Unveiling the antibiotic resistance pattern in Staphylococcus aureus: A systematic review (2013-2024)

Table 1 Characteristics of included studies (2013–2024)

Ref.	Study design (observational/cohort/case control/cross sectional)	Study setting (state/region)	Sample size (n)	Clinical source (e.g., blood, wound, nasal swab)	Patient population	Laboratory methods	Antibiotics tested
[29]	Observational	Tamil Nadu, India	26	Sputum, nasal, throat swab	Patients from tertiary care hospital	Kirby-Bauer’s method/Kirby-Bauer disc diffusion method	Methicillin, ampicillin, penicillin, oflaxacin, oxacillin, tobramycin, gentamycin, vancomycin, ciprofloxacin, bacitracin, chloramphenico
[30]	Cohort	Odisha, India	718	Blood	People from rural community	Antimicrobial susceptibility disc diffusion method	Penicillin, ampicillin, erythromycin, azithromycin, cefoxitin, cotrimoxazole, clindamycin, teicoplanin, ciprofloxacin, vancomycin, chloramphenicol, levofloxacin, tetracycline, gentamicin, linezolid
[31]	Observational	Puducherry, India	8032	Blood, body fluids	People from rural and urban community	Kirby-Bauer’s method/Kirby-Bauer disc diffusion method	Penicillin, erythromycin, cefoxitin, cotrimoxazole, clindamycin, teicoplanin, ciprofloxacin, vancomycin, tetracycline, gentamicin, linezolid
[32]	Observational	Odisha, India	278	Pus, wound swab, nasal swab, skin swab, urine, body fluids and blood	Patients from tertiary care hospital	Cefoxitin disc diffusion test, D-test	Methicillin
[33]	Observational	India	185	Throat swab	Patients from tertiary care hospital	Antimicrobial susceptibility disc diffusion method	Erythromycin, penicillin, clindamycin, amoxicillin, gentamicin, vancomycin, tetracycline, ciprofloxacin
[34]	Observational	Delhi, India	6	Pus, wound	Patients from tertiary care hospital	Cefoxitin disc diffusion test, disc diffusion	Penicillin, amoxicillin methicillin, oxacillin, cefoxitin, gentamicin, ciprofloxacin, ceftazidime
[35]	Observational	Jaipur	30	Urine, inanimate swab, semen, earswabs, corneal swab	Patients from tertiary care hospital	Agar diffusion method	Ampicillin followed by ciprofloxacin, cotrimoxazole, cefixime, doxycycline/pefloxacin, ofloxacin, norfloxacin, cefuroxime, amoxiclave, cefazolin, cephalexin, amikacin, netilmicin
[36]	Cross-sectional observational	Haryana, India	747	Pus, exudates, wound, tissue, swab	Patients from tertiary care hospital	Antimicrobial susceptibility testing by VITEK 2 AST-P628 card (bioMerieuxInc., France)	Penicillin, gentamycin, co-trimoxazole, erythromycin, clindamycin, levofloxacin, tetracycline, linezolid, teicoplanin, vancomycin
[37]	Observational	Gujarat, India	36	Rectal swab, urine sample, wound swab, hand swab	Patients from tertiary care hospital	Disc diffusion testing	Penicillin, aziothromycin, erythromycin, linezolid, co-trimoxazole, vancomycin, cefoxitin, ciprofloxacin, gatifloxacon, ofloxacin, clindamycin, gentamycin, norfloxacin, ampicillin, piperacillin/tazobactum
[38]	Observational	Odisha, India	251	wound-swabs	Patients from tertiary care hospital	Disc diffusion testing	Amikacin, gentamycin, tobramycin, amoxyclav, ampicillin, oxacillin, piperacillin/tazobactam, cefepime, ceftazidime, ceftriaxone, gatifloxacin, levofloxacin, ciprofloxacin, ofloxacin, linezolid, vancomycin
[39]	Observational	Patna, India	86	Nasal swabs	Patients from tertiary care hospital	Disc diffusion testing	Methicillin
[40]	Cross-sectional	Mysore, India	200	Anterior nares and web spaces of both hands	Patients from tertiary care hospital	Disc diffusion testing	Methicillin
[41]	Observational cross-sectional	Kashmir, India	229	Nasal swabs	Patients from tertiary care hospital	Kirby-Bauer disc diffusion	Erythromycin, clindamycin, vancomycin, tetracycline, co-trimoxazole, gentamicin, penicillin, ciprofloxacin, cefoxitin, oxacillin
[42]	Cross-sectional	Kolkata, West Bengal, India	46	23 pus, 6 blood, 17 wound swab	Patients from tertiary care hospital	Kirby-Bauer disc diffusion	Cefoxitin, clindamycin, azithromycin, erythromycin, co-trimoxazole, ciprofloxacin, vancomycin, linezolid
[43]	Retrospective study	India	26310	Pus, blood, respiratory samples, urine, sterile body fluids, tissue, ear swab, nasa swab, skin swab	Patients from tertiary care Hospital	Kirby-Bauer disc diffusion	Erythromycin, clindamycin, co-trimoxazole, gentamicin, penicillin, ciprofloxacin
[44]	Cross-sectional study	Pondicherry, India	192	Pus swab	Patients from tertiary care hospital	Kirby-Bauer disc diffusion	Methicillin
[45]	Cross sectional	South India	102	Pus swab	Patients from tertiary care hospital	Kirby-Bauer disc diffusion	Ciprofloxacin, tetracycline, gentamicin, amikacin, netilmicin, co-trimoxazole, chloramphenicol
[46]	Observational, cross-sectional	Mumbai/Pune India	143	Pus, urine, blood and sputum samples, pleural fluids and tissue bits	Patients from tertiary care hospital	Disc difusion method	Erythromycin, ciprofloxacin, trimethoprimsulfamethoxazole, gentamicin, tetracycline
[47]	Observational, cross-sectional	Karad, India	100	Pus, sputum, wound swabs, blood, urine, and other body fluids	Patients from tertiary care hospital	Disc difusion method	Penicillin-G, erythromycin, gentamycin, co-trimoxazole, clindamycin, levofloxacin, ciprofloxaci, amikacin, nitrofurantoin, linezolid, vancomycin
[48]	Observational	Kolkata, India	50	Wound	Patients from tertiary care hospital	Kirby-Bauer disc diffusion	Amoxyclav, erythromycin, ciprofloxacin, levofloxacin, cefuroxime, clindamycin, gentamicin, trimethoprim– sulfamethoxazole, amikacin, doxycycline
[49]	Observational	Punjab, India	248	Pus, blood, urine, body fluids, catheter tips etc.	Patients from tertiary care hospital	Kirby-Bauer disc diffusion	Erythromycin, clindamycin, gentamicin, ciprofloxacin, vancomycin, linezolid, Ampicillin, co-trimoxazole
[50]	Observational, cross-sectional	South, India	100	Skin swab	Patients from tertiary care hospital	Kirby-Bauer disc diffusion	Gentamicin, erythromycin, clindamycin, tetracycline, ciprofloxacin
[51]	Observational	Tamil Nadu, India	165	Throat swab	Patients from tertiary care hospital	Kirby-Bauer disc diffusion	Pethicillin
[52]	Observational	Haryana, India	104	Blood culture bottles	Patients from tertiary care hospital	Cefoxitin disc diffusion test, Kirby-Bauer disc diffusion	Penicillin, erythromycin, clindamycin, gentamicin, ciprofloxacin, cotrimoxazole
[53]	Prospective, cross sectional study	Patna, India	179	Pus, urine, blood, conjunctival swab, endo-tracheal aspirate and synovial fluid	Patients from tertiary care Hospital	Cefoxitin disc diffusion test, Kirby-Bauer disc diffusion	Penicillin, erythromycin, clindamycin, ciprofloxacin, gentamicin, cotrimoxazole, vancomycin, linezolid
[54]	Observational	Doon Valley, Uttrakhand	111	Nasal swab	Patients from tertiary care hospital	Cefoxitin disc diffusion test, Kirby-Bauer disc diffusion	Methicillin

Table 2 Quality assessment of included studies using the Newcastle–Ottawa Scale

Ref.	Quality rating (high/moderate/low)
[29]	Moderate
[30]	Moderate
[31]	High
[32]	Moderate
[33]	Moderate
[34]	Low
[35]	Moderate
[36]	Moderate
[37]	Moderate
[38]	Moderate
[39]	Moderate
[40]	Moderate
[41]	Moderate
[42]	Moderate
[43]	High
[44]	Moderate
[45]	Moderate
[46]	Moderate
[47]	Moderate
[48]	Moderate
[49]	Moderate
[50]	Moderate
[51]	Moderate
[52]	Moderate
[53]	High
[54]	Moderate

Table 3 Antibiotics reported in 26 studies and their classes

Class of antibiotics	Name of antibiotic	No of studies	Mean	Min	Max
Beta lactam	Penicillin	12	91.77	59.25	100.00
	Amoxicillin	6	75.71	17.64	100.00
	Ampicillin	7	69.85	28.00	100.00
	Cephalexin	1	17.64	17.64	17.64
	Cefazolin	1	17.64	17.64	17.64
	Ceftriaxone	1	6.00	6.00	6.00
	Cefuroxime	2	12.32	7.00	17.64
	Meropenem	0	0.00	0.00	0.00
	Imepenem	0	0.00	0.00	0.00
	Augmentin	0	0.00	0.00	0.00
	Cefoxitin	6	37.53	6.55	83.30
	Cefepime	1	67.25	67.25	67.25
	Methicillin	9	53.96	3.48	100.00
	Piperacillin	2	54.13	36.00	72.25
	Ceftazidime	2	62.98	59.25	66.70
	Cloxacillin	1	52.94	52.94	52.94
	Cefixime	0	0.00	0.00	0.00
	Cephalosporin	0		0.00	0.00
	Oxacillin	5	48.54	4.00	93.33
	Cefotaxime	0	0.00	0.00	0.00
Glycopeptides	Vancomycin	6	46.20	7.00	100.00
	Teicoplanin	3	5.52	0.10	15.00
Tetracycline	Tetracycline	9	32.22	4.80	66.60
	Doxycycline	2	26.59	12.00	41.17
	Minocycline	0		0.00	0.00
Lincosamide	Clindamycin	15	42.58	8.73	91.48
Macrolides	Erythromycin	12	63.62	9.17	100.00
	Azithromycin	4	30.56	8.00	71.00
Fluroquinolones	Ciprofloxacin	16	54.88	6.38	89.20
	Levofloxacin	4	59.63	8.00	86.00
	Ofloxacin	5	67.95	35.29	100.00
	Gatifloxain	2	64.25	52.00	76.50
	Fluoroquinolones	0	0.00	0.00	0.00
	Norfloxacin	2	30.71	29.41	32.00
Aminoglycosides	Netilmycin	2	11.85	6.05	17.64
	Streptomycin	0	0.00	0.00	0.00
	Gentamycin	17	46.76	3.00	86.00
	Amikacin	4	33.94	17.64	73.25
	Tobramycin	2	66.75	47.50	86.00
Rifamycins	Rifampicin	0		0.00	0.00
Oxazolidinones	Linezolid	4	19.60	2.90	37.50
Synthetic	Cotrimoxazole	16	48.46	20.00	81.45
Nitrobenzene ring	Chloramphenicol	3	18.12	8.00	34.10
Lipopeptide	Daptomycin	0	0.00	0.00	0.00
Phosphonic acid	Fosfomycin	0	0.00	0.00	0.00

Number of studies represent the number of research articles (published during 2013 to 2024) reporting resistance in Staphylococcus aureus to the particular drug.