Detection of methicillin-resistant Staphylococcus aureus (MRSA) in clinical samples of patients with external ocular infection

  • Ashkan Faridi Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
  • Amir Tavakoli Kareshk Infectious Diseases Reesearch Center, Birjand University of Medical Sciences, Birjand, Iran
  • Mehdi Fatahi-Bafghi Department of Microbiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences Yazd, Iran
  • Mahsa Ziasistani Pathology and Stem Cell Research Center, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
  • Mohammad Reza Kandehkar Ghahraman Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
  • Seyedeh Zeinab Seyyed-Yousefi Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  • Noshin Shakeri Shahid Labafi Nejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Davood Kalantar-Neyestanaki Department of Microbiology and Virology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Keywords: Eye infection, MRSA, PVL

Abstract

Background and Objectives: Staphylococcus aureus is the main Gram-positive bacteria isolated from patients with ocular infections. Herein, we describe the pattern of antibiotic resistance, presence of resistance genes including ermA, ermB, ermC, msrA, mecA and the pvl cytotoxin gene in S. aureus isolates collected from patients with external ocular infection. Materials and Methods: In this study, 8 S. aureus isolates were collected from 81 patients that suffered from eye damage. Antibacterial susceptibility of isolates was determined using the Kirby-Bauer disk diffusion method. Resistance genes including ermA, ermB, ermC, msrA, mecA and the pvl virulence gene were detected by PCR method. Staphylococcal cassette chromosome mec (SCCmec) in MRSA isolates were detected by the multiplex-PCR method. Results: Three isolates were resistant to cefoxitin which is considered MRSA. The mecA gene was identified in MRSA isolates. SCCmec type IV and the pvl gene were detected in one of the MRSA isolates that was recovered from a diabetic patient. Conclusion: The emergence of S. aureus isolates belonging to SCCmec type IV and pvl gene among patients with ocular infection is very serious; therefore, identify genetic characterization of MRSA isolates for empirical therapy and infection control is very important.

References

Shanmuganathan VA, Armstrong, Buller A, Tullo AB. External ocular infections due to

methicillin-resistant Staphylococcus aureus (MRSA). Eye 2005;19:284–91.

Chuang CC, Hsiao CH, Tan HY, Ma DH-K, Lin KK, Chang CJ, Huang YC. Staphylococcus

aureus Ocular Infection: Methicillin-Resistance, Clinical Features, and Antibiotic Susceptibilities. PLoS ONE 2012;8:e42437.

Chaieb K, Zmantar T, Chehab O, Bouchami O, Ben Hasen A, Mahdouani K, Bakhrouf A. Antibiotic resistance genes detected by multiplex PCR assays in Staphylococcus epidermidis strains isolated from dialysis fluid and needles in a dialysis service. Jpn J Infect Dis 2007;60:183–187.

Oliveira DC, de 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;46:2155–61.

Boye K, Bartels MD, Andersen IS, Mølle JA, Westh H. A new multiplex PCR for easy

screening of methicillin-resistant Staphylococcus aureus SCCmec types I–V. Clin

Microbiol Infect 2007;13:725–7.

Sadeghi J, Mansouri S. Molecular characterization and antibiotic resistance of clinical isolates of methicillin-resistant Staphylococcus aureus obtained from Southeast of Iran (Kerman). APMIS 2014;122:405–11.

Performance Standards for Antimicrobial Susceptibility Testing (CLSI). 27th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2017.

Zhang K, McClure JA, Elsayed S, Louie T, Conly JM. Novel multiplex PCR assay for characterization and concomitant subtyping of staphylococcal cassette chromosome mec types I to V in methicillin resistant Staphylococcus aureus. J Clin Microbiol 2005;43:5026–33.

Zmantar T, Kouidhi B, Miladi H, Bakhrouf A. Detection of macrolide and disinfectant resistance genes in clinical Staphylococcus aureus and coagulase-negative staphylococci. BMC Res Notes 2011;4:453.

Strommenger B, Kettlitz C, Werner G, Witte W. Multiplex PCR assay for simultaneous detection of nine clinically relevant antibiotic resistance genes in Staphylococcus aureus. J Clin Microbiol 2003;41:4089–94.

Singh KV, Malathum K, Murray BE. Disruption of an Enterococcus faecium species-specific gene, a homologue of acquired macrolide resistance genes of staphylococci, is associated with an increase in macrolide susceptibility. Antimicrob Agents Chemother 2001;45:263–6.

Lina G, Piémont Y, Godail-Gamot F, Bes M, Peter MO, Gauduchon V, Vandenesch F, Etienne J. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 1999;29:1128–32.

Hsiao CH, Ong SJ, Chuang CC, Ma DHK, Huang YH. A Comparison of Clinical Features between Community-Associated and Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Keratitis. J Ophthalmol 2015:923941.

Freidlin J, Acharya N, Lietman TM, Cevallos V, Whitcher JP, Margolis TP. Spectrum of eye disease caused by methicillin-resistant Staphylococcus aureus. Am J Ophthalmol 2007;144:313–315.

Khan MA, Ahmad S, Banu N. Molecular characterisation of methicillin-resistant Staphylococcus aureus (MRSA) from keratitis patients: a microbiological analysis. Br J Ophthalmol 2010;94:994–998.

Loomba PS, Taneja J, Mishra B. Methicillin and Vancomycin resistant S. aureus in hospitalized patients. J Glob Infect Dis 2010;2:275–83.

Deurenberg RH, Stobberingh EE. The evolution of Staphylococcus aureus. Infect genet Evol 2008; 8:747–763.

Published
2018-10-06
How to Cite
1.
Faridi A, Tavakoli Kareshk A, Fatahi-Bafghi M, Ziasistani M, Kandehkar Ghahraman MR, Seyyed-Yousefi SZ, Shakeri N, Kalantar-Neyestanaki D. Detection of methicillin-resistant Staphylococcus aureus (MRSA) in clinical samples of patients with external ocular infection. IJM. 10(4):215-9.
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Original Article(s)