Molecular and Anti-Microbial Resistance (AMR) Profiling of Methicillin-Resistant Staphylococcus aureus (MRSA) from Hospital and Long-Term Care Facilities (LTCF) Environment

Abstract

To provide evidence of the cross-contamination of emerging pathogenic microbes in a local network between long-term care facilities (LTCFs) and hospitals, this study emphasizes the molecular typing, the prevalence of virulence genes, and the antibiotic resistance pattern of methicillin-resistant Staphylococcus aureus. MRSA isolates were characterized from 246 samples collected from LTCFs, medical tubes of LTCF residents, and hospital environments of two cities, Chiayi and Changhua. Species identification, molecular characterization, and drug resistance analysis were performed. Hospital environments had a higher MRSA detection rate than that of LTCF environments, where moist samples are a hotspot of MRSA habitats, including tube samples from LTCF residents. All MRSA isolates in this study carried the exfoliative toxin eta gene (100%). The majority of MRSA isolates were resistant to erythromycin (76.7%), gentamicin (60%), and ciprofloxacin (55%). The percentage of multidrug-resistant MRSA isolates was approximately 50%. The enterobacterial repetitive intergenic consensus polymerase chain reaction results showed that 18 MRSA isolates belonged to a specific cluster. This implied that genetically similar isolates were spread between hospitals and LTCFs in Changhua city. This study highlights the threat to the health of LTCFs’ residents posed by hospital contact with MRSA.

Molecular Evaluation of Traditional Chicken Farm-Associated Bioaerosols for Methicillin-Resistant Staphylococcus aureus Shedding

“…Recent studies also showed a high prevalence of SCCmec IV in the MRSA isolates from poultry and livestock foods, which supports the present study [ 44 , 45 ]. Our previous report about the Chiayi’s river basin and nearby livestock areas revealed that SCCmec IV and I were distributed as 64.1% and 15.4%, respectively, wherein LA and HA-MRSA were predominant isolates from water samples, whereas CA and HA-MRSA were predominant isolates from hospital and long-term care facilities environments [ 46 , 47 ]. In the present case, SCCmec type I (HA-MRSA) was present in the bioaerosol and stool samples, which could be a future threat to the human population.…”

Role of Bioaerosols on the Short-Distance Transmission of Multidrug-Resistant Methicillin-Resistant Staphylococcus aureus (MRSA) in a Chicken Farm Environment

“…Genomic DNA of MRSA was extracted using a commercial DNA extraction kit (MagPurix Bacterial DNA Extraction Kit, ZP02006), following the protocol described in previous studies [ 2 , 11 ]. After that, different molecular typing experiments were performed via PCR analysis to characterize the MRSA isolates.…”

“…Antibiotic-resistant strains of Gram-positive pathogens, especially S. aureus , have been isolated from diverse environments such as hospitals, long-term care facilities, rivers, sediments, lakes, soil, and even the deep ocean [ 1 , 2 ]. However, bioaerosol-associated risk related to S. aureus remains to be fully understood.…”

“…Here, mecA containing the staphylococcal cassette chromosome mec (SCC mec ) element is considered a biomarker to identify whether the S. aureus strain belongs to MRSA or not [ 14 ]. Translation of this mecA gene can produce PBP2a protein (penicillin-binding protein 2a), which is mainly responsible for gaining methicillin resistance properties in the S. aureus strain [ 2 ]. Furthermore, based on the mec and ccr complex sequences in the SCC mec element, it can be classified into I–XI types [ 2 , 15 ].…”

“…Translation of this mecA gene can produce PBP2a protein (penicillin-binding protein 2a), which is mainly responsible for gaining methicillin resistance properties in the S. aureus strain [ 2 ]. Furthermore, based on the mec and ccr complex sequences in the SCC mec element, it can be classified into I–XI types [ 2 , 15 ]. On the other hand, among different kinds of methods to monitor the epidemiology of MRSA, such as pulsed field gel electrophoresis (PFGE), biotyping, coa typing, prophage typing, multi-locus sequence typing (MLST), spa typing is the most cost-effective, least time consuming, and robust method [ 15 ].…”