A comparative characterization of nasal and clinical isolates of Staphylococcus aureus from west of Iran
Abstract
Background and Objectives: Recently, the rise of methicillin-resistant Staphylococcus aureus (MRSA) isolated from hospital healthcare workers (HCWs) and various infectious samples has become one of the main concerns in hospital settings. Therefore, epidemiological studies are necessary to monitor antibiotic resistance patterns in each region and to study the pathogenesis of this strain to control infections.
Materials and Methods: In this cross-sectional study, a total of 100 S. aureus isolates, including 50 isolates obtained from the anterior nares of healthcare workers, as well as 50 other isolates cultured from the various clinical specimens from the referral hospitals in Khorramabad (West of Iran) were tested. All isolates were examined to determine antibiotic resistance pattern, and the presence of staphylococcal enterotoxin A (sea), staphylococcal enterotoxin B (seb) and mecA genes.
Results: The mecA gene was found among 36% (18/50) of the clinical S. aureus isolates (CSIs) and 14% (7/50) of nasal S. aureus isolates (NSIs), with statistically significant difference (X2 = 6.53; p = 0.011). The difference between the frequency rate of sea gene among MRSA strains isolated from clinical specimens (46.6%, 7/15) was significant compared to strains isolated from nostrils (14.3%, 1/7) (X2 = 3.85; p = 0.049).
Conclusion: The frequency of mecA, sea, and seb genes among the clinical samples was more than strains isolated from the nostrils of healthcare personnel.
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3. Bitrus AA, Zunita Z, Bejo SK, Othman S, Nadzir NA. In vitro transfer of methicillin resistance determinants mecA from methicillin resistant Staphylococcus aureus (MRSA) to methicillin susceptible Staphylococcus aureus (MSSA). BMC Microbiol 2017;17:83.
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8. Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 2005;5:751-762.
9. Hawkins G, Stewart S, Blatchford O, Reilly J. Should healthcare workers be screened routinely for meticillin-resistant Staphylococcus aureus? A review of the evidence. J Hosp Infect 2011;77:285-289.
10. Emaneini M, Jabalameli F, Rahdar H, Leeuwen WBV, Beigverdi R. Nasal carriage rate of methicillin resistant Staphylococcus aureus among Iranian healthcare workers: A systematic review and meta-analysis. Rev Soc Bras Med Trop 2017;50:590-597.
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12. Omoe K, Hu DL, Ono HK, Shimizu S, Takahashi-Omoe H, Nakane A, et al. Emetic potentials of newly identified staphylococcal enterotoxin-like toxins. Infect Immun 2013;81:3627-3631.
13. Sergelidis D, Angelidis AS. Methicillin-resistant Staphylococcus aureus: A controversial food-borne pathogen. Lett Appl Microbiol 2017;64:409-418.
14. Pinchuk IV, Beswick EJ, Reyes VE. Staphylococcal enterotoxins. Toxins (Basel) 2010;2:2177-2197.
15. Ortega E, Abriouel H, Lucas R, Gálvez A. Multiple roles of Staphylococcus aureus enterotoxins: pathogenicity, superantigenic activity, and correlation to antibiotic resistance. Toxins (Basel) 2010;2:2117-2131.
16. Klotz M, Opper S, Heeg K, Zimmermann S. Detection of Staphylococcus aureus enterotoxins A to D by Real-Time fluorescence PCR assay. J Clin Microbiol 2003;41:4683-4687.
17. Goudarzi G, Tahmasbi F, Anbari K, Ghafarzadeh M. Distribution of genes encoding resistance to macrolides among staphylococci isolated from the nasal cavity of hospital employees in Khorramabad, Iran. Iran Red Crescent Med J 2016;18(2):e25701.
18. Mahon C, Lehman D, Manuselis G (2011). Textbook of diagnostic microbiology. 5th ed. Maryland Heights: Saunders Elsevier Company.
19. CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 25th ed. CLSI supplement M100S. Wayne, PA: Clinical and Laboratory Standards Institute; 2015.
20. Mehrotra M, Wang G, Johnson WM. Multiplex PCR for detection of genes for Staphylococcus aureus enterotoxins, exfoliative toxins, toxic shock syndrome toxin 1, and methicillin resistance. J Clin Microbiol 2000;38:1032-1035.
21. Fey PD, Said-Salim B, Rupp ME, Hinrichs SH, Boxrud DJ, Davis CC, et al. Comparative molecular analysis of community-or hospital-acquired methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2003;47:196-203.
22. Harkins CP, Pichon B, Doumith M, Parkhill J, Westh H, Tomasz A, et al. Methicillin-resistant Staphylococcus aureus emerged long before the introduction of methicillin into clinical practice. Genome Biol 2017;18:130.
23. Aqel AA, Alzoubi HM, Vickers A, Pichon B, Kearns AM. Molecular epidemiology of nasal isolates of methicillin-resistant Staphylococcus aureus from Jordan. J Infect Public Health 2015;8:90-97.
24. Dibah S, Arzanlou M, Jannati E, Shapouri R. Prevalence and antimicrobial resistance pattern of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from clinical specimens in Ardabil, Iran. Iran J Microbiol 2014;6:163-168.
25. Hussein NR, Assafi MS, Ijaz T. Methicillin-resistant Staphylococcus aureus nasal colonisation amongst healthcare workers in Kurdistan region, Iraq. J Glob Antimicrob Resist 2017;9:78-81.
26. Farahani A, Mohajeri P, Gholamine B, Rezaei M, Abbasi H. Comparison of different phenotypic and genotypic methods for the detection of methicillin-resistant Staphylococcus aureus. N Am J Med Sci 2013;5:637-640.
27. Mamishi S, Mahmoudi S, Sadeghi RH, Movahedi Z, Hadipour R, Pourakbar B. Genotyping of Staphylococcus aureus strains among healthcare workers and patients in the tertiary referral children's medical hospital in Tehran, Iran. Br J Biomed Sci 2012;69:173-177.
28. Wongboot W, Chomvarin C, Engchanil C, Chaimanee P. Multiplex PCR for detection of superantigenic toxin genes in methicillin-sensitive and methicillin-resistant Staphylococcus aureus isolated from patients and carriers of a hospital in northeast Thailand. Southeast Asian J Trop Med Public Health 2013;44:660-671.
29. Hososaka Y, Hanaki H, Endo H, Suzuki Y, Nagasawa Z, Otsuka Y, et al. Characterization of oxacillin-susceptible mecA-positive Staphylococcus aureus: A new type of MRSA. J Infect Chemother 2007;13:79-86.
30. Rajabiani A, Kamrani F, Boroumand MA, Saffar H. mec-A-mediated resistance in Staphylococcus aureus in a referral hospital, Tehran, Iran. Jundishapur J Microbiol 2014;7(4):e9181.
31. Hoseini Alfatemi SM, Motamedifar M, Hadi N, Sedigh Ebrahim Saraie H. Analysis of virulence genes among methicillin resistant Staphylococcus aureus (MRSA) strains. Jundishapur J Microbiol 2014;7(6):e10741.
32. Zhang K, McClure JA, Elsayed S, Conly JM. Novel staphylococcal cassette chromosome mec type, tentatively designated type VIII, harboring class A mec and type 4 ccr gene complexes in a Canadian epidemic strain of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2009;53:531-540.
33. Yadegar A, Sattari M, Mozafari NA, Goudarzi GR. Prevalence of the genes encoding aminoglycoside-modifying enzymes and methicillin resistance among clinical isolates of Staphylococcus aureus in Tehran, Iran. Microb Drug Resist 2009;15:109-113.
34. Mistry H, Sharma P, Mahato S, Saravanan R, Kumar PA, Bhandari V. Prevalence and characterization of oxacillin susceptible mecA-positive clinical isolates of Staphylococcus aureus causing Bovine Mastitis in India. PLoS One 2016;11(9):e0162256.
35. Peck KR, Baek JY, Song JH, Ko KS. Comparison of genotypes and enterotoxin genes between Staphylococcus aureus isolates from blood and nasal colonizers in a Korean hospital. J Korean Med Sci 2009;24:585-591.
36. Cha JO, Lee JK, Jung YH, Yoo JI, Park YK, Kim BS, et al. Molecular analysis of Staphylococcus aureus isolates associated with staphylococcal food poisoning in south Korea. J Appl Microbiol 2006;101:864-871.
2. Dağı HT, Fındık D, Demirel G, Arslan U. Detection of methicillin resistance and various virulence factors in Staphylococcus aureus strains isolated from nasal carriers. Balkan Med J 2015;32:171-175.
3. Bitrus AA, Zunita Z, Bejo SK, Othman S, Nadzir NA. In vitro transfer of methicillin resistance determinants mecA from methicillin resistant Staphylococcus aureus (MRSA) to methicillin susceptible Staphylococcus aureus (MSSA). BMC Microbiol 2017;17:83.
4. Assis LM, Nedeljković M, Dessen A. New strategies for targeting and treatment of multi-drug resistant Staphylococcus aureus. Drug Resist Updat 2017;31:1-14.
5. Opacic D, Lepsanovic Z, Sbutega-Milosevic G. Distribution of disinfectant resistance genes qacA/B in clinical isolates of meticillin-resistant and -susceptible Staphylococcus aureus in one Belgrade hospital. J Hosp Infect 2010;76:266-267.
6. Dadashi M, Nasiri MJ, Fallah F, Owlia P, Hajikhani B, Emaneini M, et al. Methicillin-resistant Staphylococcus
aureus (MRSA) in Iran: A systematic review and meta-analysis. J Glob Antimicrob Resist 2017;12:96-103.
7. Xia J, Gao J, Kokudo N, Hasegawa K, Tang W. Methicillin-resistant Staphylococcus aureus antibiotic resistance and virulence. Biosci Trends 2013;7:113-121.
8. Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 2005;5:751-762.
9. Hawkins G, Stewart S, Blatchford O, Reilly J. Should healthcare workers be screened routinely for meticillin-resistant Staphylococcus aureus? A review of the evidence. J Hosp Infect 2011;77:285-289.
10. Emaneini M, Jabalameli F, Rahdar H, Leeuwen WBV, Beigverdi R. Nasal carriage rate of methicillin resistant Staphylococcus aureus among Iranian healthcare workers: A systematic review and meta-analysis. Rev Soc Bras Med Trop 2017;50:590-597.
11. Lawrynowicz-Paciorek M, Kochman M, Piekarska K, Grochowska A, Windyga B. The distribution of enterotoxin and enterotoxin-like genes in Staphylococcus aureus strains isolated from nasal carriers and food samples. Int J Food Microbiol 2007;117:319-323.
12. Omoe K, Hu DL, Ono HK, Shimizu S, Takahashi-Omoe H, Nakane A, et al. Emetic potentials of newly identified staphylococcal enterotoxin-like toxins. Infect Immun 2013;81:3627-3631.
13. Sergelidis D, Angelidis AS. Methicillin-resistant Staphylococcus aureus: A controversial food-borne pathogen. Lett Appl Microbiol 2017;64:409-418.
14. Pinchuk IV, Beswick EJ, Reyes VE. Staphylococcal enterotoxins. Toxins (Basel) 2010;2:2177-2197.
15. Ortega E, Abriouel H, Lucas R, Gálvez A. Multiple roles of Staphylococcus aureus enterotoxins: pathogenicity, superantigenic activity, and correlation to antibiotic resistance. Toxins (Basel) 2010;2:2117-2131.
16. Klotz M, Opper S, Heeg K, Zimmermann S. Detection of Staphylococcus aureus enterotoxins A to D by Real-Time fluorescence PCR assay. J Clin Microbiol 2003;41:4683-4687.
17. Goudarzi G, Tahmasbi F, Anbari K, Ghafarzadeh M. Distribution of genes encoding resistance to macrolides among staphylococci isolated from the nasal cavity of hospital employees in Khorramabad, Iran. Iran Red Crescent Med J 2016;18(2):e25701.
18. Mahon C, Lehman D, Manuselis G (2011). Textbook of diagnostic microbiology. 5th ed. Maryland Heights: Saunders Elsevier Company.
19. CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 25th ed. CLSI supplement M100S. Wayne, PA: Clinical and Laboratory Standards Institute; 2015.
20. Mehrotra M, Wang G, Johnson WM. Multiplex PCR for detection of genes for Staphylococcus aureus enterotoxins, exfoliative toxins, toxic shock syndrome toxin 1, and methicillin resistance. J Clin Microbiol 2000;38:1032-1035.
21. Fey PD, Said-Salim B, Rupp ME, Hinrichs SH, Boxrud DJ, Davis CC, et al. Comparative molecular analysis of community-or hospital-acquired methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2003;47:196-203.
22. Harkins CP, Pichon B, Doumith M, Parkhill J, Westh H, Tomasz A, et al. Methicillin-resistant Staphylococcus aureus emerged long before the introduction of methicillin into clinical practice. Genome Biol 2017;18:130.
23. Aqel AA, Alzoubi HM, Vickers A, Pichon B, Kearns AM. Molecular epidemiology of nasal isolates of methicillin-resistant Staphylococcus aureus from Jordan. J Infect Public Health 2015;8:90-97.
24. Dibah S, Arzanlou M, Jannati E, Shapouri R. Prevalence and antimicrobial resistance pattern of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from clinical specimens in Ardabil, Iran. Iran J Microbiol 2014;6:163-168.
25. Hussein NR, Assafi MS, Ijaz T. Methicillin-resistant Staphylococcus aureus nasal colonisation amongst healthcare workers in Kurdistan region, Iraq. J Glob Antimicrob Resist 2017;9:78-81.
26. Farahani A, Mohajeri P, Gholamine B, Rezaei M, Abbasi H. Comparison of different phenotypic and genotypic methods for the detection of methicillin-resistant Staphylococcus aureus. N Am J Med Sci 2013;5:637-640.
27. Mamishi S, Mahmoudi S, Sadeghi RH, Movahedi Z, Hadipour R, Pourakbar B. Genotyping of Staphylococcus aureus strains among healthcare workers and patients in the tertiary referral children's medical hospital in Tehran, Iran. Br J Biomed Sci 2012;69:173-177.
28. Wongboot W, Chomvarin C, Engchanil C, Chaimanee P. Multiplex PCR for detection of superantigenic toxin genes in methicillin-sensitive and methicillin-resistant Staphylococcus aureus isolated from patients and carriers of a hospital in northeast Thailand. Southeast Asian J Trop Med Public Health 2013;44:660-671.
29. Hososaka Y, Hanaki H, Endo H, Suzuki Y, Nagasawa Z, Otsuka Y, et al. Characterization of oxacillin-susceptible mecA-positive Staphylococcus aureus: A new type of MRSA. J Infect Chemother 2007;13:79-86.
30. Rajabiani A, Kamrani F, Boroumand MA, Saffar H. mec-A-mediated resistance in Staphylococcus aureus in a referral hospital, Tehran, Iran. Jundishapur J Microbiol 2014;7(4):e9181.
31. Hoseini Alfatemi SM, Motamedifar M, Hadi N, Sedigh Ebrahim Saraie H. Analysis of virulence genes among methicillin resistant Staphylococcus aureus (MRSA) strains. Jundishapur J Microbiol 2014;7(6):e10741.
32. Zhang K, McClure JA, Elsayed S, Conly JM. Novel staphylococcal cassette chromosome mec type, tentatively designated type VIII, harboring class A mec and type 4 ccr gene complexes in a Canadian epidemic strain of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2009;53:531-540.
33. Yadegar A, Sattari M, Mozafari NA, Goudarzi GR. Prevalence of the genes encoding aminoglycoside-modifying enzymes and methicillin resistance among clinical isolates of Staphylococcus aureus in Tehran, Iran. Microb Drug Resist 2009;15:109-113.
34. Mistry H, Sharma P, Mahato S, Saravanan R, Kumar PA, Bhandari V. Prevalence and characterization of oxacillin susceptible mecA-positive clinical isolates of Staphylococcus aureus causing Bovine Mastitis in India. PLoS One 2016;11(9):e0162256.
35. Peck KR, Baek JY, Song JH, Ko KS. Comparison of genotypes and enterotoxin genes between Staphylococcus aureus isolates from blood and nasal colonizers in a Korean hospital. J Korean Med Sci 2009;24:585-591.
36. Cha JO, Lee JK, Jung YH, Yoo JI, Park YK, Kim BS, et al. Molecular analysis of Staphylococcus aureus isolates associated with staphylococcal food poisoning in south Korea. J Appl Microbiol 2006;101:864-871.
| Files | ||
| Issue | Vol 13 No 6 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v13i6.8086 | |
| Keywords | ||
| MecA; Methicillin resistance; Staphylococcal enterotoxins; Staphylococcus aureus | ||
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How to Cite
1.
Goudarzi G, Hasanvand Y, Rezaei F, Delfani S. A comparative characterization of nasal and clinical isolates of Staphylococcus aureus from west of Iran. Iran J Microbiol. 2021;13(6):817-823.
