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Asghar F, Bano A, Waheed F, Ahmed Anjum A, Ejaz H, Javed N. Association of exogenous factors with molecular epidemiology of Staphylococcus aureus in human oral cavity. Saudi J Biol Sci 2023; 30:103613. [PMID: 36936700 PMCID: PMC10018566 DOI: 10.1016/j.sjbs.2023.103613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/11/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
The frequency of Staphylococcus aureus strains associated with oral cavity microbiota has prodigious consideration. Although S. aureus has been reflected as an ephemeral member of the human oral cavity microbiota, the isolation, identification, and characterization of S. aureus is important. The present study aimed to characterize S. aureus strains from the oral cavity microflora, isolation of S. aureus from the human oral cavity microbiota, and demographic information of the participants to evaluate exogenous factors associated with the presence of S. aureus and their genetic analysis linkage with different factors. The method used in this study is the isolation of oral cavity microbiomes using sheep blood agar and Mannitol salt agar. We performed antibiotic profiling with various antibiotics and genetic analysis utilizing gene-specific primers for specific genes, including nuc, mecA, pvl, agr, and coa. A significant number of S. aureus isolates were found in the oral cavity of humans 18/84 (21.42%), and all 18 strains tested positive for the confirmatory nuc gene. Antibiotic resistance-conferring gene mecA was positive in 10 (55.6%) isolates. It was found that the occurrence of pvl, agr, and coagulase (coa) genes was 9 (50%), 6 (33.33%), and 10 (55.6%), respectively. The genetic analysis reported that significant associations were present between male and mecA gene (P = 0.03) and coa (P = 0.03), smokers with the occurrence of mecA (P = 0.02), agr (P = 0.048) and coa (P = 0.02) genes. Likewise, the association of antibiotic usage was significantly found with mecA (P = 0.02), coa (P = 0.02); however, the individuals who have taken orthodontic treatment recently have a significant association with agr (P = 0.017). The use of mouth rinse was significantly associated with the prevalence of the pvl gene (P = 0.01), and tooth brushing frequency and inflammation of the buccal cavity were also statistically significant in relation to pvl gene prevalence (P = 0.02, 0.00, respectively). Moreover, calories and weight-controlled diet were significantly associated with mecA, agr, and highly significant with coa (P = 0.02, 0.048, 0.000), so all P < 0.05, and no significant association was found between the socioeconomic status of individuals with aforementioned analyzed genes.
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Affiliation(s)
- Farah Asghar
- Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Abida Bano
- Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Fadia Waheed
- Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Aftab Ahmed Anjum
- Quality Operations Laboratory, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Hasan Ejaz
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia
| | - Numan Javed
- Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
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Junaidi NSSA, Shakrin NNSM, Desa MNM, Yunus WMZW. Dissemination Pattern of Hospital-Acquired Methicillin-Resistant Staphylococcus aureus and Community-Acquired MRSA Isolates from Malaysian Hospitals: A Review from a Molecular Perspective. Malays J Med Sci 2023; 30:26-41. [PMID: 37102054 PMCID: PMC10125240 DOI: 10.21315/mjms2023.30.2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 01/06/2022] [Indexed: 04/28/2023] Open
Abstract
The global emergence of methicillin-resistant Staphylococcus aureus (MRSA) that unsusceptible to a wide selection of antimicrobial agents and any newly introduced antimicrobial over the past decades has triggered more extensive holistic measures to put an end to this situation. Molecular surveillance of MRSA clones is important to understand their evolutionary dynamics for investigating outbreaks, propagating precautionary measures, as well as planning for appropriate treatment. This review includes peer-reviewed reports on the molecular characterisation of clinical Staphylococcus aureus isolates within Malaysian hospitals from year 2008 to 2020. This work highlights the molecular clones of hospital-acquired MRSA (HA-MRSA) and community-acquired MRSA (CA-MRSA) isolates from Malaysian hospitals, with description on their ever-changing pattern. Among HA-MRSA, the ST22-t032-SCCmec IV MRSA clone was reported to supplant the previous dominating clone, ST239-t037-SCCmec III. Meanwhile, ST30, ST772, ST6 and ST22 were repeatedly detected in CA-MRSA, however, none of the strains became predominant. Future in-depth study on molecular epidemiology of MRSA clone is essential for the investigation of the extent of the clonal shift, especially in Malaysia.
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Affiliation(s)
| | - Nik Noorul Shakira Mohamed Shakrin
- Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur, Malaysia
- Centre for Tropicalization, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Nasir Mohd Desa
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- Laboratory of Halal Science Research, Halal Products Research Institute, Universiti Putra Malaysia, Selangor, Malaysia
| | - Wan Md Zin Wan Yunus
- Centre for Tropicalization, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur, Malaysia
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Gleich S, Kiefer-Trendelenburg T, Schlatterer K, Napp M, Monecke S, Arnold A, Goering R, Strommenger B, Werner G, Daeschlein G. Community-associated Methicillin-Resistant Staphylococcus aureus (ca-MRSA) as a Pandemic Pathogen: Risk Factors and Implications for Healthcare. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1707-7083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Abstract
Background A diversity of risk factors for ca-MRSA manifestations has been described so far. Up to date toxic contact dermatitis induced by plants has not been identified as one.
Patients and Methods After intense skin contact with poison ivy in the US a 24-year-old Afro-American showed pronounced bullous contact dermatitis on the back of the neck and subsequently massive ca-MRSA furunculitis with proof of Panton-Valentin-leukocidin (PVL). After travelling to Germany, his German girlfriend developed a subacute ca-MRSA, PVL-positive superinfection of a mosquito bite at her lower leg. Both infections required surgical intervention.
Results While the male patient displayed contact dermatitis by poison ivy, the female patient demonstrated two risk factors for ca-MRSA: contact with a ca-MRSA positive person and a predisposing skin lesion. Both cases underpin the role of ca-MRSA transmission and the potential severeness of wound infections in young and immunocompetent persons, just to be resolved by invasive intervention.
Conclusions Marked and recalcitrant skin or soft tissue infections in otherwise healthy young patients require instant microbiological analysis and surgical intervention flanked by adequate antibiotic therapy. Contact dermatitis induced by plant toxins should be taken into consideration as possible risk factor for the acquisition of ca-MRSA.
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Affiliation(s)
- Sabine Gleich
- Referat für Gesundheit und Umwelt, Department of Hygiene and Environmental Medicine, München, Germany
| | - Thomas Kiefer-Trendelenburg
- Department of Hematology-Oncology, Rehabilitationszentrum für Innere Medizin, Klinik am See, Rüdersdorf, Germany
| | - Kathrin Schlatterer
- Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
- Institute of Laboratory Medicine, Sankt Gertrauden Krankenhaus, Berlin, Germany
| | - Matthias Napp
- Department of Surgery, Universität Greifswald, Greifswald, Germany
| | - Stefan Monecke
- Institute for Medical Microbiology and Hygiene, Technical University of Dresden, Dresden, Germany
| | - Andreas Arnold
- Department of Dermatology, Universität Greifswald, Greifswald, Germany
| | - Richard Goering
- Department of Medical Microbiology and Immunology, Creighton University Medical Center, School of Medicine, Omaha, USA
| | - Birgit Strommenger
- National Reference Laboratory of Staphylococci, Robert-Koch-Institute, Wernigerode, Germany
| | - Guido Werner
- National Reference Laboratory of Staphylococci, Robert-Koch-Institute, Wernigerode, Germany
| | - Georg Daeschlein
- Section Dermatological Infectiology, Department of Dermatology, Städtisches Klinikum Dessau, Brandenburg Medical School, Dessau, Germany
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Wei J, Cheng X, Zhang Y, Gao C, Wang Y, Peng Q, Luo P, Yang L, Zou Q, Zeng H, Gu J. Identification and application of a neutralizing epitope within alpha-hemolysin using human serum antibodies elicited by vaccination. Mol Immunol 2021; 135:45-52. [PMID: 33873093 DOI: 10.1016/j.molimm.2021.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 11/15/2022]
Abstract
Staphylococcus aureus (SA), especially the methicillin-resistant variant (MRSA), is becoming a serious threat to human health in hospitals and communities, making the development of an effective vaccine urgent. Alpha-hemolysin (Hla) is a key virulence factor and also a good target for the development of SA vaccines. However, the epitopes in Hla recognized by human immunity are not characterized in detail, which hinders the design of epitope-based human vaccines against SA. In this study, we collected sera from volunteers in a phase 1b clinical trial of a novel recombinant five-antigen SA vaccine (NCT03966040). Using a Luminex-based assay, we characterized the human serologic response against Hla, and identified Hla121-138 as a neutralizing epitope. In addition, we successfully produced ferritin nanoparticles carrying the neutralizing Hla121-138 epitope (EpNP) in E. coli. EpNP presented as homogenous nanoparticles in aqueous solution. Immunization with EpNP elicited potent hemolysis-neutralizing antibodies and conferred significant protection in a mouse model of SA skin infection. Our data suggest that EpNP, carrying the neutralizing epitope Hla121-138, is a good candidate for a vaccine against SA.
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Affiliation(s)
- Jinning Wei
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China
| | - Xin Cheng
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China
| | - Yi Zhang
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China
| | - Chen Gao
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China
| | - Ying Wang
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China
| | - Qi Peng
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Ping Luo
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China
| | - Liuyang Yang
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China; Medical Laboratory Center, First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Quanming Zou
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China
| | - Hao Zeng
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China.
| | - Jiang Gu
- National Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing, 400038, PR China.
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He S, Lin J, Li L, Cai W, Ye J, Li Y, Zhang W, Liu N, Gong Z, Ye X, Yao Z. Multidrug-resistant Staphylococcus aureus nasal carriage among HIV-positive outpatients in Guangzhou, China: Prevalence, risk factors, phenotypic and molecular characteristics. J Infect Chemother 2020; 27:218-225. [PMID: 33039268 DOI: 10.1016/j.jiac.2020.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Data on comprehensive characterization of multidrug-resistant (MDR) Staphylococcus aureus (S. aureus) carriage in human immunodeficiency virus (HIV)-positive patients are limited. The objective of the present study is to determine the prevalence, risk factors, phenotypic and molecular characterization of MDR S. aureus isolated from HIV-positive population. METHODS A cross-sectional study was conducted to determine the characteristics of MDR S. aureus nasal carriage among HIV-positive outpatients in an HIV clinic from June to August 2017. Nasal swabs and risk factor data of the enrolled HIV-positive outpatients were collected. Phenotypic and molecular characteristics of MDR and non-MDR S. aureus isolates were analyzed. Risk factors for nasal carriage with MDR S. aureus were estimated by logistic regression. The relationship between phenotypic and molecular characteristics of S. aureus isolates was assessed by the correspondence analysis. RESULTS Overall, 1001 HIV-positive outpatients were included. The prevalence of MDR S. aureus nasal carriage was 15.18% (152/1001), and the proportion of multidrug resistance among S. aureus isolates was 60.08% (152/253). Having a history of respiratory tract infection was the risk factor for MDR S. aureus nasal carriage (adjusted odds ratio = 1.90, 95% confidence interval: 1.25-2.89). Multidrug resistance of S. aureus isolates was in good corresponding relationships with clonal complex (CC)5, CC15, CC59 and CC398. CONCLUSIONS We found high burden of multidrug resistance among S. aureus isolated from HIV-positive outpatients, particularly in those who had upper respiratory tract infection. Moreover, CC59 and CC398 are highly related to multidrug resistance of S. aureus isolates.
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Affiliation(s)
- Suiping He
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Jialing Lin
- School of Population Health, The University of New South Wales, Sydney, Australia
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jiaping Ye
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Ying Li
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wencui Zhang
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Ning Liu
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zijun Gong
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xiaohua Ye
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhenjiang Yao
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China.
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Molecular Detection of Panton Valentine Leukocidin Toxin in Clinical Isolates of Staphylococcus aureus from Kiambu County, Kenya. Int J Microbiol 2020; 2020:3106747. [PMID: 32908521 PMCID: PMC7474361 DOI: 10.1155/2020/3106747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 07/07/2020] [Accepted: 08/12/2020] [Indexed: 11/17/2022] Open
Abstract
Panton-Valentine leukocidin gene is produced by Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus isolates as a pore-forming toxin is largely responsible for skin and soft tissue illnesses. MRSA produces PVL toxins through lukS and lukF proteins causing tissue necrosis by damaging membrane of the defense cells. Presence of PVL toxin was tested from the 54 S. aureus clinical isolates obtained from Thika and Kiambu Level 5 Hospitals, in Kiambu County, Kenya, by Geno Type® MRSA assay (Hain Life Science, Nehren, Germany). DNA was isolated from freshly harvested bacterial cultures by spin column using Geno Type DNA isolation kit. The detection of PVL toxins was performed by amplification of genomic DNA and by reverse hybridization that identifies PVL genes using Geno Type MRSA kit. Out of 138 samples that were collected from patients in Kiambu County, 54 S. aureus isolates were obtained, of which 14 (25.9%; 95% CI = 11.9-38.9) samples had PVL toxins. The isolates that were obtained from the female patients had a higher PVL toxin prevalence of 35.7%, while the isolates collected from the male patients had a lower prevalence of 15.4% (P = 0.09). The pediatrics department had the highest PVL gene prevalence compared to outpatient department and surgical units (P = 0.08). However, the age groups of patients and the hospital attended by patients showed no significant difference in terms of PVL gene prevalence (P = 0.26). Therefore, the patients' gender and hospital units were not significantly associated with PVL gene prevalence (P = 0.08). This study shows that PVL positive isolates occur in the sampled hospitals in the county and female as well as children must be taken into consideration among patients with wound infections when isolating S. aureus.
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Petraitiene B, Conejo PR, Jankauskaite L, Kevalas R, Trumpulyte G, Snipaitiene A, Vitkauskiene A, Gurskis V. Prevalence, clinical expression, invasiveness and outcome of Staphylococcus aureus containing Panton-Valentine leukocidin in children treated in a university hospital of Lithuania. Infect Dis (Lond) 2020; 52:464-472. [PMID: 32297537 DOI: 10.1080/23744235.2020.1752395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: There is a high prevalence of Staphylococcus aureus virulence factor Panton-Valentine leukocidin (PVL) in North-East parts of Europe. The aim was to evaluate data regarding the PVL occurrences in Lithuania, determine the relationship with Methicillin resistant Staphylococcus aureus (MRSA), association with demographic and clinical conditions, invasiveness and severity of the disease in children treated in hospital Kauno klinikos (KK).Methods: We performed a prospective case-cohort single-center study on paediatric patients hospitalized from 2012 to 2015 to KK. We compared characteristics in PVL positive [SA-PVL(+)] and PVL negative [SA-PVL(-)] groups among non-invasive and invasive infections. Logistic regression was performed to detect PVL predicting factors and Cox regression was presented to define factors associated with admission to intensive care unit (ICU).Results: PVL was detected in 51.5%, MRSA in 7.0% and MRSA-PVL(+) in 4.8% of cases. In general, PVL was associated with older age comparing with SA-PVL(-) (median 8.5 vs. 4.0 years, p < .001). Skin and soft tissue infections were presented in 87.9% of all SA-PVL(+) cases. Invasive infections (44.7% vs. 12.1%, p < .001) and co-morbidities (20.5% vs. 2.9%, p < .001) were associated with SA-PVL(-) infections compared to SA-PVL(+), but ICU admission number was higher in invasive SA-PVL(+) cases comparing to invasive SA-PVL(-) cases (41.2% vs. 10.2%, p = .007).Conclusions: There was a high prevalence of pvl gene in patients treated in KK. SA-PVL(+) infections were associated with SSTI and were not common in invasive infections, but the invasive infections caused by SA-PVL(+) were related to severe disease progression and admission to ICU.
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Affiliation(s)
- Birute Petraitiene
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| | | | - Lina Jankauskaite
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| | - Rimantas Kevalas
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| | - Giedre Trumpulyte
- Department of Pediatric Surgery, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania
| | - Ausra Snipaitiene
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania.,Department of Laboratory Medicine, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania
| | - Vaidotas Gurskis
- Department of Pediatrics, Hospital of Lithuanian University of Health Sciences Kauno klinikos, Kaunas, Lithuania.,Lithuanian University of Health Science, Medical Academy, Kaunas, Lithuania
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Phylogenetic and Molecular Profile of Staphylococcus aureus Isolated from Bloodstream Infections in Northeast Brazil. Microorganisms 2019; 7:microorganisms7070210. [PMID: 31336623 PMCID: PMC6680844 DOI: 10.3390/microorganisms7070210] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 12/16/2022] Open
Abstract
Staphylococcus aureus is a notorious human pathogen associated with serious nosocomial and community-acquired infections, such as pneumonia, meningitis, endocarditis, toxic shock syndrome, and sepsis, among others. The objective of this study was to investigate the molecular profile, antimicrobial resistance, and clonal diversity of S. aureus isolated from the bloodstream. The determination of the minimum inhibitory concentration (MIC) of the antimicrobial was performed by an automated method. The presence of several virulence and resistance genes was evaluated by PCR. In addition, multilocus sequence typing (MLST) was used to analyze the clonal diversity of S. aureus. A high resistance to oxacillin (78%), clindamycin (78%), erythromycin (70%), ciprofloxacin (61%), and gentamicin (52%) was observed among the isolates. In most of them, the following virulence genes were detected: hlb (83%), ebpS (61%), icaA (57%), fnbpA (17%), and clfA (13%). Only one isolate carried the pvl gene. MLST analysis identified five new sequence types (STs): 5429, 5430, 5431, 5432, and 5433, as well as another seven-ST5, ST97, ST398, ST101, ST30, ST461, and ST2779-among the remaining strains. These seven STs and the four new STs are clustered in four clonal complexes: CC1, CC2, CC7, and CC17. Phylogenetic analysis showed the genetic relationship of the five new ST strains with another 18 strains. Altogether, these analyses indicate the horizontal transfer acquisition of virulence factor genes and multidrug resistance.
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