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Determination of Virulence Factors and Resistance Profile of Methicillin-Resistant Staphylococcus aureus Strains among Different Types of spa, agr, and SCCmec. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5863310. [PMID: 36281464 PMCID: PMC9587906 DOI: 10.1155/2022/5863310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/03/2022] [Indexed: 11/17/2022]
Abstract
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, respectively. In addition, 43 of the 55 MRSA strains (78%) harbored aminoglycoside resistance genes. The results of our study revealed that the MRSA rate in our region is dramatically high. Better infection control guidelines in hospitals, as well as ongoing epidemiological surveillance studies, could be strongly suggested for effective prevention of the spread of MRSA to inpatients.
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In Silico MLST, SCCmec and SPA Typing OF Human MRSA Strains and Determination of Antimicrobial Resistance Genes Mehmet Demirci1, Akin Yigin2, Seda Ekici3*. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2021. [DOI: 10.30621/jbachs.972251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Ahmadishoar S, Pour NK, Sadeghi J, Nahaei MR, Kheirkhah B. Genotypic and phenotypic characterisation of clinical isolates of methicillin-resistant Staphylococcus aureus in two different geographical locations of Iran. Indian J Med Microbiol 2020; 38:162-168. [PMID: 32883929 DOI: 10.4103/ijmm.ijmm_20_153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) has become more prevalent all over the world and it is important to determine MRSA prevalence and typing in different regions. The present study was carried out to determine the prevalence and frequency of circulating molecular types of MRSA isolates as well as their antibiotics susceptibility in Tabriz and Kerman cities of Iran. Materials and Methods A total of 230 S. aureus isolates were collected from Tabriz (n=125) and Kerman (n=105) during January to December 2018. MRSA isolates were identified by PCR amplification of nuc and mec A genes. Antibiotic susceptibility of MRSA isolates were determined by Kirby-Bauer disk diffusion method. Multiplex PCR was exploited to detect various types of SCCmec. Results The MRSA prevalence was 51/125 (40.8%) in Tabriz and 60/105 (57.1%) in Kerman. Overall, 36/51 (70.58%) and 15/51 (29.41%) isolates and 37/60 (61.66%) and 23/60 (38.34%) isolates were isolated from inpatients and outpatients in Tabriz and Kerman, respectively. Almost all of the isolates were resistant to penicillin and all of them were sensitive to linezolid. Thirty five (68.2%) and 34(56.6%) of MRSA isolates in Tabriz and Kerman were determined as MDR, respectively. SCCmec typing showed that the frequent SCCmec type in both Tabriz and Kerman cities was SCCmec III (56.86% and 55%, respectively). Conclusion The high prevalence of MRSA makes it necessary to revisit the antibiotics administration by physicians. Indeed, periodic evaluation of antibacterial susceptibility patterns of the MRSA strains is required for efficient treatment of MRSA infections.
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Affiliation(s)
- Shiva Ahmadishoar
- Department of Microbiology, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Nadia Kazemi Pour
- Department of Microbiology, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Javid Sadeghi
- Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Reza Nahaei
- Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Kheirkhah
- Department of Microbiology, Kerman Branch, Islamic Azad University, Kerman, Iran
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The First Report of Prevalence of Class 1-3 Integrons in Clinical Isolates of Staphylococcus aureus in Southwestern Iran: A Multicenter Study. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.90902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hasannejad-Bibalan M, Mojtahedi A, Biglari H, Halaji M, Sedigh Ebrahim-Saraie H. Antibacterial Activity of Tedizolid, a Novel Oxazolidinone Against Methicillin-Resistant Staphylococcus aureus: A Systematic Review and Meta-Analysis. Microb Drug Resist 2019; 25:1330-1337. [DOI: 10.1089/mdr.2018.0457] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Ali Mojtahedi
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Haniyeh Biglari
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehrdad Halaji
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Shahin M, Moghim S, Havaei SR, Ghanbari F, Havaei SA. Determination of antimicrobial resistance pattern and molecular characteristics of methicillin-resistant Staphylococcus aureus strains isolated from patients in a teaching hospital of Isfahan, Iran. GENE REPORTS 2018. [DOI: 10.1016/j.genrep.2018.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shahmohammadi S, Sheikh AF, Shahin M, Mir I. Evaluation of Antibiotic Susceptibility Pattern and Distribution of coa Genes in Coagulase-negative S. aureus from Ahvaz, Iran. Infect Disord Drug Targets 2018; 19:383-387. [PMID: 30113003 DOI: 10.2174/1871526518666180816101629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 08/03/2018] [Accepted: 08/04/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Staphylococcus aureus is one of the important causes of clinical infections that can be more destructive by its antibiotic resistant strains. OBJECTIVE This study aimed to determine the antibiotic susceptibility pattern and distribution of mecA and coa genes in clinical isolates of S. aureus. METHODS Two hundred seventy-three specimens suspected to S. aureus were taken from hospitals of Ahvaz, southwest of Iran. Isolates were identified by standard microbiologic tests and confirmed by the molecular method. Antimicrobial susceptibility testing was carried out by disk diffusion method. The presence of mecA and coa genes was determined by PCR method. RESULTS Of a total of 200 isolates which were tested for coagulase tube test, 143 (71.5%) showed coagulase positive, and 57 (28.5%) showed a coagulase-negative reaction. Antibacterial susceptibility pattern of 200 S. aureus isolates showed the highest and lowest susceptibility rate to linezolid (98%) and ciprofloxacin (42%), respectively. The prevalence of methicillin-resistant S. aureus (MRSA) by detection of mecA gene was estimated as 47.5 % (95/200), of which the rate of MRSA in coagulase positive and negative isolates was 35% (50/143), and 65% (45/57), respectively. Meanwhile, coa gene was detected in 100% of coagulase positive and 28.1% of coagulasenegative isolates. CONCLUSION The results of this study showed that the number of atypical CNSA in our area is high. Since the coagulase test is an essential test for diagnosis of S. aureus, our findings regarding the emergence of CNSA are a warning about the misdiagnosis and selection of appropriate treatment approach for S. aureus isolates.
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Affiliation(s)
- Saeed Shahmohammadi
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Farajzadeh Sheikh
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojtaba Shahin
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Iman Mir
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Antimicrobial Susceptibility Pattern of Six Threatening Pathogens at Mofid Children’s Hospital, Tehran, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.15576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abbasi M, BaseriSalehi M, Bahador N, Taherikalani M. Antibiotic Resistance Patterns and Virulence Determinants of Different SCCmec and Pulsotypes of Staphylococcus Aureus Isolated from a Major Hospital in Ilam, Iran. Open Microbiol J 2017; 11:211-223. [PMID: 29204221 PMCID: PMC5688384 DOI: 10.2174/1874285801711010211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/06/2017] [Accepted: 10/07/2017] [Indexed: 11/29/2022] Open
Abstract
Aims & Objectives: The aim of this study is to evaluate genetic relatedness, antibiotic resistance pattern, and virulence characteristics of different types of S. aureus isolated from air, surfaces, staff, and patients in a Public hospital in Ilam. Methods & Materials: A total of 88 of 140 staphylococci identified as S. aureus by conventional and molecular methods were used in this study. Isolate samples were obtained from surfaces, staff, patients, and hospital indoor air. The sampling from staff and surfaces was done through using swab and air by standard pump. Antimicrobial susceptibility testing and presence different resistant and virulence determinants was assessed. Isolates were then typed by pulsed-field gel electrophoresis (PFGE) and SCCmec typing methods. Results: Out of 88isolates, 36 of them (40.9%) were MRSA. Among MRSA isolates, the range of resistance to antibiotic was 0% in vancomycin to 83.3% in gentamycin. The most prevalent resistant genes among gentamicin resistant S. aureus were acc (6')/aph (2”)Ia and aph(3”)IIIa. The most common erythromycin resistant gene was ermC. Surprisingly, SCCmec types I (30.5%), II (25%)were highly distributed. PFGE analysis showed 33 different pulsotypes. Conclusion: This study confirms that different isolates of MSSA and MRSA circulate in Ilam which differ in antimicrobial susceptibility, content of resistance, and virulence determinants.
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Affiliation(s)
- Mehdi Abbasi
- Department of Microbiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.,Department of Biology, Ilam Branch, Islamic Azad University, Ilam, Iran
| | - Majid BaseriSalehi
- Department of Microbiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| | - Nima Bahador
- Department of Microbiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| | - Morovat Taherikalani
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
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Dadashi M, Nasiri MJ, Fallah F, Owlia P, Hajikhani B, Emaneini M, Mirpour M. Methicillin-resistant Staphylococcus aureus (MRSA) in Iran: A systematic review and meta-analysis. J Glob Antimicrob Resist 2017; 12:96-103. [PMID: 28941791 DOI: 10.1016/j.jgar.2017.09.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 07/15/2017] [Accepted: 09/08/2017] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) is among the most prevalent pathogens causing healthcare-associated infections. Accurate and updated data describing the epidemiology of MRSA are crucial for the development of national policies to control MRSA infection in each country. This study aimed to estimate the prevalence of MRSA in different parts of Iran. METHODS Several databases, including MEDLINE, Embase, Web of Science and Scientific Information Database (http://www.sid.ir), were searched from 1 January 2000 to 31 March 2016 to identify studies addressing the frequency or prevalence of MRSA in Iran. Comprehensive Meta-Analysis software v.2.2 was used to analyse the data. RESULTS Of the 725 records identified from the databases, 31 studies fulfilled the eligibility criteria. The analyses showed that the frequency of MRSA infections was 43.0% (95% confidence interval 36.3-50.0%) among confirmed S. aureus isolates. Further stratified analyses indicated that the prevalence of MRSA was higher in studies performed after the year 2000. CONCLUSIONS Since a high rate of MRSA infections was seen in this analysis, regular surveillance of hospital-associated infections, monitoring of antibiotic sensitivity patterns, and formulation of definite antibiotic policy may facilitate more accurate action for the prevention and control of MRSA.
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Affiliation(s)
- Masoud Dadashi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Fallah
- Pediatric Infections Research Center, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parviz Owlia
- Molecular Microbiology Research Center, Shahed University, Tehran, Iran
| | - Bahareh Hajikhani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mirsasan Mirpour
- Department of Microbiology, Faculty of Science, Islamic Azad University of Lahijan, Gilan, Iran
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Halaji M, Karimi A, Shoaei P, Nahaei M, Khorvash F, Ataei B, Yaran M, Havaei SA. Distribution of SCCmec Elements and Presence of Panton-Valentine Leukocidin in Methicillin-Resistant Staphylococcusepidermidis Isolated from Clinical Samples in a University Hospital of Isfahan City, Iran. J Clin Diagn Res 2017; 11:DC27-DC31. [PMID: 28892893 DOI: 10.7860/jcdr/2017/25518.10258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 04/20/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Coagulase Negative Staphylococcus (CoNS) is considered as a major pathogen of nosocomial infections among immunosuppressed patients. AIM The aim of this study was to identify the types of Staphylococcal Cassette Chromosome mec (SCCmec) and Panton-Valentine Leukocidin (PVL) gene among clinical Methicillin-Resistant S. epidermidis (MRSE) isolates collected from Isfahan. MATERIALS AND METHODS This cross-sectional study was performed from March 2014 to January 2015 at a tertiary care hospital of Isfahan, Iran. Antimicrobial susceptibility tests of S. epidermidis isolates were performed by the disc diffusion method. All the strains were screened for methicillin resistance based on resistance to cefoxitin (30 μg) disc and presence of mecA gene. Determination of SCCmec typing and PVL toxin gene were performed by PCR method. For categorical variables different groups were compared using the Chi-square test or Fisher exact test. A p-value of <0.05 was considered significant for all statistical tests. RESULTS The frequency of MRSE was 53.8% according to the presence of mecA gene. The overall resistance rate was high with ciprofloxacin (81.4%). PCR analysis showed that 17% (12/70) of MRSE isolate carried the PVL gene and 43% (30/70) were SCCmec type I; 11.4% (8/70) were type II; and 34.2% (24/70) were type IV, whereas, 11.4% (8/70) of the MRSE isolates could not be typed. CONCLUSION SCCmec type I was the major type of SCCmec, which indicates an emergence of this SCCmec type in the studied medical centers. Increased prevalence of SCCmec types in community is cause of an increase in antibiotic resistance among microorganisms.
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Affiliation(s)
- Mehrdad Halaji
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashkan Karimi
- Department of Microbiology, Ahar Branch, Islamic Azad University, Ahar, Iran
| | - Parisa Shoaei
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Nahaei
- Department of Microbiology, Ahar Branch, Islamic Azad University, Ahar, Iran
| | - Farzin Khorvash
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Yaran
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Asghar Havaei
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Prevalence and Genotyping of Methicillin-Resistant and - Susceptible Staphylococcus aureus Strains Isolated from Patients in a University Hospital, Isfahan, Iran. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.13571] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nikokar I, Sedigh Ebrahim-Saraie H, Ganjian H. Variations in Antibiotic Susceptibility Profile of Staphylococcus aureus after Povidone-Iodine Stress. PHARMACEUTICAL SCIENCES 2017. [DOI: 10.15171/ps.2017.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Detection of Biofilm Production Capability and icaA/D Genes Among Staphylococci Isolates from Shiraz, Iran. Jundishapur J Microbiol 2016. [DOI: 10.5812/jjm.41431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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A Frequency and Molecular Typing Study of Methicillin-Resistant Staphylococcus aureus Isolates in Teaching Hospitals in Shahrekord, SouthWestern Iran. Jundishapur J Microbiol 2016. [DOI: 10.5812/jjm.39654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mahdiyoun SM, Kazemian H, Ahanjan M, Houri H, Goudarzi M. Frequency of Aminoglycoside-Resistance Genes in Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Hospitalized Patients. Jundishapur J Microbiol 2016; 9:e35052. [PMID: 27800135 PMCID: PMC5080848 DOI: 10.5812/jjm.35052] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 06/20/2016] [Accepted: 06/28/2016] [Indexed: 01/09/2023] Open
Abstract
Background Staphylococcus aureus is one of the most important causative agents in community- and hospital-acquired infections. Aminoglycosides are powerful bactericidal drugs that are often used in combination with beta-lactams or glycopeptides to treat staphylococcal infections. Objectives The main objective of the present study was to determine the prevalence of aminoglycoside resistance among methicillin-resistant Staphylococcus aureus (MRSA) isolates in hospitalized patients in Sari and Tehran, Iran. Methods In this study, 174 MRSA strains isolated from different clinical samples, such as blood, sputum, tracheal exudates, bronchus, pleura, urine, wounds, and catheters, were collected from hospitalized patients in Tehran and Sari during 2014. Antibiotic susceptibility testing was performed against nine antibiotics with the Kirby-Bauer disk diffusion method according to CLSI guidelines. The MRSA strains were examined with oxacillin and cefoxitin disks. MRSA was then validated by detection of the mecA gene. PCR was used to evaluate the prevalence of the aminoglycoside-resistance genes aac (6’)-Ie/aph (2”), aph (3’)-IIIa, and ant (4’) among the MRSA isolates. Results The results of drug susceptibility testing showed that the highest rate of resistance was against erythromycin in Tehran (84.4%) and gentamicin (71.7%) in Sari. All isolates were sensitive to vancomycin, and all strains harbored the mecA gene. The aac (6’)-Ie/aph (2”), aph (3’)-IIIa, and ant (4’)-Ia genes were detected among 134 (77%), 119 (68.4%), and 122 (70.1%) of the isolates, respectively. Conclusions The present study showed a high prevalence of aminoglycoside-resistance genes among MRSA isolates in two cities in Iran.
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Affiliation(s)
- Seyed Mohsen Mahdiyoun
- Department of Microbiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Hossein Kazemian
- Department of Medical Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Ahanjan
- Department of Microbiology, Molecular and Cellular Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Hamidreza Houri
- Department of Medical Microbiology School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mehdi Goudarzi
- Department of Medical Microbiology School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Nejabat M, Khashei R, Bazargani A, Sedigh Ebrahim-Saraie H, Motamedifar M. Evaluation of High-Level of Mupirocin Resistance among Clinical Isolates of Methicillin-Resistant Staphylococcus aureus from Shiraz, Iran (2008-2009). PHARMACEUTICAL SCIENCES 2015. [DOI: 10.15171/ps.2015.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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