Prevalent genotypes of meticillin-resistant Staphylococcus aureus: report from Pakistan (original) (raw)
Related papers
Journal of Medical Microbiology, 2010
The levels of meticillin-resistant Staphylococcus aureus (MRSA) in Pakistan and India are known to be high, but few studies have described the epidemiology of the different MRSA clones present. In order to gain an understanding of the epidemiology of MRSA within this region, 60 MRSA isolates from Pakistan (49) and India (11) were genotyped. All isolates were typed using PFGE, staphylococcal interspersed repeat units (SIRUs), a restriction-modification method and staphylococcal cassette chromosome mec (SCCmec) typing. A subset of isolates that were distinct by PFGE and SIRUs were typed using multilocus sequence typing (MLST). Clonal complex (CC) 8 was the dominant clonal complex (57/60) and was present in both Pakistan and India. Within CC8, there were 10 SIRU profiles and 24 PFGE profiles. Two SIRU profiles were present in isolates from both India and Pakistan, whilst seven were distinct for Pakistan and one for India. All PFGE profiles were distinct for each of the two countries. Thirty-four of the 57 isolates carried SCCmec type III/IIIa and the remainder carried type IV SCCmec. MLST analysis of 14 CC8 isolates with diverse SIRU and PFGE profiles showed that all were single-locus variants, with nine belonging to sequence type (ST) 239, three to ST8 and two to ST113. From a single hospital in Pakistan, three isolates belonged to CC30 and all were indistinguishable by PFGE and SIRUs and carried the Panton-Valentine leukocidin gene. Thus, epidemiological typing of strains from three distinct locations in India and Pakistan revealed the predominance of one clonal complex and highly related STs. The ability of SIRUs and PFGE to differentiate within ST239 demonstrates their utility in defining local epidemiology in these countries.
Jundishapur Journal of Microbiology, 2020
Background: Methicillin-resistant Staphylococcus aureus (MRSA) isolates are important agents of human bacterial infections. The mecA gene as the main cause of resistance against beta-lactams is located in genetic elements which are known as staphylococcal cassette chromosome mec (SCCmec). Objectives: The research aimed to evaluate the antibiotic susceptibility pattern and SCCmec typing of MRSA isolates in Kermanshah Province, West of Iran. Methods: Identification of MRSA isolates were done using phenotypic and genotypic methods. Antimicrobial susceptibility patterns were determined using the disk diffusion method and minimum inhibitory concentration (MIC) testing by agar dilution method. The SCCmec types of isolates were identified using PCR method. The results of the research were analyzed using SPSS.V16 software. Results: In this research, of 146 isolates, 126 isolates were confirmed as S. aureus using phenotypic methods and PCR analysis of femB gene. All isolates were sensitive to vancomycin by both methods: disk agar diffusion and MIC testing by agar dilution method. The highest resistance rate was related to erythromycin (75.4%) and ciprofloxacin (73%). Of 126 S. aureus isolates, 83 cases (65.9%) and 81 cases (64.3%) were MRSA based on the existence of mecA gene and cefoxitin diffusion disk test, respectively. There was a statistically significant difference in antibiotic susceptibility pattern of MRSA and methicillin susceptible Staphylococcus aureus (MSSA) isolates for some antibiotics such as gentamicin, amikacin, erythromycin, ciprofloxacin, and linezolid (P < 0.05). SCCmec types were detected as 20 cases (24.1%) type I, 5 cases (6%) type II, 37 cases (44.6%) were type III (the most prevalent type), 6 cases (7.2%) type IVa, and 3 cases (3.6%) type IV. The prevalence of HA-MRSA (types I, II, and III) and CA-MRSA (types IV and V) in this study were 74.7% and 10.8%, respectively. Conclusions: The prevalence of MRSA isolates is high in Kermanshah Province, West of Iran. The cefoxitin diffusion disk testing could be considered a simple, cheap and reliable test for identification of MRSA isolates in all laboratories. The most frequent type of SCCmec is type III. These findings could be due to an increase in antibiotic consumption and insufficient infection control systems.
Staphylococcus aureus has become a common nosocomial infectious agent throughout the world, causing a wide range of infections. Epidemiological studies suggest that hospitals of all sizes are facing the problem of the resistant form of Staphylococcus aureus that is Methicillin Resistant Staphylococcus aureus (MRSA). Protein A of Staphylococcus aureus is a virulence factor which is encoded by spa that shows a variation in length among different strains of MRSA. In this study, ninety-six strains of MRSA were collected from private and public sector hospitals of Lahore. Sixty-seven (70%) strains were confirmed as MRSA by DNase test and Kirby-Bauer disk diffusion test. The remaining (30%) isolates were misdiagnosed as other Staphylococcus species. Subsequently, polymorphic X region of the spa gene was amplified using specific primers of spa gene by the polymerase chain reaction (PCR). Four different banding patterns, ranging in length between 300 to 500 bp, showed polymorphism of the spa gene. Most strains showed 98 % homology with isolate spa 7 Staphylococcus aureus IgG protein. Those sequences can serve as a rapid diagnostic tool for the identification of local MRSA during outbreaks.
African Health Sciences
Introduction: Methicillin resistant Staphylococcus aureus (MRSA) is one of the major human pathogen that is associated with hospital as well as community acquired infections and is responsible for huge amount of life-threatening diseases. Objective: Objective of the study was to determine MRSA prevalence, their antibiotic sensitivity patterns, frequency of virulence genes (sea, seb, sed, tst, hla, hld) and their co-occurrence with resistance marker mecA among Rawalpindi and its nearby regions of Pakistani clinical isolates. Methodology: The present study was carried out to identify the virulence and antibiotic resistance genes that co-occur in MRSA through polymerase chain reaction. Antibiotic sensitivity, presence of virulence genes and their co-occurrence with resistance marker mecA were analyzed. Results: These isolates were found resistant to number of antibiotics i.e. Amoxicillin (16.1%), Cefixime (48.38%), Doxycycline (27.415), Trimethoprim/sulfamethoxazole (37.09%), Clindamyc...
Infection, Genetics and Evolution, 2015
The burden of community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) is on the rise in population and clinical settings on account of the adaptability and virulence traits of this pathogen. We characterized 45 non-duplicate CA-MRSA strains implicated mainly in skin and soft tissue infections (SSTIs) in a tertiary care hospital in Mysore, South India. All the isolates were genotyped by staphylococcal cassette chromosome mec (SCCmec) typing, staphylococcal protein A (spa) typing, accessory gene regulator (agr) typing, and multi-locus sequence typing (MLST). Four sequence types (STs) belonging to three major clonal complexes (CCs) were identified among the isolates: CC22 (ST2371 and ST22), CC1 (ST772) and CC8 (ST8). The majority (53.3%) of the isolates was of the genotype ST2371-t852-SCCmec IV [sequence type-spa type-SCCmec type], followed by ST22-t852-SCCmec IV (22.2%), ST772-t657-SCCmec V (13.3%) and ST8-t008-SCCmec IV (11.1%). ST237I, a single locus variant of ST22 (EMRSA-15 clone), has not been reported previously from any of the Asian countries. Our study also documents for the first time, the appearance of ST8-SCCmec IV (USA300) strains in India. Representative strains of the STs were further analyzed by pulsed field gel electrophoresis (PFGE). agr typing detected type I or II alleles in the majority of the isolates. All the isolates were positive for the leukotoxin gene, pvl (Panton-Valentine leukocidin) and the staphylococcal enterotoxin gene cluster, egc. Interestingly, multidrug resistance (resistance to P3 classes of non-beta-lactam antibiotics) was observed in 77.8% (n = 35) of the isolates. The highest (75.5%) resistance was recorded for ciprofloxacin, followed by erythromycin (53.3%), and quinupristindalfopristin (51.1%). Inducible clindamycin-resistance was identified in 37.7% of the isolates and it was attributed to the presence of erm(A), erm(C) and a combination of erm(A) and erm(C) genes. Isolates which showed a phenotypic pattern of M R /L S (macrolide-resistance/lincosamide-sensitivity) harbored the msr(A) gene. In conclusion, we report a high rate of multidrug resistance among Indian strains of CA-MRSA and the emergence of the lineages ST2371 and ST8 in India.
Molecular Genetics, Microbiology and Virology, 2016
Background: Methicillin-resistant Staphylococcus aureus is the cause of nosocomial infections leading to high mortality. Since these strains have become prevalent in the world, it is necessary to identify and type them. Materials and Methods: This cross-sectional study was conducted to study a total of 1475 clinical specimens from Iranian patients in 2012-2013. Using phenotypic tests such as Gram stain, catalase, coagulase, DNase and mannitol fermentation 169 isolates of Staphylococcus aureus and by utilizing methicillin-resistance test 100 MRSA isolates were identified. SCCmec typing was performed by multiplex PCR method and the results were analyzed using chi-square tests by SPSS-18 software. Results: Disk agar diffusion test using cefoxitin disk (30 μg) showed methicillin resistance in 59% of our isolates. mecA and femB genes were identified in all of the MRSA isolates using PCR method. Frequency of SCCmec types and sub-types were as follow; SCCmecIII (77%), SCCmecI (5%), SCCmecIVa (1%), SCC-mecIVc (1%), Mixed isolates SCCmecIVc-III (1%) and Non typeable isolates (15%). Non typeable isolates recovered in two groups (10% without any band and 5% of multi-bands III-I). In this study, 82% of isolates were HA-MRSA, 3% were CA-MRSA and 15% were Non typeable. Conclusion: In our S. aureus isolates methicillin resistance was 59%. The most frequent SCCmec type was SCCmecIII (77%). Our results demonstrated the spread of HA-MRSA isolates in the community and propagating CA-MRSA isolates in the studied hospitals.
Genotypic Characterization of Clinical Isolates of Staphylococcus aureus from Pakistan
Pathogens
In this study, we compared pulsed-field gel electrophoretic (PFGE), multilocus sequence typing (MLST), Staphylococcal cassette chromosome mec (SCCmec), spa typing, and virulence gene profiles of 19 Panton–Valentine leucocidin (PVL)-positive, multidrug-, and methicillin-resistant clinical Staphylococcus aureus (MRSA) isolates obtained from a hospital intensive care unit in Pakistan. The isolates exhibited 10 pulsotypes, contained eight adhesin genes (bbp, clfA, clfB, cna, fnbA, fnbB, map-eap, and spa), 10 toxin genes (hla, hlb, hld, hlg, pvl, sed, see, seg, seh, and tst), and two other virulence genes (cfb, v8) that were commonly present in all isolates. The spa-typing indicated seven known spa types (t030, t064, t138, t314, t987, t1509, and t5414) and three novel spa types. MLST analysis indicated eight ST types (ST8, ST15, ST30, ST239, ST291, ST503, ST772, and ST1413). All isolates belonged to the agr group 1. Most of the isolates possessed SCCmec type III, but some isolates had it...
Intisari Sains Medis
Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is a big challenge for health services worldwide which causes infections both in healthcare and community. Healthcare-associated MRSA (HA-MRSA) strains are shown to be resistant to beta-lactam antibiotics and several non-beta lactam antibiotics. At the same time, the community-associated MRSA (CA-MRSA) tends to be resistant to beta-lactam antibiotics. MRSA carried staphylococcal cassette chromosome (SCCmec) types I, II, III, IV, and V. SCCmec types I, II, and III were predominantly found in HA-MRSA strain while SCCmec types IV and V predominantly found in CA-MRSA strains. Furthermore, the panton valentine leukocidine (pvl) gene is commonly found in CA-MRSA strains. Therefore, this study aimed to determine the prevalence of SCCmec types I, II, III, and pvl gene in MRSA isolated from clinical specimens in Sanglah General Hospital. Methods: This study was a cross-sectional descriptive study. MRSA was isolated from clinical...
Molecular Epidemiology of Methicillin Resistant Staphylococcus aureus (MRSA) in India
Research Journal of Pharmaceutical, Biological and Chemical Sciences
From 2006 to 2009, 315 clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates were collected from 5 hospitals across Israel. Most isolates (64%) were related to the global clones spa types t001-SCCmec-I (SCCmec-I stands for staphylococcal cassette chromosome mec type I) (n ؍ 99; 31%), t002-SCCmec-II (n ؍ 82; 26%), and t008-SCCmec-IV (n ؍ 21; 7%), five of which were identified as MRSA strain USA-300. Seventeen strains unique to Israel were identified. SCCmec types IV and V were common among hospital-acquired isolates.
Online journal of Health and Allied Sciences , 2024
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) has been known as an infectious pathogen worldwide since 1960. The epidemiological distribution of MRSA may have shifted due to outbreaks reported from several nations, making it more challenging to differentiate among CA-MRSA and HA-MRSA. It is currently important to develop a strain-based explanation for HA and CA-MRSA due to its distinct epidemiology, genetic profile, antibiogram, and quantifiable features. The study aimed to distinguish CA and HA-MRSA by Staphylococcal Cassette Chromosome mec (SCCmec) typing. Materials and Method: The study involved a total of 381 S. aureus isolates, which were processed in the department of Microbiology, JSS Hospital, Mysore. All isolates were confirmed as MRSA, initially by disk diffusion method using cefoxitin 30µg and oxacillin 1μg disk and later by using PCR technique for the detection of mecA-gene. All mecA-gene positive samples were amplified for SCCmec typing by multiplex PCR for detection of SCCmec type I, II, III, IVa, IVb, IVc, IVd, V and XI respectively. Results: PCR confirmed a total of 66% isolates as mecA-positive MRSA. Multiplex PCR method revealed only 53% isolates were SCCmec-typeable. The mainstream of the isolates belonged to SCCmec type IV (53.48%) and type V (44.18%), followed by type III (9.30%), type II (3%) and type I (1.16%) respectively. The study also demonstrated the presence of multiple SCCmec types in 10.46% of MRSA isolates. Staphylococcal cassette chromosome recombinase (ccr) typing determined only 43% of isolates were typeable. Conclusion: The study found that hospital-associated SCCmec type IV and type V were the most circulating strains in our healthcare setting. The research identified a few MRSA isolates with diverse SCCmec types. The presence of CA-MRSA infection in in-patients and HA-MRSA infection in This work is licensed under a Creative Commons Attribution-No Derivative Works 2.5 India License