Iranian Journal of Microbiology 2018. 10(1):7-13.

Distribution of staphylococcal cassette chromosome mec types among methicillin-resistant coagulase negative staphylococci in central Iran
Ehsanollah Ghaznavi-Rad, Nasimeh Fard-Mousavi, Ali Shahsavari, Ali Japoni-Nejad, Alex Van Belkum

Abstract


Background and Objectives: Methicillin-resistant coagulase-negative staphylococci (MR-CoNS) are important nosocomial pathogens. They may serve as a reservoir of SCCmec, the genomic island encoding amongst other methicillin resistance. This study was designed to determine the distribution of different SCCmec types from MR-CoNS isolated from clinical specimens in a tertiary hospital in central Iran, having high frequency of nosocomial methicillin-resistant staphylococcal infections.


Materials and Methods: We evaluated isolates from patients attending the Vali-Asr Hospital located in the center of Iran, from February to December 2012. Multiplex PCR was performed for SCCmec typing. For isolates in which SCCmec could not be typed directly, additional ccr and mec complex analyses were performed.


Results: Totally, 70 MR-CoNS isolates, comprising of 47 S. epidermidis strains (67%), 10 S. saprophyticus (14.3%), 9 S. hemolyticus (13%) and 4 S. lugdunensis (5.7%) were identified. Thirty-nine were characterized as type IVa 19 (27%), type III 11 (16%), type II 7 (10%) and type V 2 (3%). Only 20 isolates (28.6%) carried the ccr complex, while the current methods could not characterize the 11 remaining isolates.


Conclusion: A high level of SCCmec genetic diversity was found among MR-CoNS isolates. MR-CoNS may act as a reservoir of SCCmec IV for MRSA. This issue should be taken into consideration seriously.


Keywords


Coagulase negative staphylococci, Methicillin resistance, SCCmec typing

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References


Piette A, Verschraegen G. Role of coagulase-negative staphylococci in human disease. Vet Microbiol 2009; 134:45-54.

Natoli S, Fontana C, Favaro M, Bergamini A, Testore GP, Minelli S, et al. Characterization of coagulase-negative staphylococcal isolates from blood with reduced susceptibility to glycopeptides and therapeutic options. BMC Infect Dis 2009; 9:83.

Garza-Gonzalez E, Morfin-Otero R, Llaca-Diaz JM, Rodriguez-Noriega E. Staphylococcal cassette chromosome mec (SCCmec) in methicillin-resistant coagulase-negative staphylococci. A review and the experience in a tertiary-care setting. Epidemiol Infect 2010; 138:644-654.

Rezazadeh M, Yousefi Mashouf R, Ghaznavi-Rad E. Antibiotic profile of methicillin-resistant Staphylococcus aureus with multiple-drug resistances isolated from nosocomial infections in Vali-Asr Hospital of Arak. AMUJ 2013; 16:29-37.

Oliveira DC, Lencastre H. Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2002; 46:2155-2161.

Kondo Y, Ito T, Ma XX, Watanabe S, Kreiswirth BN, Etienne J, et al. Combination of multiplex PCRs for Staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr and major differences in junkyard regions. Antimicrob Agents Chemother 2007; 51:264-74.

Ito T, Hiramatsu K, Oliveira DC, de Lencastre H, Zhang K, Westh H, et al. Classification of staphylococcal cassette chromosome mec (SCCmec): guidelines for reporting novel SCCmec elements, International Working Group on the Classification of Staphylococcal Cassette Chromosome Elements (IWG-SCC). Antimicrob Agents Chemother 2009; 53: 4961-4967.

Ghaznavi-Rad E, Mariana NS, Sekawi Z, Van Belkum A, Neela V. A simplified multiplex PCR assay for fast and easy discrimination of globally distributed SCCmec types in methicillin resistant Staphylococcus aureus. J Med Microbiol 2010; 59(Pt 10):1135-1139.

Longauerova A. Coagulase negative staphylococci and their participation in pathogenesis of human infections. Bratisl Lek Listy 2006; 107(11-12): 448-452.

Diekema DJ, Pfaller MA, Schmitz FJ, Smayevsky J, Bell J, Jones RN, et al. Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997-1999. Clin Infect Dis 2001; 32 Suppl 2:S114-132.

Mert Gr, Kilià A, Bedir O, Başustaoğlu AC. Clinical significance and staphylococcal cassette chromosome mec (SCCmec) characterization of coagulase-negative staphylococci isolated from blood cultures. Turk J Medic Sci 2011; 41:859-865.

Wisplinghoff H, Rosato AE, Enright MC, Noto M, Craig W, Archer GL. Related clones containing SCCmec type IV predominate among clinically significant Staphylococcus epidermidis isolates. Antimicrob Agents Chemother 2003; 47:3574-3579.

Barbier F, Ruppe E, Hernandez D, Lebeaux D, Francois P, Felix B, et al. Methicillin-resistant coagulase-negative staphylococci in the community: high homology of SCCmec IVa between Staphylococcus epidermidis and major clones of methicillin-resistant Staphylococcus aureus. J Infect Dis 2010; 202:270-281.

Mohammadi S, Sekawi Z, Monjezi A, Maleki MH, Soroush S, Sadeghifard N, et al. Emergence of SCCmec type III with variable antimicrobial resistance profiles and spa types among methicillin-resistant Staphylococcus aureus isolated from healthcare- and community-acquired infections in the west of Iran. Int J Infect Dis 2014; 2014; 25:152-158.

Ghaznavi-Rad E, Shamsudin MN, Sekawi Z, Khoon LY, Aziz MN, Hamat RA, et al. Predominance and emergence of clones of hospital-acquired methicillin-resistant Staphylococcus aureus in Malaysia. J Clin Microbiol 2010; 48:867-872.

Namvar AE, Afshar M, Asghari B, Rastegar Lari A. Characterisation of SCCmec elements in methicillin-resistant Staphylococcus aureus isolated from burn patients. Burns 2014; 40:708-712.

Zeinali E, Moniri R, Safari M, Mousavi G. Molecular characterization and SCCmec typing in meticillin-resistant Staphylococcus aureus isolated from clinical samples. Feyz 2011; 14:439-446.

Rahimi F, Katouli M, Pourshafie MR. Characteristics of hospital- and community-acquired meticillin-resistant Staphylococcus aureus in Tehran, Iran. J Med Microbiol 2014;63(Pt 6):796-804.

Japoni-Nejad A, Rezazadeh M, Kazemian H, Fardmousavi N, Van Belkum A, Ghaznavi-Rad E. Molecular characterization of the first community-acquired methicillin-resistant Staphylococcus aureus strains from Central Iran. Int J Infect Dis 2013; 17(11):e949-954.

Machado AB, Reiter KC, Paiva RM, Barth AL. Distribution of staphylococcal cassette chromosome mec (SCCmec) types I, II, III and IV in coagulase-negative staphylococci from patients attending a tertiary hospital in southern Brazil. J Med Microbiol 2007; 56(Pt 10):1328-1333.

Jamaluddin TZ, Kuwahara-Arai K, Hisata K, Terasawa M, Cui L, Baba T, et al. Extreme genetic diversity of methicillin-resistant Staphylococcus epidermidis strains disseminated among healthy Japanese children. J Clin Microbiol 2008; 46:3778-3783.

Stranden AM, Frei R, Adler H, Fluckiger U, Widmer AF. Emergence of SCCmec type IV as the most common type of methicillin-resistant Staphylococcus aureus in a university hospital. Infection 2009; 37:44-48.

Harastani HH, Tokajian ST. Community-associated methicillin-resistant Staphylococcus aureus clonal complex 80 type IV (CC80-MRSA-IV) isolated from the Middle East: a heterogeneous expanding clonal lineage. PLoS One 2014; 9(7):e103715.

Dhawan B, Rao C, Udo EE, Gadepalli R, Vishnubhatla S, Kapil A. Dissemination of methicillin-resistant Staphylococcus aureus SCCmec type IV and SCCmec type V epidemic clones in a tertiary hospital: challenge to infection control. Epidemiol Infect 2015; 143:343-353.

Coombs GW, Monecke S, Pearson JC, Tan HL, Chew YK, Wilson L, et al. Evolution and diversity of community-associated methicillin-resistant Staphylococcus aureus in a geographical region. BMC Microbiol 2011; 11:215.

Descloux S, Rossano A, Perreten V. Characterization of new staphylococcal cassette chromosome mec (SCCmec) and topoisomerase genes in fluoroquinolone- and methicillin-resistant Staphylococcus pseudintermedius. J Clin Microbiol 2008; 46:1818-1823.

Ruppe E, Barbier F, Mesli Y, Maiga A, Cojocaru R, Benkhalfat M, et al. Diversity of staphylococcal cassette chromosome mec structures in methicillin-resistant Staphylococcus epidermidis and Staphylococcus haemolyticus strains among outpatients from four countries. Antimicrob Agents Chemother 2008;53:442-449.

Boyle-Vavra S, Ereshefsky B, Wang CC, Daum RS. Successful multiresistant community-associated methicillin-resistant Staphylococcus aureus lineage from Taipei, Taiwan, that carries either the novel Staphylococcal chromosome cassette mec (SCCmec) type V or SCCmec type IV. J Clin Microbiol 2005; 43:4719-4730.

Shore A, Rossney AS, Keane CT, Enright MC, Coleman DC. Seven novel variants of the staphylococcal chromosomal cassette mec in methicillin-resistant Staphylococcus aureus isolates from Ireland. Antimicrob Agents Chemother 2005; 49:2070-2083.

Miragaia M, Thomas JC, Couto I, Enright MC, de Lencastre H. Inferring a population structure for Staphylococcus epidermidis from multilocus sequence typing data. J Bacteriol 2007; 189:2540-2552.

Soderquist B, Berglund C. Methicillin-resistant Staphylococcus saprophyticus in Sweden carries various types of staphylococcal cassette chromosome mec (SCCmec). Clin Microbiol Infect 2009; 15:1176-1178.

Higashide M, Kuroda M, Omura CT, Kumano M, Ohkawa S, Ichimura S, et al. Methicillin-resistant Staphylococcus saprophyticus isolates carrying staphylococcal cassette chromosome mec have emerged in urogenital tract infections. Antimicrob Agents Chemother 2008; 52:2061-2068.

Zong Z, Peng C, Lu X. Diversity of SCCmec elements in methicillin-resistant coagulase-negative staphylococci clinical isolates. PLoS One 2011; 6(5): e20191.

Pereira EM, Schuenck RP, Nouer SA, Santos KR. Methicillin-resistant Staphylococcus lugdunensis carrying SCCmec type V misidentified as MRSA. Braz J Infect Dis 2011; 15:293-295.

Lin JF, Cheng CW, Kuo AJ, Liu TP, Yang CC, Huang CT, et al. Clinical experience and microbiologic characteristics of invasive Staphylococcus lugdunensis infection in a tertiary center in northern Taiwan. J Microbiol Immunol Infect 2015; 48:406-412.


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