Abstract
Staphylococcus aureus is known to be a major cause of skin and soft tissue infections, pneumonia and invasive diseases. In this study, attempts were made to examine the prevalence of tsst-1, eta, etb, and luk-PV genes among methicillin-resistant S. aureus (MRSA) isolated from children in Tehran. In the present cross-sectional study, a total of 100 MRSA were isolated from children who were referred to a pediatric hospital during 11-month period of September 2014 to August 2015. Isolates were identified using biochemical tests and then, using PCR, the isolates were tested for the presence of mecA, tsst-1, eta, etb, and luk-PV genes. Susceptibility of isolates to cefoxitin, penicillin, erythromycin, clindamycin, gentamicin, rifampin, minocycline, co-trimoxazole, linezolid, and vancomycin were evaluated using standard methods. It was found that the MRSA isolates had the greatest resistance to clindamycin (72%) and erythromycin (59%), while the lowest rates of resistance were observed to be related to minocycline (6%) and rifampin (12%). All of isolates were sensitive to vancomycin and linezolid. The mecA gene was detected in all the isolates. Moreover, luk-PV and tsst-1 were detected in 18% and 17% of the isolates, respectively. None of the isolates harbored eta and etb genes. Our data provide specifications about the toxin production status of S. aureus isolates from pediatric children. The current study showed increased resistance to different antibiotics in S. aureus isolates. Therefore, to prevent multi-resistance to other antibiotic classes, it is essential to withhold prescriptions and stop unessential use of available antibiotics.
Highlights
Staphylococcus aureus is known to be a major cause of skin and soft tissue infections, pneumonia and invasive diseases
47 isolates (47%) were collected from outpatient or those referred to emergency department and classified as CA-methicillin-resistant S. aureus (MRSA); with the remainder from different wards, including pediatric intensive care unit (PICU) (10%), respiratory (10%), surgical (10%), infection (8%), gastroenterology (5%), cardiology (5%), and other wards (5%), which were considered as HA-MRSA
54% of all MRSA isolates were obtained from nasal of asymptomatic carriers, and the remaining 46% were recovered from clinical samples of infected children, including wound (13%), blood (11%), sputum (7%), abscess (4%), ear discharges (3%), urine (2%), eye discharges (2%), catheter (2%), and synovial fluid (2%)
Summary
Staphylococcus aureus is known to be a major cause of skin and soft tissue infections, pneumonia and invasive diseases. The most important virulence factors with this pathogen are numerous exotoxins such as hemolysins (Hla, Hlb, Hld, and Hlg), Panton-Valentine leukocidin (PVL), toxic shock syndrome toxin-1 (TSST-1), staphylococcal enterotoxins (SEs), and exfoliative toxin A and B (ETA and ETB) [4,5]. It should be Esmaeili Benvidi et al – Toxin production among pediatric MRSA pointed out that most of these factors are not always expressed and their expression occurs in specified strains and under certain conditions. S. aureus strains that produce PVL are usually associated with skin and soft-tissue infections [6]
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