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Hefzy EM, Radwan TEE, Hozayen BMM, Mahmoud EE, Khalil MAF. Antiseptics and mupirocin resistance in clinical, environmental, and colonizing coagulase negative Staphylococcus isolates. Antimicrob Resist Infect Control 2023; 12:110. [PMID: 37794413 PMCID: PMC10552417 DOI: 10.1186/s13756-023-01310-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Coagulase-Negative Staphylococci (CoNS) are opportunistic and nosocomial pathogens. The excessive use of antimicrobial agents, including antiseptics, represents one of the world's major public health problems. This study aimed to test the susceptibility of CoNS to antiseptics. METHODS Out of 250 specimens collected from different sections of the hospital, 55 samples were identified as CoNS, categorized into three groups based on their sources: environmental samples (n = 32), healthcare worker carriers samples (n = 14), and clinical infection samples (n = 9). Isolates were examined for susceptibility to antibiotics and antiseptics, such as benzalkonium chloride (BC), cetyltrimethylammonium bromide (CTAB), and chlorhexidine digluconate (CHDG). Mupirocin and antiseptic resistance genes, as well as the mecA gene, were detected using polymerase chain reaction. CoNS isolates with notable resistance to antiseptics and antibiotics were identified using the API-Staph system. RESULTS A high frequency of multidrug resistance among CoNS clinical infection isolates was observed. Approximately half of the CoNS isolates from healthcare workers were susceptible to CHDG, but 93% were resistant to BC and CTAB. The frequency of antiseptics and antibiotics resistance genes in CoNS isolates was as follows: qacA/B (51/55; 92.7%), smr (22/55; 40.0%), qacG (1/55; 1.8%), qacH (6/55; 10.9%), qacJ (4/55; 7.3%), mecA (35/55; 63.6%), mupB (10/55; 18.2%), and mupA (7/55; 12.7%). A significant difference in the prevalence of smr gene and qacJ genes between CoNS isolates from healthcare workers and other isolates was reported (P value = 0.032 and ˂0.001, respectively). Four different CoNS species; S. epidermidis, S. chromogene, S. haemolyticus, and S. hominis, were identified by API. CONCLUSIONS CoNS isolates colonizing healthcare workers showed a high prevalence of antiseptic resistance genes, while clinical infection samples were more resistant to antibiotics. CHDG demonstrated greater efficacy than BC and CTAB in our hospital.
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Affiliation(s)
- Enas Mamdouh Hefzy
- Medical Microbiology and Immunology Department, Faculty of Medicine, Fayoum University, Fayoum, 63514, Egypt.
| | | | - Basma M M Hozayen
- Botany Department, Faculty of Science, Fayoum University, Fayoum, Egypt
| | - Eman E Mahmoud
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Mahmoud A F Khalil
- Microbiology and Immunology Department, Faculty of Pharmacy, Fayoum University, Fayoum, Egypt
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Santos SCL, Saraiva MMS, Moreira Filho ALB, Silva NMV, De Leon CMG, Pascoal LAF, Givisiez PEN, Gebreyes WA, Oliveira CJB. Swine as reservoirs of zoonotic borderline oxacillin-resistant Staphylococcus aureus ST398. Comp Immunol Microbiol Infect Dis 2021; 79:101697. [PMID: 34530296 DOI: 10.1016/j.cimid.2021.101697] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/18/2022]
Abstract
Methicillin resistance mediated by the mecA gene in Staphylococcus aureus, also known as "true MRSA", is typically associated with high oxacillin MIC values (≥8 mg/L). Because non-mecA-mediated oxacillin resistant S. aureus phenotypes can also cause hard-to-treat diseases in humans, their misidentification as methicillin-susceptible S. aureus strains (MSSA) can compromise the efficiency of the antimicrobial therapy. These strains have been refereed as Borderline Oxacillin-Resistant S. aureus (BORSA) but their characterization and role in clinical microbiology have been neglected. Considering the increasing importance of livestock-associated methicillin-resistant S. aureus ST398 (LA-MRSA) as an emerging zoonotic pathogen worldwide, this study aimed to report the genomic context of oxacillin resistance in porcine S. aureus ST398 strains. S. aureus isolates were recovered from asymptomatic pigs from three herds. Oxacillin MIC values ranged from 4 to 32 mg/L. MALDI-TOF-confirmed isolates were screened for mecA and mecC by PCR and genotyped by means of PFGE and Rep-PCR. Seven isolates were whole genome sequenced. None of the isolates harbored the mecA gene or its variants. Although all seven sequenced isolates belonged to one sequence type (ST398), two different spa types (t571 and t1471) were identified. All isolates harbored conserved blaZ gene operon and no mutations on genes encoding for penicillin-binding-proteins were detected. Genes conferring resistance against other drugs such as aminoglycosides, chloramphenicol, macrolide, lincosamide and streptogramin (MLS), tetracycline and trimethoprim were also detected. Isolates also harbored virulence genes encoding for adhesins (icaA; icaB; icaC; icaD; icaR), toxins (hlgA; hlgB; hlgC; luk-PV) and protease (aur). Pigs can serve as reservoirs of non-mecA-mediated oxacillin-resistant ST398 strains potentially pathogenic to humans. Considering that mecA has been the main target to screen methicillin-resistant staphylococci, the occurrence of BORSA phenotypes is probably underestimated in livestock.
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Affiliation(s)
- S C L Santos
- Department of Animal Science, College for Agricultural Sciences, Federal University of Paraiba (UFPB), Rod. PB079 Km12, s/n, 58397-000, Areia, PB, Brazil
| | - M M S Saraiva
- Department of Animal Science, College for Agricultural Sciences, Federal University of Paraiba (UFPB), Rod. PB079 Km12, s/n, 58397-000, Areia, PB, Brazil; Department of Veterinary Pathology, Sao Paulo State University (UNESP), Via de acesso Prof. Paulo Donato Castellane s/n, 14884-900, Jaboticabal, SP, Brazil
| | - A L B Moreira Filho
- Department of Animal Science, College for Agricultural, Social and Human Sciences, Federal University of Paraiba (UFPB), Rua João Pessoa s/n, 58220-000, Bananeiras, PB, Brazil
| | - N M V Silva
- Department of Animal Science, College for Agricultural Sciences, Federal University of Paraiba (UFPB), Rod. PB079 Km12, s/n, 58397-000, Areia, PB, Brazil
| | - C M G De Leon
- Department of Animal Science, College for Agricultural Sciences, Federal University of Paraiba (UFPB), Rod. PB079 Km12, s/n, 58397-000, Areia, PB, Brazil
| | - L A F Pascoal
- Department of Animal Science, College for Agricultural, Social and Human Sciences, Federal University of Paraiba (UFPB), Rua João Pessoa s/n, 58220-000, Bananeiras, PB, Brazil
| | - P E N Givisiez
- Department of Animal Science, College for Agricultural Sciences, Federal University of Paraiba (UFPB), Rod. PB079 Km12, s/n, 58397-000, Areia, PB, Brazil
| | - W A Gebreyes
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University (OSU), 43210, Columbus, OH, USA; Global One Health Initiative (GOHi), The Ohio State University, 43210, Columbus, OH, USA
| | - C J B Oliveira
- Department of Animal Science, College for Agricultural Sciences, Federal University of Paraiba (UFPB), Rod. PB079 Km12, s/n, 58397-000, Areia, PB, Brazil; Global One Health Initiative (GOHi), The Ohio State University, 43210, Columbus, OH, USA.
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Yang Q, Li X, Jia P, Giske C, Kahlmeter G, Turnidge J, Yu Y, Lv Y, Wang M, Sun Z, Lin J, Li Y, Zheng B, Hu F, Guo Y, Chen Z, Li H, Zhang G, Zhang J, Kang W, Duan S, Wang T, Jing R, Xu Y. Determination of norvancomycin epidemiological cut-off values (ECOFFs) for Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus and Staphylococcus hominis. J Antimicrob Chemother 2021; 76:152-159. [PMID: 33057728 DOI: 10.1093/jac/dkaa414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/08/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine the epidemiological cut-off values (ECOFFs) of norvancomycin for Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus and Staphylococcus hominis. METHODS We collected 1199 clinical isolates of Staphylococcus species from five laboratories located in four cities in China. MICs and inhibitory zone diameters of norvancomycin were determined by broth microdilution and the disc diffusion method, separately. ECOFFs of norvancomycin for four species were calculated by ECOFFinder software following EUCAST principles. Methicillin and vancomycin resistance genes (mecA/mecC and vanA/vanB/vanC/vanD/vanE) were screened for by PCR in all isolates. Pearson correlation and χ2 test were used to calculate the correlation of MICs and inhibition zone diameters, and MICs and resistance genes, respectively. RESULTS MICs of norvancomycin for all strains from five laboratories fell in the range of 0.12-2 mg/L. ECOFFs of norvancomycin were determined to be 2 mg/L for S. epidermidis and S. haemolyticus and 1 mg/L for S. aureus and S. hominis. A weak correlation was observed between MIC values and zone diameters for S. haemolyticus (r = -0.36) and S. hominis (r = -0.26), while no correlation was found for S. epidermidis and S. aureus. The mecA gene was detected in 63.1% of Staphylococcus, whereas no isolate carried mecC, vanA, vanB, vanC, vanD or vanE. ECOFFs of norvancomycin were not correlated with mecA gene carriage in Staphylococcus species. CONCLUSIONS ECOFFs of norvancomycin for four Staphylococcus species were determined, which will be helpful to differentiate WT strains. The correlation of MICs and zone diameters of norvancomycin was weak in Staphylococcus species.
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Affiliation(s)
- Qiwen Yang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xue Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Peiyao Jia
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Christian Giske
- EUCAST Development Laboratory for Antimicrobial Susceptibility Testing, c/o Clinical Microbiology, Central Hospital, Växjö, Sweden
| | - Gunnar Kahlmeter
- EUCAST Development Laboratory for Antimicrobial Susceptibility Testing, c/o Clinical Microbiology, Central Hospital, Växjö, Sweden
| | - John Turnidge
- Pathology, Paediatrics and Molecular Biosciences, University of Adelaide, SA, Australia
| | - Yunsong Yu
- Department of Clinical Infectious Diseases, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, China
| | - Yuan Lv
- Institute of Clinical Pharmacology, Peking University, Beijing, China
| | - Minggui Wang
- Huashan Hospital of Fudan University, Shanghai, China
| | - Ziyong Sun
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Lin
- Department of Clinical Infectious Diseases, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, China
| | - Yun Li
- Institute of Clinical Pharmacology, Peking University, Beijing, China
| | - Bo Zheng
- Institute of Clinical Pharmacology, Peking University, Beijing, China
| | - Fupin Hu
- Huashan Hospital of Fudan University, Shanghai, China
| | - Yan Guo
- Huashan Hospital of Fudan University, Shanghai, China
| | - Zhongju Chen
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haixia Li
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, China
| | - Ge Zhang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jingjia Zhang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Kang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Simeng Duan
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Tong Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ran Jing
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yingchun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Evaluation of various phenotypic methods with genotypic screening for detection of methicillin-resistant Staphylococcus aureus. ASIAN BIOMED 2020. [DOI: 10.1515/abm-2019-0065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Staphylococcus aureus is one of the common opportunistic gram-positive pathogens which are often associated with nosocomial infections. Detection of methicillin-resistant S. aureus (MRSA) has become complicated due to the complex phenotypic and genomic pattern.
Objective
To evaluate the sensitivity and specificity pattern of various phenotypic methods used in screening mec genes harboring MRSA.
Methods
Clinical isolates of S. aureus were collected from diagnostic centers in Tamil Nadu. Phenotypic identification methods such as Minimal Inhibitory Concentration for oxacillin, oxacillin screen agar (OSA), oxacillin disk diffusion, and cefoxitin disk diffusion (CFD) tests were compared. The clinical isolates were classified into MRSA and methicillin-susceptible S. aureus (MSSA) based on the polymerase chain reaction (PCR) amplification of the mecA gene.
Result
Out of 50 S. aureus, 21 were found to be MRSA based on the presence of the mecA gene. All 21 mecA-positive isolates were found to be resistant through minimum inhibitory concentration (MIC) and CFD test, having a sensitivity of 100% and specificity of 52% and 62%, respectively. OSA and oxacillin disk tests were found to have a sensitivity of 86% and specificity of 48% and 52%, respectively.
Conclusion
The combination of two phenotypic methods, CFD and oxacillin MIC, can be used for the detection of MRSA in clinical laboratories.
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Hryniewicz MM, Garbacz K. Borderline oxacillin-resistant Staphylococcus aureus (BORSA) – a more common problem than expected? J Med Microbiol 2017; 66:1367-1373. [DOI: 10.1099/jmm.0.000585] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Maria M. Hryniewicz
- Department of Oral Microbiology, Medical University of Gdansk, Dębowa 25, 80-204 Gdansk, Poland
| | - Katarzyna Garbacz
- Department of Oral Microbiology, Medical University of Gdansk, Dębowa 25, 80-204 Gdansk, Poland
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Pournajaf A, Ardebili A, Goudarzi L, Khodabandeh M, Narimani T, Abbaszadeh H. PCR-based identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles. Asian Pac J Trop Biomed 2014; 4:S293-7. [PMID: 25183100 DOI: 10.12980/apjtb.4.2014c423] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 02/19/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To evaluated the PCR for mecA gene compared with the conventional oxacillin disk diffusion method for methicillin-resistant Staphylococcus aureus (S. aureus) identification. METHODS A total of 292 S. aureus strains were isolated from various clinical specimens obtained from hospitalized patients. Susceptibility test to several antimicrobial agents was performed by disk diffusion agar according to Clinical and Laboratory Standards Institute guidelines. The PCR amplification of the mecA gene was carried out in all the clinical isolates. RESULTS Among antibiotics used in our study, penicillin showed the least anti-staphylococcal activity and vancomycin was the most effective. The rate of methicillin-resistant S. aureus prevalence determined by oxacillin disk diffusion method was 47.6%; whereas, 45.1% of S. aureus isolates were mecA- positive in the PCR assay. CONCLUSIONS This study is suggestive that the PCR for detection of mecA gene is a fast, accurate and valuable diagnostic tool, particularly in hospitals in areas where methicillin-resistant S. aureus is endemic.
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Affiliation(s)
- Abazar Pournajaf
- Department of Microbiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdollah Ardebili
- Department of Microbiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran ; Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Leyla Goudarzi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mahmoud Khodabandeh
- Department of Pediatric Infectious Disease, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahmineh Narimani
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Abbaszadeh
- Department of Pharmacology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Analysis of borderline oxacillin-resistant Staphylococcus aureus (BORSA) strains isolated in Tunisia. J Clin Microbiol 2012; 50:3345-8. [PMID: 22814459 DOI: 10.1128/jcm.01354-12] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Twenty-three strains of Staphylococcus aureus with borderline resistance to oxacillin were studied. These strains were not detected by the cefoxitin test, tests for penicillin-binding protein 2a (PBP2a), mecA, and mecA(LGA251) were negative, and the strains were genetically unrelated. To detect all strains resistant to oxacillin, laboratories should routinely test for both cefoxitin and oxacillin.
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