Multidrug-Resistant Methicillin-Resistant Staphylococcus aureus Associated with Hospitalized Newborn Infants

Abstract

Multidrug resistance (MDR) is a significant challenge in healthcare management, and addressing it requires a comprehensive approach. In this study, we employed a combination of phenotypic and genotypic approaches, along with whole genome sequencing (WGS) to investigate five hospital-associated MDR methicillin-resistant Staphylococcus aureus (MRSA) strains that were isolated from newborn infants. Our analysis revealed the following for the MDR-MRSA strains: SauR31 was resistant to three antimicrobial classes; SauR12, SauR91 and SauR110 were resistant to four antimicrobial classes; and SauR23 exhibited resistance to seven classes. All the MDR-MRSA strains were capable of producing slime and biofilms, harbored SCCmec type IV, and belonged to different spa types (t022, t032, and t548), with varying profiles for microbial surface components recognizing adhesive matrix molecules (MSCRAMMs) and virulence genes. The WGS data for the MDR SauR23 and SauR91 strains revealed that most of the antimicrobial resistance genes were present in the chromosomes, including blaZ, mecA, norA, lmrS, and sdrM, with only the ermC gene found in a small (<3 kb) plasmid. The presence of MDR-MRSA strains among neonates raises public concern, hence implementation of multifaceted interventions is recommended to address this issue. In addition, metadata is needed to improve the investigation of antimicrobial resistance genes in MDR isolates.

The Plasmidomic Landscape of Clinical Methicillin-Resistant Staphylococcus aureus Isolates from Malaysia

“…However, iMLS B strains could be induced to clindamycin resistance in the presence of low concentrations of erythromycin and this could only be detected by using the D-test [ 83 , 89 ]. This could lead to therapeutic failure if patients are treated with clindamycin [ 3 , 90 ]. The erm genes are usually transcribed on a bicistronic mRNA where the resistance gene is preceded by a regulatory coding sequence for a sensor or leader peptide (sometimes designated ermL ).…”

“…All MRSA isolates from HSNZ were validated by a combination of phenotypic and molecular methods [ 3 , 90 ]. Isolates were subcultured on mannitol salt agar with presumptive S. aureus colonies appearing yellow (i.e., mannitol fermenter).…”

“…For molecular confirmation of MRSA, PCR was performed for the detection of the nucA and mecA genes using established primers [ 3 ]. Antimicrobial susceptibility profiles for all isolates were determined by disk diffusion as previously described [ 3 , 90 ] using a panel of 18 classes of antimicrobials encompassing 26 antibiotics and interpreted using breakpoints provided by the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) [ 130 , 131 ]. Macrolide-lincosamide-streptogramin B (MLS B ) resistance phenotypes, i.e., constitutive (cMLS B ), inducible (iMLS B ), macrolide-streptogramin B (MS), or susceptible, were determined using the D-test [ 130 ].…”

Synthesis, nanostructuring and in silico studies of a new imine bond containing a macroheterocycle as a promising PBP-2a non-β-lactam inhibitor

“…34 Resistant Staphylococcus aureus strains are extremely dangerous for hospitalized newborn infants, urgent care, cancer and immune-compromised patients. [35][36][37][38] Considering all those mentioned above, the synthesis and molecular docking of new antibacterial drugs, such as furosemide analogues, non-b-lactam allosteric inhibitors or cephalosporins, targeting PBPs has great significance in fighting with antimicrobial resistance. 39,40 Considering the above-mentioned, the non-catalytic synthesis of a new 40-membered macroheterocycle (MHC3) was performed with further adsorption of it on the surface of magnetite nanoparticles, which was studied by TEM, XRD, FTIR and UV methods.…”

“…34 Resistant Staphylococcus aureus strains are extremely dangerous for hospitalized newborn infants, urgent care, cancer and immune-compromised patients. 35–38 Considering all those mentioned above, the synthesis and molecular docking of new antibacterial drugs, such as furosemide analogues, non-β-lactam allosteric inhibitors or cephalosporins, targeting PBPs has great significance in fighting with antimicrobial resistance. 39,40…”