Abstract
BackgroundThe most common clinical manifestations of Staphylococcus aureus strains in the community are skin and soft-tissue infections. S. aureus could colonize the body sites and complicate the pathogenesis of skin diseases. S. aureus colonization is a risk factor for severe conditions such as bone and joint infections, pneumonia, bacteremia, and endocarditis. This study aimed to investigate the prevalence of S. aureus strains in skin and soft tissue infections and other skin disorders in patients referring to dermatology clinics and to evaluate the antibiotic resistance pattern and molecular characteristics of S. aureus isolates.MethodsSkin swabs were collected from the lesional sites in 234 outpatients referring to dermatology clinics in three hospitals in Tehran. Antibiotic susceptibility, biofilm formation, and hemolysis tests were performed for isolates. PCR was done for SCCmec typing, agr grouping, and virulence genes detecting.ResultsThe prevalence of S. aureus strains among patients with skin and soft-tissue infections and other skin lesions was 44.77% (30/67) and 44.91% (75/167), respectively. Also, 59 (56.19%) isolates were MRSA, 35.57% were HA-MRSA, and 30.5% were CA-MRSA. The psmα gene was more prevalent (62.8%) among isolates, followed by hlaα (56.1%), tsst-1 (15.2%) eta (13.3%), etb (6.6%), and pvl (2.8%). The agr specificity groups I, II, III, and IV were identified in 49.5, 21.9, 11.4, and 14.2% of S. aureus isolates, respectively. Most (56%) S. aureus isolates produced a moderate biofilm, and 23.8% of them produced strong biofilms. α-hemolysin (46.6%), β-hemolysin (25.7%), γ-hemolysin (19%), and both α and β-hemolysin (5.7%) were also produced by isolates.ConclusionThe present study results indicated high colonization of skin lesions by HA-MRSA and CA-MRSA clones; MRSA strains were more resistant to antibiotics, contained various toxin genes, and were able to form biofilms. Therefore, they could play a vital role in the pathogenesis of various skin diseases; also, they could spread and cause infections in other body sites. Eradication and decolonization strategies could prevent recurrent infections and the spread of resistant strains and improve skin conditions.
Highlights
Staphylococcus aureus is an opportunist bacterium that causes a variety of clinical infections, ranging from skin and soft-tissue and device-related infections to bacteremia and endocarditis [1, 2]
There was no significant difference in S. aureus colonization of skin lesions between the two groups of patients (p = .985, OR = 0.997, 95% CI: 0728–1.366)
In this study, the prevalence and molecular characteristics of MSSA and methicillin-resistant S. aureus (MRSA) strains isolated from infectious and non-infectious skin and soft-lesions were investigated in Iranian dermatology clinics
Summary
Staphylococcus aureus is an opportunist bacterium that causes a variety of clinical infections, ranging from skin and soft-tissue and device-related infections to bacteremia and endocarditis [1, 2]. Methicillin-resistant S. aureus (MRSA) is a significant cause of skin and soft-tissue colonization and infections, especially community-associated MRSA (CA-MRSA), which is more virulent and grows faster than hospital associated-MRSA (HA-MRSA) [7, 8]. This study aimed to evaluate the prevalence of S. aureus in infectious and non-infectious skin and softtissue lesions in patients referring to dermatology clinics in Tehran and to evaluate antibiotic resistance pattern and molecular characteristics of S. aureus isolates. The most common clinical manifestations of Staphylococcus aureus strains in the community are skin and soft-tissue infections. This study aimed to investigate the prevalence of S. aureus strains in skin and soft tissue infections and other skin disorders in patients referring to dermatology clinics and to evaluate the antibiotic resistance pattern and molecular characteristics of S. aureus isolates
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