mecA and PVL genes in methicillin-resistant Staphylococcus aureus from clinical specimens: a cross-sectional hospital based study from Nepal
,
Abstract
Background and Objectives: Staphylococcus aureus has increasingly been associated with community and healthcare-associated infections worldwide and contributes to treatment failures due to the emergence of multidrug-resistant (MDR) and methicillin-resistant Staphylococcus aureus (MRSA) strains. We aimed to determine the prevalence and antibiotic susceptibility pattern of MRSA isolated from patients attending a burn center and to detect mecA and PVL genes among MRSA isolates.
Materials and Methods: A cross-sectional hospital based study was conducted on 1950 clinical samples collected from hospital inpatients and outpatients of Kirtipur Hospital, which is a burn specialist hospital in Kathmandu, Nepal. Each sample underwent conventional cultural methods for bacterial isolates identification.
Results: Out of 1950 samples, 452 (23.2%) samples showed bacterial growth, of which 109 isolates (24.1%) were identified as Gram positive and 343 (75.9%) as Gram negative bacteria. Among the Gram positive bacteria, 53 (48.62%) were Staphylococcus aureus. Of the total S. aureus isolates, 40 (75.5%) were MRSA and 48 (90.6%) were MDR. Of the 40 MRSA isolates, 29 (72.5%) carried the mecA gene and 3 (7.5%) harbored PVL gene.
Conclusion: The high prevalence of MRSA in a burn unit underscores the need for more rigorous infection control practices that follow standard protocols to reduce MRSA transmission in both individuals and the hospital environment.
1. Kadariya J, Thapaliya D, Bhatta S, Mahatara RL, Bempah S, Dhakal N, et al. Multidrug-resistant Staphylococcus aureus colonization in healthy adults is more common in bhutanese refugees in Nepal than those resettled in Ohio. Biomed Res Int 2019; 2019: 5739247.
2. 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.
3. Lohan K, Sangwan J, Mane P, Lathwal S. Prevalence pattern of MRSA from a rural medical college of North India: A cause of concern. J Family Med Prim Care 2021; 10: 752-757.
4. K.C. R, Timilsina G, Singh A, Sharma S. Detection of methicillin resistant Staphylococcus aureus in dairy products and anterior nares of dairy workers. TU J Microbiol 2019; 6: 59-62.
5. Khanal A, G C S, Gaire A, Khanal A, Estrada R, Ghimire R, et al. Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis. Int J Infect Dis 2021; 103: 48-55.
6. Acharya M, Joshi PR, Thapa K, Aryal R, Kakshapati T, Sharma S. Detection of metallo-β-lactamases-encoding genes among clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital, Kathmandu, Nepal. BMC Res Notes 2017; 10: 718.
7. Devkota SP, Sharma S, Bhatta DR, Paudel A, Sah AK, Kandel BP. Prevalence of the blaNDM gene among metallo-β-lactamase-producing Gram-negative isolates from western Nepal. J Glob Antimicrob Resist 2018; 12: 3-4.
8. Shakya G, Kim DW, Clemens JD, Malla S, Upadhyaya BP, Dumre SP, et al. Phenotypic and genetic characterization of Vibrio cholerae O1 clinical isolates collected through national antimicrobial resistance surveillance network in Nepal. World J Microbiol Biotechnol 2012; 28: 2671-2678.
9. Tille PM (2013). Bailey & Scott’s Diagnostic Microbiology. 13th ed. Saint Louis: Elsevier Health Sciences.
10. CLSL (2018). Performance standards for antimicrobial disk susceptibility tests. 13th edition. Wayne, PA: Clinical and Laboratory Standards Institute.
11. Carroll KC, Pfaller MA, Landry ML, McAdam AJ, Patel R, Richter SS, et al (2019). Manual of Clinical Microbiology, 12 Edition. American Society of Microbiology. Available from: https://www.amazon.com/Clinical-Microbiology-Twelfth-Michael-Pfaller/dp/1555819834
12. Dilhari A, Sampath A, Gunasekara C, Fernando N, Weerasekara D, Sissons C, et al. Evaluation of the impact of six different DNA extraction methods for the representation of the microbial community associated with human chronic wound infections using a gel-based DNA profiling method. AMB Express 2017; 7: 179.
13. 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.
14. Naji Hasan R, Abdal Kareem Jasim S. Detection of Panton-Valentine leukocidin and MecA genes in Staphylococcus aureus isolated from Iraqi Patients. Arch Razi Inst 2021; 76: 1054-1059.
15. Neopane P, Nepal HP, Shrestha R, Uehara O, Abiko Y. In vitro biofilm formation by Staphylococcus aureus isolated from wounds of hospital-admitted patients and their association with antimicrobial resistance. Int J Gen Med 2018; 11: 25-32.
16. Shrestha LB, Syangtan G, Basnet A, Acharya KP, Chand AB, Pokhrel K. Methicillin-resistant Staphylococcus aureus in Nepal. JNMA J Nepal Med Assoc 2021; 59: 518-522.
17. Kumari N, Mohapatra TM, Singh YI. Prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) in a Tertiary-Care hospital in Eastern Nepal. JNMA J Nepal Med Assoc 2008; 47: 53-56.
18. Shrestha A, Bhattarai RK, Luitel H, Karki S, Basnet HB. Prevalence of methicillin-resistant Staphylococcus aureus and pattern of antimicrobial resistance in mastitis milk of cattle in Chitwan, Nepal. BMC Vet Res 2021; 17: 239.
19. Pradhan P, Rajbhandari P, Nagaraja SB, Shrestha P, Grigoryan R, Satyanarayana S, et al. Prevalence of methicillin-resistant Staphylococcus aureus in a tertiary hospital in Nepal. Public Health Action 2021; 11(Suppl 1): 46-51.
20. Adhikari P, Basyal D, Rai JR, Bharati L, Budthapa A, Gharti KP, et al. Prevalence, antimicrobial susceptibility pattern and multidrug resistance of methicillin-resistant Staphylococcus aureus isolated from clinical samples at a tertiary care teaching hospital: an observational, cross-sectional study from the Himalayan country, Nepal. BMJ Open 2023; 13(5): e067384.
21. Dhungel S, Rijal KR, Yadav B, Dhungel B, Adhikari N, Shrestha UT, et al. Methicillin-Resistant Staphylococcus aureus (MRSA): Prevalence, antimicrobial Susceptibility Pattern, and detection of mecA gene among Cardiac patients from a tertiary care heart center in Kathmandu, Nepal. Infect Dis (Auckl) 2021; 14: 11786337211037355.
22. Elhassan MM, Ozbak HA, Hemeg HA, Elmekki MA, Ahmed LM. Absence of the mecA gene in methicillin resistant Staphylococcus aureus isolated from different clinical Specimens in Shendi City, Sudan. Biomed Res Int 2015; 2015: 895860.
23. Lakhundi S, Zhang K. Methicillin-resistant Staphylococcus aureus: molecular characterization, evolution, and epidemiology. Clin Microbiol Rev 2018; 31(4): e00020-18.
24. Schaumburg F, Köck R, Mellmann A, Richter L, Hasenberg F, Kriegeskorte A, et al. Population dynamics among methicillin-resistant Staphylococcus aureus isolates in Germany during a 6-year period. J Clin Microbiol 2012; 50: 3186-3192.
25. Klein S, Menz MD, Zanger P, Heeg K, Nurjadi D. Increase in the prevalence of Panton–Valentine leukocidin and clonal shift in community-onset methicillin-resistant Staphylococcus aureus causing skin and soft-tissue infections in the Rhine-Neckar Region, Germany, 2012–2016. Int J Antimicrob Agents 2019; 53: 261-267.
2. 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.
3. Lohan K, Sangwan J, Mane P, Lathwal S. Prevalence pattern of MRSA from a rural medical college of North India: A cause of concern. J Family Med Prim Care 2021; 10: 752-757.
4. K.C. R, Timilsina G, Singh A, Sharma S. Detection of methicillin resistant Staphylococcus aureus in dairy products and anterior nares of dairy workers. TU J Microbiol 2019; 6: 59-62.
5. Khanal A, G C S, Gaire A, Khanal A, Estrada R, Ghimire R, et al. Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis. Int J Infect Dis 2021; 103: 48-55.
6. Acharya M, Joshi PR, Thapa K, Aryal R, Kakshapati T, Sharma S. Detection of metallo-β-lactamases-encoding genes among clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital, Kathmandu, Nepal. BMC Res Notes 2017; 10: 718.
7. Devkota SP, Sharma S, Bhatta DR, Paudel A, Sah AK, Kandel BP. Prevalence of the blaNDM gene among metallo-β-lactamase-producing Gram-negative isolates from western Nepal. J Glob Antimicrob Resist 2018; 12: 3-4.
8. Shakya G, Kim DW, Clemens JD, Malla S, Upadhyaya BP, Dumre SP, et al. Phenotypic and genetic characterization of Vibrio cholerae O1 clinical isolates collected through national antimicrobial resistance surveillance network in Nepal. World J Microbiol Biotechnol 2012; 28: 2671-2678.
9. Tille PM (2013). Bailey & Scott’s Diagnostic Microbiology. 13th ed. Saint Louis: Elsevier Health Sciences.
10. CLSL (2018). Performance standards for antimicrobial disk susceptibility tests. 13th edition. Wayne, PA: Clinical and Laboratory Standards Institute.
11. Carroll KC, Pfaller MA, Landry ML, McAdam AJ, Patel R, Richter SS, et al (2019). Manual of Clinical Microbiology, 12 Edition. American Society of Microbiology. Available from: https://www.amazon.com/Clinical-Microbiology-Twelfth-Michael-Pfaller/dp/1555819834
12. Dilhari A, Sampath A, Gunasekara C, Fernando N, Weerasekara D, Sissons C, et al. Evaluation of the impact of six different DNA extraction methods for the representation of the microbial community associated with human chronic wound infections using a gel-based DNA profiling method. AMB Express 2017; 7: 179.
13. 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.
14. Naji Hasan R, Abdal Kareem Jasim S. Detection of Panton-Valentine leukocidin and MecA genes in Staphylococcus aureus isolated from Iraqi Patients. Arch Razi Inst 2021; 76: 1054-1059.
15. Neopane P, Nepal HP, Shrestha R, Uehara O, Abiko Y. In vitro biofilm formation by Staphylococcus aureus isolated from wounds of hospital-admitted patients and their association with antimicrobial resistance. Int J Gen Med 2018; 11: 25-32.
16. Shrestha LB, Syangtan G, Basnet A, Acharya KP, Chand AB, Pokhrel K. Methicillin-resistant Staphylococcus aureus in Nepal. JNMA J Nepal Med Assoc 2021; 59: 518-522.
17. Kumari N, Mohapatra TM, Singh YI. Prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) in a Tertiary-Care hospital in Eastern Nepal. JNMA J Nepal Med Assoc 2008; 47: 53-56.
18. Shrestha A, Bhattarai RK, Luitel H, Karki S, Basnet HB. Prevalence of methicillin-resistant Staphylococcus aureus and pattern of antimicrobial resistance in mastitis milk of cattle in Chitwan, Nepal. BMC Vet Res 2021; 17: 239.
19. Pradhan P, Rajbhandari P, Nagaraja SB, Shrestha P, Grigoryan R, Satyanarayana S, et al. Prevalence of methicillin-resistant Staphylococcus aureus in a tertiary hospital in Nepal. Public Health Action 2021; 11(Suppl 1): 46-51.
20. Adhikari P, Basyal D, Rai JR, Bharati L, Budthapa A, Gharti KP, et al. Prevalence, antimicrobial susceptibility pattern and multidrug resistance of methicillin-resistant Staphylococcus aureus isolated from clinical samples at a tertiary care teaching hospital: an observational, cross-sectional study from the Himalayan country, Nepal. BMJ Open 2023; 13(5): e067384.
21. Dhungel S, Rijal KR, Yadav B, Dhungel B, Adhikari N, Shrestha UT, et al. Methicillin-Resistant Staphylococcus aureus (MRSA): Prevalence, antimicrobial Susceptibility Pattern, and detection of mecA gene among Cardiac patients from a tertiary care heart center in Kathmandu, Nepal. Infect Dis (Auckl) 2021; 14: 11786337211037355.
22. Elhassan MM, Ozbak HA, Hemeg HA, Elmekki MA, Ahmed LM. Absence of the mecA gene in methicillin resistant Staphylococcus aureus isolated from different clinical Specimens in Shendi City, Sudan. Biomed Res Int 2015; 2015: 895860.
23. Lakhundi S, Zhang K. Methicillin-resistant Staphylococcus aureus: molecular characterization, evolution, and epidemiology. Clin Microbiol Rev 2018; 31(4): e00020-18.
24. Schaumburg F, Köck R, Mellmann A, Richter L, Hasenberg F, Kriegeskorte A, et al. Population dynamics among methicillin-resistant Staphylococcus aureus isolates in Germany during a 6-year period. J Clin Microbiol 2012; 50: 3186-3192.
25. Klein S, Menz MD, Zanger P, Heeg K, Nurjadi D. Increase in the prevalence of Panton–Valentine leukocidin and clonal shift in community-onset methicillin-resistant Staphylococcus aureus causing skin and soft-tissue infections in the Rhine-Neckar Region, Germany, 2012–2016. Int J Antimicrob Agents 2019; 53: 261-267.
| Files | ||
| Issue | Vol 17 No 1 (2025) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v17i1.17806 | |
| Keywords | ||
| Methicillin-resistant Staphylococcus aureus; MDR; mecA gene; PVL gene; Wound infection | ||
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How to Cite
1.
Adhikari S, Sharma S, Adhikari S, Shrestha S, Bhatta D. mecA and PVL genes in methicillin-resistant Staphylococcus aureus from clinical specimens: a cross-sectional hospital based study from Nepal. Iran J Microbiol. 2025;17(1):99-105.
