The high cross-transmission in methicillin resistant Staphylococcus aureus between healthy and patient communities
,
Abstract
Background and Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the main causes of high mortality and morbidity in hospitals. This study was aimed to examine virulence factors, molecular typing, and the antibiotic resistance pattern of MRSA isolates in hemodialysis patients and healthy communities.
Materials and Methods: Total of 231 and 400 nasal samples were obtained from hemodialysis patients and healthy communities, respectively. Virulence factors profile was examined in two groups by PCR reaction. Enterobacterial Repetitive Intergenic Consensus (ERIC-PCR) was used as a molecular typing approach.
Results: Overall, 35.49% (82/231) of hemodialysis patients were positive for S. aureus, and 47.56% (39/82) of isolates were positive for mecA. In a healthy community, 15% (60/400) of samples were positive for S. aureus, and 36.66% (22/60) were positive for mecA. The frequency of MDR was significantly higher in patients group (p-value < 0.00001). The frequency of pvl (p.value = 0.003932, P<0.05) and tsst-1 (p.value = 0.003173, p < .05) were significantly higher in patients group. The highest frequency virulence factors in healthy individuals were related to hla (68.33%, 41/60), hlb (53.33%, 32/60), and Acme/arcA (46.66%) genes. Two groups were clustered by the ERIC-PCR method into 7 clusters and 2 single isolate with a 0.74 similarity index. Based on the results, each cluster was combination with healthy and patient isolates.
Conclusion: Our findings indicate a notable variation in the frequency of virulence factors between S. aureus isolates obtained from dialysis patients and the healthy community.
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4. Magro G, Biffani S, Minozzi G, Ehricht R, Monecke S, Luini M, et al. Virulence genes of S. aureus from dairy cow mastitis and contagiousness risk. Toxins (Basel) 2017; 9: 195.
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13. Sivakumar M, Dubal ZB, Kumar A, Bhilegaonkar K, Vinodh Kumar OR, Kumar S, et al. Virulent methicillin resistant Staphylococcus aureus (MRSA) in street vended foods. J Food Sci Technol 2019; 56: 1116-1126.
14. Wilson LA, Sharp PM. Enterobacterial repetitive intergenic consensus (ERIC) sequences in Escherichia coli: Evolution and implications for ERIC-PCR. Mol Biol Evol 2006; 23: 1156-1168.
15. Lotfi F, Shojaie M, Rahbarnia L, Dehnad A, Naghili B, Lotfi H. Molecular characterization and genetic diversity of multidrug-and extensively drug-resistant A. baumannii clinical isolates. Gene Rep 2022; 26: 101455.
16. Hsu B-M, Chen J-S, Lin I-C, Hsu G-J, Koner S, Hussain B, et al. Molecular and anti-microbial resistance (AMR) profiling of methicillin-resistant Staphylococcus aureus (MRSA) from hospital and long-term care facilities (LTCF) environment. Antibiotics (Basel) 2021; 10: 748.
17. Uakarn C, Chaokromthong K, Sintao N. Sample size estimation using Yamane and Cochran and Krejcie and Morgan and green formulas and Cohen statistical power analysis by G* Power and comparisions. Apheit Int J 2021; 10: 76-86.
18. Appiah VA, Pesewu GA, Kotey FCN, Boakye AN, Duodu S, Tette EMA, et al. Staphylococcus aureus nasal colonization among children with sickle cell disease at the Children’s Hospital, Accra: prevalence, risk factors, and antibiotic resistance. Pathogens 2020; 9: 329.
19. Dehnad A, Agdam MHG, Rahbarnia L, Naghili B, Saffarian P. Detection of hemolysine genes in methicillin-resistant S. aureus isolates obtained from a healthy population in north-west of Iran. Gene Rep 2020; 21: 100874.
20. Rohlf F. NTSYS-PC: Numerical taxonomy and multivariate analysis system. Version 2.1. Exeter Software, Appl Biostat, New York. 1998.
21. Ahmadishoar S, Pour NK, Sadeghi J, Nahaei MR, Kheirkhah B. Molecular epidemiology of clinical isolates of methicillin-resistant Staphylococcus aureus by multilocus sequence typing in northwestern (Tabriz) and southern (Kerman) of Iran: The emergence of MRSA ST4848-SCCmec III. Gene Rep 2021; 24: 101212.
22. 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 2018; 12: 96-103.
23. Ghasemian R, Najafi N, Makhlough A, Khademloo M. Frequency of nasal carriage of Staphylococcus aureus and its antimicrobial resistance pattern in patients on hemodialysis. Iran J Kidney Dis 2010; 4: 218-222.
24. den Heijer CD, van Bijnen EM, Paget WJ, Pringle M, Goossens H, Bruggeman CA, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S. aureus, in nine European countries: a cross-sectional study. Lancet Infect Dis 2013; 13: 409-415.
25. Motamedi H, Rahmat Abadi SS, Moosavian SM, Torabi M. The Association of Panton-valentine leukocidin and mecA genes in methicillin-resistant Staphylococcus aureus isolates from patients referred to educational hospitals in Ahvaz, Iran. Jundishapur J Microbiol 2015; 8(8): e22021.
26. Sabat AJ, Ilczyszyn WM, van Rijen M, Akkerboom V, Sinha B, Kluytmans J, et al. Genome-wide analysis reveals two novel mosaic regions containing an ACME with an identical DNA sequence in the MRSA ST398-t011 and MSSA ST8-t008 isolates. J Antimicrob Chemother 2015; 70: 1298-1302.
27. Hoppe P-A, Hanitsch LG, Leistner R, Niebank M, Bührer C, von Bernuth H, et al. Periorbital infections and conjunctivitis due to Panton-Valentine Leukocidin (PVL) positive Staphylococcus aureus in children. BMC Infect Dis 2018; 18: 371.
2. Lindsay JA, Holden MT. Staphylococcus aureus: superbug, super genome? Trends Microbiol 2004; 12: 378-385.
3. Zeinalpour Ahrabi S, Rahbarnia L, Dehnad A, Naghili B, Ghaffari Agdam MH, Nazari A. Incidence of Oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) isolates and TSST-1 virulence factor among high school students in Tabriz, Northwest of Iran. Arch Clin Infect Dis 2019;14(4): e85341.
4. Magro G, Biffani S, Minozzi G, Ehricht R, Monecke S, Luini M, et al. Virulence genes of S. aureus from dairy cow mastitis and contagiousness risk. Toxins (Basel) 2017; 9: 195.
5. Rahbarnia L, Farajnia S, Naghili B, Ahmadzadeh V, Veisi K, Baghban R, et al. Current trends in targeted therapy for drug-resistant infections. Appl Microbiol Biotechnol 2019; 103: 8301-8314.
6. Goudarzi M, Navidinia M, Beiranvand E, Goudarzi H. Phenotypic and molecular characterization of methicillin-resistant Staphylococcus aureus clones carrying the Panton-Valentine leukocidin genes disseminating in Iranian hospitals. Microb Drug Resist 2018; 24: 1543-1551.
7. Ghavghani FR, Rahbarnia L, Naghili B, Dehnad A, Bazmani A, Varshochi M, et al. Nasal and extra nasal MRSA colonization in hemodialysis patients of north-west of Iran. BMC Res Notes 2019; 12: 260.
8. Rahbarnia L, Farajnia S, Khaneshi H, Farajnia H, Naghili B, Tanomand A. Detection of blaOXA-23 and blaNDM-1 carbapenemase among clinical isolates of A. baumannii in Tabriz, north-west of Iran. Gene Rep 2020; 18: 100555.
9. Nakaminami H, Takadama S, Ito A, Hasegawa M, Jono C, Noguchi M, et al. Characterization of SCCmec type IV methicillin-resistant Staphylococcus aureus clones increased in Japanese hospitals. J Med Microbiol 2018; 67: 769-774.
10. David MZ, Cadilla A, Boyle-Vavra S, Daum RS. Replacement of HA-MRSA by CA-MRSA infections at an academic medical center in the midwestern United States, 2004-5 to 2008. PLoS One 2014; 9(4): e92760.
11. Buck JM, Como-Sabetti K, Harriman KH, Danila RN, Boxrud DJ, Glennen A, et al. Community-associated methicillin-resistant Staphylococcus aureus, Minnesota, 2000–2003. Emerg Infect Dis 2005; 11: 1532-1538.
12. Ahmad NI, Yean Yean C, Foo PC, Mohamad Safiee AW, Hassan SA. Prevalence and association of Panton-Valentine Leukocidin gene with the risk of sepsis in patients infected with methicillin resistant Staphylococcus aureus. J Infect Public Health 2020; 13: 1508-1512.
13. Sivakumar M, Dubal ZB, Kumar A, Bhilegaonkar K, Vinodh Kumar OR, Kumar S, et al. Virulent methicillin resistant Staphylococcus aureus (MRSA) in street vended foods. J Food Sci Technol 2019; 56: 1116-1126.
14. Wilson LA, Sharp PM. Enterobacterial repetitive intergenic consensus (ERIC) sequences in Escherichia coli: Evolution and implications for ERIC-PCR. Mol Biol Evol 2006; 23: 1156-1168.
15. Lotfi F, Shojaie M, Rahbarnia L, Dehnad A, Naghili B, Lotfi H. Molecular characterization and genetic diversity of multidrug-and extensively drug-resistant A. baumannii clinical isolates. Gene Rep 2022; 26: 101455.
16. Hsu B-M, Chen J-S, Lin I-C, Hsu G-J, Koner S, Hussain B, et al. Molecular and anti-microbial resistance (AMR) profiling of methicillin-resistant Staphylococcus aureus (MRSA) from hospital and long-term care facilities (LTCF) environment. Antibiotics (Basel) 2021; 10: 748.
17. Uakarn C, Chaokromthong K, Sintao N. Sample size estimation using Yamane and Cochran and Krejcie and Morgan and green formulas and Cohen statistical power analysis by G* Power and comparisions. Apheit Int J 2021; 10: 76-86.
18. Appiah VA, Pesewu GA, Kotey FCN, Boakye AN, Duodu S, Tette EMA, et al. Staphylococcus aureus nasal colonization among children with sickle cell disease at the Children’s Hospital, Accra: prevalence, risk factors, and antibiotic resistance. Pathogens 2020; 9: 329.
19. Dehnad A, Agdam MHG, Rahbarnia L, Naghili B, Saffarian P. Detection of hemolysine genes in methicillin-resistant S. aureus isolates obtained from a healthy population in north-west of Iran. Gene Rep 2020; 21: 100874.
20. Rohlf F. NTSYS-PC: Numerical taxonomy and multivariate analysis system. Version 2.1. Exeter Software, Appl Biostat, New York. 1998.
21. Ahmadishoar S, Pour NK, Sadeghi J, Nahaei MR, Kheirkhah B. Molecular epidemiology of clinical isolates of methicillin-resistant Staphylococcus aureus by multilocus sequence typing in northwestern (Tabriz) and southern (Kerman) of Iran: The emergence of MRSA ST4848-SCCmec III. Gene Rep 2021; 24: 101212.
22. 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 2018; 12: 96-103.
23. Ghasemian R, Najafi N, Makhlough A, Khademloo M. Frequency of nasal carriage of Staphylococcus aureus and its antimicrobial resistance pattern in patients on hemodialysis. Iran J Kidney Dis 2010; 4: 218-222.
24. den Heijer CD, van Bijnen EM, Paget WJ, Pringle M, Goossens H, Bruggeman CA, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S. aureus, in nine European countries: a cross-sectional study. Lancet Infect Dis 2013; 13: 409-415.
25. Motamedi H, Rahmat Abadi SS, Moosavian SM, Torabi M. The Association of Panton-valentine leukocidin and mecA genes in methicillin-resistant Staphylococcus aureus isolates from patients referred to educational hospitals in Ahvaz, Iran. Jundishapur J Microbiol 2015; 8(8): e22021.
26. Sabat AJ, Ilczyszyn WM, van Rijen M, Akkerboom V, Sinha B, Kluytmans J, et al. Genome-wide analysis reveals two novel mosaic regions containing an ACME with an identical DNA sequence in the MRSA ST398-t011 and MSSA ST8-t008 isolates. J Antimicrob Chemother 2015; 70: 1298-1302.
27. Hoppe P-A, Hanitsch LG, Leistner R, Niebank M, Bührer C, von Bernuth H, et al. Periorbital infections and conjunctivitis due to Panton-Valentine Leukocidin (PVL) positive Staphylococcus aureus in children. BMC Infect Dis 2018; 18: 371.
| Files | ||
| Issue | Vol 15 No 3 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v15i3.12901 | |
| Keywords | ||
| Methicillin-resistant Staphylococcus aureus; Molecular typing; Virulence factors | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Haji Sheikhzadeh B, Rahbarnia L, Dehnad A, Naghili B, Saffarian P. The high cross-transmission in methicillin resistant Staphylococcus aureus between healthy and patient communities. Iran J Microbiol. 2023;15(3):408-413.
