Antibiotic Resistance Pattern of Methicillin Resistant and Methicillin Sensitive Staphylococcus aureus Isolates in Tehran, Iran

Abstract

Background: Staphylococcus aureus is associated with different infections ranging from skin and soft tissue infections to endocarditis and fatal pneumonia. S. aureus is still the most common bacterial species isolated from inpatient specimens and the second most common from outpatient specimens. Today, methicillin resistant S. aureus (MRSA) isolates are present in the hospitals of most countries and are often resistant to several antibiotics. Objectives: This study was conducted from 2007 to 2011 to detect prevalence and antibiotic resistance patterns among MRSA and methicillin sensitive S. aureus (MSSA) isolated from hospitals in Tehran, Iran. Materials and Methods: Totally 726 isolates of S. aureus were collected from three referral hospitals in Tehran. All isolates were identified at the species level by standard biochemical tests. Susceptibility to eighteen antibiotics was determined by disc diffusion method. Then oxacillin and vancomycin minimum inhibitory concentration (MIC) of resistant isolates was also determined using Etest. mecA gene was detected using specific primers. Results: A total of 216 (30%) strains were found to be MRSA isolates. The highest antibiotic resistance was to penicillin, clindamycin, tobramycin and tetracycline respectively. Ninety three and 61% of MRSA and MSSA isolates were multidrug resistant (MDR) respectively. However, no strain was resistant to vancomycin, synercid, linezolid and chloramphenicol. Sixty nine percent of MRSA isolates showed high level of resistance to oxacillin (MIC ≥ 256 μg/mL). mecA gene was detected among all MRSA isolates. Conclusions: Although the frequency of MRSA isolates in the current study was low, resistance to other antibiotics was high and most of the isolates were found to be MDR. Regular surveillance of hospital-associated infections and monitoring of their antibiotic sensitivity patterns are required to reduce MRSA prevalence. High frequency of MDR isolates of S. aureus could be considered as an urgent warning for public health.