerous reports on the prevalence and antibiotic resistance of \u003cem\u003eS. aureus\u003c/em\u003e published in recent years, reflecting the ability of pathogen to resist routinely used antibiotics [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn this study, a total of 86 different clinical samples were collected at Specialist Hospital Sokoto, and the overall prevalence rate was 22.1%. This finding is consistent with other studies in Nigeria, which reported rates of 21.3% [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e] and 21.9% [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. Other reports from outside Nigeria also show comparable results such as 28.9% in Cameroon [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e], 23.6% in Ethiopia [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], and 26.7% in Tanzania [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Although this study reported a relatively lower prevalence than other studies did, this pathogen remains an important clinical and public health concern in Sokoto, particularly in the study community. This variation observed across different studies may be attributed to differences in sample type, study population, diagnostic techniques or local epidemiology.\u003c/p\u003e\u003cp\u003eThe highest isolation rate of \u003cem\u003eS. aureus\u003c/em\u003e in this study (6.98%) was recorded in wound samples, which agrees with findings from studies in Nigeria by Akpudo et al. [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e], who reported the highest prevalence (54.5%) in wound samples and Musa et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e], who reported (26.7%). In contrast, Gaire et al. [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e] reported the highest prevalence (41.8%) in urine samples. The high prevalence rate of this pathogen in wound samples may be explained by the organism\u0026rsquo;s natural colonization of human mucosa, skin and other body sites, from which it can easily get access to open wounds through direct contact, shared items or poor hygiene practices [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eBy age-specific analysis, it was observed that children in the 0\u0026ndash;10 age group had the highest frequency of \u003cem\u003eS. aureus\u003c/em\u003e infections (9.3%). This agrees with the reports from Niger state, Nigeria [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], where the highest prevalence (25.9%) was also observed in younger age groups (0\u0026ndash;17). Conversely, no cases were observed among patients aged 41 years and above, similar to [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], who also reported a lower prevalence among older adults. The high prevalence observed in this lower age group could be due to their underdeveloped immunity and greater exposure to contaminated surfaces through play activities [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSex-specific analysis revealed that males accounted for a greater percentage (14.0%) than females did. This finding agrees with that of Kumurya [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e] but contrasts with findings from Minna [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], Abia [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e] and Zaria [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e], where a higher prevalence was reported in female subjects. These discrepancies may be attributed to the differences in study duration, sample size, and local risk factors [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. It is also possible that greater exposure of males to stress, alcohol consumption and accidents may also increase their susceptibility to \u003cem\u003eS. aureus\u003c/em\u003e infections [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe development of resistance by \u003cem\u003eS. aureus\u003c/em\u003e is very rapid to different antimicrobial agents for quite a period of time. In this study, the \u003cem\u003eS. aureus\u003c/em\u003e isolates presented the highest sensitivity to ceftriaxone and streptomycin (63.2% each), followed by ciprofloxacin and rifampicin (57.9% each). This is contrary to the work of Umar et al. [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], who reported 78.6% resistance to ciprofloxacin and 81.0% susceptibility to rifampicin. However, these results partially agree with those of Bunza et al. [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e], who reported ciprofloxacin as one of the most potent antibiotics that tested susceptible (64.0%) to \u003cem\u003eS. aureus\u003c/em\u003e isolates in Sokoto.\u003c/p\u003e\u003cp\u003eThe highest resistance in this study was observed against norfloxacin (89.5%), followed by cefuroxime (73.7%), then amoxicillin (68.4%), ampicillin\u0026thinsp;+\u0026thinsp;cloxacillin and chloramphenicol (63.2% each). However, similar resistance rates were reported in Abakaliki [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e] and Kenya [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e], where resistance to amoxicillin and penicillin exceeded 90%. The low sensitivity of \u003cem\u003eS. aureus\u003c/em\u003e to chloramphenicol, penicillin and fluoroquinolones observed in this study is consistent with earlier reports [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe high prevalence of resistant \u003cem\u003eS. aureus\u003c/em\u003e observed in this study may be linked to factors such as self-medication, poor compliance and unregulated access to antibiotics. The use of outdated susceptibility profiles to guide empirical therapy contributes to the persistence of multidrug-resistant \u003cem\u003eS. aureus\u003c/em\u003e, which consequently has implications for clinical care and public health, contributing to treatment failure and prolonged hospital stays. The potency of ceftriaxone, streptomycin, ciprofloxacin and rifampicin observed in this study suggests that they should be used as first-line treatment options by physicians for \u003cem\u003eS. aureus\u003c/em\u003e infections in this study community. Frequent up-to-date data on MDRSA are very important for promoting and strengthening antimicrobial stewardship, promoting rational prescription practices and implementing continuous local surveillance, which is essential to reduce further escalation.\u003c/p\u003e\u003cp\u003eThis study has several limitations. Molecular techniques were not employed to detect resistance genes, and the sample size was relatively small, thus making it difficult to generalize these data to all patient populations in this region or beyond. This was due to the nonavailability of funds from any organization, the short timeframe needed to complete the research and the need to increase data availability in this region. Nevertheless, this study provides valuable baseline data in this region, battling the limited up-to-date data needed to inform empirical treatment and highlight the need for multicenter studies incorporating molecular methods in the future.\u003c/p\u003e"},{"header":"5.0 Conclusion","content":"\u003cp\u003eA prevalence rate of 22.1% among various clinical samples collected at Specialist Hospital Sokoto was demonstrated in this study. This signifies the role of \u003cem\u003eS. aureus\u003c/em\u003e as a significant public health threat. Therefore, the best way to regulate \u003cem\u003eS. aureus\u003c/em\u003e infections is by performing regular monitoring of antibiotic resistance profiles to help formulate antibiotic policies and effective infection control practices. This study highlights the need for continuous surveillance of antibiotic susceptibility pattern of \u003cem\u003eS. aureus\u003c/em\u003e with the goal of selecting appropriate therapies. The results obtained showed that ceftriaxone, streptomycin, ciprofloxacin and rifampicin are recommended as first-line antibiotics which can be used for the management of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e infections in this environment. To limit the spread of antibiotic-resistant \u003cem\u003eS. aureus\u003c/em\u003e, ongoing surveillance and stricter regulation of antimicrobial distribution should be given a critical consideration.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAMR = Antimicrobial resistance\u003c/p\u003e\n\u003cp\u003eCLSI = Clinical and Laboratory Standards Institute\u003c/p\u003e\n\u003cp\u003eCSF = cerebrospinal fluid\u003c/p\u003e\n\u003cp\u003eECS = Endocervical Swab\u003c/p\u003e\n\u003cp\u003eHVS = High Vagina Swab\u003c/p\u003e\n\u003cp\u003eMDR = Multidrug resistance\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMDRSA = Multidrug-Resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMRSA = Methicillin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePBPs = penicillin-binding proteins\u003c/p\u003e\n\u003cp\u003ePDR = Pan Drug Resistance\u003c/p\u003e\n\u003cp\u003eSHS = Specialist Hospital Sokoto\u003c/p\u003e\n\u003cp\u003eSPSS = Statistical Package for Social Science\u003c/p\u003e\n\u003cp\u003eUTI = Urinary tract infection\u003c/p\u003e\n\u003cp\u003eXDR = Extreme drug resistance\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive support from any organization for the submitted work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Statement and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was performed in accordance with the principles of the Declaration of Helsinki. Approval was obtained from the\u003cstrong\u003e\u0026nbsp;Sokoto State Health Research Ethics Committee - Sokoto State Ministry of Health, Sokoto State, Nigeria\u0026nbsp;\u003c/strong\u003e (Approval Ref. No. SMH/1580/V. IV, dated 29 April 2021). Written informed consent was obtained from all participants prior to the sample collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll datasets generated and analysed during this study are included in this published article. Additional details are available from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eConceptualization, supervision and review of the manuscript were carried out by OFA\u003c/p\u003e\n\u003cp\u003eMethodology, data collection, analysis and manuscript writing were equally contributed by MS and SM.\u003c/p\u003e\n\u003cp\u003eAll the authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eDugan PR. Bacteria. In: Kreier J. (ed.) Infection, resistance, and immunity, 2nd ed. New York: Routledge; 2022. p. 283\u0026ndash;318.\u003c/li\u003e\n \u003cli\u003eIkuta KS, Swetschinski LR, Aguilar GR, Sharata F, Mestrovic T, Gray AP, et al. 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Prevalence of clindamycin-inducible resistance among methicillin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e at Bugando Medical Centre, Mwanza, Tanzania. J Health Res. 2009;11(2): 59-64. doi: 10.4314/thrb. v11i2.45197.\u003c/li\u003e\n \u003cli\u003eAkpudo MO, Jimoh O, Adeshina GO, Olayinka BO. Biofilm formation and antimicrobial susceptibility pattern of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e clinical isolates from two healthcare facilities in Zaria. Nig J Pharm Res. 2023;19(1):59-70. doi: 10.4314/njpr. v19i1.6.\u003c/li\u003e\n \u003cli\u003eGaire U, Thapa Shrestha U, Adhikari S, Adhikari N, Bastola A, Rijal KR. Antibiotic susceptibility, biofilm production, and detection of mecA gene among \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolates from different clinical specimens. Diseases. 2021;9(4):80. doi:10.3390/diseases9040080.\u003c/li\u003e\n \u003cli\u003eKanaga EL. Antimicrobial susceptibility of bacteria that cause wound sepsis in the pediatric surgical patients at Kenyatta National Hospital. J Health Care Res. 2014; 20(2): 230-40. Available from: http://erepository.uonbi.ac.ke./handle/11295/95412.\u003c/li\u003e\n \u003cli\u003eEmmanuel ON, Magaji SN. Antibiotic sensitivity pattern of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e from clinical isolates in a tertiary health institution in Kano, Northwestern Nigeria. The Pan Afr Med J. 2011;8(1):4. doi: 10.4314/pamj. v8i1.71050.\u003c/li\u003e\n \u003cli\u003eKumurya AS. In vitro activities of 6 antimicrobial agents against bacterial isolates from cases of neonatal meningitis in Kano, Nigeria. UMYU J Microbiol Res. 2017;2(1): 228-31. doi: 10.47430/ujmr.1721.033.\u003c/li\u003e\n \u003cli\u003eIfediora AC, Nwabueze RN, Amadi ES, Chikwendu CI. Methicillin and inducible clindamycin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolates from clinical samples in Abia State. Microbiol Res J Int. 2019; 29(4): 1-9. doi: 10.9734/mrji/2019/v29i430167.\u003c/li\u003e\n \u003cli\u003eAsiya UI, Shuaibu MB, Aliyu BS, Ahmad UF, Yusuf A. Phenotypic identification and distribution of methicillin resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e from clinical samples in some selected hospital laboratories in Sokoto, Sokoto State, Nigeria. UMYU Scientifica. 2022;1(2):173\u0026ndash;9. doi:10.56919/usci.1222.021.\u003c/li\u003e\n \u003cli\u003eBunza NM, Isah AA, Hafsat MD, Asiya UI. Antibiotic susceptibility pattern of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolated from clinical samples in Specialist Hospital, Sokoto. South Asian J Res Microbiol. 2019; 3(3): 1-6. doi: 10.9734/sajrm/2019/v3i330085.\u003c/li\u003e\n \u003cli\u003eAriom TO, Iroha IR, Moses IB, Iroha CS, Ude UI, Kalu AC. Detection and phenotypic characterization of methicillin resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e from clinical and community samples in Abakaliki, Ebonyi State, Nigeria. Afr health sci. 2019;19(2): 2026-35. doi: 10.4314/ahs. v19i2.26.\u003c/li\u003e\n \u003cli\u003eWilfred G, Moses M, Tituz M. Antimicrobial susceptibility pattern of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e from clinical specimens at Kenyatta National Hospital. BCR Notes. 2018;11(1):226. doi10.1186/s13104-018-2227-2.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Staphylococcus aureus, antibiotic susceptibility, clinical isolates, multidrug resistance, Nigeria","lastPublishedDoi":"10.21203/rs.3.rs-7952306/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7952306/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003e\u003cem\u003eStaphylococcus aureus\u003c/em\u003e is a major pathogen associated with both hospital- and community-acquired infections. The emergence of multidrug resistance in this organism has left physicians with limited therapeutic options to treat these infections, thus making antimicrobial surveillance very essential. Therefore, this study aimed to determine the antibiotic susceptibility pattern of \u003cem\u003eS. aureus\u003c/em\u003e in the Specialist Hospital Sokoto (SHS) in order to provide updated data that were missing from previous limited research works in this community.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This study determined the antibiotic susceptibility patterns of\u003cem\u003e Staphylococcus aureus \u003c/em\u003estrains isolated from clinical samples at SHS. A total of 86 clinical samples were collected and processed via standard microbiological techniques, and antibiotic susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines via the Kirby-Bauer disc diffusion method. The data obtained were analyzed via the Statistical Package for Social Sciences (SPSS) Windows version 20.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The overall prevalence of \u003cem\u003eS. aureus\u003c/em\u003e was 22.1%. The highest prevalence was recorded in wounds (6.98%), followed by urine (4.70%). Children aged 0-10 years had the highest infection rate (9.3%). The \u003cem\u003eS. aureus\u003c/em\u003e isolates presented the highest sensitivity to ceftriaxone and streptomycin (63.2% each), ciprofloxacin and rifampicin (57.9% each).\u003c/p\u003e\n\u003cp\u003eResistance was most pronounced against norfloxacin (89.5%), cefuroxime (73.7%) and amoxicillin (68.4%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e This study demonstrated the presence of potential \u003cem\u003eS. aureus\u003c/em\u003e isolates in this research setting that were highly resistant to several frequently used first-line antibiotics and some relatively effective options for empirical therapy. Therefore, this study highlights the need for continuous antimicrobial resistance surveillance to help guide effective therapeutic strategies, manage patients with ongoing infections and prevent further spread among people.\u003c/p\u003e","manuscriptTitle":"Antibiotic Susceptibility Pattern of Staphylococcus aureus Isolates from Different Clinical Samples from Patients at Specialist Hospital Sokoto","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-27 04:52:10","doi":"10.21203/rs.3.rs-7952306/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c3e5370e-3134-4b66-b16e-1ec7d3fc245f","owner":[],"postedDate":"November 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-09T10:39:55+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-27 04:52:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7952306","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7952306","identity":"rs-7952306","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}