Prophage Typing of Methicillin Resistant Staphylococcus aureus Isolated from a Tertiary Care Hospital in Tehran, Iran (original) (raw)
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Jundishapur Journal of Microbiology, 2023
Background: In hospitals and communities, Methicillin-resistant Staphylococcus aureus (MRSA) plays a critical role due to its ability to acquire resistance against several antibiotics and play a role in the spread of diseases. Objectives: This research aimed to investigate the pattern of antibiotic resistance in MRSA isolates and perform molecular typing of MRSA isolates using various elements, including SCCmec type, ccr type, prophage type, and gene toxin profiles. Methods: The research spanned 20 months at Al-Zahra Hospital in Isfahan and involved 148 isolates from various anatomical sites. The isolates were evaluated for their antibiotic susceptibility patterns. They were characterized by screening for SCCmec typing, ccr typing, phage typing, and PCR profiling of pvl, hlb, sak, eta, and tst toxin genes. Results: From 148 total S. aureus isolates, 42% (n = 62) were methicillin-resistant. The MRSA isolates demonstrated substantial resistance to penicillin and ciprofloxacin, and 90.3% of MRSA isolates were multiple-drug resistant. Also, SCCmec types III, I, and IV were identified in 45.16%, 35.48%, and 19.35% of MRSA isolates, respectively. Also, seven prophage patterns and 15 toxin patterns were detected among MRSA isolates. Conclusions: Multi-drug resistance is common among MRSA isolates. The only effective drug among the investigated antibiotics was chloramphenicol. The MRSA isolates can be controlled by changing the prescribing procedure of antibiotics and applying infection control strategies. The studied MRSA isolates can cause a wide range of diseases due to having several bacteriophages that encode virulence factors. Identification of different types of prophages may be useful in predicting such pathogenic agents.
Saudi Journal of Biological Sciences, 2009
Staphylococcus aureus is one of the major causes of community and hospital-acquired infections. Bacteriophage considered as a major risk factor acquires S. aureus new virulence genetic elements. A total number of 119 S. aureus isolated from different specimens obtained from (RKH) were distinguished by susceptibility to 19 antimicrobial agents, phage typing, and PCR amplification for mecA gene. All of MRSA isolates harbored mecA gene, except three unique isolates. The predominant phage group is belonging to the (mixed group). Phage group (II) considered as an epidemiological marker correlated to β-lactamase hyper producer isolates. MRSA isolates indicated high prevalence of phage group (II) with highly increase for phage types (Ø3A), which were correlated to the skin. Phage types (Ø80/Ø81) played an important roll in Community Acquired Methicillin Resistant S. aureus (CAMRSA). Three outpatients MRSA isolates had low multiresistance against Bacitracin (Ba) and Fusidic acid (FD), considered as CAMRSA isolates. It was detected that group I typed all FD-resistant MSSA isolates. Phage groups (M) and (II) were found almost to be integrated for Gentamycin (GN) resistance especially phage type (Ø95) which relatively increased up to 20% in MRSA. Tetracycline (TE) resistant isolates typed by groups (II) and (III) in MSSA. Only one isolate resistant to Sulphamethoxazole/Trimethoprim (SXT) was typed by (III/V) alone in MSSA. MRSA isolates resistant to Chloramphenicol (C) and Ba were typed by all groups except (V). It could be concluded that (PERSA) S. aureus isolates from the wound that originated and colonized, and started to build up multi-resistance against the topical treatment antibiotics. In this study, some unique sporadic isolates for both MRSA and MSSA could be used as biological, molecular and epidemiological markers such as prospective tools.
Archives of Clinical Infectious Diseases, 2016
Background: Methicillin-resistant Staphylococcus aureus (MRSA) has been known as one of the most important nosocomial pathogens that able to produce a variety of virulence factors. Objectives: In this study, we aimed to describe the prevalence, presence of different virulence factors, staphylococcal cassette chromosome mec (SCCmec) and prophage typing of MRSA strains isolated from a referral hospital in Tehran, Iran. Materials and Methods: A total of 279 S. aureus strains were collected from a referral hospital in Tehran during August to December of 2013. All isolates were confirmed using species specific primers and were tested for susceptibility to oxacillin and cefoxitin disks by the recommendations of clinical and laboratory standards institute (CLSI). The staphylococcal enterotoxin (sea-seq) and pvl, hlb and sak genes were detected and typed using prophage typing and SCCmec typing methods. Results: Out of the 279 S. aureus isolates, 91 (32.6%) strains were confirmed as MRSA. Totally, 6 enterotoxin and 2 virulence factor genes were detected in MRSA strains. The sea, sek, seq and hlb genes were present in all MRSA and sak, seg, sei and sel were detected in 85%, 35%, 23% and 44% of the strains. Only SCCmec type III and type 3 ccr and 2 different prophage patterns were identified among the strains. Conclusions: Our results show the presence of clonal groups of enterotoxin-producing MRSA strains in this hospital in Tehran. The presence of bacteriophage encoded virulence factors and resistance to oxacillin enable bacteria to produce a broad spectrum range of diseases.
innovative publication
Staphylococcus aureus remains as one of the most potent bacterial human pathogen because of its expression of various virulence factors and also due to its property of multidrug resistance. A total of 468 non –duplicate S.aureus strains obtained from various clinical specimens were included in the study. Methicillin Resistant S.aureus (MRSA) strains were screened for DNase production using DNase agar, hemolytic property of the isolates were detected in 5% sheep blood agar plates, hemagglutination property of the isolates were demonstrated using 1% O group RBC's,slime production was detected using congo red agar medium and biofilm production was quantitatively assayed by microtitre plate method. Antimicrobial susceptibility profile was studied for the MRSA isolates. Out of 468 S.aureus strains, 114(24%) strains were detected as MRSA. Among the MRSA strains 99(86%) were positive for DNase, 77(67%) were showed beta hemolysis, 49 (42%) strains were positive for hemagglutination, 70 (61%) were slime producers, most of the strains were biofilm producers, 4(3.5%) were non-adherent, 85(74%) were weakly adherent, 23(20%) were moderately adherent and 2(1.7%) were strongly adherent. About 56%, 60% and 63% of the isolates were resistant to cotrimoxazole, erythromycin and ciprofloxacin respectively and about 22% and 33% of the isolates showed resistance towards clindamycin and gentamicin respectively. All the isolates were sensitive to vancomycin, teicoplanin and linezolid. About 10(8.7%) strains showed high level mupirocin resistance (HLMR) and 1(0.8%) strain showed low level mupirocin resistance (LLMR). Both HLMR and LLMR (100%) strains showed susceptibility to fusidic acid. MRSA infections remain a major threat in both community and nosocomial settings. Therefore a thorough understanding of its virulence mechanisms and regular surveillance of antimicrobial susceptibility pattern will help the clinician to choose appropriate treatment options and to control the emergence of multidrug resistant strains.
Bacteriophage types of methicillin-resistant Staphylococcus aureus in a tertiary care hospital
Australasian Medical Journal, 2013
Background Phage typing had been utilised extensively to characterise methicillin-resistant Staphylococcus aureus (MRSA) outbreak strains in the past. It is an invaluable tool even today to monitor emergence and dissemination of MRSA strains. Aims The aim of this study was to determine the prevalent phage types of MRSA in south India and the association between phage types, antibiotic resistance pattern and risk factors. Method A total of 48 non-duplicate MRSA strains recovered from various clinical samples during January to December, 2010 were tested against a panel of anti-staphylococcal antibiotics. Phage typing was carried out at the National Staphylococcal Phage Typing Centre, New Delhi. Out of 48, 32 hospitalised patients were followed up for risk factors and response to empirical and post sensitivity antibiotic therapy. The risk factors were compared with a control group of 30 patients with methicillin sensitive Staphylococcus aureus (MSSA) infection. Results Amongst the five prevalent phage types, 42E was most common (52%), followed by a non-typable variant (22.9%), 42E/47/54/75 (16.6%), 42E/47 (6.2%) and 47 (2%). Phage type 42E was the predominant strain in all wards and OPDs except in the ICU where 42E/47/54/75 was most common. Although not statistically significant, strain 42E/47/54/75 (n=8) showed higher resistance to all drugs, except ciprofloxacin and amikacin, and were mostly D-test positive (87.5%) compared to the 42E strain (32%). Duration of hospital stay, intravenous catheterisation and breach in skin were the most significant risk factors for MRSA infection. Conclusion We found MRSA strain diversity in hospital wards with differences in their antibiotic susceptibility pattern. The findings may impact infection control and antibiotic policy significantly.
The Open Infectious Diseases Journal, 2018
Background: The multidrug resistance of Methicillin Resistant Staphylococcus aureus (MRSA) has become increasingly a major problem and responsible for most of the hospital acquired infections seen in local hospitals in Egypt. This emphasizes the importance of rapid detection of MRSA and investigating their virulence determinants that may be used as a target for certain anti-infectious agents that could help in the control measures in our hospitals. The aim of this study was to investigate some virulence determinants in MRSA isolates. Materials and findings: A total number of 164 bacterial isolates were recovered from different clinical specimens obtained from Ain Shams University Hospital patients (El Demerdash). Of these, 99 isolates (60.4 %) were recovered from pus, 35 isolates (21.3 %) from sputum, 18 (11 %) isolates from nasal swabs, 11 (6.7 %) isolates from blood and one isolate (0.6 %) was recovered from prostatic exudates. A total of 59 isolates were identified as S. aureus using microscopical examination, culture characteristics and biochemical reactions. Screening for methicillin resistance was done by agar disc diffusion method using cefoxitin discs. Out of the 59 S. aureus isolates, 48 ones were MRSA. Thereafter, all MRSA isolates were investigated for protease, lipase, hemolysin as well as biofilm formation. Results showed that all MRSA isolates possess protease activities while most of them did not show hemolysin or lipase activities. On the other hand, all MRSA isolates showed capability to form biofilm. The statistical analysis showed that there was a significant increase in mean biofilm formation among highly resistant isolates compared to those of moderate and low resistant ones (P<0.01).
Annals of International medical and Dental Research, 2016
Background: Increasing prevalence of Methicillin-resistant Staphylococcus aureus (MRSA), a major pathogen in both health care facilities and community, is an escalating public health concern. Knowledge of prevalence of MRSA and their current antimicrobial profile becomes necessary in the selection of appropriate empirical treatment of these infections. Aims & Objectives: To estimate the prevalence of MRSA & to evaluate its antibiotic sensitivity pattern and to determine Bacteriophage typing for epidemiological purposes. Methods: A total of 182 isolates of Staphylococcus aureus, collected over a period of two years, were screened by various phenotypic assays. Randomly selected 50 MRSA isolates were sent to Maulana Azad Medical College, New Delhi, for Bacteriophage typing. Antibiotic sensitivity test was done by Kirby Bauer's disc diffusion method. Results: Among the 182 isolates, 120(65.93 %) were identified as MRSA & 62(34.07 %) were identified as MSSA by various phenotypic methods. 50 isolates was sent for PhageTyping. 42(84%) strains were typable. 35(70%) strains belonged to phage III, 1(2%) to phage group II, 6(12%) to more than one phage groups. More than70% strains were resistant to Co-Trimoxazole, Erythromycin, Ciprofloxacin and Gentamicin, but were highly sensitive to Chloramphenicol and Clindamycin. 100% sensitivity was observed with Vancomycin, Teicoplanin and Linezolid. Conclusion: It is alarming that the present study reports a high prevalence (65.94%) of MRSA infection. In our study, 70% of the MRSA isolates belong to group III Phage, especially phage no.47. Despite the glycopeptides, Chloramphenicol, and preferably Clindamycin can be used to treat Staphylococcus infections.
This study reports the virulence characteristics of Methicillin-resistant Staphylococcus aureus (MRSA) isolates from different Mansoura Hospitals. From 120 S. aureus isolates 88 isolates were identified as MRSA by screening with the cefoxitin and oxacillin disc diffusion method and molecular method. Wound was considered the most predominant source for isolation of MRSA in our study. In addition, it was found that the highest prevalence of virulence factors were detected in wound isolates. Antimicrobial sensitivity testing revealed that 78.4% of MRSA isolates were resistant to cefotaxim and 54.5% of MRSA isolates were resistant to gentamicin. The most suitable antibiotic in the present study for treatment of MRSA was vancomycin and linezolid where only 0% and 4.5% were resistant respectively. Ten virulence genes (LukE, LukD, LukF, LukS, hla, geh, cna, icaA, icaD and tst) were detected by PCR. Among all tested genes, LukE (89.74%) and tst (4.55%) genes exhibited the highest and lowest frequencies, respectively. Our results indicate MRSA infection remains a significant problem in Mansoura Hospitals and to solve the MRSA infection problem effectively, further efforts toward infection control and management strength should be made with more studies about MRSA.
BioMed Research International
In order to restrict the spread of methicillin-resistant S. aureus (MRSA) in hospitals, it is necessary to characterize isolates rapidly and precisely. The objective of this study was to determine virulence factors and resistance profiles of MRSA strains among spa, agr, and SCCmec types. In total, 55 MRSA isolates were collected from clinical specimens. The MRSA isolates were characterized by antimicrobial susceptibility testing, virulence genes, agr typing, spa typing, and SCCmec typing. According to our findings, all MRSA strains were resistant to cefoxitin; 88% and 86.7% of which were resistant to erythromycin and clindamycin, respectively. Type II agr was predominant with 54.54% frequency. Among 27 different spa types, type t030 was most frequently (25.45%). Most MRSA isolates (63.3%) were SCCmec type III. The pvl and tst genes were found in 25.3% and 32.7% of MRSA isolates, respectively. Among the MRSA strains, ermA, ermB, and ermC were present in 50%, 33.3%, and 57.3% of cases...
OBJECTIVE: To find out the prevalent phage groups of Staphylococcus aureus strains (S. Aureus), and find out their correlation with antibiotic resistance. MATERIALS AND METHODS: A total of 104 S. Aureus isolates were obtained from heterogenous clinical samples and their antimicrobial susceptibility was determined against 13 antibiotics by the Kirby Bauer disk diffusion method in accordance with the Clinical and Laboratory Standards Institute guidelines. They were phage typed by the international set of Staphylococcal phages at the National reference centre, Maulana Azad Medical College (MAM), New Delhi. RESULTS: Phage groups identified during this study period were III, NT, Mixed, II, and I in the order of 36, 34, 26, 5, and 3 (34.7, 32.7, 25 ,4.8, and 2.9 %) respectively. Based on resistance of S. aureus strains to cefoxitin, it was observed that 78(75%) of the S. aureus were MRSA and only 26 (25%) were MSSA. Analysis of Phage groups in relation to MRSA / MSSA revealed maximum number of MRSA 29 (37.18%) were non-typable. All the S. aureus strains (100%) were susceptible to vancomycin, linezolid, rifampicin, fusidic acid, clindamycin and teicoplanin. The resistance pattern of MRSA / MSSA to penicillin, oxacillin, doxycycline, erythromycin, gentamicin, co-trimoxazole, and ciprofloxacin were in the order of 98.7/ 96.2, 84.6/ 0, 21.8/11.5, 55.1/34.6, 51.3/ 7.7, 24.3/7.7, and 85.9/ 61.5% respectively. CONCLUSION: Using the international set of bacteriophages 67.3% of S. aureus strains were phage typed and the predominant phage group was III -84/47. Among MRSA 37.18% strains were non typable (NT). No strain was found in phage group V and non-allocated (NA). All tested isolates were sensitive to vancomycin, linezolid, rifampicin, fusidic acid, clindamycin and teicoplanin. When compared to MSSA strains, most of the MRSA strains were found to be resistant to commonly used antibiotics. Mixed group strains were significantly sensitive to gentamicin, penicillin and oxacillin (P<0.05). Phage group III strains were resistant to gentamicin when compared to strains of phage group I, II, Mixed.