Characterisation of clinical Staphylococcus aureus isolates harbouring mecA or Panton–Valentine leukocidin genes from four tertiary care hospitals in Indonesia

Abstract

Abstractobjectives To determine the prevalence, antimicrobial susceptibility profiles and clonal distribution of either methicillin-resistant Staphylococcus aureus (MRSA) or Panton-Valentine leukocidin (PVL)-positive S. aureus obtained from clinical cultures in Indonesian hospitals.methods S. aureus isolates from clinical cultures of patients in four tertiary care hospitals in Denpasar, Malang, Padang and Semarang were included. We assessed the antimicrobial susceptibility profiles using the Vitek2 â system, determined the presence of the mecA gene and genes encoding PVL using PCR and analysed the clonal relatedness with Raman spectroscopy. SCCmec typing was performed for all MRSA isolates. Multilocus sequence typing (MLST) was performed for a subset of isolates.results In total, 259 S. aureus strains were collected. Of these, 17/259 (6.6%) and 48/259 (18.5%) were MRSA and PVL-positive methicillin-susceptible S. aureus (MSSA), respectively. The prevalence of MRSA and PVL-positive MSSA ranged between 2.5-8.9% and 9.5-29.1%, respectively and depended on geographic origin. PVL-positive MRSA were not detected. Raman spectroscopy of the strains revealed multiple Raman types with two predominant clusters. We also showed possible transmission of a ST239-MRSA-SCCmec type III strain and a ST121 PVL-positive MSSA in one of the hospitals.conclusions We showed that MRSA and PVL-positive MSSA are of clinical importance in Indonesian hospitals. A national surveillance system should be set-up to further monitor this. To reduce the prevalence of MRSA in Indonesian hospitals, a bundle of intervention measures is highly recommended.

Reducing transmission of methicillin-resistant Staphylococcus aureus in a surgical ward of a resource-limited hospital in Indonesia: an intervention study

“…Contrary to earlier studies [ 14 , 32 , 33 ], we now observed the emergence of a PVL-positive MRSA clone in the post-intervention phase of this study. The PVL-positive MRSA representing RT8 was introduced to the male surgery room by five patients who were cultured positive at the time of admission.…”

Staphylococcus aureus Toxins and Diabetic Foot Ulcers: Role in Pathogenesis and Interest in Diagnosis

“…The PVL-positive strains are responsible for SSTIs (abscesses, furuncles, carbuncles or necrotizing fasciitis), severe necrotizing pneumonia and aggressive bone and joint infections [ 48 , 105 , 127 , 128 ]. However their prevalence is extremely diverse, varying between less than 5% and 67% of MSSA [ 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 ]. Interestingly, PVL-positive strains are statistically associated with younger patients [ 137 ].…”

Geographic distribution and prevalence of potential asymptomatic Staphylococcus spp. in the nasopharyngeal cavity of elementary school boys at Al-Madinah, KSA

“…Such data indicates a close association between resistance towards methicillin and the presence of mecA gene in the tested isolates. Other studies on S. aureus isolates showed similar results in which most of the investigated isolates of MRSA certainly had mecA gene [59][60][61]. Such resistance towards methicillin along with all beta-lactam groups of antibiotics is related to a mutation that resulted in changing the normal antibiotic binding protein which resulted in lowering the binding affinity of beta-lactams to their site [62].…”