Abstract
Purpose: To investigate the occurrence, species prevalence, antibacterial resistance, and molecular characteristics of S. aureus isolates from different wards located in a university hospital.Methods: A total of one hundred and fifty S. aureus isolates were recovered from various clinical specimens. The isolates were tested phenotypically by conventional methods and genotypically by polymease chain reaction (PCR) for direct detection of femB and mecA genes.Results: Thirty one isolates (20.7 %) of these were identified as methicillin-resistant Staphylococcus aureus (MRSA) by oxacillin agar screen test and 124 (82.7 %) of the isolates were β-lactamase producers. The prevalence of MRSA strains among S. aureus isolates was 20.7 %. The overall resistance of MRSA to a variety of antibiotics tested was linezolid, 48.7 %; ciprofloxacin, 15.3 %; sulfamethoxazole/trimethoprim (TMS), 14.0 %; gentamicin, 12.7 %; and rifampicin, 6.7 %. All MRSA isolates were positive for femB and mecA genes; one MSSA carried mecA gene.Conclusion: Since S. aureus isolates are commonly associated with wound infections, skin and soft tissue infections and blood stream infections, glycopeptides, mupirocin, and quinupristin/dalfopristin (Q/D) would be the most effective antibiotics for the treatment of MRSA infections.Keywords: Staphylococcus aureus, mecA, femB, Antibiotics, Staphylococcal infections, Methicillin resistance
Highlights
S. aureus is a major cause of serious hospital and community-acquired infections associated with morbidity and mortality rates with rapid development of resistance [1]
It is clinically crucial to determine quickly whether S. aureus isolates are methicillin resistant or not, as this is very significant for both treatment and requires extensive hygienic precautions to limit the spread of such strains
Of the 18083 clinical specimens included in the present study, only 2764 (15.3 %) were positively cultured and 150 (5.4 %) were identified as S. aureus
Summary
S. aureus is a major cause of serious hospital and community-acquired infections associated with morbidity and mortality rates with rapid development of resistance [1]. The main bacterial species has been associated with a variety of diseases, such as skin and soft tissue infections, endovascular infections, pneumonia, endocarditis and septic shock [4] These strains show resistance to a wide range of antimicrobials including vancomycin, the drug of last resort for MRSA infections [5]. It is clinically crucial to determine quickly whether S. aureus isolates are methicillin resistant or not, as this is very significant for both treatment and requires extensive hygienic precautions to limit the spread of such strains. The S. aureus isolates were subjected to susceptibility testing using disc diffusion technique according to the Clinical and Laboratory Standards Institute (CLSI) [19] guidelines with quality controls. The MRSA detection was carried out according to CLSI guidelines with Oxacillin agar screen test [19] using Mueller-Hinton agar MHA (Difco Laboratories, Detroit, Mich.) containing 4 % NaCl and 6 μg/ml oxacillin.
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