Isolation and Genetic Characterization of Vancomycin-resistant and mecC+ Methicillin-resistant Staphylococcus aureus Strains in Clinical Samples of Bojnurd, Northeastern Iran

Moghaddam, Parastoo Zarghami; Azimian, Amir; Sepahy, Abbas Akhavan; Iranbakhsh, Alıreza

doi:10.5812/jjm.118949

Cited by 3 publications

(5 citation statements)

References 26 publications

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“…Data obtained from Saudi Arabia showed that ST239 is the most common in Riyadh and Dammam, located in the eastern region of Saudi Arabia [49], while in the western region this clone is not common [50], which is consistent with our findings. All clones identified here have been identified sporadically in the western region by Al-Zahrani et al [51].…”

Section: Antibiotics Testedsupporting

confidence: 59%

“…Genes responsible for beta-lactam resistance (blaZ, mecA, and mecC) were identified in the studied isolates: the mecA gene was detected in three MRSA isolates (S14, S21, and S23), mecC was identified in S8 and S9 isolates, and blaZ was commonly identified in all isolates except S23 (Table 5). Interestingly, we identified the presence of mecC-MRSA for the first time in our region; mecC is a new divergent from mecA usually associated with animal transmission, and these patients are usually from rural areas [51]. Eight antimicrobial-resistance-associated genes were identified in all of the isolates: the quinolone resistance genes (norA and norC) and their regulators (MgrA for norC and arlS for norA), the major facilitator superfamily MDR efflux pump in S. aureus (LmrS), the multidrug efflux pump (sdrM), the mepA gene which acts as a repressor for multidrug export protein, and the SepA gene that confers resistance to disinfecting agents and dyes [52].…”

Section: Prediction Of Antimicrobial Resistance Mechanism In the Stud...mentioning

confidence: 74%

Section: Resultsmentioning

confidence: 99%

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Antibiotic Susceptibility Profiling of Human Pathogenic Staphylococcus aureus Strains Using Whole Genome Sequencing and Genome-Scale Annotation Approaches

et al. 2023

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Staphylococcus species are major pathogens with increasing importance due to the rise in antibiotic resistance. Whole genome sequencing and genome-scale annotation are promising approaches to study the pathogenicity and dissemination of virulence factors in nosocomial methicillin-resistant and multidrug-resistant bacteria in intensive care units. Draft genome sequences of eight clinical S. aureus strains were assembled and annotated for the prediction of antimicrobial resistance genes, virulence factors, and phylogenetic analysis. Most of the studied S. aureus strains displayed multi-resistance toward the tested drugs, reaching more than seven drugs up to 12 in isolate S22. The mecA gene was detected in three isolates (S14, S21, and S23), mecC was identified in S8 and S9, and blaZ was commonly identified in all isolates except strain S23. Additionally, two complete mobile genomic islands coding for methicillin resistance SCCmec Iva (2B) were identified in strains S21 and S23. Numerous antimicrobial resistance genes (norA, norC, MgrA, tet(45), APH(3′)-IIIa, and AAC(6′)-APH(2″)) were identified in chromosomes of different strains. Plasmid analysis revealed the presence of blaZ, tetK, and ermC in different plasmid types, located in gene cassettes containing plasmid replicons (rep) and insertion sequences (IS). Additionally, the aminoglycoside-resistant determinants were identified in S1 (APH(3′)-IIIa), while AAC(6)-APH(2″) was detected in strains S8 and S14. The trimethoprim (dfrC) resistance gene was detected in S. aureus S21, and the fosfomycin (fosB) resistance gene was detected only in S. aureus S14. We also noted that S. aureus S1 belongs to ST1-t127, which has been reported as one of the most frequent human pathogen types. Additionally, we noted the presence of rare plasmid-mediated mecC-MRSA in some of our isolates.

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Section: Antibiotics Testedsupporting

confidence: 59%

Section: Prediction Of Antimicrobial Resistance Mechanism In the Stud...mentioning

confidence: 74%

Section: Resultsmentioning

confidence: 99%

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Antibiotic Susceptibility Profiling of Human Pathogenic Staphylococcus aureus Strains Using Whole Genome Sequencing and Genome-Scale Annotation Approaches

et al. 2023

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“…Bacterial co-infections cause higher rates of morbidity and mortality among COVID-19 patients (8). Gram-positive bacteria, especially members of Staphylococcaceae and Streptococcaceae, are among the main causative agents of these co-infections (9).…”

Section: Discussionmentioning

confidence: 99%

“…The presence of mecA, vanA, cfr, and qacA/B genes was evaluated by polymerase chain reaction (PCR) using the primers listed in Table 1, as described previously (8,9).…”

Section: Polymerase Chain Reaction Detection Of Resistance Genesmentioning

confidence: 99%

Increasing Antimicrobial Resistance of Gram-Positive Cocci in the Nostrils of Health Care Workers in the Post–COVID-19 Era Compared to Pre–COVID-19 Era in North Khorasan, Iran

Besharati

Ajoudanifar

Ghasemzadeh‐Moghaddam

et al. 2023

Jundishapur J Microbiol

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Background: In the COVID-19 era, co-infections can lead to an increase in morbidity and mortality. Normal flora bacteria can transfer to the pulmonary tract and create bacterial co-infections. The nasal cavity is one of the main areas housing normal flora in the human body. Objectives: In this study, we evaluated the prevalence and antibiotic resistance of gram-positive cocci in the pre– and post–COVID-19 eras among health care workers. Methods: We assessed 376 nasal swabs from the pre–COVID-19 era and 376 from the post–COVID-19 era. Conventional and molecular methods were used to identify bacterial types and evaluate antimicrobial resistance. Results: The most common gram-positive cocci in the pre–COVID-19 samples were Staphylococcus aureus, S. epidermidis, S. capitis, S. hominis, S. haemolyticus, Streptococcus pneumoniae, and Enterococcus faecalis. In the post–COVID-19 samples, the most common gram-positive cocci were S. aureus, S. epidermidis, S. warneri, S. hominis, and E. faecalis. We observed higher resistance rates in post–COVID-19 samples, as well as resistance to linezolid and vancomycin in S. aureus, S. epidermidis, and S. hominis. Additionally, our isolates showed a high resistance rate to antiseptics. Conclusions: It seems that after the beginning of the COVID-19 pandemic, due to the change in the protective procedures in hospitals, the prevalence and variety of bacteria have decreased, but instead, they have been replaced by more pathogenic bacteria with higher antibiotic resistance.

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Reduced vancomycin susceptibility in Staphylococcus aureus clinical isolates: a spectrum of less investigated uncertainties

Tawfeek,

Khattab,

Elmaraghy

et al. 2024

BMC Infect Dis

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Background Staphylococcus aureus clinical isolates with vancomycin MICs of 2 µg/ml have been associated with vancomycin therapeutic failure and the heterogenous vancomycin-intermediate S. aureus (hVISA) phenotype. While carriage of van genes has usually been associated with higher level of MIC and frank vancomycin resistance, the unrecognized risk of hetero-resistance is frequently underestimated. Methods used for assessing vancomycin susceptibility have also shown different concordance and variable performance and accessibility in routine clinical diagnostics posing a challenge to inform treatment selection in hospital settings. Methods A total of 195 clinical samples were obtained among which 100 S. aureus isolates were identified. Ninety-six MRSA isolates have been identified using cefoxitin disc and mecA gene detection. The vanA and vanB genes have been screened for in the studied isolates using conventional PCR amplification. Examination of reduced vancomycin susceptibility has been performed using vancomycin screen agar, Broth Micro Dilution method (BMD), and VITEK2. Blood isolates were screened for hVISA using PAP-AUC method. Results Vancomycin screening agar applied to 96 MRSA isolates revealed 16 isolates with reduced vancomycin susceptibility. Further MIC testing revealed that 7 isolates were VISA and only 1 isolate was identified as VRSA using both BMD MIC method and VITEK2. Among 24 tested blood isolates, 4 isolates (16.7%) revealed the hVISA phenotype as identified using PAP-AUC method. Using PCR, vanA gene was identified in 5 S. aureus isolates (5%). Three of them were VSSA while the other two isolates were VISA. Conclusion In this study, we report the very low prevalence of VRSA among the tested S. aureus clinical isolates (1%) and the existence of hVISA phenotype among studied S. aureus blood isolates at the rate of 16.7% in our setting. Fifty percent (8/16) of isolates that demonstrated reduced vancomycin susceptibility using vancomycin agar screen tested susceptible using both broth dilution method and VITEK2. These finding together with the concerning silent carriage of vanA gene among VSSA and VISA (5%) may underly hidden and uninvestigated factors contributing to vancomycin treatment failure that warrant cautious vancomycin prescription.

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Isolation and Genetic Characterization of Vancomycin-resistant and mecC+ Methicillin-resistant Staphylococcus aureus Strains in Clinical Samples of Bojnurd, Northeastern Iran

Cited by 3 publications

References 26 publications

Antibiotic Susceptibility Profiling of Human Pathogenic Staphylococcus aureus Strains Using Whole Genome Sequencing and Genome-Scale Annotation Approaches

Antibiotic Susceptibility Profiling of Human Pathogenic Staphylococcus aureus Strains Using Whole Genome Sequencing and Genome-Scale Annotation Approaches

Increasing Antimicrobial Resistance of Gram-Positive Cocci in the Nostrils of Health Care Workers in the Post–COVID-19 Era Compared to Pre–COVID-19 Era in North Khorasan, Iran

Reduced vancomycin susceptibility in Staphylococcus aureus clinical isolates: a spectrum of less investigated uncertainties

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