Antibiotic Resistance Patterns and Virulence Determinants of Different SCCmec and Pulsotypes of Staphylococcus Aureus Isolated from a Major Hospital in Ilam, Iran (original) (raw)
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European Journal of Clinical Microbiology & Infectious Diseases
The aim of this study was to investigate the molecular features and the antibiotic resistance profile of 98 clinical Staphylococcus aureus isolates collected during 6 months in two hospitals of Kabul, Afghanistan. For all isolates, antimicrobial resistance patterns were determined by the disc diffusion method (including methicillin resistance which was detected using cefoxitin). The presence of the mecA/mecC genes was detected by PCR. Strains were then extensively characterized using microarray analysis. Of the 98 S. aureus isolates, methicillin-resistant S. aureus (MRSA) prevalence was high at 66.3%. Antibiotic susceptibility testing also revealed a high resistance rate to penicillin (100%), erythromycin (66.3%), ciprofloxacin (55.1%), and cotrimoxazole (40.8%). Resistance to tobramycin was detected in 25.5%, to gentamicin in 16.3%, to chloramphenicol in 34.7%, and to doxycycline in 23.5% of the isolates. All the MRSA isolates were mecA-positive and none of them harbored mecC. Isolates were grouped into twelve clonal complexes and twenty-seven distinct clones. The most frequently detected clones were the Southwest Pacific clone (CC30-MRSA-IV PVL+) (21/65 MRSA, 32.3%), the CC22-MRSA-IV TSST-1+ clone (11/65 MRSA, 16.9%), and the Bengal Bay clone (ST772-MRSA-V PVL+) (11/65 MRSA, 16.9%). The PVL genes were found in 59.2% (46/65 MRSA and 12/33 methicillin-susceptible S. aureus, MSSA) and tst1 gene in 16.3% of isolates. This molecular study highlights the high prevalence of MRSA and the large genetic diversity of the S. aureus isolates circulating and detected in two hospitals of Kabul, with the presence of multiple virulence and antibiotic resistance genes.
Molecular typing of Staphylococcus aureus collected from a Major Hospital in Amman, Jordan
The Journal of Infection in Developing Countries, 2014
Introduction: Over the past decade methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as a major cause of healthcare associated infections. Recently, however, epidemiology of this pathogen has changed drastically with the emergence of new clones in the community. Efficient epidemiological typing methods are essential to monitor and limit the occurrence and spread of epidemic clones. Methodology: A total of sixty S. aureus isolates were collected from the Jordan University hospital in Amman-Jordan. All isolates were characterized using Staphylococcus protein A (spa) typing and pulsed-field gel electrophoresis (PFGE). Samples were tested for their susceptibility patterns against seven antimicrobial agents and for their potential to form biofilms. Results: spa typing showed that spa type t044 was the most common representing 28% of the isolates studied and 38% of the MRSA population. PFGE revealed fourty-six pulsotypes among the sixty tested isolates clustering similar spa types together. The predominant resistance was detected against levofloxacin, chloramphenicol and clindamycin. One MSSA isolate typed as spa t955 showed biofilm formation potential through protein deposition.. Conclusion: The study results are based on one hospital, but the findings of this and other studies conducted in the region indicate that there is an urgent need for standardized surveillances combined with the application of well-validated typing methods to assess the occurrence of MRSA and to control its spread.
Archives of Clinical Infectious Diseases, 2012
Background: Staphylococcus aureus is a major human pathogen. Due to high prevalence of S. aureus infections and increasing resistance to antibiotics, physicians have been facing problems in choosing the appropriate empirical antibiotic therapy for such infections. Objectives: The aim of this study was to determine the pattern of antibiotic resistance in S. aureus clinical isolates of Mashhad Quaem Hospital between 2009 and 2011. Materials and Methods: In this study 170 isolates of Staphylococcus aureus were identified in laboratory. The specimens (including 82 urine, 43 wound, 37blood, 8 stool samples) were collected and examined by standard diagnostic methods. Determination of S. aureus sensitivity to antibiotics was performed using standard disc diffusion method. The antibiotic sensitivity of bacteria were reported according to the clinical laboratory standards institute (CLSI) manual as sensitive (S), intermediate (I) and resistant (R). Results: Among tested antibiotics, Staphylococci isolates were highly resistant against Ceftazidime (94%), followed by Penicillin (91%), Ampicillin (82%), Cefotaxime (65%), Erythromycin (60%), and Oxacillin (43%). Nearly all strains were susceptible to tested Vancomycin. Conclusions: Our results are similar to the reports from other parts of Iran. According to this study, resistance pattern among Staphylococcus aureus strains were widespread in Quaem hospital. The implication of this high resistance is that Staphylococcus aureus infections should be treated more consciously and not with Penicillin and other ineffective antibiotics.
Introduction: Methicillin-resistant Staphylococcus aureus is commonly a cause of nosocomial infections. The increase in infection rates caused by this bacterium in developing countries has led to many problems. The aim of this study is to determine the antibiotic resistance pattern in methicillin- resistant S. aureus strains isolated from clinical specimens. Methods: In this cross-sectional study, 256 isolates of S. aureus were collected from Tabriz hospitals and treatment centers. The isolates were identified by standard laboratory methods and cultured in a specific environment. Identification of Methicillin-Resistant Staphylococcus aureus (MRSA) strains was made through phenotypic method. In order to evaluate antibiotic susceptibility patterns of strains, a disk diffusion method based on CLSI protocol was also performed. Data was analyzed by Chi-square test and SPSS. P value of <0.05 was considered as significant. Results: Out of 256 examined samples, 197 (76.95%) of them were methicillin-resistant Staphylococcus aureus. The phenotypic evaluation of the antibiotic resistance pattern of methicillin-resistant S. aureus showed that the highest resistance was for 100% penicillin antibiotics, 94.22% co- amoxiclav and 81.22% gentamicin antibiotics and the lowest resistance was observed as chloramphenicol (16.75%). There was no significant relationship between age, sex, and MRSA infections (P> 0.05). Conclusion: High resistance S. aureus to penicillin, co-amoxiclav, gentamicin and also the high frequency of isolation of MRSA of hospital studied samples are remarkable. The present study demonstrates the need for continuous monitoring of antimicrobial susceptibility in S. aureus in order to determine the optimal drug regimens
BMC Research Notes
Objectives Molecular typing such as spa typing is used to control and prevent Staphylococcus aureus widespread in hospitals and communities. Hence, the aim of this study was to find the most common types of S. aureus strain circulating in Shiraz via spa and SCCmec typing methods. Results Total of 159 S. aureus isolates were collected from two tertiary hospitals in Shiraz. Isolates were identified by biochemical tests. Antimicrobial susceptibility tests were performed by standard disk diffusion method and then genetic analysis of bacteria was performed using SCCmec and spa typing. In this study 31.4% of the isolates were methicillin-resistant S. aureus. The majority of isolates were SSCmec type III. Spa type t030 was the most prominent type among MRSA strains. For the first time in Iran, spa003, t386, t1877, t314, t186, t1816, t304, t325, t345 were reported in this study. It was shown that there is a possibility that these spa types are native to this region. Our findings showed that...
Chemotherapy, 2021
Background: Emergence and prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA) has become a major universal health concern, limiting therapeutic options. Methods: In the North side of Iran, during the years 2015 to 2017, a total number of 37 MRSA isolates, including 19 clinical isolates from hospitalized patients and 18 colonizing isolates from health care workers were identi ed from three hospitals, in Gorgan, North of Iran. Antimicrobial susceptibility test was performed using the disk diffusion method and E-test. The presence of virulence and antibiotic resistance determinants were evaluated by PCR. The genotypic characterization was further analyzed using multi-locus sequence, spa, SCCmec, and agr typing. Results: The frequency of MRSA among S. aureus isolates was 38.14% (37/97). The most frequent S. aureus resistant isolates were found to be obstinate against penicillin (98%) and gentamicin (82.5%). Additionally, the lowest resistance rates were found against daptomycin (0%), vancomycin (2.7%), and quinupristin-dalfopristin (5.4%). All MRSA isolates were susceptible to daptomycin with MIC 50 /MIC 90 of 0.25/0.5 µg/ml. One isolate belonging to the ST239-SCCmecIII/t037 clone (MIC≥16μg/ml) was resistant to vancomycin. All but one isolate that shares the ST22-SCCmec IV/t790 strain were positive for both tsst and pvl genes. The most predominant MRSA isolates (27%) were associated with the ST239-SCCmec III/t037 clone; and followed by ST239-SCCmec III/t924 (16.2%). Conclusions: In our study, circulating MRSA strains were genetically diverse with a high prevalence of the ST239-SCCmecIII/t037 clone. These ndings emphasize the need for future and continuous surveillance studies on MRSA to prevent the dissemination of multidrug resistance and existing MRSA clones in an effective manner. [2, 13]. The geographical differences in the genotypic characteristic of MRSA have been reported [2]. In Asia, there is signi cant divergence among countries and regions with respect to prevalence of MRSA; in fact, ST22-SCCmec IV/t790 and ST239-SCCmec III/t037 clones are predominant among patients in Iran [2, 14], and so is ST239-spa t037 and ST5-spa t002 in China [15]. On the other hand, in many regions in Asia [16, 17], sequence type 239 (ST239) is most prevalent, where, in UK, ST36 and ST30 are the most common types [18]. With this background, we are evaluating the molecular characteristics, antibiotic resistance patterns, and virulence genes pro les of MRSA isolates obtained from two kinds of study populations, namely hospitalized patients and health care workers (HCWs) in Gorgan, North of Iran. Methods Study Design and Sample Collection of S. aureus Isolates This cross-sectional study was conducted from January 2, 2016 to October 28, 2018 in three hospitals (total of 920-beds) in Gorgan, North of Iran. Written informed consent was obtained from all the patients or HCWs and the study protocol was approved by the Ethics Committee in Golestan University of Medical Sciences (No. 31078693122419), and was conducted in accordance with the Declaration of Helsinki. The demographic pro les of patients and HCWs were recorded. We identi ed S. aureus and MRSA in hospitalized patients and HCWs as well (Table 1). Only the rst sample of each patient was included in the study. In case of HCWs, samples were collected from both anterior nares. 302 unduplicated clinical samples (blood, urine, wound, sputum, and others) were obtained from in-patients, out of which S. aureus and MRSA were identi ed in 53 (17.5%), and 19 specimens (6.29%), respectively. Likewise, 351 unduplicated non-clinical samplings from the anterior nares of HCWs were carried out. All the samples were sent for bacterial culturing and identi cation, using Gram staining, and standard biochemical tests, such as catalase, tube coagulase, DNase test, and mannitol fermentation [19]. The identi cation process of all S. aureus isolates was con rmed by using genotypic methods for the presence of nucA, and femA genes [2, 20]. Data on department and period of hospitalization, clinical symptoms, antibiotic usages, and underlying conditions were recorded.
Iranian Journal of Microbiology, 2018
Background and Objectives: Staphylococcus aureus is an important pathogen that can be colonized in the nose and increase the risk of spreading infections in hospitals. The present study aimed at determining the phenotypic and genotypic characterization of S. aureus strains isolated from patients and healthcare workers (HCWs) from a teaching hospital in Isfahan, Iran. Materials and Methods: This cross-sectional study was performed on 262 nasal swabs and 23 clinical isolates that were collected from a teaching hospital during February and April 2016. Staphylococcal cassette chromosome mec (SCCmec) and multilocus sequence typing (MLST) were performed for selected isolates. Results: Overall, 23% and 18% of healthcare workers and patients were carriers, respectively. Methicillin-resistant S. aureus (MRSA) rate was 13%, 33% and 52% in nasal HCWs, nasal patients, and clinical samples, respectively. The molecular typing of MRSA isolates revealed that the most common SCCmec type is SCCmec ty...
Jundishapur Journal of Microbiology, 2021
Background: Staphylococcus aureus is a bacterial pathogen that can cause a wide range of nosocomial infections. Nasal colonization by S. aureus plays an important role both in the epidemiology and pathogenesis of infection. Objectives: This study aimed at detecting the biofilm-forming capacity of clinical isolates and detection of icaA and agr genes. Methods: A total of 150 clinical specimens was collected from patients in different hospitals in Baghdad. The clinical samples included wounds, abscess, sputum, and ear infections. The suspected isolates were cultured for one day at 37 °C on mannitol salt agar in an aerobic environment. Results: The results showed that of 150 samples, 44 isolates were S. aureus (29.3%), of wounds samples, 22 isolates (45.83%) were S. aureus, 13 (37.14%) were from abscess, 7 (17.95%) from sputum, and 2 isolates (7.14%) from ear samples. This study found that most isolates formed biofilm, but the levels of biofilm were distributed across three ranges. The...
International Journal of Enteric Pathogens, 2015
Background: Biofilm formation plays an important role in resistance of Staphylococcus aureus isolates; especially multidrug-resistant isolates are a threat to healthcare settings. Objectives: The aims of this study were to detect biofilm formation and presence of several related genes among multidrug-resistant (MDR) isolates of Staphylococcus aureus. Patients and Methods: A total Of 209 S. aureus strains were isolated from patients and identified by conventional diagnostic tests. The multidrug-resistant MRSA isolates were detected by antibiotic susceptibility test. The phenotypic biofilm formation was detected by microtitre tissue plate assay. The polymerase chain reaction (PCR) was performed to detect the mecA, Staphylococcal Cassette Chromosome mec (SCCmec) types, accessory gene regulatory (agr) genes, the icaADBC and several genes encoding staphylococcal surface proteins including clfAB, fnbAB, fib, eno, can, ebps and bbp genes with specific primers. Results: Sixty-four (30.6%) isolates were methicillin-resistant, among which thirty-six (56.2%) were MDR. These isolates were resistant to amoxicillin, tetracycline, ciprofloxacin, gentamicin, erythromycin and trimethoprim-sulfamethoxazole (except to 6 isolates). All the isolates were susceptible to vancomycin and linezolid. All the MDR-MRSA harbored SCCmec type III. All the MDR-MRSA isolates were strong biofilm producers in the phenotypic test. The majority of MDR-MRSA was belonged to agrI (67%, n = 24), followed by agr II (17%, n = 6), agrIV (11%, n = 4) and agrIII (5.5%, n = 2). The frequency of icaADBC genes were 75% (n = 27), 61% (n = 22), 72% (n = 26) and 72% (n = 26), respectively. Furthermore, the prevalence of clfA, clfB, fnbA, fnbB, fib, can, eno, ebps and bbp genes was 100%, 100%, 67%, 56%, 80%, 63%, 78%, 7% and 0%, respectively. Furthermore, approximately all the MRSA was strong biofilm producers. Conclusions: Multidrug-resistant isolates produced biofilm strongly and the majority harbored most of biofilm related genes, suggesting that biofilm formation is associated to the presence of these genes, and also biofilm production can increase the antibiotic resistance as have demonstrated in MDR-MRSA isolates.