Antimicrobial Resistance of Streptococci Sp. Isolated From Different Clinical Sources in Al-Muthanna Province

Background: The genus Streptococcus includes Gram-positive organisms cocci shape and organized in chains. Streptococcus has spacious importance in medicine, different streptococci are significant as part of the commensals of humans; some can as well cause illnesses that may be subacute, acute or chronic. From the considerable human illnesses belong to streptococci are rheumatic heart disease, scarlet fever, pneumococcal pneumonia and glomerulonephritis. Antibiotic Resistance is a growing concern for public health and the main cause for the failure of streptococcal infections treatment is the increase resistance to antibiotics.
Aim: Determine the antimicrobial resistance of Streptococci sp .isolated from different clinical sources in Al- Muthanna Province.
Method: The study included the collection of (270) samples from different clinical source(Throat swabs,burns, wounds, abscess, pus, vagina swabs,teeth,ear,mouth and sputum ) from patients in different hospitals and clinics in Al-Muthanna Province, during the period from first of September to the mid December of 2022 .The patients were with different ages ranging from 1 day-80 year, and from both sexes. The identification of bacterial isolates were achieved by morphological characteristics of bacterial colonies on selective media, result of Bacitracin sensitivity test, Optochin sensitivity test, CAMP test, Gram stain, and biochemical tests and then confirmed the diagnosis by using Remel RapID™ STR System. The antibiotics sensitivity test was achieved for all isolates by disk diffusion method.
Results: A total of 50 (18.5 %) isolates were identified as Streptococcus spp. from (270) clinical samples that collected from different sources, that distributed by 16 (20.77% )from Throat Swab, 12 (33.33%) from sputum, 10(29.41%) from Tooth swab, 7 (13.20%) from Vaginal swab, 3 (10%) from Mouth swab, 2 (10%) from Ear swab, and No isolate detected from burns, wounds, abscess and pus samples. The Fifty isolates included 16(32%) of them were identified as S. pyogenes, 11(22%) were S.sanguins, 10(20%) were S.aglactiae, 9(18%) were S. mutans and 4(8%) were identified as S. pneumoniae
The antibiotic susceptibility of the bacterial isolates was achieved against 10 types of antibiotics; most S.pyogenes isolates have resistance to three or more antibiotics. The highest percentage of S. pyogenes resistance was (93.7%) to Ceftriaxone, 87% to Penicillin and Ampicillin, (62.5%) to Tetracycline, 50% to Chloramphenicol and Clindamycin. Whereas (81.25 of the isolates were sensitive to Levofloxacin, Vancomycin (75, Azithromycin (62.5%), erythromycin (56.25%), and Clindamycin (50%). All S. agalactiae isolates were resistance (100%) for ceftriaxone, tetracycline, Azithromycin, Chloramphenicol, clindamycin and erythromycin. On the other hand,the isolates were resistance to vancomycin and Levofloxacin with rate( 90%) and( 60%) respectively. While they were sensitive for Ampicillin and Penicillin with percentage (80%, 60%) respectively. Antibiotic susceptibility profile for Streptococcus mutans isolates revealed that all the isolates were resistant to Ampicillin and clindamycin, 77.77 % of them were resistant to penicillin, 66.66% isolates were resistant to Ceftriaxone. Whereas all isolates were sensitive to Azithromycin, erythromycin and Levofloxacin. While, the sensitivity to Chloramphenicol, vancomycin, ceftriaxone and Tetracyclin were (88.88 %, 77.77%, 33.33%,33.33%) respectively. Streptococcus pneumoniae isolates were resistant to penicillin, Ampicillin, Ceftriaxone, tetracycline, clindamycin and vancomycin (100,100.100,75,75,and 50) respectively. While, all isolates were sensitive to Azithromycin, Erythromycin, Levofloxacin, Chloramphenicol. S.sanguinis isolates were sensitive to clindamycin, Levofloxacin, Azithromycin and erythromycin (90.90%,81.81%,81.81%,63.63%)) respectively. and all the isolates were resistant to Ampicillin and Ceftriaxone, nine isolates were resistant to vancomycin and penicillin (81.81%) and six isolates were resistant to tetracycline (54.54%).