Abstract
Staphylococcus aureus is a major cause of hospital-acquired infections worldwide. Increased frequency of methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients and possibility of vancomycin resistance requires rapid and reliable characterization of isolates and control of MRSA spread in hospitals. Typing of isolates helps to understand the route of a hospital pathogen spread. The aim of this study was to investigate and compare genotypic and phenotypic characteristics of MRSA samples on three different geography locations. In addition, our aim was to evaluate three different methods of MRSA typing: spa-typing, agr-typing and GenoType MRSA. We included 104 samples of MRSA, isolated in 3 different geographical locations in clinical hospitals in Zagreb, Mostar, and Heidelberg, during the period of six months. Genotyping and phenotyping were done by spa-typing, agr-typing and dipstick assay GenoType MRSA. We failed to type all our samples by spa-typing. The most common spa-type in clinical hospital Zagreb was t041, in Mostar t001, and in Heidelberg t003.We analyzed 102/104 of our samples by agr-typing method. We did not find any agr-type IV in our locations. We analyzed all our samples by the dipstick assay GenoType MRSA. All isolates in our study were MRSA strains. In Zagreb there were no positive strains to PVL gene. In Mostar we have found 5/25 positive strains to PVL gene, in Heidelberg there was 1/49. PVL positive isolates were associated with spa-type t008 and agr-type I, thus, genetically, they were community-associated MRSA (CA-MRSA). Dipstick assay GenoType MRSA has demonstrated sufficient specificity, sensibility, simple performance and low cost, so we could introduce it to work in smaller laboratories. Using this method may expedite MRSA screening, thus preventing its spread in hospitals.
Highlights
Staphylococci are among the most important causes of both hospital- and community-acquired infections worldwide
All methicillin-resistant Staphylococcus aureus (MRSA) isolates were resistant to the tested β-lactam antibiotics, i.e. penicillin, oxacillin and cefoxitin, and all isolates were susceptible to linezolid, teicoplanin and vancomycin
While our results do not show a direct role of the agr-type in the type of human disease caused by MRSA, the higher prevalence of agr-type II in our samples could suggest that agr-type II is associated with nosocomial MRSA infections [33]
Summary
Staphylococci are among the most important causes of both hospital- and community-acquired infections worldwide. In the early 1950s, acquisition and spread of Submitted: 28 February 2015 / Accepted: 27 March 2015 β-lactamase-producing plasmids decreased the effectiveness of penicillin for treating S.aureus infections. The resistance was a result of S. aureus’s acquiring the mecA gen, which encodes for an altered penicillin-binding protein gen (PBP2a). It was not blocked by methicillin and could replace the other PBPs, allowing the survival of S.aureus in the presence of methicillin [6,7,8,9]. The presence of PBP2a means MRSA is resistant to methicillin and to all β-lactam antibiotics, including synthetic penicillins, cephalosporins and carbapenems. By the early 1960s, European hospitals were reporting outbreaks of MRSA
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