Antibiotic resistance profile of Staphylococcus aureus isolated fromhealth facilities in Conakry

Antibiotic resistance profile of Staphylococcus aureus isolated fromhealth facilities in Conakry | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Antibiotic resistance profile of Staphylococcus aureus isolated fromhealth facilities in Conakry Mamadou Bobo DIALLO, Jean Selle BAVOGUI, Almamy Amara TOURE, Tiany SIDIBE, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8522464/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction : Staphylococcus aureus is a major public health issue, particularly due to the emergence of methicillin-resistant strains (MRSA). Little data are available on the resistance profile of Guinea. This study aimed to determine the prevalence, phenotypic distribution, and factors associated with the resistance of S. aureus strains isolated in Conakry. Methods : A descriptive cross-sectional study was conducted from January 2023 to December 2024 atfour microbiological diagnostic facilities in Conakry. A total of 238 clinical specimens positive for S. aureus were included. Isolations were identified by conventional and Vitek2 methods, and sensitivity profiles were established according to CASFM/EUCAST recommendations. Sociodemographic and microbiological data were analyzed with SPSS 26. Proportions were compared by chi-square or Fisher's exact test, with a significance threshold of p < 0.05. Results : Among the 238 isolates, 68.1% were MRSA, 21.8% were penicillinase producers and 10.1% were wild-type strains. Resistance to penicillin G was almost universal (99%), and resistance to oxacillin (79%), tetracycline (72%) and ciprofloxacin (50%) was high. Glycopeptides (vancomycin 99% sensitivity), linezolid and tigecycline remained active. The incidenceof MRSA was significantly greater in the hospital setting (74.2%) than in the community setting (57.5%; p = 0.027). Penicillinase producers were evenly distributed, while wild strains were rare (12.6% in the community vs. 8.6% in hospitals). Conclusion : The high prevalence of MRSA infection, particularly in hospital settings, combined with significant circulation in the community underlines the urgency of strengthening integrated hospital-community surveillance, improving infection control and promoting the rational use of antibiotics in Guinea. Bacteriology General Microbiology Methicillin-resistant Staphylococcus aureus Antibiotic resistance MRSA Guinea Figures Figure 1 Figure 2 Figure 3 Introduction Staphylococcus aureus infections are a major public health problem worldwide, both in community and hospital settings. This opportunistic bacterium is responsible for a wide spectrum of infections, ranging from superficial skin infections to severe sepsis and osteoarticular infections [ 1 , 2 ]. The emergence of methicillin-resistant strains (MRSA) represents a major challenge due to their associated multidrug resistance and the therapeutic difficulties they cause [ 3 ]. According to World Health Organization (WHO) reports, the incidence of MRSA varies greatly from region to region, with high rates observed in Africa and Asia [ 4 , 5 ]. A recent meta-analysis showed that the average incidence of MRSA in sub-Saharan Africa was above 40%, with wide variability across countries [ 6 – 9 ]. Regional studies have shown high MRSA incidence rates—36% in Benin [ 10 ], 32% in Burkina Faso [ 11 ], 66% in Mali [ 12 ], and up to 80% in a study of healthcare-associated infections in Conakry [ 13 ]. Methicillin resistance is of particular concern, as it severely limits treatment options, leaving room for the use of last-resort antibiotics such as vancomycin [ 14 ]. The emergence and spread of multidrug-resistant strains are driven by inappropriate antibiotic use, lack of systematic microbiological surveillance, and gaps in infection control in hospital settings [ 15 , 16 ]. Despite the establishment of some surveillance programmes in several African countries (Burkina Faso, Nigeria, Senegal, Kenya, etc.), the available data are limited, heterogeneous and often not very representative [ 17 ]. In this context, it becomes imperative to regularly assess the resistance profiles of local S strains. aureus to adapt therapeutic protocols and prevention policies. The present study aimed to determine the prevalence of Staphylococcus aureus strains isolated in Conakry as well as their resistance profile to other antibiotics. Materials and Method 1. Type and setting of study 1.1 Type and period of study This was a cross-sectional descriptive study conducted over a period of two (2) years, from January 2023 to December 2024, on the analysis of clinical samples (urine, blood, puncture fluid and pus). 1.2 Study Setting: The data for this study were collected from four major structures with a national scope and located mainly in Conakry. These establishments were selected because of their central role in microbiological diagnosis and their representativeness of the different health contexts: hospital, community, institutional and private. National Institute of Public Health (INSP) The National Reference Laboratory is responsible for the surveillance and diagnosis of epidemic diseases and has modern microbiology and biosafety infrastructures (at the P2 level). Donka University Hospital Center (CHU) Donka University Hospital, Guinea's main university hospital, is a reference center for the management of complex cases and a major player in the surveillance of nosocomial infections. Biomar-24 Laboratory Biomar-24, located in the commune of Dixinn, is the first private laboratory in Guinea with advanced technologies, particularly in chemiluminescence for biological diagnostics. National Social Security Fund (CNSS) Although the CNSS is mainly in charge of managing the social security scheme for Guinean workers, it also has active medicosocial services. The latter carries out health check-ups and biological samples for the health monitoring of members. 2. Study population and sampling All the clinical samples (urine, blood, CSF, and puncture fluid) were sent for suspected bacterial infection. 2.1 Inclusion criteria All specimens for which Staphylococcus aureus strains were isolated and whose records contained complete information necessary for the analysis (age, sex, type of specimen, antimicrobial susceptibility test result) were included. 2.2 Noninclusion criteria The noninclusion criteria used in this study excluded the following: Samples contaminated with commensal flora or polymicrobial bacteria cannot be interpreted in the clinical context. The absence of isolation of Staphylococcus aureus . Incomplete files that did not allow analysis (age, sex, type of sample, missing antibiogram). 2.3 Sampling and sample size The sample was comprehensive, and the sample size was 538 clinical samples that met the inclusion criteria. 3. Study variables These variables were grouped into two categories: Sociodemographic variables (age, sex, hospital or community origin) were collected. Microbiological variables (isolated species, resistance profile, phenotype). 4. Microbiological analysis techniques 4.1 Sample collection and transport: Urine: medium stream after local washing; Delivery≤2 hrs (or 2-8°C ≤24 hrs) Blood: The collection of aerobic and anaerobic blood culture vials under conditions of rigorous asepsis and incubation in an automated system Pus/CSF/puncture fluids: Sampling was performed in sterile vials, and transport was performed immediately. 4.2 Isolation, identification and antibiotic susceptibility testing Classical bacteriological methods were used, namely, direct examination; isolation on Chapman's agar medium; ClED; and blood or chocolate agar depending on the sample type. Identification was based on morphological and biochemical characteristics: smooth, rounded, yellow or nonyellow "S" type colonies; gram-positive cocci in clusters; optional aeranaerobic bacteria; presence of catalase; and confirmation of the Vitek2 compact PLC. Antibiotic susceptibility tests were performed on the Viteck 2compact automaton according to the recommendations of the French Society of Microbiology (CASFM/EUCAST) [18]. The reference strain S. aureus strain ATCC 6538 was used as an internal control. 5. Statistical analysis The data were entered into Kobocollect software version 1.25.1 and then exported and processed in Microsoft 365. The statistical analysis was performed using SPSS version 26 (SPSS, Inc., Chicago, IL, USA). Statistical tests (χ² or Fisher's exact test) were used to compare proportions, with a significance threshold set at p < 0.05. Quantitative variables such as age are presented as medians. Qualitative variables (sex, resistance phenotype, etc.) are presented as frequencies and are expressed as percentages. Results A total of 238 patients were included in the study. The proportion of males (56.3%) was slightly greater than that of females (43.7%) (Table 1). The mean age of the patients was 27.9 ± 10.7 years, with a predominance of the 21–40 age group (32.3%), followed by the 1–20 years (29.8%), 41–60 years (23.9%), and 61 years of age (13.9%). Table 1: Sociodemographic characteristics of the patients ( n = 238) Characteristics Number (N=238) Percentage Sex Feminine 104 43,70% Masculine 134 56,30% Age range 1- 20 71 29,83% 21-40 77 32,35% 41-60 57 23,95% >61 years old 33 13,87% Average age (SD ±) 27,9 ± 10,7 Sensitivity analysis of the 238 strains of S. aureus revealed near-universal resistance to penicillin G (99%) and high resistance to oxacillin (79%), reflecting a high proportion of MRSA (Table 2). Strong resistance was observed for tetracycline (72%), ciprofloxacin (50%), gentamicin (43%) and trimethoprim-sulfamethoxazole (43%). In contrast, vancomycin (1% resistance), linezolid (7%), tigecycline (7%) and teicoplanin (2%) remained largely active. Table 2: Antibiotic resistance patterns of S. aureus strains Antibiotics Resistance fighters (%) N=238 Penicillin G 99% Oxacilline 79% Gentamicin 43% Erythromycin 38% Clindamycine 22% Quinupristine-Dalfopristine 8% Ciprofloxacin 50% Moxifloxacin 42% Levofloxacin 36% Tetracycline 72% Tigecycline 7% Linezolide 7% Nitrofurantoin 4% Teicoplanin 2% Vancomycine 1% Trimethoprim-Sulfamethoxazole 43% Figure 2 shows a high predominance of methicillin-resistant S. aureus isolates (68.1%), a significant number of resistant strains through penicillinase production (21.8%), and a low proportion of methicillin-susceptible isolates (10.1%). Comparative analysis of data from the four laboratories participating in the study highlighted marked heterogeneity in the distribution of Staphylococcus aureus phenotypes, particularly with regard to methicillin resistance (MRSA). The distribution of phenotypes revealed that penicillinase-producing strains were more common in pus (71.1%), followed by urine (15.4%) and blood (7.7%). MRSA was mostly isolated from pus (43.8%) and urine (36.4%), while the percentage of MRSA in CSF was zero (Table 3). Table 3: Distribution of S. aureus phenotypes by sample type Type of samples Pénicillinases Wild phenotypes SARM LCR 0.00% 12.50% 0.00% Pus 71.15% 58.33% 43.83% Blood 7.69% 20.83% 17.90% Semen 5.77% 0.00% 1.85% Urine 15.38% 8.33% 36.42% MRSA predominated among the 238 isolates, with a significantly greater frequency in the hospital setting (74.2%) than in the community setting (57.5%) (p<0.01). Penicillinases exhibit a balanced distribution between the two environments, unlike those of wild strains, which remain in the minority. Phenotypes Origins of the levy P value Total Community Hospital Pénicillinases 26 26 52 Wild phenotypes 11 13 p < 0.01 24 SARM 50 112 162 Total 87 151 238 The proportion of MRSA increased significantly between 2023 and 2024 ( p < 0.01 ). In 2023, 32.7% of the isolates were MRSA (n=53), whereas 67.3% were MRSA in 2024 (n=109) (Table 4). The majority of MRSA strains originated in pus (43.8%) and urine (36.4%). Table 4: Distribution of MRSA by year and sample type SARM (N=162) P value Years p < 0.01 2023 53 (32,72%) 2024 109 (67,28%) Types of samples Pus (n=122) 71 (43,83%) p < 0.01 Urine ((n=69) 59 (36,42%) Blood (n=38) 29 (17,90%) Semen (n=06) 3 (1,85%) CSF (n=03) 0 (0,00%) Among all 162 MRSA strains, the following strains exhibited marked multidrug resistance: gentamicin (50%), erythromycin (46%), ciprofloxacin (50%), moxifloxacin (49%), tetracycline (67%), and trimethoprim-sulfamethoxazole (51%) (Table 5). In contrast, resistance to linezolid (6%), tigecycline (8%) and vancomycin (1%) remained low. Table 5: MRSA resistance patterns to other antibiotic families ( n = 162) Antibiotics Nonbre de SARM (N=162) Resistance Percentage Gentamicin 81 50% Erythromycin 75 46% Clindamycine 46 28% Quinupristine-Dalfopristine 12 7% Ciprofloxacin 81 50% Moxifloxacin 80 49% Levofloxacin 58 36% Tetracycline 109 67% Tigecycline 13 8% Linezolide 9 6% Nitrofurantoin 8 5% Trimethoprim/sulfamethoxazole 83 51% Discussion The high prevalence of resistant strains of Staphylococcus aureus observed in this study is a major warning signal in the context of the fight against antibiotic resistance. Among the 238 patients included, 68.1% of the isolates were MRSA, a proportion comparable to that reported in several countries in sub-Saharan Africa (Cameroon, Uganda, Nigeria), where the prevalence of MRSA ranged from 40% to more than 70% [ 19 , 20 ]. This is in stark contrast to European or North American countries, where strict control programmes have maintained a prevalence of approximately 20–30% [ 21 , 22 ]. The distribution of patients was predominantly male (56.3%), and the mean age was 27.9 years. These results are in agreement with the findings of other African studies in which staphylococcal infections were found to mainly affect young men and active adults [ 23 , 24 ]. The 21–40 age group, the most represented (32.3%), was also the most affected group, which may be explained by increased exposure to trauma, community infections and repeated hospitalizations [ 17 , 25 , 26 ]. At the microbiological level, the almost universal ineffectiveness of penicillin G (99%) confirms its obsolescence in the presence of S. aureus , a phenomenon also described in Morocco and Mauritania [ 27 , 28 ]. Oxacillin has an alarming resistance rate (79%), placing Guinea among the highly MRSA endemic areas, well above the global average (~ 29%) [ 17 , 29 – 32 ]. The prevalence of resistance to fluoroquinolones (ciprofloxacin 50%, moxifloxacin 42%, levofloxacin 36%) and tetracycline (72%) far exceeds the available African data (~ 30–40% and ~ 40%, respectively) [ 33 – 35 ]. These results suggest massive and insufficiently regulated consumption of these molecules in Guinea. Conversely, last-resort antibiotics such as vancomycin (99% sensitivity), linezolid (93%) and tigecycline (93%) remain effective, consistent with global trends [ 36 ]. The distribution of the samples highlights the predominance of pus (43.8%) and urine (36.4%), illustrating both community and complicated urinary tract infections [ 37 – 39 ]. The absence of MRSA in CSF is consistent with the rarity of meningitis caused by S. aureus , although the prognosis is particularly severe [ 40 ]. The results of this study revealed a very high incidence of MRSA among the 238 isolates analyzed, with a significantly greater frequency in hospital settings (74.2%) than in community settings (57.5%; p = 0.027), suggesting increased selection pressure within healthcare settings. However, the high proportion of community-acquired MRSA observed in Guinea far exceeds the rates reported in other sub-Saharan African countries, where prevalences vary from 3.7% in Kenya to 96.8% in Ethiopia, depending on the setting and population studied [ 41 , 42 ]. This out-of-hospital spread of MRSA probably reflects the frequent and often uncontrolled use of antibiotics in outpatient settings, associated with insufficient hygiene practices and porosity between care sectors. In addition, the penicillinase-producing strains were relatively evenly distributed between the two media, indicating an ancient and well-established resistance mechanism. Wild strains constitute the minority (10%) of strains, reflecting widespread selective pressure linked to the massive use of β-lactams [ 43 ]. The significant association between the origin of the samples and the distribution of phenotypes (χ² = 7.206; p = 0.027) underlines the importance of an integrated "hospital-community" approach in the fight against resistance. Strengthening the proper use of antibiotics, hygiene and training of health personnel appears essential for curbing the spread of these multidrug-resistant strains [ 44 ]. Equally worrying is the evolution of time, with a rapid increase in the proportion of MRSA from 32.7% in 2023 to 67.3% in 2024. This trend is in line with international observations that highlight a resurgence of MRSA after a period of decline, notably exacerbated by the COVID-19 pandemic [ 45 ]. A study from Northern Cyprus confirmed this trend, with the incidence of MRSA increasing from 38% before the pandemic to 56% during the pandemic, while Taiwanese surveillance showed similar fluctuations, with 48.9% in 2022, 42.3% in 2023, and 48.5% in 2024 [ 46 – 49 ]. Finally, the analysis of resistance patterns revealed marked multidrug resistance: approximately half of the MRSA isolates were resistant to gentamicin and ciprofloxacin, 46% were resistant to erythromycin, and 67% were resistant to tetracycline. These findings are in line with international data highlighting the increasing difficulty in managing MRSA infections [ 50 – 52 ]. Although glycopeptides and antibiotics of last resort retain high activity, the slightest occurrence of resistance in this group requires strict vigilance and reasoned use, in accordance with international recommendations for the management of antibiotic therapy (AMS) [ 53 ]. Conclusion This study highlights the worrying situation of antimicrobial resistance in Staphylococcus aureus in Guinea, which is marked by a high prevalence of methicillin-resistant strains (68.1%) and widespread resistance to first-line antibiotics, including beta-lactams, fluoroquinolones and macrolides. The rapid increase in the incidence of MRSA between 2023 and 2024 reflects a worrying diffusion dynamic in hospital and community settings. Maintaining high susceptibility to last-resort antibiotics, such as vancomycin, linezolid and tigecycline, still offers effective treatment options. However, their use must be strictly regulated to avoid the emergence of subsequent resistance. These results underscore the urgent need to establish a national antibiotic resistance surveillance system to strengthen the continuous training of health professionals on the rational use of antibiotics and to improve infection prevention and control measures in health facilities. 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Trends in Incidence and Epidemiology of Methicillin-Resistant Staphylococcus aureus Bacteremia, Six Emerging Infections Program Surveillance Sites, 2005–2022. Open Forum Infect Dis 2025; 12:ofaf282. https://doi.org/10.1093/ofid/ofaf282. Hurdoganoglu U, Gokbulut N, Guler E, Suer K, Hincal E. Trend determination of methicillin-resistant Staphylococcus aureus infections with statistical modeling. North Clin Istanb 2025; 12:12–20. https://doi.org/10.14744/nci.2023.66891. Chen Y-J, Er T-K. Staphylococcus aureus prevalence surveillance methicillin-resistant disease in Taiwan: a hospital-based surveillance study from 2022 to 2024. IJID Reg 2025;16:100702. https://doi.org/10.1016/j.ijregi.2025.100702. Emerging Trends in Antimicrobial Resistance: A Global Review of Surveillance, Challenges, and Strategies - Premier Science 2025. https://premierscience.com/pjph-25-964/(accessed September 28, 2025). Subramanian A, Shabi Y, Alazraqi T, Abdelrahim IM, Hamid ME, Al Bshabshe A, et al. Epidemiological Dynamics and Rising Trends of MRSA in Saudi Arabia: A 12-Year Observational Study. Front Cell Infect Microbiol 2025;15. https://doi.org/10.3389/fcimb.2025.1622647. Kutty G, Davis AS, Schuck K, Masterson M, Wang H, Liu Y, et al. Characterization of Pneumocystis murina Bgl2, an Endo-β-1,3-Glucanase and Glucanosyltransferase. J Infect Dis 2019; 220:657–65. https://doi.org/10.1093/infdis/jiz172. Wang S-H, Pancholi P, Stevenson K, Yakrus MA, Butler WR, Schlesinger LS, et al. Pseudo-Outbreak of “Mycobacterium paraffinicum” Infection and/or Colonization in a Tertiary Care Medical Center. Infect Control Hosp Epidemiol 2009; 30:848–53. https://doi.org/10.1086/599071. Chopra I, Roberts M. Tetracycline Antibiotics: Mode of Action, Applications, Molecular Biology, and Epidemiology of Bacterial Resistance. Microbiol Mol Biol Rev 2001; 65:232–60. https://doi.org/10.1128/mmbr.65.2.232-260.2001. Nickerson EK, Hongsuwan M, Limmathurotsakul D, Wuthiekanun V, Shah KR, Srisomang P, et al. Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance. PloS One 2009; 4:e4308. https://doi.org/10.1371/journal.pone.0004308. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8522464","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":569635485,"identity":"f458d70b-b603-4dcd-bf4a-9a271c789a80","order_by":0,"name":"Mamadou Bobo 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1","display":"","copyAsset":false,"role":"figure","size":31727,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDiagram of Included\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8522464/v1/fe2de13fe90254550426ae3b.png"},{"id":99768403,"identity":"95b6ca5e-f5e0-4fea-93ce-67c2dbe4ff70","added_by":"auto","created_at":"2026-01-08 08:26:34","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":85947,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eResistance phenotypes of \u003c/strong\u003e\u003cem\u003e\u003cstrong\u003eS. aureus strains\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8522464/v1/55ecaa21c11f9383698080c6.png"},{"id":99768399,"identity":"fcc7d1af-cf33-4e1c-98ad-6e0b7ea5e8ba","added_by":"auto","created_at":"2026-01-08 08:26:34","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":32740,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of \u003c/strong\u003e\u003cem\u003eS. aureus phenotypes \u003c/em\u003eby laboratory\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8522464/v1/1c631b4e6437360e9c8628b0.png"},{"id":99805747,"identity":"5e14653e-9aac-43df-9d90-11bddec4e775","added_by":"auto","created_at":"2026-01-08 14:17:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1368073,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8522464/v1/60926543-8b7f-4d4e-83f3-520444991529.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eAntibiotic resistance profile of \u003c/strong\u003e\u003cem\u003e\u003cstrong\u003eStaphylococcus aureus\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e isolated fromhealth facilities in Conakry\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003e \u003cem\u003eStaphylococcus aureus\u003c/em\u003e infections are a major public health problem worldwide, both in community and hospital settings. This opportunistic bacterium is responsible for a wide spectrum of infections, ranging from superficial skin infections to severe sepsis and osteoarticular infections [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The emergence of methicillin-resistant strains (MRSA) represents a major challenge due to their associated multidrug resistance and the therapeutic difficulties they cause [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAccording to World Health Organization (WHO) reports, the incidence of MRSA varies greatly from region to region, with high rates observed in Africa and Asia [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. A recent meta-analysis showed that the average incidence of MRSA in sub-Saharan Africa was above 40%, with wide variability across countries [\u003cspan additionalcitationids=\"CR7 CR8\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Regional studies have shown high MRSA incidence rates\u0026mdash;36% in Benin [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], 32% in Burkina Faso [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], 66% in Mali [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], and up to 80% in a study of healthcare-associated infections in Conakry [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Methicillin resistance is of particular concern, as it severely limits treatment options, leaving room for the use of last-resort antibiotics such as vancomycin [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe emergence and spread of multidrug-resistant strains are driven by inappropriate antibiotic use, lack of systematic microbiological surveillance, and gaps in infection control in hospital settings [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Despite the establishment of some surveillance programmes in several African countries (Burkina Faso, Nigeria, Senegal, Kenya, etc.), the available data are limited, heterogeneous and often not very representative [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. In this context, it becomes imperative to regularly assess the resistance profiles of local S strains. aureus to adapt therapeutic protocols and prevention policies.\u003c/p\u003e \u003cp\u003eThe present study aimed to determine the prevalence of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e strains isolated in Conakry as well as their resistance profile to other antibiotics.\u003c/p\u003e"},{"header":"Materials and Method","content":"\u003ch2\u003e1. Type and setting of study\u003c/h2\u003e\n\u003ch3\u003e\u003cstrong\u003e1.1 Type and period of study\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThis was a cross-sectional descriptive study conducted over a period of two (2) years, from January 2023 to December 2024, on the analysis of clinical samples (urine, blood, puncture fluid and pus).\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003e1.2 Study Setting:\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe data for this study were collected from four major structures with a national scope and located mainly in Conakry. These establishments were selected because of their central role in microbiological diagnosis and their representativeness of the different health contexts: hospital, community, institutional and private.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eNational Institute of Public Health (INSP)\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eThe\u0026nbsp;\u003c/strong\u003eNational Reference Laboratory is responsible for the surveillance and diagnosis of epidemic diseases and has modern microbiology and biosafety infrastructures (at the P2 level).\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eDonka University Hospital Center (CHU)\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eDonka University Hospital, Guinea\u0026apos;s main university hospital, is a reference center for the management of complex cases and a major player in the surveillance of nosocomial infections.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eBiomar-24 Laboratory\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eBiomar-24, located in the commune of Dixinn, is the first private laboratory in Guinea with advanced technologies, particularly in chemiluminescence for biological diagnostics.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eNational Social Security Fund (CNSS)\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eAlthough the CNSS is mainly in charge of managing the social security scheme for Guinean workers, it also has active medicosocial services. The latter carries out health check-ups and biological samples for the health monitoring of members.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e2. Study population and sampling\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eAll the clinical samples (urine, blood, CSF, and puncture fluid) were sent for suspected bacterial infection.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003e2.1 Inclusion criteria\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eAll specimens for which \u003cem\u003eStaphylococcus aureus\u003c/em\u003e strains were isolated and whose records contained complete information necessary for the analysis (age, sex, type of specimen, antimicrobial susceptibility test result) were included.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003e2.2 Noninclusion criteria\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe noninclusion criteria used in this study excluded the following:\u003c/p\u003e\n\u003cul class=\"decimal_type\"\u003e\n \u003cli\u003eSamples contaminated with commensal flora or polymicrobial bacteria cannot be interpreted in the clinical context.\u003c/li\u003e\n \u003cli\u003eThe absence of isolation of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eIncomplete files that did not allow analysis (age, sex, type of sample, missing antibiogram).\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003e2.3 Sampling and sample size\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eThe sample was comprehensive, and the sample size was 538 clinical samples that met the inclusion criteria.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e3. Study\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003evariables\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThese variables were grouped into two categories:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eSociodemographic variables (age, sex, hospital or community origin) were collected.\u003c/li\u003e\n \u003cli\u003eMicrobiological variables (isolated species, resistance profile, phenotype).\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch2\u003e\u003cstrong\u003e4. Microbiological analysis techniques\u003c/strong\u003e\u003c/h2\u003e\n\u003ch3\u003e\u003cstrong\u003e4.1 Sample collection and transport:\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eUrine: medium stream after local washing; Delivery\u0026le;2 hrs (or 2-8\u0026deg;C \u0026le;24 hrs)\u003c/p\u003e\n\u003cp\u003eBlood: The collection of aerobic and anaerobic blood culture vials under conditions of rigorous asepsis and incubation in an automated system\u003c/p\u003e\n\u003cp\u003ePus/CSF/puncture fluids: Sampling was performed in sterile vials, and transport was performed immediately.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003e4.2 Isolation, identification and antibiotic susceptibility testing\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eClassical bacteriological methods were used, namely, direct examination; isolation on Chapman\u0026apos;s agar medium; ClED; and blood or chocolate agar depending on the sample type. Identification was based on morphological and biochemical characteristics: smooth, rounded, yellow or nonyellow \u0026quot;S\u0026quot; type colonies; gram-positive cocci in clusters; optional aeranaerobic bacteria; presence of catalase; and confirmation of the Vitek2 compact PLC. Antibiotic susceptibility tests were performed on the Viteck 2compact automaton according to the recommendations of the French Society of Microbiology (CASFM/EUCAST) [18]. The reference strain \u003cem\u003eS. aureus\u003c/em\u003e strain ATCC 6538 was used as an internal control.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e5. Statistical analysis\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe data were entered into Kobocollect software version 1.25.1 and then exported and processed in Microsoft 365.\u003c/p\u003e\n\u003cp\u003eThe statistical analysis was performed using SPSS version 26 (SPSS, Inc., Chicago, IL, USA). Statistical tests (\u0026chi;\u0026sup2; or Fisher\u0026apos;s exact test) were used to compare proportions, with a significance threshold set at p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003eQuantitative variables such as age are presented as medians.\u003c/p\u003e\n\u003cp\u003eQualitative variables (sex, resistance phenotype, etc.) are presented as frequencies and are expressed as percentages.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 238 patients were included in the study. The proportion of males (56.3%) was slightly greater than that of females (43.7%) (Table 1). The mean age of the patients was 27.9 \u0026plusmn; 10.7 years, with a predominance of the 21\u0026ndash;40 age group (32.3%), followed by the 1\u0026ndash;20 years (29.8%), 41\u0026ndash;60 years (23.9%), and 61 years of age (13.9%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: Sociodemographic characteristics of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ethe\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003epatients (\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;= 238)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber (N=238)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eFeminine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e43,70%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eMasculine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e56,30%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge range\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1- 20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e29,83%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e21-40\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e77\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e32,35%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e41-60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e23,95%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026gt;61 years old\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 37px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e13,87%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAverage age (SD \u0026plusmn;) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 27,9 \u0026plusmn; 10,7\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSensitivity analysis of the 238 strains of \u003cem\u003eS. aureus\u003c/em\u003e revealed near-universal resistance to penicillin G (99%) and high resistance to oxacillin (79%), reflecting a high proportion of MRSA (Table 2). Strong resistance was observed for tetracycline (72%), ciprofloxacin (50%), gentamicin (43%) and trimethoprim-sulfamethoxazole (43%). In contrast, vancomycin (1% resistance), linezolid (7%), tigecycline (7%) and teicoplanin (2%) remained largely active.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Antibiotic resistance patterns of \u003cem\u003eS. aureus\u003c/em\u003e strains\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntibiotics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResistance fighters (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN=238\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePenicillin G\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e99%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOxacilline\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e79%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGentamicin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eErythromycin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e38%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClindamycine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e22%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuinupristine-Dalfopristine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCiprofloxacin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMoxifloxacin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e42%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevofloxacin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e36%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTetracycline\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e72%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTigecycline\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLinezolide\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNitrofurantoin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTeicoplanin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVancomycine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTrimethoprim-Sulfamethoxazole\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Figure 2 shows a high predominance of methicillin-resistant \u003cem\u003eS. aureus\u003c/em\u003e isolates (68.1%), a significant number of resistant strains through penicillinase production (21.8%), and a low proportion of methicillin-susceptible isolates (10.1%).\u003c/p\u003e\n\u003cp\u003eComparative analysis of data from the four laboratories participating in the study highlighted marked heterogeneity in the distribution of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e phenotypes, particularly with regard to methicillin resistance (MRSA).\u003c/p\u003e\n\u003cp\u003eThe distribution of phenotypes revealed that penicillinase-producing strains were more common in pus (71.1%), followed by urine (15.4%) and blood (7.7%). MRSA was mostly isolated from pus (43.8%) and urine (36.4%), while the percentage of MRSA in CSF was zero (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Distribution of \u003cem\u003eS. aureus\u003c/em\u003e phenotypes by sample type\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of samples\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u0026eacute;nicillinases\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWild phenotypes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSARM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003eLCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e0.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e12.50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e0.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003ePus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e71.15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e58.33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e43.83%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003eBlood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e7.69%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e20.83%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e17.90%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003eSemen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e5.77%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e0.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1.85%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 32px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21px;\"\u003e\n \u003cp\u003e15.38%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e8.33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e36.42%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMRSA predominated among the 238 isolates, with a significantly greater frequency in the hospital setting (74.2%) than in the community setting (57.5%) (p\u0026lt;0.01). Penicillinases exhibit a balanced distribution between the two environments, unlike those of wild strains, which remain in the minority.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhenotypes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 44px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOrigins of the levy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 15px;\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003eCommunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003eHospital\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eP\u0026eacute;nicillinases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eWild phenotypes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep \u0026lt; 0.01\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e24\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003eSARM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e162\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e87\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e151\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e238\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe proportion of MRSA increased significantly between 2023 and 2024 (\u003cem\u003ep \u0026lt; 0.01\u003c/em\u003e). In 2023, 32.7% of the isolates were MRSA (n=53), whereas 67.3% were MRSA in 2024 (n=109) (Table 4). The majority of MRSA strains originated in pus (43.8%) and urine (36.4%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Distribution of MRSA by\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eyear\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003esample type\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSARM\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(N=162)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 23px;\"\u003e\n \u003cp\u003e\u003cem\u003ep \u0026lt; 0.01\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e53 (32,72%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e109 (67,28%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTypes of samples\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 23px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003ePus (n=122)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e71 (43,83%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 23px;\"\u003e\n \u003cp\u003e\u003cem\u003ep \u0026lt; 0.01\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003eUrine ((n=69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e59 (36,42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003eBlood (n=38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e29 (17,90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003eSemen (n=06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e3 (1,85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003eCSF (n=03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e0 (0,00%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAmong all 162 MRSA strains, the following strains exhibited marked multidrug resistance: gentamicin (50%), erythromycin (46%), ciprofloxacin (50%), moxifloxacin (49%), tetracycline (67%), and trimethoprim-sulfamethoxazole (51%) (Table 5). In contrast, resistance to linezolid (6%), tigecycline (8%) and vancomycin (1%) remained low.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5: MRSA resistance patterns to other antibiotic families (\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;= 162)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntibiotics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNonbre de SARM (N=162)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResistance Percentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eGentamicin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eErythromycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e46%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eClindamycine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e28%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eQuinupristine-Dalfopristine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eCiprofloxacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e50%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMoxifloxacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e49%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eLevofloxacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e36%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eTetracycline\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e67%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eTigecycline\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eLinezolide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eNitrofurantoin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003eTrimethoprim/sulfamethoxazole\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 30px;\"\u003e\n \u003cp\u003e51%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe high prevalence of resistant strains of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e observed in this study is a major warning signal in the context of the fight against antibiotic resistance. Among the 238 patients included, 68.1% of the isolates were MRSA, a proportion comparable to that reported in several countries in sub-Saharan Africa (Cameroon, Uganda, Nigeria), where the prevalence of MRSA ranged from 40% to more than 70% [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. This is in stark contrast to European or North American countries, where strict control programmes have maintained a prevalence of approximately 20\u0026ndash;30% [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe distribution of patients was predominantly male (56.3%), and the mean age was 27.9 years. These results are in agreement with the findings of other African studies in which staphylococcal infections were found to mainly affect young men and active adults [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The 21\u0026ndash;40 age group, the most represented (32.3%), was also the most affected group, which may be explained by increased exposure to trauma, community infections and repeated hospitalizations [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAt the microbiological level, the almost universal ineffectiveness of penicillin G (99%) confirms its obsolescence in the presence of \u003cem\u003eS. aureus\u003c/em\u003e, a phenomenon also described in Morocco and Mauritania [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Oxacillin has an alarming resistance rate (79%), placing Guinea among the highly MRSA endemic areas, well above the global average (~\u0026thinsp;29%) [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan additionalcitationids=\"CR30 CR31\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe prevalence of resistance to fluoroquinolones (ciprofloxacin 50%, moxifloxacin 42%, levofloxacin 36%) and tetracycline (72%) far exceeds the available African data (~\u0026thinsp;30\u0026ndash;40% and ~\u0026thinsp;40%, respectively) [\u003cspan additionalcitationids=\"CR34\" citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. These results suggest massive and insufficiently regulated consumption of these molecules in Guinea. Conversely, last-resort antibiotics such as vancomycin (99% sensitivity), linezolid (93%) and tigecycline (93%) remain effective, consistent with global trends [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe distribution of the samples highlights the predominance of pus (43.8%) and urine (36.4%), illustrating both community and complicated urinary tract infections [\u003cspan additionalcitationids=\"CR38\" citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. The absence of MRSA in CSF is consistent with the rarity of meningitis caused by \u003cem\u003eS. aureus\u003c/em\u003e, although the prognosis is particularly severe [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe results of this study revealed a very high incidence of MRSA among the 238 isolates analyzed, with a significantly greater frequency in hospital settings (74.2%) than in community settings (57.5%; p\u0026thinsp;=\u0026thinsp;0.027), suggesting increased selection pressure within healthcare settings. However, the high proportion of community-acquired MRSA observed in Guinea far exceeds the rates reported in other sub-Saharan African countries, where prevalences vary from 3.7% in Kenya to 96.8% in Ethiopia, depending on the setting and population studied [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. This out-of-hospital spread of MRSA probably reflects the frequent and often uncontrolled use of antibiotics in outpatient settings, associated with insufficient hygiene practices and porosity between care sectors.\u003c/p\u003e \u003cp\u003eIn addition, the penicillinase-producing strains were relatively evenly distributed between the two media, indicating an ancient and well-established resistance mechanism. Wild strains constitute the minority (10%) of strains, reflecting widespread selective pressure linked to the massive use of β-lactams [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. The significant association between the origin of the samples and the distribution of phenotypes (χ\u0026sup2; = 7.206; p\u0026thinsp;=\u0026thinsp;0.027) underlines the importance of an integrated \"hospital-community\" approach in the fight against resistance. Strengthening the proper use of antibiotics, hygiene and training of health personnel appears essential for curbing the spread of these multidrug-resistant strains [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEqually worrying is the evolution of time, with a rapid increase in the proportion of MRSA from 32.7% in 2023 to 67.3% in 2024. This trend is in line with international observations that highlight a resurgence of MRSA after a period of decline, notably exacerbated by the COVID-19 pandemic [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. A study from Northern Cyprus confirmed this trend, with the incidence of MRSA increasing from 38% before the pandemic to 56% during the pandemic, while Taiwanese surveillance showed similar fluctuations, with 48.9% in 2022, 42.3% in 2023, and 48.5% in 2024 [\u003cspan additionalcitationids=\"CR47 CR48\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFinally, the analysis of resistance patterns revealed marked multidrug resistance: approximately half of the MRSA isolates were resistant to gentamicin and ciprofloxacin, 46% were resistant to erythromycin, and 67% were resistant to tetracycline. These findings are in line with international data highlighting the increasing difficulty in managing MRSA infections [\u003cspan additionalcitationids=\"CR51\" citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Although glycopeptides and antibiotics of last resort retain high activity, the slightest occurrence of resistance in this group requires strict vigilance and reasoned use, in accordance with international recommendations for the management of antibiotic therapy (AMS) [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the worrying situation of antimicrobial resistance in \u003cem\u003eStaphylococcus aureus\u003c/em\u003e in Guinea, which is marked by a high prevalence of methicillin-resistant strains (68.1%) and widespread resistance to first-line antibiotics, including beta-lactams, fluoroquinolones and macrolides. The rapid increase in the incidence of MRSA between 2023 and 2024 reflects a worrying diffusion dynamic in hospital and community settings.\u003c/p\u003e \u003cp\u003eMaintaining high susceptibility to last-resort antibiotics, such as vancomycin, linezolid and tigecycline, still offers effective treatment options. However, their use must be strictly regulated to avoid the emergence of subsequent resistance.\u003c/p\u003e \u003cp\u003eThese results underscore the urgent need to establish a \u003cb\u003enational antibiotic resistance surveillance system\u003c/b\u003e to strengthen \u003cb\u003ethe continuous training of health professionals\u003c/b\u003e on the rational use of antibiotics and to improve \u003cb\u003einfection prevention and control measures\u003c/b\u003e in health facilities. In addition, additional studies, including \u003cb\u003emolecular typing\u003c/b\u003e of strains, are needed to better understand the epidemiological dynamics of MRSA in Guinea and to guide public health strategies.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConsent to participate statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll human participants included in this study provided informed consent. Personal data were collected and processed in a strictly confidential and anonymous manner.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study received approval from the Institutional Ethics Committee of the National Institute of Public Health (INSP), Conakry, Guinea (accreditation number: 010/Lab/INSP/2025).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not receive any specific funding from public, commercial, or not-for-profit organizations.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eTong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG. Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management. Clin Microbiol Rev 2015; 28:603\u0026ndash;61. https://doi.org/10.1128/CMR.00134-14.\u003c/li\u003e\n\u003cli\u003eNdedy MM, Nyasa RB, Esemu SN, Kfusi JA, Keneh NK, Masalla TN, et al. A cross-sectional study on the prevalence and drug susceptibility pattern of methicillin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolated from patients in the Buea Health District, Cameroon. Pan Afr Med J 2023;45:28. https://doi.org/10.11604/pamj.2023.45.28.36860.\u003c/li\u003e\n\u003cli\u003eShittu AO, Lin J. Antimicrobial susceptibility patterns and characterization of clinical isolates of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e in KwaZulu-Natal province, South Africa. BMC Infect Dis 2006;6:125. https://doi.org/10.1186/1471-2334-6-125.\u003c/li\u003e\n\u003cli\u003eDavid MZ, Daum RS. Community-Associated Methicillin-Resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e : Epidemiology and Clinical Consequences of an Emerging Epidemic. Clin Microbiol Rev 2010; 23:616\u0026ndash;87. https://doi.org/10.1128/CMR.00081-09.\u003c/li\u003e\n\u003cli\u003ePrice R. O\u0026rsquo;Neill report on antimicrobial resistance: funding for antimicrobial specialists should be improved. Eur J Hosp Pharm 2016; 23:245\u0026ndash;7. https://doi.org/10.1136/ejhpharm-2016-001013.\u003c/li\u003e\n\u003cli\u003eNsubuga F, Kabwama SN, Ampeire I, Luzze H, Gerald P, Bulage L, et al. Comparing static and outreach immunization strategies and associated factors in Uganda, Nov-Dec 2016. Pan Afr Med J 2019;32. https://doi.org/10.11604/pamj.2019.32.123.16093.\u003c/li\u003e\n\u003cli\u003eHasanpour AH, Sepidarkish M, Mollalo A, Ardekani A, Almukhtar M, Mechaal A, et al. The global prevalence of methicillin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e colonization in residents of elderly care centers: a systematic review and meta-analysis. 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JAMA Netw Open 2024; 7:e2417199. https://doi.org/10.1001/jamanetworkopen.2024.17199.\u003c/li\u003e\n\u003cli\u003eDa L, Som\u0026eacute; D, Yehouenou C, Som\u0026eacute; C, Zoungrana J, Ou\u0026eacute;draogo A-S, et al. State of play of antibiotic resistance in sub-Saharan Africa. Medicine Mal Infect Form 2023; 2:3\u0026ndash;12. https://doi.org/10.1016/j.mmifmc.2023.01.003.\u003c/li\u003e\n\u003cli\u003eOrganization WH. Global report on infection prevention and control 2024. World Health Organization; 2024.\u003c/li\u003e\n\u003cli\u003eStanley IJ, Bwanga F, Itabangi H, Nakaye M, Bashir M, Bazira J. Prevalence and Antibiotic Susceptibility Patterns of Clinical Isolates of Methicillin-Resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e in a Tertiary Care Hospital in Western Uganda. Microbiol Res J Int 2014:1168\u0026ndash;77. https://doi.org/10.9734/BMRJ/2014/9909.\u003c/li\u003e\n\u003cli\u003eAdeiza SS, Onaolapo JA, Olayinka BO. 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Prevalence of methicillin‐resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e in eight African hospitals and Malta n.d.\u003c/li\u003e\n\u003cli\u003eMohamadou M, Essama SR, Essome MCN, Akwah L, Nadeem N, Kamga HG, et al. High prevalence of Panton-Valentine leukocidin positive, multidrug resistant, Methicillin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e strains circulating among clinical setups in Adamawa and Far North regions of Cameroon. PLOS ONE 2022; 17:e0265118. https://doi.org/10.1371/journal.pone.0265118.\u003c/li\u003e\n\u003cli\u003eAuctores. Prevalence of Methicillin Resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e strains among Medical Undergraduate Students in South‒West Nigeria. 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MRSA in Africa: Filling the Global Map of Antimicrobial Resistance. PLOS ONE 2013; 8:e68024. https://doi.org/10.1371/journal.pone.0068024.\u003c/li\u003e\n\u003cli\u003eKadri SS, Boucher HW. U.S. Efforts to Curb Antibiotic Resistance \u0026mdash; Are We Saving Lives? N Engl J Med 2020; 383:806\u0026ndash;8. https://doi.org/10.1056/NEJMp2004743.\u003c/li\u003e\n\u003cli\u003eKandel SN, Adhikari N, Dhungel B, Shrestha UT, Angbuhang KB, Karki G, et al. Characteristics of \u003cem\u003eStaphylococcus aureus\u003c/em\u003e Isolated From Clinical Specimens in a Tertiary Care Hospital, Kathmandu, Nepal. Microbiol Insights 2020;13:1178636120972695. https://doi.org/10.1177/1178636120972695.\u003c/li\u003e\n\u003cli\u003eJaradat ZW, Khwaileh M, Al Mousa W, Ababneh QO, Al Nabulsi A. Occurrence, distribution and pattern analysis of methicillin resistant (MRSA) and methicillin sensitive (MSSA) \u003cem\u003eStaphylococcus aureus\u003c/em\u003e on fomites in public facilities. 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IJID Reg 2025;16:100702. https://doi.org/10.1016/j.ijregi.2025.100702.\u003c/li\u003e\n\u003cli\u003eEmerging Trends in Antimicrobial Resistance: A Global Review of Surveillance, Challenges, and Strategies - Premier Science 2025. https://premierscience.com/pjph-25-964/(accessed September 28, 2025).\u003c/li\u003e\n\u003cli\u003eSubramanian A, Shabi Y, Alazraqi T, Abdelrahim IM, Hamid ME, Al Bshabshe A, et al. Epidemiological Dynamics and Rising Trends of MRSA in Saudi Arabia: A 12-Year Observational Study. Front Cell Infect Microbiol 2025;15. https://doi.org/10.3389/fcimb.2025.1622647.\u003c/li\u003e\n\u003cli\u003eKutty G, Davis AS, Schuck K, Masterson M, Wang H, Liu Y, et al. Characterization of Pneumocystis murina Bgl2, an Endo-\u0026beta;-1,3-Glucanase and Glucanosyltransferase. J Infect Dis 2019; 220:657\u0026ndash;65. https://doi.org/10.1093/infdis/jiz172.\u003c/li\u003e\n\u003cli\u003eWang S-H, Pancholi P, Stevenson K, Yakrus MA, Butler WR, Schlesinger LS, et al. Pseudo-Outbreak of \u0026ldquo;Mycobacterium paraffinicum\u0026rdquo; Infection and/or Colonization in a Tertiary Care Medical Center. Infect Control Hosp Epidemiol 2009; 30:848\u0026ndash;53. https://doi.org/10.1086/599071.\u003c/li\u003e\n\u003cli\u003eChopra I, Roberts M. Tetracycline Antibiotics: Mode of Action, Applications, Molecular Biology, and Epidemiology of Bacterial Resistance. Microbiol Mol Biol Rev 2001; 65:232\u0026ndash;60. https://doi.org/10.1128/mmbr.65.2.232-260.2001.\u003c/li\u003e\n\u003cli\u003eNickerson EK, Hongsuwan M, Limmathurotsakul D, Wuthiekanun V, Shah KR, Srisomang P, et al. \u003cem\u003eStaphylococcus aureus\u003c/em\u003e bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance. PloS One 2009; 4:e4308. https://doi.org/10.1371/journal.pone.0004308. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"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":"Methicillin-resistant Staphylococcus aureus, Antibiotic resistance, MRSA, Guinea","lastPublishedDoi":"10.21203/rs.3.rs-8522464/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8522464/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e: \u003cem\u003eStaphylococcus aureus\u003c/em\u003e is a major public health issue, particularly due to the emergence of methicillin-resistant strains (MRSA). Little data are available on the resistance profile of Guinea. This study aimed to determine the prevalence, phenotypic distribution, and factors associated with the resistance of \u003cem\u003eS. aureus strains \u003c/em\u003eisolated in Conakry.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A descriptive cross-sectional study was conducted from January 2023 to December 2024 atfour microbiological diagnostic facilities in Conakry. A total of 238 clinical specimens positive for \u003cem\u003eS. aureus\u003c/em\u003e were included. Isolations were identified by conventional and Vitek2 methods, and sensitivity profiles were established according to CASFM/EUCAST recommendations. Sociodemographic and microbiological data were analyzed with SPSS 26. Proportions were compared by chi-square or Fisher's exact test, with a significance threshold of p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Among the 238 isolates, 68.1% were MRSA, 21.8% were penicillinase producers and 10.1% were wild-type strains. Resistance to penicillin G was almost universal (99%), and resistance to oxacillin (79%), tetracycline (72%) and ciprofloxacin (50%) was high. Glycopeptides (vancomycin 99% sensitivity), linezolid and tigecycline remained active. The incidenceof MRSA was significantly greater in the hospital setting (74.2%) than in the community setting (57.5%; p = 0.027). Penicillinase producers were evenly distributed, while wild strains were rare (12.6% in the community vs. 8.6% in hospitals).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The high prevalence of MRSA infection, particularly in hospital settings, combined with significant circulation in the community underlines the urgency of strengthening integrated hospital-community surveillance, improving infection control and promoting the rational use of antibiotics in Guinea.\u003c/p\u003e","manuscriptTitle":"Antibiotic resistance profile of Staphylococcus aureus isolated fromhealth facilities in Conakry","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-08 08:26:23","doi":"10.21203/rs.3.rs-8522464/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":"4e53d202-ded3-4bbb-b566-db34fa5d0210","owner":[],"postedDate":"January 8th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":60608675,"name":"Bacteriology"},{"id":60608676,"name":"General Microbiology"}],"tags":[],"updatedAt":"2026-01-28T00:23:39+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-08 08:26:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8522464","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8522464","identity":"rs-8522464","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}