Community-acquired methicillin-resistant Staphylococcus aureus from skin and soft tissue infections (in a sample of Egyptian population): analysis of mec gene and staphylococcal cassette chromosome

Sobhy, Nagat; Aly, Fatma; Kader, Ola; Ghazal, Abeer; ElBaradei, Amira

doi:10.1016/j.bjid.2012.08.004

Cited by 29 publications

(30 citation statements)

References 29 publications

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“…The prevalence of MRSA was higher in our study compared to similar studies from Turkey (31.81%) (16), Beijing (3%) (17), Egypt (47.37%) (18), and Sao Paulo (10.6%) (15). It was similar to the rate reported from Torrance, California (66.57%) (3), and lower than the rate found in a general report from the United States (79%) (19).…”

Section: Discussionsupporting

confidence: 69%

“…Miller et al (3) in Torrance, California, also reported high PVL positivity (76%) in S. aureus causing SSTIs. However, other reports employing the same criteria showed lower prevalences of 15.1%, 15.79%, and 41.46% in Brazil, Egypt, and China, respectively (15,17,18). Although our results of pvl gene positivity among S. aureus strains is in concordance with the findings of Momtaz and Hafezi (46.34%) (10), it should be considered that a lower prevalence of pvl was observed in other reports from Iran (6,(26)(27)(28).…”

Section: Discussionmentioning

confidence: 82%

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Epidemiology and molecular characteristics of methicillin-resistantStaphylococcus aureus from skin and soft tissue infections in Shiraz, Iran

Mehrshad¹,

Haghkhah²,

Aghaei³

2017

Turk J Med Sci

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IntroductionAmong staphylococcal species, Staphylococcus aureus has been shown as a clinically relevant human pathogen, and in many individuals it may lead to asymptomatic colonization (1). Various infections from skin and soft tissue infections (SSTIs) to life-threatening infections like endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, and sepsis are caused by this bacterium (2). Carriage of S. aureus is a risk factor for subsequent infection in various settings. Recent investigations suggest that nares-only screening may underestimate the prevalence of S. aureus colonization, and accurate determination requires sampling from other body sites (3). The spread of antibiotic resistance among strains of S. aureus has been dramatically elevated, such that methicillin-resistant S. aureus (MRSA) is recognized as a nosocomial pathogen worldwide. MRSA strains were once exclusively limited to hospital care; however, after outbreaks of infection in hospitals and health care facilities they have increasingly been detected among patients in the community who lack conventional risk factors for MRSA infection (4). MRSA represents a significant cause of morbidity and mortality in both hospital and community settings, which raises serious concerns in the treatment of staphylococcal infections; hence, the accurate and early determination of methicillin resistance is a necessity for the prognosis of S. aureus infections (5). Most MRSA and some methicillin-susceptible S. aureus (MSSA) isolates produce Panton-Valentine leukocidin (PVL), a pore-forming toxin consisting of two subunits S (LukE) and F (LukD) (6,7). It has become increasingly important as a virulence factor in necrotizing SSTIs such as furuncle and pneumonia (6). Both MSSA and community-associated MRSA can express PVL (8). Contrary to European countries (9), PVL-associated infections are increasing in some regions of Iran (10). This study aimed to assess the microbiological, epidemiological, and clinical features of purulent skin infections caused by S. aureus in Shiraz, southern Iran.Background/aim: Panton-Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) infections are increasing in some regions of Iran. The aim of the current study was to assess the epidemiology and molecular characteristics of S. aureus isolated from patients with skin infections in Shiraz, Iran.Materials and methods: Swab samples were obtained from patients admitted to the skin and burn units of hospitals. The medical records of each patient were collected via questionnaire. All staphylococcal isolates were collected and examined by conventional methods for detecting S. aureus strains. PCR was used to detect S. aureus harboring the mecA and pvl genes.Results: Out of 243 staphylococcal isolates, 55 (22.6%) S. aureus and 91 (37.4%) S. epidermidis were detected. Of the 45 patients, 21 (46.7%) were S. aureus carriers. The mecA gene was identified in 60% of S. aureus isolates, and the rest were sensitive to methicillin. Of the S. aur...

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 82%

Epidemiology and molecular characteristics of methicillin-resistantStaphylococcus aureus from skin and soft tissue infections in Shiraz, Iran

Mehrshad¹,

Haghkhah²,

Aghaei³

2017

Turk J Med Sci

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“…Public areas should be the subject of particular scrutiny, as antibiotic resistant strains are likely to spread through crowds and people in close contact in these areas. By now, antibiotic resistant strains can be found in public areas like schools [2], shopping centers or markets [3], offices [4] and so on. The inspection of antibiotic resistant strains in community was of important meaning to the control of community-acquired infections.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Antibiotic Resistance of Airborne Staphylococcus Isolated from Metro Stations

Zhang

Wang

2013

IJERPH

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This study focused on the presence of antibiotic-resistant bacteria in a metro system as an example of a public transportation system. The molecular characteristics of Staphylococcus were investigated to discern which strains were isolated from metro stations in Shanghai. These were compared with strains isolated from hospital treatment rooms and parks. Airborne Staphylococcus samples in the metro were resistant to an average of 2.64 antibiotic types, and 58.0% of the strain samples were resistant to at least three antibiotics; this was a significantly higher rate than strains from the park, but was lower than those from hospitals. The presence of two antibiotic resistance genes of Staphylococcus strains, mecA (28.0%) and qac (40.0%), were also found at significantly higher levels in metro samples than park samples, but did not differ significantly from hospital samples. Furthermore, 22.0% of the metro Staphylococcus samples were found to be biofilm-positive. The high rate of antibiotic resistance found in Staphylococcus samples collected from metro stations, and the discovery of antibiotic-resistant genes, indicate that the closed indoor environment and crowded passengers may accelerate the spread of antibiotic resistant strains. More attention should be paid to the inspection and control of antibiotic resistant strains in public transportation systems.

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“…25 In addition, other studies have reported MRSA prevalence in excess of 50%, but this study has mostly included hospital inpatients. 25 On the other hand, the carriage rate observed in this study is higher than previously reported rates from other countries in the Middle East area. 24,26 Several factors could have been responsible for the higher carriage rate of CA-MRSA including the overconsumption of antibiotics in both Egypt and Saudi Arabia, which is a contributing factor for multidrug resistant bacteria.…”

Section: Discussionmentioning

confidence: 99%

Staphylococcus aureus nasal carriage among outpatients attending primary health care centers: a comparative study of two cities in Saudi Arabia and Egypt

Shady

Bakr

Hashad

et al. 2015

The Brazilian Journal of Infectious Diseases

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Epidemiological and molecular data on community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) are still scarce in both Egypt and Saudi Arabia. There is almost no data regarding methicillin resistant Staphylococcus aureus (MRSA) prevalence in both countries. This study was conducted to investigate the prevalence and molecular epidemiology of S. aureus and MRSA nasal carriage among outpatients attending primary health care centers in two big cities in both countries. A total of 206 nasal swabs were obtained, 103 swabs from each country. S. aureus isolates were characterized by antibiotic susceptibility, presence of mecA and PVL genes, SCCmec-typing and spa typing, the corresponding Multi locus sequence typing clonal complex was assigned for each spa type based on Ridom StaphType database. MRSA was detected in 32% of the Egyptian outpatients while it was found in 25% of the Saudi Arabian outpatients. All MRSA isolates belonged to SCCmec type V and IVa, where some isolates in Saudi Arabia remained nontypeable. Surprisingly PVL(+) isolates were low in frequency: 15% of MRSA Egyptian isolates and 12% of MRSA isolates in Saudi Arabia. Two novel spa types were detected t11839 in Egypt, and t11841 in Saudi Arabia. We found 8 spa types among 20 isolates from Egypt, and 12 spa types out of 15 isolates from Saudi Arabia. Only two spa types t008 and t223 coexisted in both countries. Four clonal complexes (CC5, CC8, CC22, and CC80) were identified in both Egypt and Saudi Arabia. However, the data collected lacked a representation of isolates from different parts of each country as only one health center from each country was included, it still partially illustrates the CA-MRSA situation in both countries. In conclusion a set of control measures is required to prevent further increase in MRSA prevalence.

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Community-acquired methicillin-resistant Staphylococcus aureus from skin and soft tissue infections (in a sample of Egyptian population): analysis of mec gene and staphylococcal cassette chromosome

Abstract: CA-MRSA must be considered when treating skin and soft tissue infections, especially in developing countries. Empirical use of agents active against CA-MRSA is warranted for patients presenting with serious SSTIs.

Cited by 29 publications

References 29 publications

Epidemiology and molecular characteristics of methicillin-resistantStaphylococcus aureus from skin and soft tissue infections in Shiraz, Iran

Epidemiology and molecular characteristics of methicillin-resistantStaphylococcus aureus from skin and soft tissue infections in Shiraz, Iran

Characteristics of Antibiotic Resistance of Airborne Staphylococcus Isolated from Metro Stations

Staphylococcus aureus nasal carriage among outpatients attending primary health care centers: a comparative study of two cities in Saudi Arabia and Egypt

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