Genetic Variability and Integron Occurrence in Methicillin Resistant Staphylococcus aureus Strains Recovered from Patients with Urinary Tract Infection

Abstract

Background: Treatment for infections caused by Methicillin-Resistant Staphylococcus aureus (S. aureus) is one of the main concerns of public health. Objectives: The aim of this study was to investigate the prevalence of toxin, enterotoxin, and resistant encoding genes and analyze the distribution of different SCCmec types. The prevalence of integron was also determined in S. aureus isolates obtained from patients with urinary tract infections (UTIs). Methods: In the present study, 126 MRSA isolates obtained from patients with UTI were examined for susceptibility to antimicrobial agents. Genes encoding integrase, resistance, toxin, and SEs were detected by the polymerase chain reaction (PCR) screening. The SCCmec types were determined using the multiplex PCR. Integrase positive strains were evaluated for determination of integron classes using PCR-restriction fragment length polymorphism assay. Results: From 126 MRSA isolates studied, 107 isolates (84.9%) were multi-drug resistant. The most prevalent genes in isolates under study was aac (6´)-Ie/aph (2˝) (50%) followed by tet (M) (47.6%), msr (A) (38.1%), aph (3´)-IIIa (25.4%), erm (A) (23%), ant (4´)-Ia (16.7%), erm (B) (14.3%), msr (B) (9.5%), and erm (C) (7.1%). Staphylococcal enterotoxins sea, sec, see, sed, seg, seb, and sei were detected in 27%, 20.6%, 16.7%, 14.3%, 11.1%, 7.1%, and 5.6% of the isolates, respectively. The results revealed that 126 MRSA isolates fell in the SCCmec type III (37.3%), SCCmec type I (23%), SCCmec type II (14.3%), SCCmec type IV (13.5%), and SCCmec type V (11.9%). Class 1 and 2 integrons were commonly found in 34.1% and 14.3% of the isolates, respectively. Seven isolates (5.6%) were observed to carry class 1 and 2 integrons, simultaneously. Conclusions: The current findings showed that identification and screening of integrons and SCCmec elements as reservoirs that should be considered for various resistance genes to consume proper antibiotic and perform a systematic surveillance.

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“…The most genes encoded AMEs common were namely aac(6')/aph (2");80%, aph (3')-IIIa;45%, and ant (4')-Ia; 35% (Tables 2 and 4). Many reports from Iran have reported that the aac(6')/aph (2") gene was the most frequent AMEs gene followed by aph (3')-IIIa gene and ant (4')-Ia gene in MRSA isolates (Fatholahzadeh et al, 2009;Emaneini et al, 2013;Mohammadi et al, 2014;Khosravi et al, 2017;Khoramrooz et al, 2017;Seyedi-Marghaki et al,2019;Goudarzi et al,2019d), from Turkey (Ardic et al, 2006), from Australia (Baines et al,2019), from India (Perumal et al, 2016) and Europe (Vanhoof et al, 1994). However, the prevalence of MRSA strains containing aac(6')/aph (2") gene in Al-Diwaniya (80%), is similar with Goudarzi et al (2019a), Szymanek-Majchrzak, et al (2018a, Baines et al (2019), Kavusi et al (2019), Mohammadi et al (2014) and Mahdiyoun et al (2016)in Iran(80%), Europe(80.5%), Australian clade (79.7%), Iran(78.3%), (77.8%) and (77%) respectively, and is less compared to similar studies in Iran (97.22%) (Khoramrooz et al, 2017) and Asian-Australian clade (93.2%) (Baines et al,2019).…”

“…This gene is encoded to important protein in the synthesis of MRSA cell wall it is termed an acronym PBP2ʹ, while abbreviated SCCmec refers to the chromosomal elements transfer of this protein (Gajdács, 2019). Therefore, MRSA infections cure is considered a major public health concern (Goudarzi et al, 2019d). It causes much mortality of patients because of multiple drug resistance to antimicrobial categories (Watkins et al, 2019).…”

A preliminary study of Aminoglycoside Modifying Enzymes (AMEs) of Multiple Antibiotic Resistance of Methicillin-resistant Staphylococcus aureus (MRSA) isolated from clinical specimens in Al-Diwaniya/Iraq

“…The most genes encoded AMEs common were namely aac(6')/aph (2");80%, aph (3')-IIIa;45%, and ant (4')-Ia; 35% (Tables 2 and 4). Many reports from Iran have reported that the aac(6')/aph (2") gene was the most frequent AMEs gene followed by aph (3')-IIIa gene and ant (4')-Ia gene in MRSA isolates (Fatholahzadeh et al, 2009;Emaneini et al, 2013;Mohammadi et al, 2014;Khosravi et al, 2017;Khoramrooz et al, 2017;Seyedi-Marghaki et al,2019;Goudarzi et al,2019d), from Turkey (Ardic et al, 2006), from Australia (Baines et al,2019), from India (Perumal et al, 2016) and Europe (Vanhoof et al, 1994). However, the prevalence of MRSA strains containing aac(6')/aph (2") gene in Al-Diwaniya (80%), is similar with Goudarzi et al (2019a), Szymanek-Majchrzak, et al (2018a, Baines et al (2019), Kavusi et al (2019), Mohammadi et al (2014) and Mahdiyoun et al (2016)in Iran(80%), Europe(80.5%), Australian clade (79.7%), Iran(78.3%), (77.8%) and (77%) respectively, and is less compared to similar studies in Iran (97.22%) (Khoramrooz et al, 2017) and Asian-Australian clade (93.2%) (Baines et al,2019).…”

“…This gene is encoded to important protein in the synthesis of MRSA cell wall it is termed an acronym PBP2ʹ, while abbreviated SCCmec refers to the chromosomal elements transfer of this protein (Gajdács, 2019). Therefore, MRSA infections cure is considered a major public health concern (Goudarzi et al, 2019d). It causes much mortality of patients because of multiple drug resistance to antimicrobial categories (Watkins et al, 2019).…”