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Yıldız SS, Hekimoğlu CH, Sucaklı MB, Bakkaloğlu Z, Çevik YN, Ünaldı Ö, Arslantürk H, Zikusooka M, Keçik M, Nellums L, Elci OC. Community-acquired antimicrobial resistance among Syrian refugees and the local population in Türkiye. Eur J Public Health 2023; 33:809-814. [PMID: 37464952 PMCID: PMC10567246 DOI: 10.1093/eurpub/ckad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The long-standing antimicrobial resistance (AMR) pandemic has proven difficult to resolve and is becoming more complex, especially in the context of increasing forced migration, with little evidence around patterns of AMR in migrant communities. This study aimed to determine the frequency in the carriage of common types of antimicrobial-resistant bacteria between Syrian refugees and the local communities in Türkiye: extended-spectrum β-lactamase (ESBL), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). METHODS We collected nasal swabs and stool samples from the study participants, the local community members, and refugees, between September 2020 and March 2021. We screened clinical samples for the presence of ESBL, MRSA and VRE. Antimicrobial-resistant bacterial isolates were tested by phenotypic analysis to determine the AMR status. RESULTS The study included a total of 3960 participants: 1453 individuals in the local community (36.2%) and 2525 Syrian refugees (63.8%). Overall, a significantly greater proportion of refugees (6.7%) carried MRSA compared to the local community (3.2%) (P < 0.001). The ESBL-positivity rate was 17.9% in Syrian refugees and 14.3% in the local community (P = 0.041). Carbapenemase activity was detected in three isolates from Syrian refugees. No VRE was detected in Syrian refugees or the local community. CONCLUSIONS This large, community-based study on the frequency and the distribution of AMR among Syrian refugees and the local population is the first study in Türkiye.
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Affiliation(s)
- Serap Süzük Yıldız
- Department of Microbiology Reference Laboratory and Biological Product, Ministry of Health, General Directorate of Public Health, Ankara, Türkiye
| | - Can Hüseyin Hekimoğlu
- Department of Microbiology Reference Laboratory and Biological Product, Ministry of Health, General Directorate of Public Health, Ankara, Türkiye
| | | | - Zekiye Bakkaloğlu
- Department of Microbiology Reference Laboratory and Biological Product, Ministry of Health, General Directorate of Public Health, Ankara, Türkiye
| | - Yasemin Numanoğlu Çevik
- Department of Microbiology Reference Laboratory and Biological Product, Ministry of Health, General Directorate of Public Health, Ankara, Türkiye
| | - Özlem Ünaldı
- Department of Microbiology Reference Laboratory and Biological Product, Ministry of Health, General Directorate of Public Health, Ankara, Türkiye
| | - Hayal Arslantürk
- Department of Microbiology Reference Laboratory and Biological Product, Ministry of Health, General Directorate of Public Health, Ankara, Türkiye
| | - Monica Zikusooka
- World Health Organization, Türkiye Country Office, Ankara, Türkiye
| | - Melda Keçik
- World Health Organization, Türkiye Country Office, Ankara, Türkiye
| | - Laura Nellums
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Omur Cinar Elci
- World Health Organization, Türkiye Country Office, Ankara, Türkiye
- Clinical & Behavioral Medicine, Western Atlantic University School of Medicine Freeport, Grand Bahama, The Bahamas
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Pasandideh NK, Tahmasebi H, Dehbashi S, zeyni B, Arabestani MR. Inhibitory activities of vitamins K2 against clinical isolates of quinolone-resistant and methicillin-resistant Staphylococcus aureus (QR-MRSA) with different multi-locus sequence types (MLST), SCCmec, and spa types. Eur J Med Res 2022; 27:295. [PMID: 36528637 PMCID: PMC9758948 DOI: 10.1186/s40001-022-00939-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The inhibitory activities of vitamins K2 against clinical isolates of quinolone-resistant and methicillin-resistant Staphylococcus aureus (QR-MRSA) are unclear. The main aim is to better understand of inhibitory activities of vitamins K2, multi-locus sequence typing (MLST), SCCmec, and spa typing in clinical isolates of QR-MRSA on those mutation and gene expressions. MATERIALS AND METHODS After collecting S. aureus clinical isolates and detecting QR-MRSA, the genes encoding norA, grlA, grlB, gyrA, and gyrB were sequenced. After treating isolates by vitamin K2, isolates were prepared to measure norA, grlA, grlB, gyrA, and gyrB gene expression. The quantitative-real-time PCR was used to measure the expression of efflux pump genes. RESULTS QR-MRSA, MDR, and XDR strains were reported in 59.4%, 73.9%, and 37.6% of isolates, respectability. SCCmecIV (36.5%) and SCCmecV (26.8%) had the highest frequency. Thirty-nine spa types were identified, t021, t044, and t267 types most prevalent in QR-MRSA isolates. ST22 and ST30 dominated the invasive, drug-resistant isolates and QR-MRSA. In 24 h incubated isolates, the most noticeable change of gene expression with vitamin K2 was that the norA, gyrA, and grlB genes were highly repressed. However, the down-regulation of grlA at 24 h after being treated by vitamin K2 was more than another gene. Further, a significant decrease was observed in QR-MRSA-treated isolates compared to un-treated isolates. In other words, norA, grlA, grlB, gyrA, and gyrB genes were less suppressed by QR-MRSA (p ≤ 0.01, p ≤ 0.05). CONCLUSION Vitamin K2 has significant inhibitory effects on the genes responsible for resistance to fluoroquinolone antibiotics. However, a subminimum inhibitory concentration (sub-MIC) level of vitamin K2 was delayed but did not completely inhibit norA, grlA, grlB, gyrA, and gyrB genes in MRSA strains.
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Affiliation(s)
- Naime Kashefi Pasandideh
- Department of Microbiology, Faculty of Basic Sciences, Hamadan Branch, Islamic Azad University, Hamadan, Iran ,grid.411950.80000 0004 0611 9280Department of Microbiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamed Tahmasebi
- grid.444858.10000 0004 0384 8816School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran ,grid.411950.80000 0004 0611 9280Department of Microbiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sanaz Dehbashi
- grid.513395.80000 0004 9048 9072Department of Laboratory Sciences, Varastegan Institute of Medical Sciences, Mashhad, Iran ,grid.411950.80000 0004 0611 9280Department of Microbiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behrouz zeyni
- grid.513395.80000 0004 9048 9072Department of Laboratory Sciences, Varastegan Institute of Medical Sciences, Mashhad, Iran ,grid.411950.80000 0004 0611 9280Department of Microbiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Arabestani
- grid.513395.80000 0004 9048 9072Department of Laboratory Sciences, Varastegan Institute of Medical Sciences, Mashhad, Iran ,grid.411950.80000 0004 0611 9280Department of Microbiology, Hamadan University of Medical Sciences, Hamadan, Iran
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Rasheed NA, Abdulrahman RF, Hussein NR. Phylogenetic relatedness of methicillin-resistant Staphylococcus aureus isolates from the host community and Syrian refugees in Duhok Governorate based on 16S rRNA. IJID REGIONS 2022; 4:42-46. [PMID: 36093367 PMCID: PMC9453217 DOI: 10.1016/j.ijregi.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/01/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) isolates were identical and highly similar to globally published isolates. MRSA strains in the Iraqi and Syrian populations were genetically closely related. Study isolates were grouped into two major groups on the phylogenetic tree. Most strains in the study were SCCmec type IVa, clustered on the same tree lineage. The highest rate of vancomycin resistance was found among the isolates from refugees.
Objectives The aim of the study was to investigate the genetic relatedness between methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from the host community of Duhok City and Syrian refugees based on the partial sequences of the 16S rRNA gene, and to investigate the prevalence of SCCmec and vancomycin resistance. Methods Thirty MRSA isolates that had previously been detected and characterized were included. PCR was used for SCCmec typing, vancomycin detection, and amplification of the 16S rRNA gene for sequencing. Results The MRSA isolates were identical and highly similar to globally published S. aureus strains, especially human nasal cavity strains. The phylogenetic tree showed that the isolates were grouped into two major groups: groups 1 and 2. Group 2 was divergent from group 1 and included isolates from the host community and Syrian refugees (new arrivals). Group 1 included isolates from the three groups, and these were genetically closely related. Most strains in both study groups were SCCmec type IVa and clustered on the same lineage of the tree. The highest rate of vancomycin resistance was found among the isolates from refugees. Conclusions The close relationship between MRSA strains in the two study groups could be due to the geographical location of neighboring countries, which enhances the spread of MRSA strains between them.
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Affiliation(s)
- Narin A. Rasheed
- Medical Department, Akre Technical Institute, Duhok Polytechnic University, Duhok, Kurdistan Region, Iraq
- Corresponding author: Narin A. Rasheed, Medical Department, Akre Technical Institute, Duhok Polytechnic University, Duhok, Kurdistan Region, Iraq.
| | - Rezheen F. Abdulrahman
- Pathology and Microbiology Department, College of Veterinary Medicine, University of Duhok, Duhok, Kurdistan Region, Iraq
| | - Nawfal R. Hussein
- Department of Medicine, College of Medicine, University of Zakho, Zakho, Kurdistan Region, Iraq
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Khalid FK, Rasheed NA, Hussein NR, Naqid IA. A study of HBV infection and its risk factors in pregnant women in Zakho city, Iraq. PLoS One 2022; 17:e0273362. [PMID: 35998191 PMCID: PMC9397870 DOI: 10.1371/journal.pone.0273362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022] Open
Abstract
Background Despite vaccine and antiviral treatment availability, hepatitis B virus (HBV) continues to circulate among pregnant women in Iraq. HBV spread is due to many factors. This study evaluated HBV prevalence among pregnant women and Syrian refugees residing in Zakho city, Iraq, and identified risk factors associated with infection. Materials and methods Demographic data were collected from 2,054 pregnant women via a questionnaire assessing risk factors associated with HBV infection. Blood samples were collected for hepatitis B surface antigen (HBsAg) and were screened using an enzyme-linked immunosorbent assay. Results Tests revealed that 1.1% of pregnant women in Zakho and 11.3% of Syrian refugees (p = 0.001) were positive for HBsAg. The average age of HBsAg-positive patients was 31.4286 ± 6.6746 years (p = 0.002). Average rates of parity and abortion in HBV-infected subjects were 3.5 ± 2.6874 and 0.1785 ± 0.5479, respectively (p = 0.044 and 0.012, respectively). The following were identified as associated risk factors for HBV infection: nationality, (Zakho versus the city centre), tattoos, and polygamy (p = 0.001, 0.03, 0.007, and 0.001, respectively). No significant associations between HBV prevalence and blood transfusion, prior injection history, dental procedures, or surgical procedures were found. Conclusion The prevalence of HBV infection among Syrian refugees was higher than that of indigenous participants. Several risk factors were significantly associated with HBV positivity, which may facilitate effective preventive program implementation and decrease mother-to-child transmission risk. This will likely reduce infant and childhood HBV chronicity, and mortality rates.
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Affiliation(s)
- Fatima K. Khalid
- Department of Biomedical Sciences, College of Medicine, University of Zakho, Zakho, Kurdistan Region of Iraq, Iraq
| | - Narin A. Rasheed
- Department of Medical Microbiology, College of Medicine, University of Duhok, Duhok, Kurdistan Region of Iraq, Iraq
- * E-mail:
| | - Nawfal R. Hussein
- Department of Biomedical Sciences, College of Medicine, University of Zakho, Zakho, Kurdistan Region of Iraq, Iraq
| | - Ibrahim A. Naqid
- Department of Biomedical Sciences, College of Medicine, University of Zakho, Zakho, Kurdistan Region of Iraq, Iraq
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5
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The challenge of antibiotic resistance in post-war Mosul, Iraq: An analysis of 20 months microbiological samples from a tertiary orthopaedic care centre. J Glob Antimicrob Resist 2022; 30:311-318. [PMID: 35768065 DOI: 10.1016/j.jgar.2022.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/18/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Iraq has suffered unrest and conflicts in the past decades leaving behind a weakened healthcare system. In 2018, Médecins Sans Frontières (MSF) opened a tertiary orthopaedic care centre in Mosul providing reconstructive surgery with access to microbiological analysis. METHODS A retrospective cross-sectional analysis of microbiological and clinical data of patients admitted between April 2018 - December 2019. RESULTS There were 174 patients who were included in this study; there were more males than females (135 to 38 respectively), and the mean age was 32.6 years. Of the 174 patients, the majority had more than one bacterial isolate detected (n= 122, 70.1%); 141 (81.0%) had at least one multi-drug resistant (MDR) isolate detected during their hospital stay. Staphylococcus aureus (n=197, 48.2%) was the most common organism isolated. Overall, most isolates detected were MDR (n=352, 86%), mostly MRSA (n=186, 52.8%) or ESBL-producing Enterobacterales (n=117, 33.2%). Among patients admitted to the Operating Department (n=111, 63.7%), 81.1% (n=90) were admitted for violent trauma injuries. Patients who had more than one procedure performed per surgery had significantly increased odds of having at least one MDR organism isolated (OR 8.66, CI 1.10-68.20, p=0.03). CONCLUSION This study describes a high prevalence of antibiotic resistance in patients with trauma-related wounds in Mosul, Iraq. It highlights the importance of microbiological analysis and ongoing surveillance to provide optimal treatment. Additionally, it underscores the importance of infection prevention and control measures and antibiotic stewardship.
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Abdullahi IN, Lozano C, Ruiz-Ripa L, Fernández-Fernández R, Zarazaga M, Torres C. Ecology and Genetic Lineages of Nasal Staphylococcus aureus and MRSA Carriage in Healthy Persons with or without Animal-Related Occupational Risks of Colonization: A Review of Global Reports. Pathogens 2021; 10:1000. [PMID: 34451464 PMCID: PMC8400700 DOI: 10.3390/pathogens10081000] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 01/16/2023] Open
Abstract
In this conceptual review, we thoroughly searched for appropriate English articles on nasal staphylococci carriage among healthy people with no reported risk of colonization (Group A), food handlers (Group B), veterinarians (Group C), and livestock farmers (Group D) published between 2000 and 2021. Random-effects analyses of proportions were performed to determine the pooled prevalence of S. aureus, MRSA, MRSA-CC398, and MSSA-CC398, as well as the prevalence of PVL-positive S. aureus from all eligible studies. A total of 166 eligible papers were evaluated for Groups A/B/C/D (n = 58/31/26/51). The pooled prevalence of S. aureus and MRSA in healthy humans of Groups A to D were 15.9, 7.8, 34.9, and 27.1%, and 0.8, 0.9, 8.6, and 13.5%, respectively. The pooled prevalence of MRSA-CC398 nasal carriage among healthy humans was as follows: Group A/B (<0.05%), Group C (1.4%), Group D (5.4%); and the following among Group D: pig farmers (8.4%) and dairy farmers (4.7%). The pooled prevalence of CC398 lineage among the MSSA and MRSA isolates from studies of the four groups were Group A (2.9 and 6.9%), B (1.5 and 0.0%), C (47.6% in MRSA), and D (11.5 and 58.8%). Moreover, MSSA-CC398 isolates of Groups A and B were mostly of spa-t571 (animal-independent clade), while those of Groups C and D were spa-t011 and t034. The MRSA-CC398 was predominately of t011 and t034 in all the groups (with few other spa-types, livestock-associated clades). The pooled prevalence of MSSA and MRSA isolates carrying the PVL encoding genes were 11.5 and 9.6% (ranges: 0.0-76.9 and 0.0-28.6%), respectively. Moreover, one PVL-positive MSSA-t011-CC398 isolate was detected in Group A. Contact with livestock and veterinary practice seems to increase the risk of carrying MRSA-CC398, but not in food handlers. Thus, this emphasizes the need for integrated molecular epidemiology of zoonotic staphylococci.
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Affiliation(s)
| | | | | | | | | | - Carmen Torres
- Area of Biochemistry and Molecular Biology, University of La Rioja, Madre de Dios 53, 26006 Logroño, Spain; (I.N.A.); (C.L.); (L.R.-R.); (R.F.-F.); (M.Z.)
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7
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Osman M, Rafei R, Ismail MB, Omari SA, Mallat H, Dabboussi F, Cazer C, Karah N, Abbara A, Hamze M. Antimicrobial resistance in the protracted Syrian conflict: halting a war in the war. Future Microbiol 2021; 16:825-845. [PMID: 34223789 DOI: 10.2217/fmb-2021-0040] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The Syrian conflict has damaged key infrastructure and indirectly affected almost all parts of the Middle East and Europe, with no end in sight. Exhausting conditions created by the Syrian crisis and related massive displacement promote the emergence of numerous public health problems that fuel antimicrobial resistance (AMR) development. Here, we explore the current situation of the Syrian displaced population, and AMR inside Syria and among refugees in host countries. We then suggest a roadmap of selected key interventions and strategies to address the threat of AMR in the context of the Syrian crisis. These recommendations are intended to urge health policy-makers in governments and international health organizations to optimize and push for implementing an effective policy taking into consideration the current obstacles.
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Affiliation(s)
- Marwan Osman
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Department of Population Medicine & Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA
| | - Rayane Rafei
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Mohamad Bachar Ismail
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Faculty of Sciences, Lebanese University, Tripoli, Lebanon
| | - Sarah Al Omari
- Department of Epidemiology & Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hassan Mallat
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Fouad Dabboussi
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Casey Cazer
- Department of Population Medicine & Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA
| | - Nabil Karah
- Department of Molecular Biology, Umeå Centre for Microbial Research, Umeå University, Umeå, Sweden
| | - Aula Abbara
- Department of Infection, Imperial College, London, UK
| | - Monzer Hamze
- Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences & Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
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Holm MKA, Winther TN, Kammann S, Rasmusson MS, Brooks L, Westh H, Bartels MD. Prevalence of MRSA nasal carriage among pregnant women in Copenhagen. PLoS One 2021; 16:e0246343. [PMID: 33513178 PMCID: PMC7845946 DOI: 10.1371/journal.pone.0246343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/15/2021] [Indexed: 12/04/2022] Open
Abstract
Background Methicillin resistant Staphylococcus aureus (MRSA) frequently causes outbreaks in neonatal intensive care units (NICUs). It is believed that MRSA predominantly enters the NICU with MRSA colonized parents. In Denmark, 27 MRSA NICU outbreaks have been registered between 2008 and 2019. Aim The aim of this study was to determine the prevalence of MRSA nasal carriage in pregnant women in Copenhagen and to clarify if MRSA screening during pregnancy could add to the prevention of NICU outbreaks. Methods All pregnant women 18 years or older were offered MRSA nasal screening at their first midwife visit between 13 and 20 weeks of gestation. Results 1778 pregnant women were included, two (0.11%) carried MRSA in the nose. Conclusion Infants of the two MRSA positive women were not admitted to a NICU and therefore the screening had no impact on NICU outbreaks. The low prevalence of MRSA found in this study does not justify MRSA screening of all pregnant women in Denmark.
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Affiliation(s)
| | - Thilde Nordmann Winther
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Sisse Kammann
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Lis Brooks
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Henrik Westh
- Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mette Damkjær Bartels
- Department of Clinical Microbiology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Goudarzi M, Navidinia M, Dadashi M, Hashemi A, Pouriran R. First report of methicillin-resistant Staphylococcus aureus carrying the mecC gene in human samples from Iran: prevalence and molecular characteristics. New Microbes New Infect 2020; 39:100832. [PMID: 33425366 PMCID: PMC7777544 DOI: 10.1016/j.nmni.2020.100832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022] Open
Abstract
There is a lack of information concerning mecC clinical methicillin-resistant Staphylococcus aureus (MRSA) strains throughout the world. In the present survey, 345 MRSA strains were characterized by antimicrobial susceptibility testing and staphylococcal cassette chromosome mec element (SCCmec) typing. mecC-positive MRSA isolates were characterized by study of biofilm formability, adhesion and virulence analysis, multilocus sequence typing, accessory gene regulator (agr) typing, S. aureus protein A locus (spa) typing and staphylocoagulase typing. The present study found ten SCCmec types, with the majority being SCCmec type III (38.3%). The presence of mecC was confirmed in three isolates from skin wounds (two isolates) and burn wounds (one isolate). All the mecC-positive isolates carried SCCmec XI and belonged to coa type III. Molecular typing showed that these isolates belonged to clonal complex/ST130-spa type t843-agr type III (two isolates) and clonal complex/ST599-spa type 5930-agr type I. The presence of SCCmec type IV confirms the hypothesis of extensive infiltration from the community to the hospital. Detection of MRSA isolates harbouring the mecC gene highlights the need to perform routine detection methods and molecular investigations in order to identify these emerging strains and limit their transfer in hospitals and communities.
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Affiliation(s)
- M Goudarzi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Navidinia
- School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Dadashi
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - A Hashemi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - R Pouriran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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