Volume 12, Issue 2 (8-2024)
jmsthums 2024, 12(2): 41-52 |
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A P, M S, S Y, M J, K K, A G, et al . Investigating the antibiotic resistance pattern and determining the phenotypic and genotypic resistance to mupirocin in Staphylococcus aureus isolated from nasal carriers. jmsthums 2024; 12 (2) :41-52
URL: http://jms.thums.ac.ir/article-1-1294-en.html
URL: http://jms.thums.ac.ir/article-1-1294-en.html
Pournajaf A 
1, Shokri M1 , Yaghoubi S2 , Jafari M1 , Kamran K1 , Ghasemi A3 , Hasanzadeh A4 , Mirhafez S5
1, Shokri M1 , Yaghoubi S2 , Jafari M1 , Kamran K1 , Ghasemi A3 , Hasanzadeh A4 , Mirhafez S5
1- Babol University of Medical Sciences
2- Faculty of Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran & Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences
3- Gonabad University of Medical Sciences
4- Urmia University of Medical Sciences, Urmia, Iran
5- Neyshabur University of Medical Sciences
2- Faculty of Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran & Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences
3- Gonabad University of Medical Sciences
4- Urmia University of Medical Sciences, Urmia, Iran
5- Neyshabur University of Medical Sciences
Abstract: (337 Views)
Background & Aim: Mupirocin is used to decolonize Staphylococcus aureus using inhibiting protein synthesis. Therefore, the purpose of this study is to investigate the pattern of antibiotic resistance and determine the phenotypic and genotypic resistance to mupirocin in S. aureus isolated from nasal carriers.
Methods: In this cross-sectional study, 121 nasal swabs were collected from healthcare workers. Methicillin-resistant strains were tested using cefoxitin disk in the antibiogram test and mecA gene amplification in PCR method. E-test method was performed to check high and low level resistance to mupirocin and finally the genes encoding resistance to mupirocin including ileS-1, mupA and mupB were identified using PCR.
Results: 68 isolates (56.2%) of S. aureus were isolated, of which 42 isolates (61.8%) were MRSA. Also, the highest and lowest levels of resistance were related to tetracycline (70.1%) and gentamicin (16.2%). Only, 7 isolates (16.7%) of MRSA and 2 isolates (7.6%) of S. aureus sensitive to methicillin were resistant to mupirocin. MIC E-test results showed that 7 and 2 strains had high and low level resistance to mupirocin, respectively. Also, one strain (11.1%) had iles-1 gene and 5 strains (55.5%) had mupA gene.
Conclusion: The results showed a relatively high prevalence of colonization and antibiotic resistance in S. aureus strains isolated from healthcare workers; therefore, it is essential to carry out further studies and necessary measures to reduce the amount of carriers.
Methods: In this cross-sectional study, 121 nasal swabs were collected from healthcare workers. Methicillin-resistant strains were tested using cefoxitin disk in the antibiogram test and mecA gene amplification in PCR method. E-test method was performed to check high and low level resistance to mupirocin and finally the genes encoding resistance to mupirocin including ileS-1, mupA and mupB were identified using PCR.
Results: 68 isolates (56.2%) of S. aureus were isolated, of which 42 isolates (61.8%) were MRSA. Also, the highest and lowest levels of resistance were related to tetracycline (70.1%) and gentamicin (16.2%). Only, 7 isolates (16.7%) of MRSA and 2 isolates (7.6%) of S. aureus sensitive to methicillin were resistant to mupirocin. MIC E-test results showed that 7 and 2 strains had high and low level resistance to mupirocin, respectively. Also, one strain (11.1%) had iles-1 gene and 5 strains (55.5%) had mupA gene.
Conclusion: The results showed a relatively high prevalence of colonization and antibiotic resistance in S. aureus strains isolated from healthcare workers; therefore, it is essential to carry out further studies and necessary measures to reduce the amount of carriers.
Type of Study: Research |
Subject:
Special
Received: 2024/05/20 | Accepted: 2024/08/24 | Published: 2024/10/1
Received: 2024/05/20 | Accepted: 2024/08/24 | Published: 2024/10/1
References
1. Foster TJ, Geoghegan JA. Staphylococcus aureus. Molecular Medical Microbiology. 2024; 1(655-79). [DOI:10.1016/B978-0-12-818619-0.00026-5]
2. Iredia QI, Ebode NO, Iyoha UJ, Ogbeide JO. Nasal Carriage of Staphylococcus aureus among Students of a Tertiary Institution in Edo State. Nasal Carriage of Staphylococcus aureus among Students of a Tertiary Institution in Edo State. Biology and Life Sciences. 2024; 25; 141(1):8- [DOI:10.47119/IJRP1001411120245986]
3. Adediran TY, Robinson GL, Johnson JK, Liang Y, Bejo S, Leekha S, Rasko DA, Stine OC, Harris AD, Thom KA. Factors associated with patient-to-healthcare personnel (HCP) and HCP-to-subsequent patient transmission of methicillin-resistant Staphylococcus aureus. Infection Control & Hospital Epidemiology. 2024; 18:1-7. [DOI:10.1017/ice.2023.269]
4. Johnson SS, Mietchen MS, Lofgren ET. Healthcare Worker Staffing Ratios Affect Methicillin-Resistant Staphylococcus aureus Acquisition. medRxiv. 2024; -02. [DOI:10.1101/2024.02.14.24302485]
5. Verhoeven PO, Gagnaire J, Botelho-Nevers E, Grattard F, Carricajo A, Lucht F, Pozzetto B, Berthelot P. Detection and clinical relevance of Staphylococcus aureus nasal carriage: an update. Expert review of anti-infective therapy. 2014; 1;12(1):75-89. [DOI:10.1586/14787210.2014.859985]
6. Huang YH, Tseng SP, Hu JM, Tsai JC, Hsueh PR, Teng LJ. Clonal spread of SCCmec type IV methicillin-resistant Staphylococcus aureus between community and hospital. Clinical microbiology and infection. 2007; 1;13(7):717-24. [DOI:10.1111/j.1469-0691.2007.01718.x]
7. Liu J, Chen D, Peters BM, Li L, Li B, Xu Z, Shirliff ME. Staphylococcal chromosomal cassettes mec (SCCmec): A mobile genetic element in methicillin-resistant Staphylococcus aureus. Microbial pathogenesis. 2016; 101:56-67. [DOI:10.1016/j.micpath.2016.10.028]
8. Dadashi M, Hajikhani B, Darban-Sarokhalil D, van Belkum A, Goudarzi M. Mupirocin resistance in Staphylococcus aureus: A systematic review and meta-analysis. Journal of global antimicrobial resistance. 2020; 1;20:238-47. [DOI:10.1016/j.jgar.2019.07.032]
9. Prakash R, Garg A, Arya R, Kumawat RK. Chronicity of high and low level mupirocin resistance in Staphylococcus aureus from 30 Indian hospitals. Scientific Reports. 2023; 22; 13(1):10171. [DOI:10.1038/s41598-023-37399-0]
10. Duan XC, Li XX, Li XM, Wang S, Zhang FQ, Qian P. Exploiting Broad-Spectrum Chimeric Lysin to Cooperate with Mupirocin against Staphylococcus aureus-Induced Skin Infections and Delay the Development of Mupirocin Resistance. Microbiology Spectrum. 2023; 15;11(3):e05050-22. [DOI:10.1128/spectrum.05050-22]
11. Mondino PJ, Netto dos Santos KR, do Carmo de Freire Bastos M, Giambiagi-deMarval M. Improvement of mupirocin E-test for susceptibility testing of Staphylococcus aureus. Journal of medical microbiology. 200; 52(5):385-7. [DOI:10.1099/jmm.0.05011-0]
12. Chen W, He C, Yang H, Shu W, Cui Z, Tang R, Zhang C, Liu Q. Prevalence and molecular characterization of methicillin-resistant Staphylococcus aureus with mupirocin, fusidic acid and/or retapamulin resistance. BMC microbiology. 2020; 20:1-2. [DOI:10.1186/s12866-020-01862-z]
13. Udo EE, Jacob LE, Mathew B. Genetic analysis of methicillin-resistant Staphylococcus aureus expressing high-and low-level mupirocin resistance. Journal of Medical Microbiology. 2001; 50(10):909-15 [DOI:10.1099/0022-1317-50-10-909]
14. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing. 33rd ed. CLSI supplement M100 (ISBN 978-1-68440-170-3 [Print]; ISBN 978-1-68440-171-0 [Electronic]). Clinical and Laboratory Standards Institute, USA, 2023.
15. Simor AE, Stuart TL, Louie L, Watt C, Ofner-Agostini M, Gravel D, Mulvey M, Loeb M, McGeer A, Bryce E, Matlow A. Mupirocin-resistant, methicillin-resistant Staphylococcus aureus strains in Canadian hospitals. Antimicrobial agents and chemotherapy. 2007; 51(11):3880-6. [DOI:10.1128/AAC.00846-07]
16. Perez-Roth E, Claverie-Martın F, Villar J, Mendez-Alvarez S. Multiplex PCR for simultaneous identification of Staphylococcus aureus and detection of methicillin and mupirocin resistance. Journal of clinical microbiology. 2001;39(11):4037-41. [DOI:10.1128/JCM.39.11.4037-4041.2001]
17. Heininger U, Datta F, Gervaix A, Schaad UB, Berger C, Vaudaux B, Aebi C, Hitzler M, Kind C, Gnehm HE, Frei R. Prevalence of nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) in children a multicenter cross-sectional study. The Pediatric infectious disease journal. 2007; 26(6):544-6. [DOI:10.1097/INF.0b013e31804d244a]
18. Price JR, Cole K, Bexley A, Kostiou V, Eyre DW, Golubchik T, Wilson DJ, Crook DW, Walker AS, Peto TE, Llewelyn MJ. Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing. The Lancet Infectious Diseases. 2017;17(2):207-14. [DOI:10.1016/S1473-3099(16)30413-3]
19. Cimolai N. The role of healthcare personnel in the maintenance and spread of methicillin-resistant Staphylococcus aureus. Journal of infection and public health. 2008; 1(2):78-100. [DOI:10.1016/j.jiph.2008.10.001]
20. Sadari H, Olya P, Habibi M. Identification of mupirocin resistance in Staphylococcus aureus strains isolated from patients of 4 Tehran University Hospitals by PCR method. Medical Scholar [Internet]. 1387;16(78):29-36. magiran.com/p668061
21. Walana W, Bobzah BP, Kuugbee ED, Acquah S, Ezekiel VK, Yabasin IB, Abdul-Mumin A, Ziem JB. Staphylococcus aureus nasal carriage among healthcare workers, inpatients and caretakers in the Tamale Teaching Hospital, Ghana. Scientific African. 20201; 8:e00325. [DOI:10.1016/j.sciaf.2020.e00325]
22. Kaur DC, Narayan PA. Mupirocin resistance in nasal carriage of Staphylococcus aureus among healthcare workers of a tertiary care rural hospital. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2014; 18(11):716. [DOI:10.4103/0972-5229.144013]
23. Agarwal L, Singh AK, Sengupta C, Agarwal A. Nasal carriage of Methicillin-and Mupirocin-resistant S. aureus among health care workers in a tertiary care hospital. Journal of research in pharmacy practice. 2015; 4(4):182-6. [DOI:10.4103/2279-042X.167046]
24. Pournajaf A, Ardebili A, Allah-Ghaemi E, Omidi S, Borhani K, Khodabandeh M, Davarpanah M. Identification of clinical methicillin and mupirocin-resistant Staphylococcus aureus by multiplex-PCR. Journal of Medical Bacteriology. 2014;3(1-2):52-9.
25. Vestberg N, Razavi M, Giske CG, Fang H. Antimicrobial susceptibilities and genomic characteristics of methicillin‐resistant Staphylococcus aureus resistant to mupirocin in Stockholm, Sweden. APMIS. 2024; 132(2):94-9. [DOI:10.1111/apm.13357]
26. Mostafa MS, Awad AR. Localization and Characterization of MupA Gene in High and Low-Level Mupirocin Resistant Methicillin Resistant Staphylococcus aureus. Egyptian Journal of Medical Microbiology. 2020; 29(3):171-7. [DOI:10.51429/EJMM29322]
27. Hesami S, Hosseini SD, Amouzandeh-Nobaveh A, Eskandari S, Ghaznavi-Rad E. Phenotypic and genotypic determination of mupirocin resistance among methicillin susceptibility and resistance in Staphylococci isolated from nosocomial infections. Journal of Mazandaran University of Medical Sciences. 2013; 22(1):30-39.
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