Staphylococcal Cassette Chromosome mec Types Among Methicillin-Resistant Staphylococcus aureus in Northern Iran

New update on molecular diversity of clinical Staphylococcus aureus isolates in Iran: antimicrobial resistance, adhesion and virulence factors, biofilm formation and SCCmec typing

BACKGROUND

Staphylococcus aureus is often considered as a potential pathogen and resistant to a wide range of antibiotics. The pathogenicity of this bacterium is due to the presence of multiple virulence factors and the ability to form biofilm. SCCmec types I, II and III are mainly attributed to HA-MRSA, while SCCmec types IV and V have usually been reported in CA-MRSA infections.

METHODS AND RESULTS

In this study, we performed a cross-sectional study to determine the antimicrobial resistance, adhesion and virulence factors, biofilm formation and SCCmec typing of clinical S. aureus isolates in Iran. S. aureus isolates were identified using microbiological standard methods and antibiotic susceptibility tests were performed as described by the Clinical and Laboratory Standards Institute (CLSI) guidelines. Inducible resistance phenotype and biofilm formation were determined using D-test and tissue culture plate methods, respectively. Multiplex-PCRs were performed to detect adhesion and virulence factors, antibiotic resistance genes, biofilm formation and SCCmec typing by specific primers. Among 143 clinical samples, 67.8% were identified as MRSA. All isolates were susceptible to vancomycin. The prevalence of cMLS_B, iMLS_B and MS phenotypes were 61.1%, 22.2% and 14.8%, respectively. The TCP method revealed that 71.3% of isolates were able to form biofilm. The predominant virulence and inducible resistance genes in both MRSA and MSSA isolates were related to sea and ermC respectively. SCCmec type III was the predominant type.

CONCLUSIONS

Data show the high prevalence rates of virulence elements among S. aureus isolates, especially MRSA strains. This result might be attributed to antibiotic pressure, facilitating clonal selection.

Diversity of SCCmec elements and spa types in South African Staphylococcus aureus mecA-positive blood culture isolates

BACKGROUND

The prevalence of Staphylococcus aureus varies depending on the healthcare facility, region and country. To understand its genetic diversity, transmission, dissemination, epidemiology and evolution in a particular geographical location, it is important to understand the similarities and variations in the population being studied. This can be achieved by using various molecular characterisation techniques. This study aimed to provide detailed molecular characterisation of South African mecA-positive S. aureus blood culture isolates by describing the SCCmec types, spa types and to lesser extent, the sequence types obtained from two consecutive national surveillance studies.

METHODS

S. aureus blood culture isolates from a national laboratory-based and enhanced surveillance programme were identified and antimicrobial susceptibility testing was performed using automated systems. A real-time PCR assay confirmed the presence of the methicillin-resistance determinant, mecA. Conventional PCR assays were used to identify the SCCmec type and spa type, which was subsequently analysed using the Ridom StaphType™ software. Multilocus sequence typing was performed on selected isolates using conventional methods. MRSA clones were defined by their sequence type (ST), SCCmec type and spa type.

RESULTS

A detailed description of findings is reported in this manuscript. SCCmec type III predominated overall followed by type IV. A total of 71 different spa types and 24 novel spa types were observed. Spa type t037 was the most common and predominated throughout followed by t1257. Isolates were multidrug resistant; isolates belonging to all SCCmec types were resistant to most of the antibiotics with the exception of type I; isolates with spa type t045 showed resistance to all antibiotics except vancomycin. The most diverse SCCmec-spa type complex was composed of the SCCmec type IV element and 53 different spa types.

CONCLUSION

Although ST data was limited, thereby limiting the number of clones that could be identified, the circulating clones were relatively diverse.

SNP Scanning in mecA Gene for Methicillin-Resistant Staphylococcus aureus

Background:

Staphylococcus aureus (SA) is known as an important human pathogen, which is responsible for many cases of both hospital and community-acquired infections all over the world. Studying on drug resistance is regarded as an important prevention strategy regarding these types of infections.

Objectives:

The current study is aimed to assess the association between the single-nucleotide polymorphism (SNP) and resistance to antibiotics in the methicillin-resistant Staphylococcus aureus (MRSA) strains as well as the molecular typing of isolates, collected from the clinical samples.

Materials and Methods:

We used the disc-diffusion method to test the isolates antibiotic resistance. In addition, the genotypes of staphylococcal cassette chromosome mec (SCCmec) in the Methicillin-resistant Staphylococcus aureus isolates were determined by multiplex -polymerase chain reaction (PCR). SNP was identified in the mecA gene using sequencing and amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) method.

Results:

The highest resistance was shown against oxacillin, and erythromycin and cephalexin. The most sensitive antibiotic was vancomycin (97%) and resistance to at least three antibiotic classes were identified in all isolates. Eighty six percent of isolates were positive for mecA gene and more than 50% of which were healthcare-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA). Moreover, SCCmec type 3, 1were the predominant strains of the identified MRSA. Also, 23 isolates (23%) were non-typable. By using the ARMS-PCR method, it was found that 10% of the clinical specimens had SNP in the mecA gene.

Conclusion:

According to the Chi-square test (χ2), it reveals that the association between SNP in the mecA gene and oxacillin, cefoxitin, and erythromycin resistance was confirmed among clinical MRSA. Furthermore, there is a 95%probability of association between SNP and resistance to more than three antibiotics in MRSA strains.

Determination of antimicrobial susceptibility and biofilm production in Staphylococcus aureus isolated from white coats of health university students

This study aimed at detecting Staphylococcus aureus from white coats of college students and characterizing antimicrobial susceptibility and biofilm production. Bacterial samples (n = 300) were obtained from white coats of 100 college students from August 2015 to March 2017 S. aureus was isolated and it´s resistance profile was assessed by antimicrobial disk-diffusion technique, screening for methicillin-resistant Staphylococcus aureus (MRSA), detection of mecA gene by PCR, and determination of staphylococcal cassette chromosome mec (SCCmec) by multiplex PCR. Congo red agar (CRA) and icaA and icaD genes by PCR were used for biofilm characterization. S. aureus was identified in 45.0% of samples. Resistance of S. aureus sample to antimicrobial was seen for penicillin (72.59%), erythromycin (51.85%), cefoxitin (20.74%), oxacillin (17.04%), clindamycin (14.81%) and levofloxacin (5.18%). MRSA was detected in 53.3% of the samples with SCCmec I (52.8%), SCCmec III (25%) and SCCmec IV (11.1%). Biofilm production was observed in 94.0% S. aureus samples. These data show that biosafety measures need to be enhanced in order to prevent dissemination of multiresistant and highly adhesive bacteria across other university settings, relatives, and close persons.

Characterization of Livestock-Associated Methicillin-Resistant Staphylococcus aureus Isolates Obtained From Commercial Rabbitries Located in the Iberian Peninsula

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have been a growing problem in human medicine since the 1960s, and more recently in veterinary medicine with the appearance of livestock-associated MRSA (LA-MRSA). Nevertheless, information about the presence of MRSA in rabbits is quite scarce since only one LA-MRSA identification has been previously reported. The present study aimed to determine genotypic characterization by verifying the presence of resistance determinants, virulence, and toxin genes of different S. aureus strains that cause lesions in rabbits, and their phenotypic traits based on the antimicrobial susceptibility profile. The analysis of 240 S. aureus isolates obtained from different lesion types collected from 89 Spanish and Portuguese rabbit commercial farms in the last 4 years (2014-2017) was performed. The methicillin-resistant gene mecA was found in 11.25% of the studied isolates (27 of 240) from 19 farms (13 Spanish and 6 Portuguese). Staphylococcal cassette chromosome mec (SCCmec) typing predominantly revealed type III (n = 15). Additionally, three MRSA isolates carrying the mecC gen were detected in samples from three different farms (two Spanish and one Portuguese). None of the 30 MRSA isolates was PVL-positive or tst-positive. After the multilocus sequence typing (MLST) procedure, 16 belonged to ST2855, 6 to ST146, 6 to ST398, and 2 ST4774. No ST121 isolate was mec-positive. ST398 and ST4774 isolates lacked the immune-evasion-cluster (IEC) genes. ST2855 strains were associated with the presence only of the sak gene, and ST146 isolates were ascribed to IEC type E. Therefore, this is the first description of LA-MRSA from rabbits belonging to ST2855. Interestingly, one ST2855 and two ST4774 isolates were mecC-positive, which could act as a mecC-MRSA reservoir. More studies are needed to further characterize these isolates and their relationship with humans and other animal species.

Eradication of methicillin resistant S. aureus biofilm by the combined use of fosfomycin and β-chloro-L-alanine

BACKGROUND AND OBJECTIVES

Biofilm formation is an important virulence factor for methicillin-resistant Staphylococcus aureus (MRSA). Fosfomycin is a borad-spectrum antibiotic with inhibitory effects on biofilm production and β-Chloro-L-alanine (β-CLA) is an amino acid analog. The aim of this study was to determine effect of the combination of fosfomycin and β-CLA on biofilm production by MRSA isolates. Also, the clonal relatedness of the isolates was evaluated.

MATERIALS AND METHODS

To determine the ability of biofilm production by 42 MRSA isolates, microtiter plate method was used. Antibacterial activities of fosfomycin and β-CLA were investigated by determining MICs and MBCs. Antibiofilm activities were measured in the presence of sub-MIC concentrations of fosfomycin, β-CLA or a combination of both. RAPD-PCR was used for investigating the clonal relationship between isolates by the two specific primers.

RESULTS

21.4% of isolates were strong and 5% were moderate biofilm producers. The effect of fosfomycin plus β-CLA treatment on biofilm production was significantly different from non-treated, fosfomycin and β-CLA groups (p=0.00, 0.004 and 0.000 respectively). RAPD-PCR analysis revealed that the RAPD1 primer had more discriminatory power. The Sizes of RAPD-PCR bands ranged from 150 bp to 1500 bp and the number of bands varied from 1 to 13.

CONCLUSION

Clonal relatedness of isolates showed that the majority of biofilm producing isolates had identical pattern and only three isolates showed more than 80% similarity. The combination of fosfomycin and β-CLA could be introduced as an excellent mixture for eradication of MRSA biofilms in vitro.