Distribution of erm genes among Staphylococcus aureus isolates with inducible resistance to clindamycin in Isfahan, Iran

Ghanbari, Fahimeh; Ghajavand, Hasan; Havaei, Roholla; Jami, Mohammad‐Saeid; Khademi, Farzad; Heydari, Leila.; Shahin, Mojtaba; Havaei, Seyed Asghar

doi:10.4103/2277-9175.179184

Cited by 31 publications

(23 citation statements)

References 14 publications

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“…In the current survey, the ermA gene predominated in the strains with the inducible phenotype, while ermC was more common in the isolates with the constitutive phenotype, which is similar to the data reported by Ghanbari et al (26). In this study, the frequency of the cMLS B phenotype was 50 (52.6%), iMLS B was 12 (12.6%), and MLS B was 5 (5.3%).…”

Section: Discussionsupporting

confidence: 79%

Molecular Characterization and Resistance Profile of Methicillin Resistant Staphylococcus aureus Strains Isolated from Hospitalized Patients in Intensive Care Unit, Tehran-Iran

Nezhad

Meybodi

Rezaee

et al. 2017

Jundishapur J Microbiol

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Background: Staphylococcus aureus is an important opportunistic pathogen and can cause a wide range of infections. The ability of this pathogen to successfully persist within the hospital and the community is largely due to its remarkable ability to acquire resistance against various antimicrobial agents. Objectives: The aim of this study was to determine the carriage of antibacterial resistance genes and virulence markers of S. aureus isolates from hospitalized patients in intensive care units in Tehran, the capital of Iran. Methods: In this cross-sectional study that was conducted during an 11-month period since March 2015 to January 2016, a total of 105 S. aureus strains were investigated. MRSA screening was performed by phenotypic and genotypic methods. The Kirby-Bauer disk diffusion method was used to assess the sensitivity of S. aureus strains. The strains were typed based on the polymorphisms in SCCmec types. The presence of resistance (ermA, ermB, ermC, mupA, msrA, msrB, tetM, ant (4´)-Ia, aac (6´)-Ie/aph (2˝), aph (3´)-IIIa) and toxin (etb, eta, pvl, tst) encoding genes were investigated by the polymerase chain reaction (PCR) technique. Results: In this study, 105 isolates of S. aureus were obtained from 299 various clinical specimens. Ninety five (90.5%) strains were confirmed as methicillin-resistant S. aureus. The lowest levels of resistance were related to quinupristin-dalfopristin (16.8%) while the highest levels of resistance were related to penicillin (94.7%). Multi-drug resistance was observed in 91.5% of the isolates. Type IV was the most prevalent SCCmec type (57.9%), followed by type III (22.1), type V (12.6%), I (5.3%), and II (2.1%). Overall, 25 isolates (26.3%) harbored PVL-encoding genes, and all of them belonged to SCCmec type IV. The presence of resistance genes ant(4´) ermA, ermB, ermC, msrA, msrB, and tetM was detected in 94.7%, 81.1%, 31.6%, 31.6%, 15.9%, 18.9%, 47.3%, 21.1%, 56.8%. The frequency of the etb, eta, and tst genes were 1.1%, 4.2%, and 32.6%, respectively. Conclusions:The results illustrated the diversity of antibacterial resistance and virulence gene profiles among different SCCmec types of S. aureus. The increased prevalence of methicillin-resistant S. aureus isolates containing different toxin and antibiotic resistance genes is a serious threat for the hospitalized patients in the intensive care units.

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Section: Discussionsupporting

confidence: 79%

Molecular Characterization and Resistance Profile of Methicillin Resistant Staphylococcus aureus Strains Isolated from Hospitalized Patients in Intensive Care Unit, Tehran-Iran

Nezhad

Meybodi

Rezaee

et al. 2017

Jundishapur J Microbiol

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“…Based on in vitro susceptibility data, 114 (57%) isolates were resistant to erythromycin and 96 (48%) isolates resistant to clindamycin. The percentage of iMLS B resistance in the current study was relatively low (13%), which was higher than the previous findings reported from Iran (4.18%) (36) and USA (37) (7%) and was lower than those of Turkey (18%) (38) and Canada (35.3%) (39). In line with other studies, an increased resistance rate of cMLS B phenotype was observed among the current study isolates (44%).…”

Section: Discussioncontrasting

confidence: 47%

Distribution of Genes Encoding Toxin, Adhesion, and Antibacterial Resistance Among Various SCCmec Types of Methicillin-Resistant Staphylococcus aureus Isolated From Intensive Care Unit, Tehran, Iran

Abiri

Sepahi

Goudarzi

et al. 2017

Jundishapur J Microbiol

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Background: Most methicillin-resistant Staphylococcus aureus (MRSA) infections occur in health care settings; therefore, it is important to know about antimicrobial susceptibility, and carriage of virulence genes in S. aureus isolates. Objectives: The current study aimed at determining the prevalence of genes coding antimicrobial resistance, toxins, and adhesion factors among various SCCmec types of MRSA isolated from intensive care units (ICUs). Methods: From April 2016 to March 2017, a total of 200 MRSA species were isolated from various clinical samples of patients hospitalized in ICUs. The Kirby-Bauer disk diffusion method was employed to determine resistance pattern. Conventional polymerase chain reaction (PCR) assay was utilized to demonstrate antimicrobial resistance, toxins, and adhesion genes. Different SCCmec types of MRSA strains were determine by the multiplex PCR assay. Results: Antibiotic susceptibility testing revealed that all the isolates were sensitive to linezolid, teicoplanin, and vancomycin. The frequency of high-level mupirocin-resistant MRSA was 5.5%. The presence of resistance genes ant(4')-Ia, aac(6')-Ie/aph(2"), tetM, msrA, ph(3')-IIIa, ermA, msrB, ermB, ermC, and mupA were detected 73.5%, 60.5%, 57.5%, 37%, 36.5%, 34.5%, 24%, 17%, 15% and 5.5%, respectively. The most prevalent adhesion genes were clfA (93.5%) followed by clfB (90%), fnbA (81.5%), fnbB (77%), can (51%), ebp (46.5%), and bbp (2.5%). The frequency of etb, eta, pvl, and tst genes were 4.5%, 9.5%, 21.5%, and 61.5%, respectively. Inducible macrolide-lincosamidestreptogramin B (inducible MLSB resistance; iMLSB), and constitutive MLSB (cMLSB) phenotypes were observed in 88 (44%) and 26 (13%) isolates. Different SCCmec types comprising type III (56.5%), type IV (25%), type II (11%) and type I (7.5%) were identified among the MRSA strains. Conclusions: Results of the current study showed a high prevalence of resistance to commonly used antibiotics that can be a serious threat to patients hospitalized in ICUs. Also, the current study findings showed that different SCCmec types causing nosocomial infections were associated with specific antimicrobial resistance, adhesion, and toxin gene profiles.

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“…In Press(In Press):e14495. 5 U n C o r r e c t e d P r o o f that of iMLS B phenotype; a similar finding was noted previously by Ghanbari et al (31).…”

Section: U N C O R R E C T E D P R O O Fsupporting

confidence: 82%

Molecular Investigation of Methicillin-Resistant Staphylococcus aureus Strains Recovered from the Intensive Care Unit (ICU) Based on Toxin, Adhesion Genes and agr Locus Type Analysis

Nasirian

Saadatmand

Goudarzi

et al. 2018

Arch Clin Infect Dis

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Background: Staphylococcus aureus, as one of the most common causes of nosocomial infections, has widely spread to all parts of the world and is becoming a serious concern in public health. Objectives: The present study aimed at evaluating the prevalence of adhesion and toxin gene profiles and their distribution among different agr types. Methods: The current cross-sectional study was performed in Tehran, Iran, by analyzing 125 methicillin resistant Staphylococcus aureus (MRSA) strains isolated from hospitalized patients at the ICUs from March, 2016 to January, 2017. In vitro antibiotic susceptibility testing of isolates was assessed using the Kirby-Bauer disk diffusion method. The MRSA strains were genetically typed by agr typing and virulence and adhesion genes profile by conventional PCR. Results: Antibiotic susceptibility testing showed that inducible macrolide-lincosamide-streptogramin B, constitutive macrolidelincosamide-streptogramin B, and high-level mupirocin resistance phenotypes had a frequency of 18 (14.4%), 50 (56%), and 10 (31.3%), respectively. The predominant resistance profile among MDR-MRSA isolates included resistance profile to seven antibiotics (32%). A total of ten virulence genotypes were observed, from which genotype spa, clfA, clfB, fnbB, fnbA, ebp, and can / tst (36%, 45/125) comprised the majority followed by spa, clfA, clfB, and fnbB (24%, 30/125). Type I was the most prevalent agr type (52%), followed by type III (34.4%), type II (9.6%), I 5(5.3%), and IV (4%). All isolates carrying PVL-encoding genes and HLMUPR-MRSA strains corresponded exclusively to agr type I. Conclusions:The current data demonstrated that virulence gene profiles among different agr types of MRSA isolates were divers. The present study suggests that molecular characterization of MRSA strains should periodically be studied.

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Distribution of erm genes among Staphylococcus aureus isolates with inducible resistance to clindamycin in Isfahan, Iran

Cited by 31 publications

References 14 publications

Molecular Characterization and Resistance Profile of Methicillin Resistant Staphylococcus aureus Strains Isolated from Hospitalized Patients in Intensive Care Unit, Tehran-Iran

Molecular Characterization and Resistance Profile of Methicillin Resistant Staphylococcus aureus Strains Isolated from Hospitalized Patients in Intensive Care Unit, Tehran-Iran

Distribution of Genes Encoding Toxin, Adhesion, and Antibacterial Resistance Among Various SCCmec Types of Methicillin-Resistant Staphylococcus aureus Isolated From Intensive Care Unit, Tehran, Iran

Molecular Investigation of Methicillin-Resistant Staphylococcus aureus Strains Recovered from the Intensive Care Unit (ICU) Based on Toxin, Adhesion Genes and agr Locus Type Analysis

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