P064 A study of multidrug resistance pattern in scabies-associated infections in endemic communities

Abstract Scabies, caused by Sarcoptes scabiei var. hominis, is a highly contagious skin infestation prevalent in developing countries. Vulnerable populations are affected, such as children, the older population and individuals in overcrowded environments. Secondary bacterial infections, commonly caused by Staphylococcus aureus and Streptococcus pyogenes, frequently complicate scabies. The growing prevalence of multidrug resistance among these pathogens is emerging as a significant challenge for effective treatment and disease control. The aim of this study was to analyse and highlight the multidrug resistance patterns in bacterial pathogens associated with scabies infections. A cross-sectional study was conducted in 55 patients with clinically diagnosed scabies and evidence of secondary bacterial infections. Demographic details were collected. Pus samples were collected from infected lesions and processed for bacterial identification using Gram staining and culture techniques. Antibiotic susceptibility testing was performed using the Kirby–Bauer disk diffusion method, and patterns of antibiotic resistance was analysed. The mean age of patients was 9 years, with a male-to-female ratio of 2 : 3. The most common bacterium isolated was S. aureus, in 97% of cases (Table). Benzyl penicillin showed 94.4% resistance, while oxacillin had 79.6%. Tigecycline, linezolid and daptomycin exhibited 100% susceptibility. High resistance was noted for erythromycin (91.6%) and ciprofloxacin (53.7%). Gentamicin and clindamycin had moderate susceptibility rates of 57.4% and 51.9%, respectively. Nitrofurantoin and rifampicin maintained high susceptibility (98.1% and 92.6%). Among bacterial strains, methicillin-resistant S. aureus (MRSA) was most prevalent (46.3%), followed by coagulase-negative staphylococci (5.6%) and vancomycin-resistant S. aureus (5.6%). In conclusion, scabies infections are a significant public health concern in developing countries, further complicated by the emergence of multidrug-resistant strains. The dominance of Gram-positive bacteria like S. aureus and S. pyogenes, along with alarmingly high resistance rates to commonly used antibiotics such as penicillin, oxacillin and erythromycin, raises urgent questions about the efficacy of standard treatments. The high prevalence of MRSA highlights the urgent need for improved infection control measures and the judicious use of antibiotics. While newer drugs like tigecycline, linezolid and daptomycin offer alternative treatment options, robust surveillance and targeted antibiotic stewardship programmes are crucial to address this growing challenge and ensure effective patient care.TableBacteria isolated from 55 patients with scabiesOrganism isolatedn (%)Staphylococcus aureus47 (97)Staphylococcus haemolyticus2 (4)Staphylococcus epidermidis2 (4)Streptococcus pyogenes2 (4)Staphylococcus pyogenes1 (2)Staphylococcus pseudintermedius1 (2)