Molecular Characterization, Virulence Determinants, and Antimicrobial Resistance Profile of Methicillin-Resistant Staphylococcus aureus in the North of Iran; a High Prevalence of ST239-SCCmec III/t037 Clone

Chemotherapy ◽  
2021 ◽  
pp. 1-10
Author(s):  
Hao Ying ◽  
Trias Mahmudiono ◽  
Tawfeeq Alghazali ◽  
Walid Kamal Abdelbasset ◽  
Parand Khadivar ◽  
...  

<b><i>Objectives:</i></b> Emergence and prevalence of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) have become a major universal health concern, limiting therapeutic options. <b><i>Methods:</i></b> A total number of 37 MRSA isolates, including 19 clinical isolates from hospitalized patients and 18 colonizing isolates from health care workers were identified from 3 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 genotypical characterization was further analyzed using multi-locus sequence, <i>spa</i>, staphylococcal cassette chromosome, <i>mec</i> (SCC<i>mec)</i>, and <i>agr</i> typing. <b><i>Results:</i></b> The frequency of MRSA among <i>S. aureus</i> isolates was 38.14% (37/97). The most frequent <i>S. aureus</i> 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 minimum inhibitory concentration (MIC)50/MIC90 of 0.25/0.5 μg/mL. One isolate belonging to sequence type 239 (ST239)-SCC<i>mec</i>III/t037 clone (MIC ≥16 μg/mL) was resistant to vancomycin. All but 1 isolate that shares ST22-SCC<i>mec</i> IV/t790 strain were positive for both <i>tsst</i> and <i>pvl</i> genes. The most predominant MRSA isolates (27%) were associated with ST239-SCC<i>mec</i> III/t037, and ST239-SCC<i>mec</i> III/t924 (16.2%) clones, subsequently. In our study, circulating MRSA strains were genetically diverse with a high prevalence of ST239-SCC<i>mec</i> III/t037 clone. <b><i>Conclusion:</i></b> These findings emphasize the need for future and continuous surveillance studies on MRSA to prevent the dissemination of existing multidrug resistance MRSA clones in an effective manner.

2020 ◽  
Author(s):  
Ebrahim Kouhsari ◽  
Mojgan Hosseini ◽  
Alireza Ahmadi ◽  
Parand Khadivar ◽  
Somayeh Rahimi ◽  
...  

Abstract 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 identified 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 MIC50/MIC90 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 findings 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.


Author(s):  
Joel Manyahi ◽  
Sabrina J. Moyo ◽  
Said Aboud ◽  
Nina Langeland ◽  
Bjørn Blomberg

AbstractDifficult-to-treat infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are of concern in people living with HIV infection as they are more vulnerable to infection. We aimed to identify molecular characteristics of MRSA colonizing newly diagnosed HIV-infected adults in Tanzania. Individuals newly diagnosed with HIV infection were recruited in Dar es Salaam, Tanzania, from April 2017 to May 2018, as part of the randomized clinical trial CoTrimResist (ClinicalTrials.gov identifier: NCT03087890). Nasal/nasopharyngeal isolates of Staphylococcus aureus were susceptibility tested by disk diffusion method, and cefoxitin-resistant isolates were characterized by short-reads whole genome sequencing. Four percent (22/537) of patients carried MRSA in the nose/nasopharynx. MRSA isolates were frequently resistant towards gentamicin (95%), ciprofloxacin (91%), and erythromycin (82%) but less often towards trimethoprim-sulfamethoxazole (9%). Seventy-three percent had inducible clindamycin resistance. Erythromycin-resistant isolates harbored ermC (15/18) and LmrS (3/18) resistance genes. Ciprofloxacin resistance was mediated by mutations of the quinolone resistance-determining region (QRDR) sequence in the gyrA (S84L) and parC (S80Y) genes. All isolates belonged to the CC8 and ST8-SCCmecIV MRSA clone. Ninety-five percent of the MRSA isolates were spa-type t1476, and one exhibited spa-type t064. All isolates were negative for Panton-Valentine leucocidin (PVL) and arginine catabolic mobile element (ACME) type 1. All ST8-SCCmecIV-spa-t1476 MRSA clones from Tanzania were unrelated to the globally successful USA300 clone. Carriage of ST8 MRSA (non-USA300) was common among newly diagnosed HIV-infected adults in Tanzania. Frequent co-resistance to non-beta lactam antibiotics limits therapeutic options when infection occurs.


2012 ◽  
Vol 45 (2) ◽  
pp. 189-193 ◽  
Author(s):  
Karinne Spirandelli Carvalho Naves ◽  
Natália Vaz da Trindade ◽  
Paulo Pinto Gontijo Filho

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is spread out in hospitals across different regions of the world and is regarded as the major agent of nosocomial infections, causing infections such as skin and soft tissue pneumonia and sepsis. The aim of this study was to identify risk factors for methicillin-resistance in Staphylococcus aureus bloodstream infection (BSI) and the predictive factors for death. METHODS: A retrospective cohort of fifty-one patients presenting bacteraemia due to S. aureus between September 2006 and September 2008 was analysed. Staphylococcu aureus samples were obtained from blood cultures performed by clinical hospital microbiology laboratory from the Uberlândia Federal University. Methicillinresistance was determined by growth on oxacillin screen agar and antimicrobial susceptibility by means of the disk diffusion method. RESULTS: We found similar numbers of MRSA (56.8%) and methicillin-susceptible Staphylococcus aureus (MSSA) (43.2%) infections, and the overall hospital mortality ratio was 47%, predominantly in MRSA group (70.8% vs. 29.2%) (p=0.05). Age (p=0.02) was significantly higher in MRSA patients as also was the use of central venous catheter (p=0.02). The use of two or more antimicrobial agents (p=0.03) and the length of hospital stay prior to bacteraemia superior to seven days (p=0.006) were associated with mortality. High odds ratio value was observed in cardiopathy as comorbidity. CONCLUSIONS: Despite several risk factors associated with MRSA and MSSA infection, the use of two or more antimicrobial agents was the unique independent variable associated with mortality.


Author(s):  
Abolfazl Jafari-Sales ◽  
Zahra Sadeghi Deylamdeh ◽  
Afsoon Shariat

Introduction: Staphylococcus aureus causes a wide range of infections and as a multivalent pathogen is one of the causative agents of nosocomial and community infections. Therefore, the aim of this study was to identify and determine the pattern of antibiotic resistance of methicillin-resistant Staphylococcus aureus (MRSA) isolates from patients in hospitals and medical centers in Marand city and also to evaluate the presence of mecA gene. Materials and Methods: In this cross-sectional descriptive study, 385 samples of S. aureus were collected from different clinical samples of patients in hospitals and medical centers of Marand city. S. aureus was identified using standard biochemical methods.  Methicillin resistance was determined by disk diffusion method in the presence of oxacillin and cefoxitin. The pattern of antibiotic resistance of the strains was determined by disk diffusion method and according to CLSI recommendation and also PCR method was used to evaluate the frequency of MecA gene. Results: In the present study, out of 385 samples of S. aureus, 215 (55.84%) samples were methicillin resistant. PCR results for mecA gene showed that 110 samples had mecA gene.  The highest antibiotic resistance was observed against penicillin (100%) and erythromycin (83.63%). Most MRSA were isolated from urine and wound samples. Conclusion: The results of this study indicate the prevalence of methicillin-resistant species and also the increase in antibiotic resistance of MRSA to various antibiotics.  Therefore, in order to prevent increased resistance to other antibiotics, it is recommended to avoid inappropriate use of antibiotics.


2021 ◽  
Vol 30 (1) ◽  
pp. 109-114
Author(s):  
Nancy M. Attia ◽  
Abeer Abd El Rahim Ghazal ◽  
Omnia M. Khaleel ◽  
Ahmed Gaballah

Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization is considered a major risk factor for nosocomial infections and its decolonization has reduced these infections. Mupirocin (MUP) is the topical antibiotic of choice for decolonization. MUP decolonization failure is attributed to MUP resistance. Objective: The aim of the current study is to assess MUP resistance among MRSA isolates phenotypically and genotypically. Methodology: Fifty MRSA isolates were identified in Microbiology Department in the Medical Research Institute hospital, Alexandria University. Antibiotic susceptibility to different classes of antibiotics by disk diffusion method was done. MUP minimum inhibitory concentration (MIC) was determined phenotypically by MUP Ezy MIC™ Strips. MUP resistance was determined genetically by multiplex PCR detection of mupA and mupB. Results: Of all MRSA isolates, 6% exhibited high level and none showed low level MUP resistance. Only mupA was detected in all resistant isolates. Conclusion: Despite low prevalence of MUP resistance, it is appropriate to test MUP resistance prior nasal decolonization


2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Zahra Hashemizadeh ◽  
Nahal Hadi ◽  
Samane Mohebi ◽  
Davood Kalantar-Neyestanaki ◽  
Abdollah Bazargani

Abstract 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 SCCmec II, III and IV disseminate from hospital to community and vice versa. Thus, effective monitoring of MRSA in hospital and community is necessary.


Antibiotics ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. 375
Author(s):  
Vanessa Silva ◽  
Sara Hermenegildo ◽  
Catarina Ferreira ◽  
Célia M. Manaia ◽  
Rosa Capita ◽  
...  

In this study we aimed to characterize antimicrobial resistance in methicillin-resistant Staphylococcus aureus (MRSA) isolated from bloodstream infections as well as the associated genetic lineages of the isolates. Sixteen MRSA isolates were recovered from bacteremia samples from inpatients between 2016 and 2019. The antimicrobial susceptibility of these isolates was tested by the Kirby–Bauer disk diffusion method against 14 antimicrobial agents. To determine the macrolide–lincosamide–streptogramin B (MLSB) resistance phenotype of the isolates, erythromycin-resistant isolates were assessed by double-disk diffusion (D-test). The resistance and virulence genes were screened by polymerase chain reaction (PCR). All isolates were characterized by multilocus sequence typing (MLST), spa typing, staphylococcal chromosomal cassette mec (SCCmec) typing, and accessory gene regulator (agr) typing. Isolates showed resistance to cefoxitin, penicillin, ciprofloxacin, erythromycin, fusidic acid, clindamycin, and aminoglycosides, confirmed by the presence of the blaZ, ermA, ermC, mphC, msrA/B, aac(6’)-Ie-aph(2’’)-Ia, and ant(4’)-Ia genes. Three isolates were Panton–Valentine-leukocidin-positive. Most strains (n = 12) presented an inducible MLSB phenotype. The isolates were ascribed to eight spa-types (t747, t002, t020, t1084, t008, t10682, t18526, and t1370) and four MLSTs (ST22, ST5, ST105, and ST8). Overall, most (n = 12) MRSA isolates had a multidrug-resistance profile with inducible MLSB phenotypes and belonged to epidemic MRSA clones.


2019 ◽  
Author(s):  
zahra hashemizadeh ◽  
nahal hadi ◽  
samane mohebi ◽  
davood kalantar-Neyestanaki ◽  
abdolla bazargani

Abstract Objectives: Molecular typing such as spa typing is used to control and prevent of Staphylococcus. aureus widespread in hospitals and community acquired. Hence, the aim of this study was to find the common types of S. aureus strains 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 SSC mec type ІІІ. Spa type t030 was the most prominent type among MRSA strains. In this study, for the first time in Iran, spa003, t386, t1877, t314, t186, t1816, t304, t325, t345 were reported. It was shown that there is a possibility that these spa types are natives to this region. Our findings showed that SCCmec ІІ, ІІІ and IV disseminate from hospital to community and vice versa. Thus, effective monitoring of MRSA in hospital and community is desirable. Keyword: Staphylococcus aureus , methicillin-resistant S. aureus (MRSA), SCCmec typing, spa typing


2021 ◽  
Vol 4 (1) ◽  
pp. 56
Author(s):  
Shinta Levea Ni'matul Fadlilah ◽  
Mustofa Helmi Effendi ◽  
Wiwiek Tyasningsih ◽  
Lucia Tri Suwanti ◽  
Jola Rahmahani ◽  
...  

This study aimed to determine the in vitro antibacterial activities of essential oil from cinnamon bark (Cinnamomum burmannii) on Methicillin-resistant Staphylococcus aureus (MRSA) isolated from raw milk. Essential oil from cinnamon bark obtained from the steam distillation method and essential oil was made in a series dilution with a concentration of 1%, 2%, 4%, and 8%. The antibacterial activities were tested using the disk diffusion method. Results showed from five isolates of MRSA, one isolate was sensitive of essential oil with a concentration 2% and all of the isolate was sensitive with a concentration 4% and 8%. The antibacterial activity showed by inhibition zones on  MRSA. The results suggest that the activity of the essential oils of cinnamon bark has an antibacterial effect on MRSA and it is developed as phytopharmaca.


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