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Background   Staphylococcus aureus , one of the most frequently isolated pathogens in both hospitals and the community, has been particularly efficient at developing resistance to antimicrobial agents. In developed countries, as methicillin-resistant  S. aureus  (MRSA) has prevailed and, furthermore, as  S. aureus  with reduced susceptibility to vancomycin has emerged, the therapeutic options for the treatment of  S. aureus  infections have become limited. In developing countries and especially African countries very little is known concerning the resistance of  S. aureus  to antibiotics. In Madagascar no data exist concerning this resistance.    Objective  To update the current status of antibiotic resistance of  S. aureus  in Antananarivo, Madagascar.    Methods  Clinical  S. aureus  isolates were collected from patients at the Institut Pasteur of Madagascar from January 2001 to December 2005. Susceptibility tests with 18 antibiotics were performed by the disk diffusion method.    Results  Among a total of 574 isolates, 506 were from community-acquired infections and 68 from nosocomial infections. There was no significant difference in the methicillin resistance rate between community-acquired strains (33 of 506; 6.5%) and nosocomial strains (3 of 68, 4.4%). Many MRSA isolates were resistant to multiple classes of antibiotics. Resistance to tetracyclin, trimethoprim-sulfamethoxazole and erythromycin was more common. Among MRSA isolates resistance rates to rifampicin, fusidic acid, gentamicin and ciprofloxacin were lower than that observed with other drugs easily available in Madagascar. No isolates were resistant to glycopeptides.    Conclusion  The rate of methicillin-resistant  S. aureus  is not different between community-acquired and nosocomial infections and is still rather low in Madagascar.

In vitro activities of 18 antimicrobial agents against Staphylococcus aureus isolates from the Institut Pasteur of Madagascar