Epidemiology and molecular characteristics of methicillin-resistant Staphylococcus aureus from skin and soft tissue infections in Shiraz, Iran
Epidemiology and molecular characteristics of methicillin-resistant Staphylococcus aureus from skin and soft tissue infections in Shiraz, Iran
Background/aim: Panton Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) infections are increasing in some regions of Iran. The aim of the current study was to assess the epidemiology and molecular characteristics of S. aureus isolated from patients with skin infections in Shiraz, Iran. Materials and methods: Swab samples were obtained from patients admitted to the skin and burn units of hospitals. The medical records of each patient were collected via questionnaire. All staphylococcal isolates were collected and examined by conventional methods for detecting S. aureus strains. PCR was used to detect S. aureus harboring the mecA and pvl genes. Results: Out of 243 staphylococcal isolates, 55 (22.6%) S. aureus and 91 (37.4%) S. epidermidis were detected. Of the 45 patients, 21 (46.7%) were S. aureus carriers. The mecA gene was identified in 60% of S. aureus isolates, and the rest were sensitive to methicillin. Of the S. aureus isolates, 54.5% were positive for the pvl gene. Conclusion: This study revealed a high prevalence of PVL-positive MRSA strains in the evaluated hospitals. Thus, early diagnosis of infections caused by this pathogen seems to be necessary by intake screening allowing for proper treatment, especially in high-risk patients and in order to prevent the spread of infection.
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- 1. Chua KY, Stinear TP, Howden BP. Functional genomics of Staphylococcus aureus. Brief Funct Genomics 2013; 12: 305- 315.
- 2. Yao D, Yu FY, Qin ZQ, Chen C, He SS, Chen ZQ, Zhang XQ, Wang L. Molecular characterization of Staphylococcus aureus isolates causing skin and soft tissue infections (SSTIs). BMC Infect Dis 2010; 10: 133.
- 3. Miller LG, Eells SJ, Taylor AR, David MZ, Ortiz N, Zychowski D, Kumar N, Cruz D, Boyle-Vavra S, Daum RS. Staphylococcus aureus colonization among household contacts of patients with skin infections: risk factors, strain discordance, and complex ecology. Clin Infect Dis 2012; 54: 1523-1535.
- 4. Glick SB, Samson DJ, Huang E, Vats V, Weber S, Aronson N. Screening for Methicillin-Resistant Staphylococcus aureus (MRSA). Report No.: 13-EHC043-EF. Rockville, MD, USA: Agency for Healthcare Research and Quality; 2013.
- 5. Libert M, Elkholti M, Massaut J, Karmali R, Maskart G, Cherifi S. Risk factors for methicillin-resistance and outcome of Staphylococcus aureus blood stream infection in a Belgian university hospital. J Hosp Infect 2008; 68: 17-24.
- 6. Khosravi AD , Hoveizavi H, Farshadzadeh Z. The prevalence of genes encoding leukocidins in Staphylococcus aureus strains resistant and sensitive to methicillin isolated from burn patients in Taleghani hospital, Ahvaz, Iran. Burns 2012; 38: 247-251.
- 7. Daskalaki M, Rojo P, Marin-Ferrer M, Barrios M, Otero JR, Chaves F. PantonValentine leukocidin-positive Staphylococcus aureus skin and soft tissue infections among children in an emergency department in Madrid, Spain. Clin Microbiol Infect 2010; 16: 74-77.
- 8. Mine Y, Nakasone I, Yamamoto Y, Utani A, Yamane N, Uezato H, Takahashi K. Dissemination of PantonValentine leukocidin-positive methicillin-resistant Staphylococcus aureus in Okinawa, Japan. J Dermatol 2013; 40: 34-38.
- 9. Schaumburg F, Köck R, Mellmann A, Richter L, Hasenberg F, Kriegeskorte A, Friedrich AW, Gatermann S, Peters G, Von Eiff C et al. Population dynamics among methicillin resistant Staphylococcus aureus Isolates in Germany during a 6-year period. J Clin Microbiol 2012; 50: 3186-3192.
- 10. Momtaz H, Hafezi L. Methicillin-resistant Staphylococcus aureus isolated from Iranian hospitals: virulence factors and antibiotic resistance properties. Bosn J Basic Med Sci 2014; 14: 219-226.
- 11. Forbes BA, Sahm DF, Weissfeld AS. Bailey and Scotts Diagnostic Microbiology. 12th ed. St. Louis, MO, USA: Mosby; 2007.
- 12. Esmailnezhad Z, Haghkhah M, Ghaffari N. Coagulase gene heterogeneity in bovine mastitic S. aureus isolates. Online Journal of Veterinary Research 2012; 16: 53-61.
- 13. Shittu A, Lin J, Morrison D, Kolawole D. Identification and molecular characterization of mannitol salt positive, coagulase-negative staphylococci from nasal samples of medical personnel and students. J Med Microbiol 2006; 55: 317-324.
- 14. Gould IM, David MZ, Esposito S, Garau J, Lina G, Mazzei T, Peters G. New insights into methicillin-resistant Staphylococcus aureus (MRSA) pathogenesis, treatment and resistance. Int J Antimicrob Agents 2012; 39: 96-104.
- 15. Bonesso MF, Marques SA, Camargo CH, Fortaleza CMCB, da Cunha Mde L. Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections. Braz J Microbiol 2014; 45: 1401-1407.
- 16. Demir T, Coplu N, Bayrak H, Turan M, Buyukguclu T, Aksu N, Eksioglu M, Yalcin B, Atakan N, Kilic S et al. PantonValentine leucocidin gene carriage among Staphylococcus aureus strains recovered from skin and soft tissue infections in Turkey. J Antimicrob Chemother 2012; 67: 837-840.
- 17. Zhao Ch, Liu Y, Zhao M, Liu Y, Yu Y, Chen H, Sun Q, Chen H, Jiang W, Liu Y et al. Characterization of community acquired Staphylococcus aureus associated with skin and soft tissue infection in Beijing: high prevalence of PVL+ ST398. PLoS One 2012; 7: e38577.
- 18. Sobhy N, Aly F, Kader OA, Ghazal A, Elbaradei A. Communityacquired methicillin-resistant Staphylococcus aureus from skin and soft tissue infections (in a sample of Egyptian population): analysis of mec gene and staphylococcal cassette chromosome. Braz J Infect Dis 2012; 16: 426-431.
- 19. Talan DA, Krishnadasan A, Gorwitz RJ, Fosheim GE, Limbago B, Albrecht V, Moran GJ. Comparison of Staphylococcus aureus from skin and soft-tissue infections in US emergency department patients, 2004 and 2008. Clin Infect Dis 2011; 53: 144-149.
- 20. Fatholahzadeh B, Emaneini M, Aligholi M, Gilbert G, Taherikalani M, Jonaidi N, Eslampour MA, Feizabadi MM. Molecular characterization of methicillin-resistant Staphylococcus aureus clones from a teaching hospital in Tehran. Jpn J Infect Dis 2009; 62: 309-311.
- 21. Rahbar M, Yaghoobi M, Fattahi A. Comparison of different laboratory methods for detection of methicillin resistant Staphylococcus aureus. Pak J Med Sci 2006; 22: 442-445.
- 22. Ekrami A, Samarbafzade AR, Alavi M, Kalantar E, Hamzeloi F. Prevalence of methicillin resistant Staphylococcus species isolated from burn patients in a burn center, Ahvaz, Iran. Jundishapur Journal of Microbiology 2010; 3: 84-91.
- 23. Vahdani P, Saifi M, Aslani MM, Asarian AA, Sharifi K. Antibiotic resistance patterns in MRSA isolated from patients admitted in ICU infectious ward. Tanaffos 2004; 3: 37-44.
- 24. Japoni A, Alborzi A, Orafa F, Rasoli M, Farshad S. Distribution of methicillin resistance genes (mecA) in Staphylococcus aureus isolated from clinical specimens. Iranian Biomedical Journal 2004; 8: 173-178.
- 25. Stefani S, Chung DR, Lindsay JA, Friedrich AW, Kearns AM, Westh H, Mackenzie FM. Meticillin-resistant Staphylococcus aureus (MRSA): global epidemiology and harmonisation of typing methods. Int J Antimicrob Agents 2012; 39: 273-282.
- 26. Havaei SA, Ohadian Moghadam S, Pourmand MR, Faghri J. Prevalence of genes encoding bi-component leukocidins among clinical isolates of methicillinresistant Staphylococcus aureus. Iran J Public Health 2010; 39: 8-14.
- 27. Ohadian Moghadam S, Havaei SA, Pourmand MR. Prevalence of methicillin-resistant Staphylococcus aureus carrying pantonvalentine leukocidin gene in cutaneous infections in the city of Isfahan. J Med Bacteriol 2012; 1: 9-16.
- 28. Hoseini Alfatemi SM, Motamedifar M, Hadi N, Sedigh H, Saraie E. Analysis of virulence genes among methicillin resistant Staphylococcus aureus (MRSA) strains. Jundishapur Journal of Microbiology 2014; 7: e10741.
- 29. Rastegar Lari A, Pourmand MR, Ohadian Moghadam S, Abdossamadi Z, Ebrahimzadeh Namvar A, Asghari B. Prevalence of PVL-containing MRSA isolates among hospital staff nasal carriers. LABMEDICINE 2011; 42: 283-286.
- 30. Casewell MW. The nose: an underestimated source of Staphylococcus aureus causing wound infection. J Hosp Infect 1998; 40: S3-11.
- 31. Safdar N, Bradley EA. The risk of infection after nasal colonization with Staphylococcus aureus. Am J Med 2008; 121: 310-315.