Phenotypic and genotypic characterization of macrolide, lincosamide and streptogramin B resistance among clinical isolates of staphylococci in southwest of Iran

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Abstract

Objective

The present study aimed to determine the phenotypic and genotypic profile of macrolide, lincosamide and streptogramin B (MLS _B) resistance in clinical isolates of staphylococci.

Results

This cross-sectional study was conducted on 164 non-duplicated staphylococci isolates collected during August 2015 to February 2016 from two tertiary care hospitals in Shiraz, southwest of Iran. Of the 164 isolates, 86 erythromycin-resistant isolates consist of 35 Staphylococcus aureus and 51 coagulase negative staphylococci (CoNS) were included in the study. Of the 35 S. aureus, the prevalence of cMLS (constitutive), iMLS (inducible), and MS phenotypes were found 82.9%, 8.6% and 8.6%, respectively. Among 51 CoNS, the frequencies of cMLS, iMLS, and MS phenotypes were detected 66.7%, 11.8% and 21.6%, respectively. Among S. aureus isolates, the predominant genes were ermC in 82.9% isolates, followed by ermA in 57.1% and msrA in 28.6% of isolates. Among CoNS isolates, the most frequent genes were diagnosed ermC in 70.6% isolates followed by msrA in 68.6% and ermA in 11.8% of isolates. In conclusion, regarding the presence of MLS _B resistance in our region, diagnosis of this resistance type on a routine basis in staphylococcal clinical isolates is of particular importance.

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Most cited references 33

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Novel multiplex PCR assay for characterization and concomitant subtyping of staphylococcal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus.

Kunyan Zhang, Jo-Ann McClure, Sameer Elsayed … (2005)

Staphylococcal cassette chromosome mec (SCCmec) typing is essential for understanding the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA). SCCmec elements are currently classified into types I to V based on the nature of the mec and ccr gene complexes, and are further classified into subtypes according to their junkyard region DNA segments. Previously described traditional SCCmec PCR typing schemes require multiple primer sets and PCR experiments, while a previously published multiplex PCR assay is limited in its ability to detect recently discovered types and subtypes such as SCCmec type V and subtypes IVa, b, c, and d. We designed new sets of SCCmec type- and subtype-unique and specific primers and developed a novel multiplex PCR assay allowing for concomitant detection of the methicillin resistance (mecA gene) (also serving as an internal control) to facilitate detection and classification of all currently described SCCmec types and subtypes I, II, III, IVa, b, c, d, and V. Our assay demonstrated 100% sensitivity and specificity in accurately characterizing 54 MRSA strains belonging to the various known SCCmec types and subtypes, when compared with previously described typing methods. Further application of our assay in 453 randomly selected local clinical isolates confirmed its feasibility and practicality. This novel assay offers a rapid, simple, and feasible method for SCCmec typing of MRSA, and may serve as a useful tool for clinicians and epidemiologists in their efforts to prevent and control infections caused by this organism.

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Analysis of Virulence Genes Among Methicillin Resistant Staphylococcus aureus (MRSA) Strains

Seyedeh Mahsan Hoseini Alfatemi, Mohammad Motamedifar, Nahal Hadi … (2014)

Background: Staphylococcus aureus is amongst major human pathogens both in hospitals and the community. This bacterium is an opportunistic pathogen responsible for a large number of self-limiting and even life-threatening diseases in humans. Methicillin resistant S. aureus (MRSA) strains are common causes of emerging nosocomial infections and are considered as a major problem for public health. Objectives: We aimed to study the profile of some virulence genes including: sea, seb, sed, tst, eta, etb, LuKS/F-PV, hla and hld in methicillin-resistant S. aureus by the PCR technique. Materials and Methods: A total of 345 isolates of S. aureus were collected from clinical specimens of patients referred to teaching hospitals of Shiraz; identification was done by biochemical (catalase, coagulase and DNase) and molecular tests. One hundred and forty six isolates of methicillin-resistant S. aureus (MRSA) were obtained and the presence of some toxin genes in these isolates was investigated by the polymerase chain reaction (PCR) technique. Results: The results showed that among the 345 isolates of S. aureus, 148 were confirmed as MRSA by screening with the cefoxitin disc diffusion (30 µg) method. Also among the 148 MRSA isolates, 146 isolates were confirmed as methicillin-resistant by molecular methods. The results showed that the frequency of methicillin-resistant and methicillin-sensitive S. aureus isolates during 2012 to 2013 in Namazi and Faghihi hospitals were 146 (42.3%) and 199 (57.7%), respectively. Besides, among the 146 confirmed MRSA isolates, 36.98% (54 isolates) and 63.02% (92 isolates) were related to female and male, respectively. The largest number of cases belonged to sputum samples (58 out of 146). The frequency of the eta, etb, sed, LuKS/F-PV, seb, tst, sea, hld and hla genes were 0.68%, 2.05%, 2.05%, 5.47%, 10.95%, 11.64%, 27.39%, 84.24% and 93.15%, respectively. In addition, amongst all examined genes, hla (93.15%) and eta (0.68%) genes had the highest and lowest frequencies, respectively. The greatest coexistence of genes was observed for the hla + hld gene combination (48.83%). The results of our study indicate that 98.63% of the isolates were positive for at least one of the virulence genes. Conclusions: The relative higher frequency of some virulence genes in this study may reflect the emergence of isolates containing these genes in Shiraz medical centers.

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Future challenges and treatment of Staphylococcus aureus bacteremia with emphasis on MRSA.

E Bruun, Luke V Rasmussen, Robert Skov … (2010)

Staphylococcus aureus bacteremia (SAB) is an urgent medical problem due to its growing frequency and its poor associated outcome. As healthcare delivery increasingly involves invasive procedures and implantable devices, the number of patients at risk for SAB and its complications is likely to grow. Compounding this problem is the growing prevalence of methicillin-resistant S. aureus (MRSA) and the dwindling efficacy of vancomycin, long the treatment of choice for this pathogen. Despite the recent availability of several new antibiotics for S. aureus, new strategies for treatment and prevention are required for this serious, common cause of human infection.

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Author and article information

Contributors

Reza Khashei: +98 71 32305410 , re.khashei@gmail.com , khasheir@sums.ac.ir

Yalda Malekzadegan: malekzadeganyalda@gmail.com

Hadi Sedigh Ebrahim-Saraie: seddigh.hadi@gmail.com

Zahra Razavi: zohal_z70@yahoo.com

Journal

Journal ID (nlm-ta): BMC Res Notes

Journal ID (iso-abbrev): BMC Res Notes

Title: BMC Research Notes

Publisher: BioMed Central (London )

ISSN (Electronic): 1756-0500

Publication date (Electronic): 10 October 2018

Publication date PMC-release: 10 October 2018

Publication date Collection: 2018

Volume: 11

Electronic Location Identifier: 711

Affiliations

[1 ]ISNI 0000 0000 8819 4698, GRID grid.412571.4, Department of Bacteriology and Virology, School of Medicine, , Shiraz University of Medical Sciences, ; Shiraz, Iran

[2 ]ISNI 0000 0000 8819 4698, GRID grid.412571.4, Student Research Committee, , Shiraz University of Medical Sciences, ; Shiraz, Iran

Article

Publisher ID: 3817

DOI: 10.1186/s13104-018-3817-4

PMC ID: 6180372

PubMed ID: 30305181

SO-VID: 111d4043-b7fb-4067-90d2-b0b8a198cf4d

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 17 August 2018

Date accepted : 3 October 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004320, Shiraz University of Medical Sciences;

Award ID: 93-8690

Award Recipient : Yalda Malekzadegan

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ScienceOpen disciplines: Medicine

Keywords: inducible resistance,staphylococcus,clindamycin,erythromycin,erm genes

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ScienceOpen disciplines: Medicine

Keywords: inducible resistance, staphylococcus, clindamycin, erythromycin, erm genes

Phenotypic and genotypic characterization of macrolide, lincosamide and streptogramin B resistance among clinical isolates of staphylococci in southwest of Iran

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Abstract

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Point-Of-Care Testing for Hepatitis

Most cited references 33

Novel multiplex PCR assay for characterization and concomitant subtyping of staphylococcal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus.

Analysis of Virulence Genes Among Methicillin Resistant Staphylococcus aureus (MRSA) Strains

Future challenges and treatment of Staphylococcus aureus bacteremia with emphasis on MRSA.

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