Sulfonamide resistance, virulence traits, and in-silico target interactions among clinical isolates in Setif, Algeria (2021–2023)

Abstract

Background and Objectives: Antibiotic-resistant bacteria are a growing global health concern, particularly in developing regions. Sulfonamides, once widely used, now face increasing resistance. This study assessed the prevalence, resistance profiles, and virulences traites of sulfonamide-resistant strains in Sétif, Algeria (2021-2023). Materials and Methods: A total of 215 clinical isolates were collected from patients aged 1 day to 96 years (mean 42.7). Most were community-acquired (77.2%), with urinary tract infections predominating (49.3% in women, 32.1% in men). Identification and susceptibility testing followed standard microbiological and Kirby–Bauer methods. Virulence factors (bio- film, hemolysin, protease, lecithinase, and lipase) were examined. Molecular docking compared sulfamethoxazole and tri- methoprim binding to their enzymatic targets. Results: Escherichia coli was the most frequent isolate (47.9%), followed by Enterobacter spp. (11.6%). Biofilm formation was common (88.8%), with complete production in Klebsiella, Citrobacter, Providencia, and Acinetobacter. Hemolysis pat- terns were α (30.7%), β (27.9%), and none (41.4%). Enzymatic activity included protease (48.8%), lecithinase (22.8%), and lipase (9.8%). High resistance was observed to penicillins (87.9%), cephalosporins (63.7%), and fluoroquinolones (56.3%). Resistance was lower to imipenem (33.0%) and amikacin (14.4%). Docking showed weaker sulfamethoxazole binding to DHPS than trimethoprim to DHFR. Conclusion: The high prevalence of multidrug-resistant bacteria, especially E. coli, combined with biofilm and enzyme production, underscores the urgent need for careful antibiotic stewardship in this region.