Isolation of Asian endemic and livestock associated clones of methicillin resistant Staphylococcus aureus from ocular samples in Northeastern Iran
-
Seyed-Asghar Havaei
,
Amir Azimian
,
Hosein Fazeli
,
Mahmood Naderi
,
Kiarash Ghazvini
,
Siamak Mirab Samiee
,
Masoud Soleimani
Abstract
Background and Objectives: Methicillin Resistant Staphylococcus aureus (MRSA) strains are divided into Community Associated (CA-) and Hospital Associated (HA-) MRSA. These strains vary in antimicrobial resistance and pathogenicity. S. aureus is one of the most common microorganisms in ocular infections. This study was aimed to determine antimicrobial resistance patterns and genetic characteristics of MRSA strains isolated from ocular infections in Iran.
Material and Methods: Out of 171 S. aureus strains isolated from various clinical samples during September-December 2011 at Mashhad Emam Reza Hospital, 3 were cultured from eye discharge samples. Antimicrobial resistance tests were performed with MIC and disk diffusion methods and also genetic evaluation was done with Staphylococcal Cassette Chromosome mec (SCCmec), Accessory Gene Regulator (agr) and Staphylococcal Protein A (spa) typing, Multi Locus Sequence Typing (MLST) and determination of toxin gene profile.
Results: All strains were MRSA and showed resistance to tetracycline, gentamicin and clindamycin too. Vancomycin, minocyclin and trimethoprim/sulfamethoxazole were effective on all ocular isolates. All isolates belonged to SCCmec IV type. MRSA1 belonged to ST239, CC8, Spa type t7688 and agrIII and had tst1 and hla toxin genes. MRSA2 belonged to ST239, CC8, Spa type t037 and agrI and had the hla toxin gene. Finally, MRSA3 belonged to ST291, CC398, Spa type t304, and agrI and had pvl and hla toxin genes.
Conclusion: phenotypic and genotypic evaluation of the isolated MRSA strains revealed that these strains belong to endemic Asian and livestock related clones that could reach from other body sites or environment to the eye of patients and developed ocular infection.
Chambers HF, DeLeo FR. Waves of Resistance: Staphylococcus aureus in the Antibiotic Era. Nat Rev Microbiol 2009; 7: 629-641.
Feng Y, Chen C-J, Su L-H, Hu S, Yu J, Chiu C-H.Evolutionand pathogenesis of Staphylococcus aureus: lessons learned from genotyping and comparative genomics. FEMS Microbiol Rev 2007; 32: 23-37.
Ramesh S, Ramakrishnan R, Bharathi MJ, Amuthan M, Viswanathan S. Prevalence of bacterial pathogens causing ocular infections in South India. Indian J Pathol Microbiol 2010; 53: 281-286.
Behlau I, Gilmore MS. Microbial Biofilms in Ophthalmology and Infectious Disease. Arch Ophthalmol 2008; 126: 1572-1581.
Khosravi AD, Mehdinejad M, Heidari M. Bacteriological findings in patients with ocular infection and antibiotic susceptibility patterns of isolated pathogens. Singapore Med J 2007; 48: 741-743.
Nadig S, Velusamy N, Lalitha P, Kar S, Sharma S, Arakere G. Staphylococcus aureus eye infections in two Indian hospitals: emergence of ST772 as a major clone. Clin Ophthalmol 2012; 6: 165-173.
Chuang C-C, Hsiao C-H, Tan H-Y, Ma DH-K, Lin K-K, Chang C-J, et al. Staphylococcus aureus Ocular Infection: Methicillin- Resistance, Clinical Features, and Antibiotic Susceptibilities. PLoS ONE 2012; 8: e42437.
Rehm SJ, Tice A. Staphylococcus aureus: Methicillin- Susceptible S. aureus to Methicillin-Resistant S. aureus and Vancomycin-Resistant S. aureus. Clin Infect Dis 2010; 51: S176-S82.
Sievert DM, Rudrik JT, Patel JB, McDonald LC, Wilkins MJ, Hageman JC. Vancomycin-Resistant Staphylococcus aureus in the United States, 2002–2006. Clin Infect Dis 2008; 46: 668-674.
Price LB, Stegger M, Hasman H, Aziz M, Larsen J, Andersen PS, et al. Staphylococcus aureus CC398: host adaptation and emergence of methicillin resistance in livestock. Mbio 2012; 3: 1-6.
Herold B, Immergluck L, Maranan M, Lauderdale D, Gaskin R, Boyle-Vavra S, et al. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 1998; 279:593-598.
Fridkin SK, Hageman JC, Morrison M, Sanza LT, Como-Sabetti K, Jernigan JA, et al. Methicillin-Resistant Staphylococcus aureus Disease in Three Communities. N Engl J Med 2005; 352: 1436-1444.
Mediavilla JR, Chen L, Uhlemann A-C, Hanson BM, Rosenthal M, Stanak K, et al. Methicillin Susceptible Staphylococcus aureus ST398, New York and New Jersey, USA. Emerg Infect Dis 2012;18:700-702.
Graveland H, Wagenaar J. A, Bergs K, Heesterbeek H, Heederik D. Persistence of livestock associated MRSA CC398 in humans is dependent on Intensity of animal contact. PLoS ONE. 2011; 6: 1-7.
Cleef BAGLv, Monnet DL, Voss A, Krziwanek K, Allerberger F, Struelens M, et al. Livestock associated Methicillin- Resistant Staphylococcus aureus in Humans, Europe. Emerg Infect Dis 2011; 17: 502-505.
CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests. Standard - 11th ed CLSI document M02-A11. CLSI, 950 West Valley Rd., Suite 25002010.
CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests. Approved Standard - 11th ed 2010.
Peerayeh SN, Azimian A, Nejad QB, Kashi M. Prevalence of agr specificity groups among Staphylococcus aureus isolates from university hospitals in Tehran. Lab Med 2009; 40: 27-29.
Boye K, Bartels M, Andersen I, Møller J, Westh H. A new multiplex PCR for easy screening of methicillin- resistant Staphylococcus aureus SCCmec types I-V. Clin Microbiol Infect 2007; 13: 725-727.
Enright MC, Day NPJ, Davies CE, Peacock SJ, Spratt BG. Multilocus Sequence Typing for Characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol 2000; 38: 1008-1015.
Harmsen D, Claus H, Witte W, Rothga¨nger Jr, Claus H, Turnwald D, et al. Typing of methicillin-resistant Staphylococcus aureus in a university hospital setting by using novel software for spa repeat determination and database management. J Clin Microbiol 2003; 41:5442-5448.
Emaneini M, Khoramrooz SS, Taherikalani M, Jabalameli F, Aligholi M. Molecular characterization of Staphylococcus aureus isolated from children with adenoid hypertrophy: Emergence of new spa types t7685 and t7692. Int J Ped Otorhinolaryng 2011; 75:1446-1449.
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.
Azimian A, Havaei SA, Fazeli H, Naderi M, Ghazvini K, Samiee SM, et al. Genetic characterization of a Vancomycin-Resistant Staphylococcus aureus isolated from respiratory tract of a hospitalized patient in a university hospital in Northeastern Iran. J Clin Microbiol 2012; 50: 3581-3585.
Hesje CK, Sanfilippo CM, Haas W, Morris TW.Molecular Epidemiology of Methicillin- Resistant and Methicillin-Susceptible Staphylococcus aureus Isolated from the Eye. Cur Eye Res 2011; 36: 94-102.
Sakoulas G, Eliopoulos GM, Robert C. Moellering J, Wennersten C, Venkataraman L, Novick RP, et al. Accessory gene regulator (agr) locus in geographically diverse Staphylococcus aureus isolates with reduced susceptibility to vancomycin. Antimicrob Agent Chemother 2002; 46: 1492-1502.
Leeuwen Wv, Nieuwenhuizen Wv, Gijzen C, Verbrugh H, Belkum AV. Population studies of methicillin- resistant and -sensitive Staphylococcus aureus strains reveal a lack of variability in the agrD gene, encoding a staphylococcal autoinducer peptide. J Bacteriol 2000;182: 5721-5729.
Shanmuganathan V, Armstrong M, Buller A, Tullo A.External ocular infections due to methicillin-resistant Staphylococcus aureus (MRSA). Eye 2005; 19: 284-291.
Schubert TL, Hume EB, Willcox MD. Staphylococcus aureus ocular isolates from symptomatic adverse events: antibiotic resistance and similarity of bacteria causing adverse events. Clin Exp Optom 2008;91:148-155.
30. Hsiao CH, Chuang CC, Tan HY, Ma DHK, Lin KK, Chang CJ, et al. Methicillin-resistant Staphylococcus aureus ocular infection: a 10-year hospital-based study. Ophthalmology 2012;119(8).
31. Hasani A, Sheikhalizadeh V, Hasani A, Naghili B, Valizadeh V, Nikoonijad AR. Methicillin resistant and susceptible Staphylococcus aureus: Appraising therapeutic approaches in the Northwest of Iran. Iran J Microbiol 2013;5:56-62.
32. Kaleem F, Usman J, Hassan A, Omair M, Khalid A, Uddin R. Sensitivity pattern of methicillin resistant Staphylococcus aureus isolated from patients admitted in a tertiary care hospital of Pakistan. Iran J Microbiol 2010;2:143-146.
33. Havaei S, Vidovic S, Narimani T, Kazemi M, Karbalaei M, Starnino S, et al. Epidemic Methicillin- Susceptible Staphylococcus aureus Lineages Are the Main Cause of Infections at an Iranian University Hospital. J Clin Microbiol 2011;49:3990-3993.
| Files | ||
| Issue | Vol 5 No 3 (2013) | |
| Section | Articles | |
| Keywords | ||
| MLST MRSA SCCmec type Spa typing Staphylococcus aureus agr ocular infection | ||
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