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Abdulmanea AA, Alharbi NS, Somily AM, Khaled JM, Algahtani FH. The Prevalence of the Virulence Genes of Staphylococcus aureus in Sickle Cell Disease Patients at KSUMC, Riyadh, Saudi Arabia. Antibiotics (Basel) 2023; 12:1221. [PMID: 37508317 PMCID: PMC10416153 DOI: 10.3390/antibiotics12071221] [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: 06/20/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Staphylococcus aureus in the blood of sickle cell disease (SCD) patients may result in a significant increase in morbidity and mortality. S. aureus strains contain various virulence characteristics, including the ability to create a variety of toxins and develop drug resistance. The current study sought to assess the prevalence of S. aureus in SCD patients and to identify the pathogen's virulence characteristics. Between 2017 and 2021, blood samples and data were collected at King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia. The Vitek system PCR and gene sequencing methods were used for identification, antibiotic resistance patterns, and genetic analysis. During the study period, 47 S. aureus blood isolates (methicillin-resistant S. aureus (MRSA) 41.6% and non-MRSA 58.4%) were isolated from 2406 SCD patients. The prevalence percentages of virulence genes (finbB, sdrC, sdrD, icaA, coa, nuc, hlg, hla, finbA, clfA, efb, pvl, agr, spa, seb, sea, sec, tst, and sed) among all the isolates from the SCD patients compared with non-SCD patients (control group) were as follows: (100% vs. 100%), (100% vs. 100%), (100% vs. 100%), (100% vs. 87.5%), (100% vs. 81.3%), (100% vs. 100%), (100% vs. 100%), (100% vs. 100%), (97.9% vs. 81.3%), (97.9% vs. 100%), (97.9% vs. 87.5%), (54.3% vs. 56.3%), (46.8% vs. 75%), (42.6% vs. 43.8%), (27.7% vs. 0%), (25.5% vs. 12.5%), (12.8% vs. 6.3%), (4.3% vs. 12.5%), and (4.3% vs. 0%). Regarding the resistance genes (plaZ, mecA, ermA, ermC, tetK, tetM, and ermB) of the S. aureus strains isolated from the SCD patients compared with non-SCD patients (control group), the prevalence percentages were as follows: (100% vs. 100%), (100% vs. 56.3%), (0% vs. 31.3%), (31.9% vs. 18.8%), (40.4% vs. 25%), (0% vs. 0%), and (0% vs. 0%). As for the antibiotic (ampicillin, penicillin, amoxicillin, cefazolin, imipenem, oxacillin, erythromycin, tetracycline, azithromycin, ciprofloxacin, moxifloxacin, and levofloxacin) resistance of the S. aureus strains isolated from the SCD patients compared with non-SCD patients (control group), the prevalence percentages were as follows: (100% vs. 100%), (97.9% vs. 100%), (72.3% vs. 25%), (68.1% vs. 37.5%), (68.1% vs. 25%), (66% vs. 25%), (36.2% vs. 18.8%), (23.4% vs. 12.5%), (19.1% vs. 12.5%), (17% vs. 12.5%), (14.9% vs. 25%), and (10.6% vs. 18.7%). This study concluded that several virulence genes were present in the S. aureus strains recovered from the SCD patients at KSUMC, with all the isolates containing the finbB, sdrC, sdrD, icaA, coa, nuc, hlg, and hla genes.
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Affiliation(s)
- Adel A. Abdulmanea
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (N.S.A.); (J.M.K.)
| | - Naiyf S. Alharbi
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (N.S.A.); (J.M.K.)
| | - Ali M. Somily
- Department of Pathology, College of Medicine, King Saud University and King Saud University Medical City, P.O. Box 2925, Riyadh 11451, Saudi Arabia;
| | - Jamal M. Khaled
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (N.S.A.); (J.M.K.)
| | - Farjah H. Algahtani
- Department of Hematology, College of Medicine, King Saud University and King Saud University Medical City, P.O. Box 2925, Riyadh 11451, Saudi Arabia;
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Phenotypic and Molecular Detection of Biofilm Formation in Methicillin-Resistant Staphylococcus Aureus Isolated from Different Clinical Sources in Erbil City. Mediterr J Hematol Infect Dis 2023; 15:e2023016. [PMID: 36908866 PMCID: PMC10000948 DOI: 10.4084/mjhid.2023.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/16/2023] [Indexed: 03/05/2023] Open
Abstract
Background Staphylococcus aureus is an important causative pathogen. The production of biofilms is an important factor and makes these bacteria resistant to antimicrobial therapy. Objectives the current study aimed to assess the prevalence of resistance to antibacterial agents and to evaluate the phenotypic and genotypic characterization of biofilm formation among S. aureus strains. Methods This study included 50 isolates of Methicillin-resistant S. aureus (MRSA) and Methicillin-Susceptible S. aureus (MSSA). S. aureus was identified by molecular and conventional methods, and antimicrobial resistance was tested with a disc diffusion method. The biofilm formation was performed through the Microtiter plate method. Strains were subjected to PCR to determine the presence of nuc, mecA, icaA, icaB, icaC, and icaD genes. Results Of the 50 S. aureus isolates, 32(64%) and 18(36%) were MRSA and MSSA, respectively. A large number of MRSA and MSSA isolates showed resistance to Penicillin and Azithromycin, and a lower number of MRSA and MSSA isolates showed resistance to Amikacin Gentamicin. None of the isolates was resistant to Vancomycin. The MRSA strains had significantly higher resistance against antibiotics than MSSA strains (P = 0.0154). All isolates (MRSA and MSSA) were able to produce biofilm with levels ranging from strong (31.25 %), (16.6%) to moderate (53.12%), (50%) to weak (15.6%), (33.3%) respectively. The MRSA strains had a significantly higher biofilm formation ability than the MSSA strains (P = 0.0079). The biofilm-encoding genes were detected among isolates with different frequencies. The majority of S. aureus isolates, 42 (84%), were positive for the icaA. The prevalence rates of the icaB, icaC and icaD genes were found to be 37 (74%), 40 (80%) and 41 (82%), respectively. Conclusions The prevalence of biofilm encoding genes associated with multidrug resistance in S. aureus strains is high. Therefore, identifying epidemiology, molecular characteristics, and biofilm management of S. aureus infection would be helpful.
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Mirzaei R, Alikhani MY, Arciola CR, Sedighi I, Irajian G, Jamasbi E, Yousefimashouf R, Bagheri KP. Highly Synergistic Effects of Melittin With Vancomycin and Rifampin Against Vancomycin and Rifampin Resistant Staphylococcus epidermidis. Front Microbiol 2022; 13:869650. [PMID: 35814659 PMCID: PMC9260053 DOI: 10.3389/fmicb.2022.869650] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/11/2022] [Indexed: 12/27/2022] Open
Abstract
Methicillin-resistant Staphylococcus epidermidis (MRSE) strains are increasingly emerging as serious pathogens because they can be resistant to many antibiotics called multidrug resistance (MDR) that limit the therapeutic options. In the case of vancomycin- and rifampin-resistant MDR-MRSE, the physicians are not allowed to increase the doses of antibiotics because of severe toxicity. Accordingly, we investigated the synergistic activity of melittin antimicrobial peptide with vancomycin and rifampin against vancomycin-resistant, and rifampin-resistant MDR-MRSE isolates. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), fractional inhibitory concentration index (FICi), and fractional bactericidal concentration index (FBCi) of antimicrobial agents against isolates were determined. Coagulate activities and serum and salt stability as well as melittin cytotoxicity on the human embryonic kidney (HEK) 293 cells and human red blood cells (RBCs) at their synergistic concentrations. MIC and MBC values for melittin were in the range of 0.312–2.5 and 0.312–5, respectively. Results also showed that the interaction of melittin with drugs was highly synergistic in which the geometric means of FICi and FBCi were < 0.5. Induced synergism led to a decrease in melittin, rifampin, and vancomycin concentrations by 8–1,020, 2–16, and 4–16-folds, respectively. This phenomenon caused a reduction in melittin toxicity by which the synergistic concentration of melittin needed to kill bacteria did not show cytotoxicity and hemolytic activity. Besides, no coagulation activity was found for the synergistic and alone concentrations of melittin in both Prothrombin Time (PT) and Partial Thromboplastin Time (PTT). Interestingly, the antibacterial activity of melittin in Mueller Hinton Broth (MHB) containing human serum did no significant differences between MIC and MBC values of melittin in MHB and MHB containing 10% human serum. The present findings showed that the therapeutic index of melittin was improved by 32.08- and 12.82-folds when combined with vancomycin and rifampin, respectively. Taken together, the obtained data show that melittin alone was effective against MDR-MRSE isolates and this antimicrobial peptide showed highly synergistic effects with vancomycin and rifampin without causing toxicity. Therefore, the combination of melittin and traditional antibiotics could be a promising strategy for the treatment of infections caused by MDR-MRSE.
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Affiliation(s)
- Rasoul Mirzaei
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Venom and Biotherapeutics Molecules Laboratory, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Yousef Alikhani
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Carla Renata Arciola
- Laboratorio di Patologia delle Infezioni Associate all’Impianto, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Laboratorio di Immunoreumatologia e Rigenerazione Tissutale, IRCCS Istituto Ortopedico Rizzoli, Bologn, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Iraj Sedighi
- Department of Pediatrics, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - GholamReza Irajian
- Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elaheh Jamasbi
- Research Center of Oils and Fats, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Rasoul Yousefimashouf
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- *Correspondence: Rasoul Yousefimashouf,
| | - Kamran Pooshang Bagheri
- Venom and Biotherapeutics Molecules Laboratory, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
- Kamran Pooshang Bagheri,
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Effects of Imipenem-containing Niosome nanoparticles against high prevalence methicillin-resistant Staphylococcus Epidermidis biofilm formed. Sci Rep 2022; 12:5140. [PMID: 35332241 PMCID: PMC8948213 DOI: 10.1038/s41598-022-09195-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/16/2022] [Indexed: 12/20/2022] Open
Abstract
We aim to assess the antibacterial and anti-biofilm properties of Niosome-encapsulated Imipenem. After isolating Staphylococcus epidermidis isolates and determining their microbial sensitivity, their ability to form biofilms was examined using plate microtiter assay. Various formulations of Niosome-encapsulated Imipenem were prepared using the thin-film hydration method, Minimum Biofilm Inhibitory Concentration (MBIC) and Minimum Inhibitory Concentration (MIC) were determined, and biofilm genes expression was examined. Drug formulations’ toxicity effect on HDF cells were determined using MTT assay. Out of the 162 separated S. epidermidis, 106 were resistant to methicillin. 87 MRSE isolates were vancomycin-resistant, all of which could form biofilms. The F1 formulation of niosomal Imipenem with a size of 192.3 ± 5.84 and an encapsulation index of 79.36 ± 1.14 was detected, which prevented biofilm growth with a BGI index of 69% and reduced icaD, FnbA, EbpS biofilms’ expression with P ≤ 0.001 in addition to reducing MBIC and MIC by 4–6 times. Interestingly, F1 formulation of niosomal Imipenem indicated cell viability over 90% at all tested concentrations. The results of the present study indicate that Niosome-encapsulated Imipenem reduces the resistance of MRSE to antibiotics in addition to increasing its anti-biofilm and antibiotic activity, and could prove useful as a new strategy for drug delivery.
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Mupirocin-Resistant Staphylococcus aureus in Iran: A Biofilm Production and Genetic Characteristics. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7408029. [PMID: 35075429 PMCID: PMC8783719 DOI: 10.1155/2022/7408029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/29/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022]
Abstract
The spread of mupirocin-resistant Staphylococcus aureus strains in hospitals and communities is a universal challenge. Limited data is available on the genetic features of high-level mupirocin resistant- (HLMUPR-) S. aureus isolates in Tehran. In the present research, we investigated 48 high-level mupirocin resistance S. aureus by antimicrobial activity, virulence analysis, biofilm formation, multilocus sequence typing (MLST), and staphylocoagulase (SC) typing. All the HLMUPR strains were positive for mupA gene. The frequency of multidrug resistance was 97.9%. Twenty-one (43.8%) were toxinogenic with 14 producing pvl (29.2%), 5 tst (10.4%), and two eta (4.2%). Among the HLMUPR isolates, biofilm production was detected in 45 (89.6%) isolates with complete dominance clfB, clfA genes, and a noticeably high frequency fnbA (95.8%), followed by fnbB (93.8%), eno and icaD (each 83.3%), sdrC (81.3%), ebps (79.2%), icaA (75%), sdrD (66.7%), fib (60.4%), sdrE (50%), cna (41.7%), and bap (4.2%). Coagulase typing distinguished isolates into four genotypic patterns including III (50%), II (27.1%), and type IVa (22.9%). A total of three clonal complexes (CCs) and 4 sequence types (STs) including CC/ST22 as the most prevalent (52.1%), CC8/ST239 (20.8%), CC/ST8 (16.7%), and CC/ST5 (10.4%) were identified in current work. According to our analysis, nonbiofilm producer isolates belonged to CC8/ST239 (6.3%) and CC/ST8 (4.2%). Fusidic acid-resistant isolates belonged to CC/ST45 (n = 3) and CC8/ST239 (n = 1). Observations highlighted the circulation of the CC/ST22 HLMUPR S. aureus strains with strong biofilm-production ability in our hospitals, indicating the possibility of transmission of this type between community and hospital.
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Isolation and Genetic Characterization of Vancomycin-resistant and mecC+ Methicillin-resistant Staphylococcus aureus Strains in Clinical Samples of Bojnurd, Northeastern Iran. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.118949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The emergence of antibiotic-resistant Staphylococcus aureus strains is one of the major concerns about the various staphylococcal infections. Vancomycin is one the most important effective antibiotics on staphylococcal lethal infections. To date, vancomycin-resistant strains are increasingly isolated in different parts of the world, and it is alerting. Objectives: The current study was designed to evaluate the prevalence, and antibiotic susceptibility pattern of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant S. aureus (VRSA) isolates in the main tertiary hospital of Bojnurd, Iran. Methods: Staphylococcus aureus isolates were collected from different clinical samples in Imam Reza Hospital of Bojnurd. After identification of isolates through using conventional methods, they were evaluated by agar screening, disk diffusion, and minimum inhibitory concentration (MIC) methods to determine resistance to vancomycin and methicillin. We also performed polymerase chain reaction (PCR) for the detection of mecA, mecC, vanA, and vanB genes. After confirmation of vancomycin resistance, genetic analysis was performed using SCCmec, agr, and spa typing, and multilocus sequence typing (MLST) methods on VRSA isolates. Results: We found four vancomycin-resistant isolates (1.29%). Also, 75% of isolates were resistant to cefoxitin. Using the PCR method, mecA was found in 73%, mecC in 0.64%, and vanA in 1.29% of isolates. Interestingly, we found two mecC positive isolates in MRSA isolates. The alpha-hemolysin (81.81%) and enterotoxin C (27%) had the highest and lowest toxins percentage, respectively. Among mecA positive isolates, SCCmec IV (37%), SCCmec III (31.27%), SCCmec I (14%), SCCmec II (11%), and SCCmec V (5.7%) were the most prevalent SCCmec types, respectively. It should be noted that the two mecC positive isolates belonged to SCCmec XI. Agr I (76.29%) was the highest agr type. We recognized t037 as the dominant spa type, and ST239, ST6, ST97, and ST8 were found in VRSA isolates. Conclusions: In our study, the frequency of mecA genes in MRSA isolates was very high. It seems that the resistant isolates belonged to endemic clones of Iran.
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Goudarzi H, Goudarzi M, Sabzehali F, Fazeli M, Salimi Chirani A. Genetic analysis of methicillin‐susceptible
Staphylococcus aureus
clinical isolates: High prevalence of multidrug‐resistant ST239 with strong biofilm‐production ability. J Clin Lab Anal 2020; 34:e23494. [PMID: 32696587 PMCID: PMC7676197 DOI: 10.1002/jcla.23494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/28/2020] [Accepted: 07/03/2020] [Indexed: 01/08/2023] Open
Abstract
Background The distributions of methicillin‐susceptible Staphylococcus aureus (MSSA) are divers geographically with different genetic backgrounds. Data related to molecular characteristics of MSSA compare to methicillin‐resistant Staphylococcus aureus (MRSA) is sparse. Methods In this cross‐sectional study, antimicrobial susceptibility testing, virulence genes analysis, biofilm formation, accessory gene regulator (agr) typing, and multilocus sequence typing (MLST) characterized on 75 MSSA isolates. Results Multidrug‐resistance MSSA was found to be 84%. Forty‐eight (64%) isolates were toxinogenic with 34 and 14 isolates carrying pvl and tst representing 45.3% and 18.7%. The most common SE genes were sed (20%), sec (16%), and sea (16%). Fifty‐five (73.3%) isolates were confirmed as biofilm producer with a markedly high prevalence of fnbA (93.3%), fnbB (86.7%), icaA (65.3%), icaD (53.3%), can (24%), ebp (10.7%), and bap (1.3%). A total of 3 agr types (I, 73.3%; III, 16%; II, 10.7%) and 4 clonal complexes (CCs) and sequence types (STs), namely CC8/ST293 (45.3%), CC/ST22 (28%), CC/ST30 (16%), and CC/ST5 (10.7%) were detected in this study. All the high and low‐level mupirocin resistance strains belonged to ST239 and ST22 strains, respectively. All the fusidic acid‐resistant isolates carried fusC and belonged to ST30. Conclusions These findings indicated that ST239 with strong biofilm production ability is the most common type in MSSA strains isolated from patients. It seems that the antimicrobial resistance profiles, toxin, and biofilm formation were closely associated with specific STs. Further studies are required to identify and control of these clonal lineages in our area.
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Affiliation(s)
- Hossein Goudarzi
- Department of Microbiology School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Mehdi Goudarzi
- Department of Microbiology School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Fattaneh Sabzehali
- Department of Microbiology School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Maryam Fazeli
- Department of Virology Pasteur Institute of Iran Tehran Iran
| | - Alireza Salimi Chirani
- Department of Microbiology School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
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Goudarzi M, Tayebi Z, Fazeli M, Miri M, Nasiri MJ. Molecular Characterization, Drug Resistance and Virulence Analysis of Constitutive and Inducible Clindamycin Resistance Staphylococcus aureus Strains Recovered from Clinical Samples, Tehran - Iran. Infect Drug Resist 2020; 13:1155-1162. [PMID: 32368106 PMCID: PMC7183778 DOI: 10.2147/idr.s251450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/08/2020] [Indexed: 11/23/2022] Open
Abstract
Background Macrolide-lincosamide streptogramin B family is one of the important alternative antibiotics for treating staphylococcal infections. The aim of this study was to determine the characteristics and prevalence of antibiotic resistance genes in different coagulase types of clinical Staphylococcus aureus strains. Methods In the present study, 86 isolates with different phenotypes of MLSB resistance were investigated. In vitro susceptibility was assessed by the disk diffusion and broth microdilution methods. PCR assays were used to detect resistance-related genes. Coagulase and SCCmec types were identified by multiplex PCR assay. Results The prevalences of constitutive MLSB, inducible MLSB, and MS phenotypes were found to be 23%, 14.2%, and 4.9%, respectively. The rates of resistance to mupirocin, fusidic acid, and tigecycline were found to be 9.3%, 4.6%, and 2.3%, respectively. The top three predominant resistance genes were mecA, tet(M), erm(C) representing 75.6, 50, and 40.7% of isolates. mupA (7%), fusB (3.5%), and fusC (1.2%) genes were also detected among tested isolates. Coagulase types were mainly type II (34.9%), followed by III (32.6%), V (20.9%), and I (11.6%). Conclusion These findings indicated high resistance rate and low genetic variability with the prominence of coa type II, highlighting the particular importance of diagnosis of these strains to avoid treatment failure.
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Affiliation(s)
- Mehdi Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Tayebi
- Microbiology Department, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Maryam Fazeli
- Department of Virology, Pasteur Institute of Iran, Tehran, Iran
| | - Mirmohammad Miri
- Department of Critical Care and Anesthesiology, 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
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Mohammadi M, Bahrami N, Khajavian M, Faghri J. The Occurrence of Type I, II, and III Integrons in Multi-drug Resistance and Methicillin-Resistant Staphylococcus aureus Isolates in Iran. Curr Microbiol 2020; 77:1653-1659. [PMID: 32279187 DOI: 10.1007/s00284-020-01956-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/18/2020] [Indexed: 01/26/2023]
Abstract
Integrons are mobilizable platforms-DNA elements with impacts on moving antibiotic resistance genes among bacteria and capable of spreading multi-drug resistance (MDR) in pathogens. Methicillin-resistant Staphylococcus aureus (MRSA) strains are the main cause of community-acquired and nosocomial infections with high mortality and morbidity rates worldwide. This work is mainly aimed at calculating the frequency of Type I, II, and III integrons within multi-drug resistance and Methicillin-resistant S. aureus Isolates in Iran. In this cross-sectional study, 230 clinical isolates of S. aureus were gathered from patients of educational hospitals in the provinces of Iran. These isolates were verified utilizing particular biochemical examinations and then assessed for antibiotic susceptibility through disk diffusion technique and standard procedures were done. Genomic and plasmid DNA of all isolates were extracted using Extraction Kit and PCR assay was used for the detection of Type I, II and III integrons genes. Out of the 230 S. aureus isolates, 136 (59.1%) isolates were MRSA and 141 (61.3%) isolates exhibited the MDR pattern. PCR and sequencing showed that 57 (24.8%) of tested isolates carry Type I integron. Among the isolates investigated, MRSA and MDR isolates showed frequencies of 56.1% and 57.9%, respectively. Type II and III integrons were found in none of 230 isolates. The IntI I gene was present in approximately one-quarter of this study isolates. The great prevalence rate of MDR and MRSA isolates and concurrently the existence of Type I integron among those isolates have been considered an important concern in medical society.
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Affiliation(s)
- Mehrdad Mohammadi
- Department of Medical Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
| | - Nikou Bahrami
- Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mona Khajavian
- Department of Microbiology, Yasooj Branch, Islamic Azad University, Yasooj, Iran
| | - Jamshid Faghri
- Department of Microbiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Characteristics of enterotoxin-producing methicillin-resistant Staphylococcus aureus strains isolated from meat in Tehran, Iran. J Verbrauch Lebensm 2019. [DOI: 10.1007/s00003-019-01239-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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The prevalence of antibiotic resistance and exfoliative toxin A gene in Staphylococcus aureus strains isolated from patients and healthy individuals. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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High Prevalence of Multiple Drug Resistant and Biofilm Forming Staphylococcus aureus among HIV-Infected Patients with Suspected Pneumonia. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.4.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Prevalence of vancomycin-intermediate Staphylococcus aureus among clinical isolates in Iran: A systematic review and meta-analysis. J Glob Antimicrob Resist 2018; 15:178-187. [DOI: 10.1016/j.jgar.2018.06.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/28/2018] [Accepted: 06/28/2018] [Indexed: 01/04/2023] Open
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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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Frequency of efflux pump genes mediating ciprofloxacin and antiseptic resistance in methicillin-resistant Staphylococcus aureus isolates. Microb Pathog 2017; 111:71-74. [PMID: 28826767 DOI: 10.1016/j.micpath.2017.08.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 01/26/2023]
Abstract
Efflux pumps are well known as a key role to fluoroquinolone resistance in methicillin-resistant Staphylococcus aureus (MRSA). In this study, among 60 clinical MRSA isolates, 42 isolates (70%) were resistant to ciprofloxacin. MRSA were isolated to detect efflux genes including norA, norB, norC, mepA, sepA, mdeA, qacA/B and smr. Isolates subjected to PCR detection and DNA sequence analysis for these genes. PCR detection showed that 42 isolates (70%) contained at least one efflux pump gene. Among ciprofloxacin-resistant isolates, mdeA and qacA/B genes were found with the highest (61.7%) and lowest (3.3%) frequency, respectively. We also observed that the highest minimum inhibitory concentrations of ciprofloxacin in the presence of mdeA+mepA+norA-C+sepA+smr combination. This type of combination may have the greatest impact on resistance to ciprofloxacin. Finally, compared to previous studies, our study demonstrates that prevalence of ciprofloxacin resistance has been increasing among MRSA clinical isolates.
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Rahimi F, Katouli M, Karimi S. Biofilm production among methicillin resistant Staphylococcus aureus strains isolated from catheterized patients with urinary tract infection. Microb Pathog 2016; 98:69-76. [PMID: 27374894 DOI: 10.1016/j.micpath.2016.06.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
Between June 2011 and May 2014, we isolated a total of 419 Staphylococcus aureus strains from catheterized patients with UTI in a referral hospital in Tehran. Of these, 108 were identified as methicillin resistant (MRSA) based on their phenotypic resistance to oxacillin and the presence of mecA gene. The MRSA isolates were tested for their clonality using a combination of PFGE, prophage typing, SCCmec and ccr typing and examined for their biofilm formation as well as their resistance against 17 antibiotics. In all, 15 common pulsotypes consisted of 105 isolates and 3 single types were identified among the MRSA strains of which, 97% carried SCCmec type III and type 3 ccr. Eighty three (77%) strains were positive for biofilm formation and also carried icaA and icaD genes. Moreover, agr group III and its related tst gene were detected in 81% and 77% of biofilm producing strains, respectively 105 of the 108 MRSA were multidrug resistant with 82.4% being resistant to more than 10 antibiotics. Strains with SCCmec type IV and type 2 ccr, contained SGA and SGL prophage types, were positive for pvl gene and belonged to single PFGE types. This study highlights the important role of biofilm formation and virulence factors of MRSA strains in catheterized patients.
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Affiliation(s)
- Fateh Rahimi
- Department of Microbiology, Faculty of Science, University of Isfahan, Isfahan, Iran.
| | - Mohammad Katouli
- Genecology Research Centre, Faculty of Science, Health and Education and Engineering, University of the Sunshine Coast, Queensland, Australia
| | - Sharmin Karimi
- Department of Microbiology, Faculty of Science, University of Isfahan, Isfahan, Iran
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Rahimi F. Characterization of Resistance to Aminoglycosides in Methicillin-Resistant Staphylococcus aureus Strains Isolated From a Tertiary Care Hospital in Tehran, Iran. Jundishapur J Microbiol 2016; 9:e29237. [PMID: 27099687 PMCID: PMC4833945 DOI: 10.5812/jjm.29237] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 07/06/2015] [Accepted: 07/29/2015] [Indexed: 11/24/2022] Open
Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens which can cause a broad spectrum of infections. Objectives: The current study aimed to describe the frequency and antibiotic susceptibility patterns of clonal groups of gentamicin-resistant strains of MRSA isolated from a tertiary care hospital in Tehran, Iran. Materials and Methods: A total of 301 S. aureus isolates were collected during January to November 2012. All of the isolates were identified at the species level and typed using the Phene-Plate (PhP) system. The antibiotic susceptibility patterns of the MRSA strains and the presence of different aminoglycoside resistance genes were determined. Results: Of the 301 S. aureus isolates, 90 (29.9%) strains were confirmed as MRSA, and they showed high resistance to penicillin, ciprofloxacin, kanamycin, tobramycin, erythromycin, and tetracycline. On the other hand, 43 of the 90 strains (47.8%) were resistant to gentamicin. Aac (6’)-Ie + aph (2’’), ant (4’)-Ia, aph (3’)-IIIa, and ant (6)-Ia were detected in 65.6%, 42.2%, 20%, and 47.8% of the gentamicin-resistant strains, respectively. Diverse PhP types consisting of seven common types and four single types were identified among the strains. Conclusions: Our results illustrated the presence of clonal groups of highly gentamicin-resistant strains of MRSA in hospitals in Tehran. The PhP typing method provided useful information for both clonal dissemination and determining the epidemiological links of the clonal groups of the MRSA strains.
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Affiliation(s)
- Fateh Rahimi
- Department of Microbiology, Faculty of Sciences, University of Isfahan, Isfahan, IR Iran
- Corresponding author: Fateh Rahimi, Department of Microbiology, Faculty of Sciences, University of Isfahan, Isfahan, IR Iran. Tel: +98-3137932250, Fax: +98-3137932456, E-mail:
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Khani M, Fatollahzade M, Pajavand H, Bakhtiari S, Abiri R. Increasing Prevalence of Aminoglycoside-Resistant Enterococcus faecalis Isolates Due to the aac(6')-aph(2") Gene: A Therapeutic Problem in Kermanshah, Iran. Jundishapur J Microbiol 2016; 9:e28923. [PMID: 27217920 PMCID: PMC4870677 DOI: 10.5812/jjm.28923] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 12/02/2015] [Accepted: 12/23/2015] [Indexed: 12/18/2022] Open
Abstract
Background: Enterococci are important pathogens in nosocomial infections. Various types of antibiotics, such as aminoglycosides, are used for treatment of these infections. Enterococci can acquire resistant traits, which can lead to therapeutic problems with aminoglycosides. Objectives: This study was designed to identify the prevalence of, and to compare, the aac(6’)-aph(2”) and aph(3)-IIIa genes and their antimicrobial resistance patterns among Enterococcus faecalis and E. faecium isolates from patients at Imam Reza hospital in Kermanshah in 2011 - 2012. Patients and Methods: One hundred thirty-eight clinical specimens collected from different wards of Imam Reza hospital were identified to the species level by biochemical tests. Antimicrobial susceptibility tests against kanamycin, teicoplanin, streptomycin, imipenem, ciprofloxacin, and ampicillin were performed by the disk diffusion method. The minimum inhibitory concentrations of gentamicin, streptomycin, kanamycin, and amikacin were evaluated with the microbroth dilution method. The aminoglycoside resistance genes aac(6’)-aph(2”) and aph(3”)-IIIa were analyzed with multiplex PCR. Results: The prevalence of isolates was 33 (24.1%) for E. faecium and 63 (46%) for E. faecalis. Eighty-nine percent of the isolates were high-level gentamicin resistant (HLGR), and 32.8% of E. faecium isolates and 67.2% of E. faecalis isolates carried aac(6’)-aph(2”). The prevalence of aph(3”)-IIIa among the E. faecalis and E. faecium isolates was 22.7% and 77.3%, respectively. Conclusions: Remarkably increased incidence of aac(6’)-aph(2”) among HLGR isolates explains the relationship between this gene and the high level of resistance to aminoglycosides. As the resistant gene among enterococci can be transferred, the use of new-generation antibiotics is necessary.
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Affiliation(s)
- Mitra Khani
- Department of General Practitioner Training, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Mahdie Fatollahzade
- Department of General Practitioner Training, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Hamid Pajavand
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Somaye Bakhtiari
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
| | - Ramin Abiri
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
- Corresponding author: Ramin Abiri, Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, IR Iran. Tel: +98-9122773648, Fax: +98-4276477, E-mail:
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Characteristics of Virulence Factors in Methicillin-Resistant Staphylococcus aureus Strains Isolated From a Referral Hospital in Tehran, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2016. [DOI: 10.5812/archcid.33220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Characteristics of Methicillin Resistant Staphylococcus aureus Strains Isolated From Poultry in Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2015. [DOI: 10.5812/archcid.30885] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Rahimi F, Bouzari M. Biochemical Fingerprinting of Methicillin-Resistant Staphylococcus aureus Isolated From Sewage and Hospital in Iran. Jundishapur J Microbiol 2015; 8:e19760. [PMID: 26421131 PMCID: PMC4584139 DOI: 10.5812/jjm.19760v2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 09/08/2014] [Accepted: 11/04/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) is known as a common pathogen in nosocomial and community-acquired infections. Sewage acts as an environmental reservoir and may have a significant role in development and dissemination of antibiotic resistance. OBJECTIVES This study was undertaken to determine the epidemiological relatedness between the MRSA isolated from sewage and human infections. MATERIALS AND METHODS Samples were collected from a referral hospital and also a sewage treatment plant in Tehran, Iran, during 2010. All the MRSA isolates were identified at the species level and typed using Phene plate (PhP) system and SCCmec typing. Antibiotic susceptibility tests were also performed. RESULTS Of the 1142 isolates, 200 MRSA strains from the sewage (n = 100) and the clinic (n = 100) were isolated. Distinct PhP types, consisting of 16 common types and 13 single types, and also 3 different staphylococcal cassette chromosome mec (SCCmec) types (III, IVa and IVc) were found amongst the MRSA isolated from the two different sources. The results of antibiotic susceptibility testing showed an increased resistance to penicillin, ciprofloxacin, erythromycin, clindamycin and tetracycline. In addition, none of the isolates showed resistance to vancomycin, quinupristin -dalfopristin and linezolid. CONCLUSIONS The presence of common PhP types and also SCCmec type III, as an indicator for hospital strains, among the isolates, may indicate an epidemiological link between clinical and sewage MRSA isolates in Tehran.
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Affiliation(s)
- Fateh Rahimi
- Department of Biology, Faculty of Sciences, University of Isfahan, Isfahan, IR Iran
| | - Majid Bouzari
- Department of Biology, Faculty of Sciences, University of Isfahan, Isfahan, IR Iran
- Corresponding author: Majid Bouzari, Department of Biology, Faculty of Sciences, University of Isfahan, IR Iran. Tel: +98-3137932459, Fax: +98-3137932456, E-mail:
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Mehrabi F, Asgari A. Resistant Strains of Enterotoxigenic Staphylococcus aureus; Unknown Risk for Multiple Sclerosis Exacerbation. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e12596. [PMID: 26473065 PMCID: PMC4601249 DOI: 10.5812/ircmj.12596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 07/04/2015] [Indexed: 11/23/2022]
Abstract
Background: Despite all advances in neurological sciences, there are unknown aspects in the epidemiology of multiple sclerosis (MS). Based on this hypothesis, the enterotoxigenic strains of Staphylococcus aureus (S. aureus) are possible risk factors for exacerbations of MS. Objectives: The present study was carried out to investigate the role of resistant strains of enterotoxigenic S. aureus in MS exacerbation. Materials and Methods: Two-hundred nasal swab samples were collected from non-MS (n = 80), MS stable (n = 60) and MS exacerbation (n = 60) groups. Samples were cultured and those that were S. aureus-positive were analyzed for the presence of enterotoxins, using polymerase chain reaction (PCR). Antimicrobial susceptibility was performed using disk diffusion method. Results: Ninety out of 200 nasal samples (45%) were positive for S. aureus. The highest levels of nasal colonization were seen in MS exacerbation group (68.33%). The most commonly detected enterotoxins were sea (30%), sec (15.55%) and seb (11.11%). There were significant differences between S. aureus colonization and type of samples (P = 0.026) and, also, between type of samples and prevalence of enterotoxins (P = 0.022). The highest levels of enterotoxigenic genes were seen in MS exacerbation group. The S. aureus strains had the highest levels of resistance against tetracycline (80%), ampicillin (72.22%), methicillin (66.66%), erythromycin (66.66%), oxacillin (63.33%), trimethoprim-sulfamethoxazole (61.11%) and cotrimoxazole (55.55%). Conclusions: Our findings should raise awareness about the role of sea and sec enterotoxins, in resistant strains of S. aureus, as a risk factor for MS exacerbation. It is better to keep MS patients away from polluted environments of hospitals and health centers.
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Affiliation(s)
- Farzad Mehrabi
- Department of Neurology, AJA University of Medical Sciences, Tehran, IR Iran
| | - Ali Asgari
- Department of Infectious Diseases, AJA University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Ali Asgari, Department of Infectious Diseases, AJA University of Medical Sciences, Tehran, IR Iran. Tel: +98-9123811056, E-mail:
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Nahaei MR, Shahmohammadi MR, Ebrahimi S, Milani M. Detection of Methicillin-Resistant Coagulase-Negative Staphylococci and Surveillance of Antibacterial Resistance in a Multi-Center Study from Iran. Jundishapur J Microbiol 2015; 8:e19945. [PMID: 26468362 PMCID: PMC4600999 DOI: 10.5812/jjm.19945v2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 06/16/2014] [Accepted: 07/24/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Coagulase-negative staphylococci (CNS) are a common cause of nosocomial infections. In recent years, an increase in the incidence of methicillin-resistant coagulase-negative staphylococci (MRCNS) has led to the severity of the disease. OBJECTIVES The aim of this study was to isolate and identify MRCNS strains by oxacillin disk agar diffusion, oxacillin agar screening, and polymerase chain reaction (PCR) and to evaluate their antibacterial resistance patterns. PATIENTS AND METHODS Totally, 122 CNS isolates were collected from the clinical specimens of four hospitals in Iran. Susceptibility testing was performed by disk agar diffusion against 15 antimicrobial agents. Then, disk agar diffusion, agar screening, and PCR were applied to determine susceptibility to oxacillin. RESULTS Out of the 122 isolates, 92 isolates were found to be MRCNS by PCR. The sensitivities and specificities of disk agar diffusion and agar screening were 89.2% and 69% and 93.8% and 96.3%, respectively. Also, 93 CNS isolates were resistant to Methicillin according to disk agar diffusion. DISCUSSION Our results indicated that agar screening was superior to oxacillin disk agar diffusion. A comparison between the antibiotic sensitivity patterns of the MRCNS and the Methicillin-Susceptible Coagulase-Negative Staphylococci (MSCNS) showed that the MRCNS were predominantly multiple-drug resistant isolates as the simultaneous resistance rate to 4 or more antibiotics in the MRCNS and MSCNS was 93% and 56%, respectively.
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Affiliation(s)
- Mohammad Reza Nahaei
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Department of Microbiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Mohammad Reza Shahmohammadi
- Shabestar Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Aalinasab Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Department of Microbiology, Ahar Branch, Islamic Azad University, Ahar, IR Iran
| | - Shiva Ebrahimi
- Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Morteza Milani
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
- School of Advanced Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding author: Morteza Milani, School of Advanced Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel/Fax: +98-4113364661, E-mail:
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Shahmohammadi MR, Nahaei MR, Akbarzadeh A, Milani M. Clinical test to detect mecA and antibiotic resistance in Staphylococcus aureus, based on novel biotechnological methods. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2015; 44:1464-8. [PMID: 25950954 DOI: 10.3109/21691401.2015.1041639] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common organisms isolated from clinical samples, and has been associated with morbidity and mortality among hospitalized patients. The aim of this study was to evaluate the prevalence and antibiotic susceptibility patterns among MRSA and methicillin-sensitive S. aureus (MSSA) isolates collected from four hospitals in Iran. MATERIAL AND METHODS A total of 183 isolates of S. aureus were collected from various clinical specimens of four hospitals in Iran. The isolates were identified by using the conventional biochemical tests. Three methods-oxacillin agar disk diffusion, oxacillin agar screening, and PCR- were applied to determine susceptibility to oxacillin. The conventional disk agar diffusion test was used to evaluate the antibiotic sensitivity of our isolates against 15 antibiotics, according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). RESULTS Of 183 isolates, 77 isolates (42.1%) were found to be MRSA, by the PCR method. The highest antibiotic resistance was found to be against penicillin, co-trimoxazole, erythromycin, and tetracycline respectively. All isolates were susceptible to vancomycin, according to the results of disk agar diffusion. Among other antibiotics, teicoplanin (84%) and fusidic acid (80.5%) were more active against MRSA isolates. For the different methods evaluated, the sensitivities and specificities were as follows: for disk agar diffusion (84.9% and 95.9%) and for agar screening test with oxacillin concentrations of 0.6 μg/ml (70.8% and 97.4%), 4 μg/ml (96.1%and 97.2%) and 6 μg/ml (96% and 96.3%), respectively. CONCLUSION The results of our study showed that 47% of S. aureus isolates were MRSA. Overall, in this research study, resistance to all test antimicrobial agents in MRSA isolates were higher than that of MSSA isolates. Our results also revealed that 85% of mecA-positive isolates and 15% of mecA-negative isolates were resistant to methicillin; while 96% of mecA-negative isolates were sensitive to methicillin. Meanwhile 4% of mecA-positive isolates were also sensitive to methicillin.
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Affiliation(s)
| | - Mohammad Reza Nahaei
- a Department of Microbiology , Ahar Branch, Islamic Azad University , Ahar , Iran.,b Department of Microbiology , School of Medicine, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Abolfazl Akbarzadeh
- d Department of Medical Nanotechnology , Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Morteza Milani
- c Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences , Tabriz , Iran.,d Department of Medical Nanotechnology , Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences , Tabriz , Iran
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Molecular analysis and susceptibility pattern of meticillin-resistant Staphylococcus aureus strains in emergency department patients and related risk factors in Iran. J Hosp Infect 2015; 89:186-91. [DOI: 10.1016/j.jhin.2014.11.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 11/21/2014] [Indexed: 11/22/2022]
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Rahimi F, Katouli M, Pourshafie MR. Characteristics of hospital- and community-acquired meticillin-resistant Staphylococcus aureus in Tehran, Iran. J Med Microbiol 2014; 63:796-804. [PMID: 24648470 DOI: 10.1099/jmm.0.070722-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Staphylococcus aureus is a leading cause of hospital-acquired (HA) and community-acquired (CA) infections worldwide. Recently, S. aureus strains resistant to meticillin (MRSA) have become established within both communities. We isolated 314 isolates of MRSA from hospitalized patients in a referral hospital (HA isolates) and 268 isolates from its outpatient clinic (CA isolates) in Tehran, Iran, between February 2008 and December 2010. These isolates were tested for their susceptibility to 17 antibiotics and typed using the PhPlate system. The diversity in the structures of staphylococcal cassette chromosome mec (SCCmec) elements and ccr types was also detected using a multiplex-PCR assay and isolates were examined for the presence of different classes of prophages. Whilst all isolates were resistant to penicillin, the HA isolates were significantly more resistant to all other antibiotics tested than the CA isolates. Isolates carrying only SCCmec type III and ccr type 3 were dominant (91 %), but 20 % of the CA isolates belonging to less prevalent types carried only SCCmec types IVa, c and ccr type 2. These isolates also carried pvl genes and contained SGA prophage type. Our results indicate that whilst the dominant clonal groups of HA- and CA-MRSA belong to SCCmec type III and carry ccr type 3 genes, several distinct but less prevalent types of CA-MRSA carrying SCCmec type IVa, c and type 2 ccr are also found in Tehran. These strains carry pvl genes and the SGA prophage type, a characteristic that might be used as a marker for detection of CA-MRSA in this country.
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Affiliation(s)
- Fateh Rahimi
- Department of Microbiology, Faculty of Science, University of Isfahan, Iran
| | - Mohammad Katouli
- Genecology Research Centre, Faculty of Science, Health and Education and Engineering, University of the Sunshine Coast, Queensland, Australia
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