Aminoglycoside Resistance Among Clinical Bacterial Isolates in Sétif, Algeria: Epidemiology, Multidrug Resistance, and Virulence Features

Abstract

Background. Antibiotic resistance is a growing global health challenge, complicating the management of infections. Aminoglycosides are increasingly associated with resistance, raising the risk of clinical complications and mortality in severe infections. This study aimed to characterize the epidemiological profile of 135 aminoglycoside-resistant clinical strains collected in Setif between 2021 and 2023. Methods. Antibiotic susceptibility testing was performed according to EUCAST guidelines, and phenotypic assays were conducted to assess key virulence traits, including biofilm formation and enzyme production. Results. Aminoglycoside resistance was more frequently observed in female patients (55.6%) and was found to be predominant among adults (68.1%). Urinary tract infections represented the main clinical presentation (76.3%), with Escherichia coli being the most common isolate (40.7%). High resistance rates were detected for amoxicillin (83%), amoxicillin-clavulanic acid (80%), cephalexin (74.8%), cefixime (71.1%), trimethoprim-sulfamethoxazole (74.8%), and gentamicin (72.6%). Conversely, chloramphenicol (53.3%), imipenem (47.4%), amikacin (47.4%), and piperacillin-tazobactam (31.1%) remained comparatively more effective. Multidrug resistance involving seven antibiotics occurred in 25.6% of isolates, with notable cross-resistance patterns between gentamicin and beta-lactam antibiotics (5 out of 22). Genotypic analysis showed that 43% of isolates carried at least one beta-lactamase gene, whereas 9.6% harbored a qnr determinant. Regarding virulence factors, isolates with low biofilm-forming ability were found to be the most common (62.96%). Conclusion. In conclusion, this study revealed substantial variations in aminoglycoside resistance in Setif, shaped by demographic, clinical, and bacteriological factors.