Identification of CA-MRSA Causing Hospital-Acquired Infections in Suez Canal University Hospitals, Egypt, by Detection of its Major Virulence Determinants

Sweify, Mohamed Ali Al; Raheel, Atef; Aboul-Atta, Hassan; Elhadidy, Gehan; Hessam, Waheed

doi:10.21608/mid.2020.41062.1057

Cited by 4 publications

(4 citation statements)

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“…In Egypt, there are a few studies on the molecular epidemiology of PVL -encoding MRSA isolates [ 34 – 36 ]. In the present study, the overall rate of detection of PVL genes was 46.60% (48/103) among MRSA isolates.…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports from three different geographical locations in Egypt suggested different rates of prevalence of PVL genes. PVL-MRSA prevalence rates in Cairo and Ismailia were 19.04% and 92.2% in CA-MRSA, respectively, and 22.2% and 28.6% in HA-MRSA [ 34 , 35 ]. On the other hand, the incidence of PVL genes was 16.67% in HCWs in the city of Fayoum [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

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Panton-Valentine Leukocidin (PVL) genes may not be a reliable marker for community-acquired MRSA in the Dakahlia Governorate, Egypt

Shohayeb,

El-Banna,

Elsawy

et al. 2023

BMC Microbiol

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Background Methicillin-resistant Staphylococcus aureus is linked to both nosocomial and community infections. One of the key virulence factors of S. aureus is Panton-Valentine leukocidin (PVL). The PVL genes are mostly associated with community-acquired MRSA (CA-MRSA). This study evaluates the prevalence of PVL genes as a marker for CA-MRSA at tertiary hospitals in Mansoura, Dakahlia, Egypt. S. aureus was isolated from clinical specimens obtained from different departments of tertiary hospitals, outpatient clinics, and hospital healthcare workers (HCWs). PCR was used to detect the mecA, PVL, and SCCmec genes among the recovered isolates. Standard broth microdilution method was used to determine the minimum inhibitory concentrations (MIC) of nine antibiotics against S. aureus. Results Two hundred S. aureus isolates were recovered and identified out of the total isolates (n = 320). The mecA gene was detected in 103 S. aureus isolates (51.5%). Among the MRSA isolates, 46.60% were PVL-positive. The incidence of the PVL genes of MRSA in nosocomial (HA), outpatient clinics (CA), and HCWs was 46.66%, 56.52%, and 42%, respectively. All MRSA isolates showed resistance to cefoxitin. The percentage of resistance to most tested antibiotics was high, except for ciprofloxacin (6.85%). Both antibiotic resistance and multidrug resistance among MRSA isolates were generally higher in PVL-positive isolates than in PVL-negative isolates in HA- and CA-MRSA isolates. While SCCmec type V was the most prevalent in PVL-positive MRSA stains, type I was the most prevalent in PVL-negative isolates. Conclusion This study revealed that PVL genes are generally highly prevalent among mecA-positive MRSA isolates, whether they are CA-MRSA, HA-MRSA, or HCW isolates. Therefore, PVL is not a valid marker for CA-MRSA in Mansoura, Dakahlia Governorate, Egypt, as has been reported in other countries. Further epidemiologic studies are required to track the incidence of PVL in HA-MRSA, CA-MRSA, and HCW isolates in other Egyptian governorates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Panton-Valentine Leukocidin (PVL) genes may not be a reliable marker for community-acquired MRSA in the Dakahlia Governorate, Egypt

Shohayeb,

El-Banna,

Elsawy

et al. 2023

BMC Microbiol

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“…Most of the articles report bacteria with resistance to antibiotics based on conventional methods (as disk diffusion method, Double disc synergy test, dilution methods, Epsilometer test), especially in countries of Africa (2,11,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), Asia and Latin America (1, 6, 61-66). Phenotypic detection of antibiotic resistance by Disk Diffusion Method was reported in 60.5% of the total studies, followed by the Vitek 2 system (18.4%).…”

Section: Study Characteristicsmentioning

confidence: 99%

Bacterial Resistance in Hospital-Acquired Infections Acquired in the Intensive Care Unit: A Systematic Review

Loaiza

Ruiz

Patiño

et al. 2023

Acta Med. (Hradec Kralove, Czech Repub.)

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Purpose: In this review we present the status of the prevalence of bacteria resistant to antibiotics and the main antibiotic resistance genes that are reported in infections acquired in intensive care units (ICU) around the world. Methods: A systematic review based on the PRISMA guide was carried out, from the Science Direct, Redalyc, Scopus, Hinari, Scielo, Dialnet, PLOS, ProQuest, Taylor, Lilacs and PubMed/Medline databases. Inclusion criteria of this review were original research study published in a scientific journal in a 10-year time span from 1 January 2017 and 30 April 2022. Results: A total of 1686 studies were identified, but only 114 studies were considered eligible for inclusion. Klebsiella pneumoniae and Escherichia coli resistant to carbapenems and producers of extended-spectrum β-lactamases (ESBL) are the most frequently isolated pathogens in ICUs in Asia, Africa and Latin America. The blaOXA and blaCTX were antibiotic resistance genes (ARG) most commonly reported in different geographic regions (in 30 and 28 studies, respectively). Moreover, multidrug-resistant (MDR) strains were reported in higher frequency in hospital-acquired infections. Reports of MDR strains vary between continents, with the majority of publications being in Asia and between countries, with Egypt and Iran being highlighted. There is a predominance of few bacterial clones with MDR phenotype, for example, clonal complex 5 Methicillin-Resistant Staphylococcus aureus (CC5-MRSA) circulates frequently in hospitals in the United States, clone ST23-K. pneumoniae is reported in India and Iran, and clone ST260 carbapenemase-producing P. aeruginosa in the United States and Estonia. Conclusion: Our systematic review reveals that ESBL- and carbapenemase-producing K. pneumoniae and E. coli are the most problematic bacteria that are reported, mainly in tertiary hospitals in Asia, Africa, and Latin America. We have also found propagation of dominant clones with a high degree of MDR, becoming a problem due to its high capacity to cause morbidity, mortality and additional hospital costs.

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“…However, in 1961, Methicillin-resistant strains of S. aureus (MRSA) were first recognized. Since then, MRSA isolates have increased and become one of the most important nosocomial and community-acquired pathogenic bacteria (Al sweify et al, 2020). The gene for methicillin resistance, mecA was found on the chromosome (Lovering, et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Antibiotic resistance and β-lactamase production and biofilm formation by MRSA Isolated from Dakahlia Governorate, Egypt

Elsawy,

Shohayeb,

El-Banna

et al. 2023

Delta University Scientific Journal

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Methicillin-resistant Staphylococcus aureus (MRSA) causes a wide range of infections in humans. These infections include pneumonia, abscesses, osteomyelitis, endocarditis, phlebitis, mastitis, and meningitis. This study aimed to investigate MRSA prevalence among patients, outpatients, and health care workers (HCWs) at tertiary university hospitals in Mansoura, Dakahlia. The strains were collected from different sources (puss, blood, eye, urine, HCWs) and PCR was used to detect mecA. The isolates were investigated for their susceptibility to different antibiotic classes and their ability to produce β-lactamases and biofilms. Out of the 200 S. aureus strains, 103 (51.5%) were MRSA. The prevalence of MRSA among inpatients, outpatients, and HCWs was 43.5%, 46.0%, and 61.7%, respectively. MRSA isolates were tested for their susceptibility to 15 antibiotics. More than 50% of the MRSA isolates were resistant to eight antibiotics. Less than 10% of the isolates were resistant to amikacin, ciprofloxacin and lomefloxacin. Alarming resistance levels for vancomycin (23.30%) and linezolid (56.31%) were observed. MRSA strains were multidrug-resistant (MDR) and were resistant to 4-13 antibiotic classes. All MRSA strains were biofilm producers. The strong, moderate and weak biofilm producers were 23.30%, 49.51% and 27.18%, respectively. The percentages of β-lactamase production by inpatients, outpatients, and HCWs were 90%, 95.7%, and 96%, respectively. We may conclude that MRSA isolates are prevalent in outpatients, inpatients, and HCWs in university tertiary hospitals at Mansoura. All MRSA were MDR-resistant and biofilms and most of them were β-lactamase producers. Therefore, infection control procedures must be urgently implemented.

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Identification of CA-MRSA Causing Hospital-Acquired Infections in Suez Canal University Hospitals, Egypt, by Detection of its Major Virulence Determinants

Cited by 4 publications

References 14 publications

Panton-Valentine Leukocidin (PVL) genes may not be a reliable marker for community-acquired MRSA in the Dakahlia Governorate, Egypt

Panton-Valentine Leukocidin (PVL) genes may not be a reliable marker for community-acquired MRSA in the Dakahlia Governorate, Egypt

Bacterial Resistance in Hospital-Acquired Infections Acquired in the Intensive Care Unit: A Systematic Review

Antibiotic resistance and β-lactamase production and biofilm formation by MRSA Isolated from Dakahlia Governorate, Egypt

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