Molecular characterization of invasive Staphylococcus aureus strains isolated from patients with diabetes in Iran: USA300 emerges as the major type

Tayebi, Zahra; Fazeli, Maryam; Hashemi, Ali; Abdi, Saeed; Dadashi, Masoud; Nasiri, Mohammad Javad; Goudarzi, Mehdi

doi:10.1016/j.meegid.2020.104679

Cited by 4 publications

(13 citation statements)

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“…This finding supports previous results reported by Shore et al [ 25 ], Goudarzi et al [ 12 ], and Monecke et al [ 3 ]. Although biofilm formability and antibiotic resistance profiles in CC/ST22 isolates were found to be varied, resistance to mupirocin and biofilm formability in these strains have been described by several investigators [ 4 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…353), and consent was obtained from consent participants. HLMUPR strains were detected by the broth microdilution method (MIC value was ≥512 μ g/ml) according to the clinical and the laboratory standards institute (CLSI) guideline (CLSI 2019) and PCR of mupA gene [ 4 ]. HLMUPR strains that were obtained on or after 96 hours of admission to a hospital were considered as hospital onset (HO) while a positive culture prior to four days of hospitalization along with one or more of the following criteria: (i) a history of hospitalization, surgery, dialysis, or residence in a long-term care facility in 12 months prior to culture date or (ii) the presence of a central vascular catheter (CVC) within two days before S. aureus culture was considered as community onset (CO).…”

Section: Methodsmentioning

confidence: 99%

“…The antibiotic resistance pattern of isolates was evaluated using the Kirby Bauer method according to the CLSI instructions against amikacin (AMK), clindamycin (CLI), ciprofloxacin (CIP), erythromycin (ERY), gentamicin (GEN), kanamycin (KAN), linezolid (LIN), penicillin (PEN), quinupristin-dalfopristin (SYN), rifampicin (RIF), tobramycin (TOB), tetracycline (TET), teicoplanin (TEC), and trimethoprim-sulfamethoxazole (SXT) (Mast Co., UK). MRSA strains were identified phenotypically using the Cefoxitin disk diffusion method (30 μ g) according to the CLSI guidelines and detection of the mecA gene as previously described [ 4 ].…”

Section: Methodsmentioning

confidence: 99%

“…The microdilution was performed to determine minimum inhibitory concentration (MIC) titer for antibiotics vancomycin (VAN), tigecycline (TIG), and fusidic acid (FUS) according to the procedure detailed in our previous report [ 4 ]. Results for fusidic acid and tigecycline were interpreted based on the European Committee for antimicrobial susceptibility testing (EUCAST) recommendations ( http://www.eucast.org ).…”

Section: Methodsmentioning

confidence: 99%

“…The high prevalence of antibiotic resistance due to inappropriate antibiotic use and the remarkable ability of this bacterium to acquire resistance to multiple antimicrobials, particularly mupirocin-resistant S. aureus (mupR- S. aureus ), complicated the treatment of related infections. Moreover, the scenario worsens with resistance to commonly used antibiotics, biofilm-forming ability, and various virulence factors for S. aureus [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Mupirocin-Resistant Staphylococcus aureus in Iran: A Biofilm Production and Genetic Characteristics

Zamani

Mohammadi

Hajikhani

et al. 2022

BioMed Research International

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The spread of mupirocin-resistant Staphylococcus aureus strains in hospitals and communities is a universal challenge. Limited data is available on the genetic features of high-level mupirocin resistant- (HLMUPR-) S. aureus isolates in Tehran. In the present research, we investigated 48 high-level mupirocin resistance S. aureus by antimicrobial activity, virulence analysis, biofilm formation, multilocus sequence typing (MLST), and staphylocoagulase (SC) typing. All the HLMUPR strains were positive for mupA gene. The frequency of multidrug resistance was 97.9%. Twenty-one (43.8%) were toxinogenic with 14 producing pvl (29.2%), 5 tst (10.4%), and two eta (4.2%). Among the HLMUPR isolates, biofilm production was detected in 45 (89.6%) isolates with complete dominance clfB, clfA genes, and a noticeably high frequency fnbA (95.8%), followed by fnbB (93.8%), eno and icaD (each 83.3%), sdrC (81.3%), ebps (79.2%), icaA (75%), sdrD (66.7%), fib (60.4%), sdrE (50%), cna (41.7%), and bap (4.2%). Coagulase typing distinguished isolates into four genotypic patterns including III (50%), II (27.1%), and type IVa (22.9%). A total of three clonal complexes (CCs) and 4 sequence types (STs) including CC/ST22 as the most prevalent (52.1%), CC8/ST239 (20.8%), CC/ST8 (16.7%), and CC/ST5 (10.4%) were identified in current work. According to our analysis, nonbiofilm producer isolates belonged to CC8/ST239 (6.3%) and CC/ST8 (4.2%). Fusidic acid-resistant isolates belonged to CC/ST45 ( n = 3 ) and CC8/ST239 ( n = 1 ). Observations highlighted the circulation of the CC/ST22 HLMUPR S. aureus strains with strong biofilm-production ability in our hospitals, indicating the possibility of transmission of this type between community and hospital.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mupirocin-Resistant Staphylococcus aureus in Iran: A Biofilm Production and Genetic Characteristics

Zamani

Mohammadi

Hajikhani

et al. 2022

BioMed Research International

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L-arginine supplementation abrogates hypoxia-induced virulence of Staphylococcus aureus in a murine diabetic pressure wound model

Baker,

Seo,

Park

et al. 2024

mSphere

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Diabetic foot ulcers (DFUs) are the most common complications of diabetes resulting from hyperglycemia leading to ischemic hypoxic tissue and nerve damage. Staphylococcus aureus is the most frequently isolated bacteria from DFUs and causes severe necrotic infections leading to amputations with a poor 5-year survival rate. However, very little is known about the mechanisms by which S. aureus dominantly colonizes and causes severe disease in DFUs. Herein, we utilized a pressure wound model in diabetic TALLYHO/JngJ mice to reproduce ischemic hypoxic tissue damage seen in DFUs and demonstrated that anaerobic fermentative growth of S. aureus significantly increased the virulence and the severity of disease by activating two-component regulatory systems leading to expression of virulence factors. Our in vitro studies showed that supplementation of nitrate as a terminal electron acceptor promotes anaerobic respiration and suppresses the expression of S. aureus virulence factors through inactivation of two-component regulatory systems, suggesting potential therapeutic benefits by promoting anaerobic nitrate respiration. Our in vivo studies revealed that dietary supplementation of L-arginine (L-Arg) significantly attenuated the severity of disease caused by S. aureus in the pressure wound model by providing nitrate. Collectively, these findings highlight the importance of anaerobic fermentative growth in S. aureus pathogenesis and the potential of dietary L-Arg supplementation as a therapeutic to prevent severe S. aureus infection in DFUs. IMPORTANCE S. aureus is the most common cause of infection in DFUs, often resulting in lower-extremity amputation with a distressingly poor 5-year survival rate. Treatment for S. aureus infections has largely remained unchanged for decades and involves tissue debridement with antibiotic therapy. With high levels of conservative treatment failure, recurrence of ulcers, and antibiotic resistance, a new approach is necessary to prevent lower-extremity amputations. Nutritional aspects of DFU treatment have largely been overlooked as there has been contradictory clinical trial evidence, but very few in vitro and in vivo modelings of nutritional treatment studies have been performed. Here we demonstrate that dietary supplementation of L-Arg in a diabetic mouse model significantly reduced duration and severity of disease caused by S. aureus . These findings suggest that L-Arg supplementation could be useful as a potential preventive measure against severe S. aureus infections in DFUs.

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Hospital-Related Lineage of USA300 Methicillin-Resistant Staphylococcus aureus (MRSA) to Cause Bacteremia in Iran

Navidinia

Zamani

Mohammadi

et al. 2023

BioMed Research International

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Staphylococcus aureus is an important pathogen that causes bloodstream infections. This study is aimed at assessing the genotypic characteristics of S. aureus strains responsible for bloodstream infections. An epidemiological study was conducted using 85 S. aureus strains isolated from bloodstream infections. Susceptibility was tested using the broth microdilution method and disk diffusion. All detected methicillin-resistant S. aureus (MRSA) isolates were confirmed by mecA PCR assays. S. aureus isolated from bacteremia were characterized using SCCmec, spa, and multilocus sequence typing methods. The prevalence of S. aureus strains responsible for bloodstream infections was 38.8%. All isolates were MRSA. Multidrug resistance (MDR) was present in 84.7% of isolates. MRSA isolated categorized within six clonal complexes including CC8 (60%), CC22 (22.4%), CC5 (5.9%), CC30 (4.7%), CC45 (4.7%), and CC59 (2.3%). The main lineages found were USA300/CC8-MRSA-IV/t008 (41.2%), followed by ST22-SCCmecIV/t790 (9.4%), ST239-SCCmecIII/t037 (7.1%), ST22-SCCmecIV/t032 (7.1%), ST239-SCCmecIII/t631 (5.9%), ST239-SCCmecIII/t860 (5.9%), ST22-SCCmecIV/t852 (5.9%), ST5-SCCmecIV/t002 (4.7%), ST45-SCCmecIV/t038 (4.7%), ST30-SCCmecIV/t318 (4.7%), ST59-SCCmecIV/t437 (2.3%), and ST225-SCCmecII/t045 (1.1%). Resistance to vancomycin amounted to 5.9% of isolates that belonged to ST239-SCCmecIII/t037 (80%) and ST8-SCCmecIV/t008 (20%). The emergence of USA300 strains in bloodstream infections in our country is a serious alarm and highlights the significant invasion of this lineage into the healthcare system. MDR patterns among these strains appear to be becoming the biggest problem in healthcare treatment.

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Molecular characterization of invasive Staphylococcus aureus strains isolated from patients with diabetes in Iran: USA300 emerges as the major type

Cited by 4 publications

References 45 publications

Mupirocin-Resistant Staphylococcus aureus in Iran: A Biofilm Production and Genetic Characteristics

Mupirocin-Resistant Staphylococcus aureus in Iran: A Biofilm Production and Genetic Characteristics

L-arginine supplementation abrogates hypoxia-induced virulence of Staphylococcus aureus in a murine diabetic pressure wound model

Hospital-Related Lineage of USA300 Methicillin-Resistant Staphylococcus aureus (MRSA) to Cause Bacteremia in Iran

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