Abstract
Methicillin-Resistant Staphylococcus aureus (MRSA) is an important cause of healthcare associated infections globally. New mecA homologue (mecC), was first reported in the UK and Denmark. The mecC mediated MRSA is resistant only to Β-lactams antibiotics and is sensitive to other antibiotics. Detecting the prevalence of mecC MRSA provides more options in treatment of MRSA infections. The aim of this study was to prevalence of mecC gene in clinical isolates of MRSA in Ain-Shams university hospitals & to correlate Minimal Inhibitory concentration (MIC) of Oxacillin with the mecC gene expression in MRSA isolates. Fifty MRSA isolates were collected from different intensive care units (ICUs) of Ain-Shams university hospital from April-December 2018. Methicillin resistance was detected by Cefoxitin disc, and antimicrobial susceptibility testing was done for all isolates and its results were interpreted according to Clinical & Laboratory Standards Institute (CLSI) guidelines 2018. Minimal Inhibitory Concentration of Oxacillin was detected using Oxacillin E-test and the results were interpreted according to the manufacturer’s instructions, then Polymerase Chain Reaction was done to detect mecA and mecC genes among MRSA isolates. Fifty isolates were identified as MRSA by Cefoxitin disc out of 163 samples. Twelve isolates were sensitive to Oxacillin while 38 isolates were resistant to Oxacillin. All isolates were positive to mecA gene while only 3 isolates were positive to both mecA and mecC genes. MecC is a new emerging gene responsible for methicillin resistance in staphylococci and was detected in 6 % of the isolates in this study.
Highlights
Methicillin-Resistant Staphylococcus aureus (MRSA) is considered as one of the most common causes of community and hospitalacquired infections, leading to high morbidity and mortality
Methicillin resistance was detected by Cefoxitin disc, and antimicrobial susceptibility testing was done for all isolates and its results were interpreted according to Clinical & Laboratory Standards Institute (CLSI) guidelines 2018
Detection of MRSA strains was done by Cefoxitin discs 30μg (FOX) supplied by (Oxoid, Basingstoke, UK) using Kirbey-Bauer disc diffusion method and the results were interpreted according to CLSI guidelines 20188
Summary
Methicillin-Resistant Staphylococcus aureus (MRSA) is considered as one of the most common causes of community and hospitalacquired infections, leading to high morbidity and mortality. MRSA poses a serious problem in hospitals and its detection is crucial for infection prevention and control. The report of MRSA carrying a new variant of the mecA gene in 2011 in humans was highly significant. This new variant was named mecC gene. The presence of this gene poses diagnostic problems due to the probability of misdiagnosis of isolates as methicillin-sensitive S. aureus which may affect the results of MRSA surveillance. MRSA isolates carrying mecC gene have been reported in different European countries and from several host species
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