Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial infections because of its high resistance. Here, we study the antibiotic resistance in MRSA clinical isolates and their relation to integron I occurrence. A total of 88 clinical Staphylococcus aureus isolates were collected. MRSA were identified by the disk diffusion method (DDM) and confirmed by PCR, and antibiogram was determined by DDM. Integron I, II and the aacA4 gene were investigated by PCR. Integrase-positive strains were analyzed for the presence of resistance gene cassettes by sequencing. All isolates were identified as MRSA by DDM and confirmed by PCR. All isolates were resistant to ampicillin and cefoxitin. Concerning aminoglycosides, the frequency of resistance was reported for streptomycin (60.7%), tobramycin (37.1%) gentamicin (36%), and for amikacin (15.9%). Integron I was detected in 41 isolates (46.6%), while integron II was detected in three isolates (3.4%). Sequencing of the integron I-cassette indicated the exclusive prevalence of addA gene variants mediating aminoglycoside resistance. The aacA4 gene was found in DNA of 31 isolates (35.22%). This study revealed the high existence of MRSA. Furthermore, the AacA4 gene and class I integron harboring aadA gene were predominant in MRSA isolates.
Highlights
Staphylococcus aureus is a major human pathogen responsible for a wide range of infections including superficial and fatal systemic infections [1]
With the misuse of penicillin, penicillin-resistant S. aureus and methicillin-resistant S. aureus (MRSA) have appeared; MRSA resistance is mediated by the mecA gene [4,5]
In the last few decades, multidrug resistant (MDR)-MRSA isolates have become prominent in Egypt due to several factors including carriage between healthcare workers, persistence in the hospital environment and the misuse of antibiotics [8,9]
Summary
Staphylococcus aureus is a major human pathogen responsible for a wide range of infections including superficial and fatal systemic infections [1]. S. aureus is identified as one of the world’s leading causes of nosocomial infections [2]. Infections caused by S. aureus were well-controlled by penicillin [3]. MRSA has rapidly become the most frequently occurring resistant pathogen that leads to high rates of morbidity and mortality [6,7]. In the last few decades, multidrug resistant (MDR)-MRSA isolates have become prominent in Egypt due to several factors including carriage between healthcare workers, persistence in the hospital environment and the misuse of antibiotics [8,9]
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