Antimicrobial resistance ofStaphylococcusspp. from human specimens submitted to diagnostic laboratories in South Africa, 2012–2017

Background Antimicrobial drug resistance is of public health importance due to its potential to reduce treatment options and increase healthcare expenditure. There is, however, a paucity of studies that have examined antimicrobial resistance in countries with poor to moderate income. The present study examined the patterns and predictors of antimicrobial resistance in Staphylococcus isolates collected from humans at diagnostic laboratories in South Africa between 2012 and 2017.

and materials A cross-sectional study design using retrospective data of 404 217 diagnostic laboratory records of staphylococcal isolates collected between 2012 and 2017 was adopted in this study. Isolates were assessed for antimicrobial drug resistance against 24 antimicrobials. Descriptive statistics, and binary logistic regression models were used to analyse the data. Significance was assessed at < 0.05.

The highest resistance was observed against Cloxacillin (70.3%), while the lowest resistance was against Colistin (0.1%). A significant (p < 0.05) decreasing trend in AMR was observed over the study period, while a significant increasing temporal trend (p < 0.05) was observed for MDR over the same period. A Significant (p < 0.05) association was observed between specimen type, species of organism, and year of isolation with AMR outcome. Significant (p < 0.05) associations were observed between specimen type and season, with MDR.

and recommendations The observed high levels of AMR and the increasing temporal trend in MDR is of public health concern. Clinicians should consider these findings when deciding on therapeutic options. Continued monitoring of AMR among Staphylococcus spp. and judicious use of antimicrobials in human medicine should be promoted. Competing Interest Statement The authors have declared no competing interest. Funding Statement The authors received no financial support for the research, authorship, and publication of this article. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was obtained from the University of South Africa, College of Agriculture & Environmental Sciences, Health Research and Animal Research Ethics Committees (Ref: 2018/ CAES/107). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability The data that support the findings of this study are available upon reasonable request and under specific conditions. For inquiries regarding access to the data, including requests for collaboration or data sharing agreements, please contact Thomas Papo, Data analyst, at thomas.papo{at}nhls.ac.za. Requests are considered on a case-by-case basis, taking into consideration the nature of the request, compliance with relevant ethics, and any associated agreements or protocols.