Distribution of Staphylococcal cassette chromosome mecA (SCCmec) types among coagulase-negative Staphylococci isolates from healthcare workers in the North-West of Iran

Document Type : Original Article

Authors

1 Department of Microbiology, Faculty of Basic Science, Islamic Azad University, Science and Research Branch of Tehran, Markazi, Iran

2 Biotechnology Department, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran

Abstract

Objective(s): Methicillin-resistant coagulase-negative Staphylococci (MR-CoNS) are recognized as one of the major causes of healthcare-associated infections in hospitals. The present investigation aimed to study the prevalence of Staphylococcal cassette chromosome mec (SCCmec) types, along with aminoglycoside modifying enzymes (AMEs) genes in the nasal carriage of MR-CoNS in the north-west of Iran.
Materials and Methods: To assess the potential of coagulase-negative Staphylococci as hidden reservoirs for antibiotic resistance, we analyzed the antimicrobial susceptibility of MR-CoNS using the disk diffusion method. In addition, PCR and multiplex PCR assays were performed to determine the prevalence of AME encoding genes and SCCmec types in methicillin-resistant coagulase-negative Staphylococci isolates.
Results: A total of 51 MR-CoNS isolates were recovered from the anterior nares of healthcare workers. The observed resistance rates to tobramycin, gentamicin, cotrimoxazole, kanamycin, erythromycin, tetracycline, and ciprofloxacin were 74.5%, 68.5%, 57%, 53%, 51%, 49%, and 8%, respectively. Of the 51 tested MR-CoNS isolates, 2(4%) were harboring SCCmec type I, four (8%) were type II, six (12%) type III, eleven (21.6%) type IVa, two (4%) type IVb, two (4%) type IVc, six (12%) type IVd, and two (4%) type V. The rates of prevalence of the aminoglycoside modifying enzyme genes were as follows: aac (6′)/aph (2′′) (28 cases, 55 %), ant (4′)-Ia (20 cases, 39%), and the aph (3´)-IIIa gene (9 cases, 17.6 %).
Conclusion: Subtypes IVa and IVd were the most prevalent SCC elements, and aac (6′)/aph (2′′) was the most common AME gene detected among the MR-CoNS isolates.

Keywords

References

1. Kadkhoda H, Ghalavand Z, Nikmanesh B, Kodori M, Houri H, Maleki DT, et al. Characterization of biofilm formation and virulence factors of. Iran J Basic Med Sci 2020; 23:692.
2. Watanabe K, Nakaminami H, Azuma C, Tanaka I, Nakase K, Matsunaga N, et al. Methicillin-resistant Staphylococcus epidermidis is part of the skin flora on the hands of both healthy individuals and hospital workers. Biol Pharm Bull 2016:b16-00528.
3. Pung H, Azis MN, Rachman AA, Zakaria Z, Desa MM. Presence of methicillin resistance and heteroresistance among coagulase negative Staphylococci (CoNS) isolates obtained from Health Sciences students at a Public University. Trop Biomed 2017; 34:84-88.
4. Cave R, Misra R, Chen J, Wang S, Mkrtchyan HV. Whole genome sequencing revealed new molecular characteristics in multidrug resistant Staphylococci recovered from high frequency touched surfaces in London. Sci Rep 2019; 9:9637.
5. Askari E, Soleymani F, Arianpoor A, Tabatabai SM, Amini A, Naderinasab M. Epidemiology of mecA-methicillin resistant Staphylococcus aureus (MRSA) in Iran: a systematic review and meta-analysis. Iran J Basic Med Sci 2012; 15:1010-1019.
6. Salehzadeh A, Zamani H, Langeroudi MK, Mirzaie A. Molecular typing of nosocomial Staphylococcus aureus strains associated to biofilm based on the coagulase and protein A gene polymorphisms. Iran J Basic Med Sci 2016; 19:1325-1330.
7. Delpón MT, Demelo-Rodríguez P, Ballesteros JCC, de la Cruz LV. Absceso de psoas por Staphylococcus lugdunensis. Rev Argent Microbiol 2016; 48:119-121.
8. Velásquez SdCJ, Higuera LDT, Arango JLP, Bautista JLR, Castro FEG, Burbano REP. Perfil de resistencia antimicrobiana en aislamientos de Staphylococcus spp. obtenidos de leche bovina en Colombia. Rev Argent Microbiol 2020; 52:121-130.
9. Khoramrooz SS, Dolatabad SA, Dolatabad FM, Marashifard M, Mirzaii M, Dabiri H, et al. Detection of tetracycline resistance genes, aminoglycoside modifying enzymes, and coagulase gene typing of clinical isolates of Staphylococcus aureus in the Southwest of Iran. Iran J Basic Med Sci 2017; 20:912-919.
10.  Zipperer A, Konnerth MC, Laux C, Berscheid A, Janek D, Weidenmaier C, et al. Human commensals producing a novel antibiotic impair pathogen colonization. Nature 2016; 535:511-516.
11. Ma XX, Sun DD, Wang S, Wang ML, Li M, Shang H, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus among preclinical medical students: epidemiologic and molecular characteristics of methicillin-resistant S. aureus clones. Diagn Microbiol Infect Dis 2011; 70:22-30.
12. Mehrshad S, Haghkhah M, Aghaei S. Epidemiology and molecular characteristics of methicillin-resistant Staphylococcus aureus from skin and soft tissue infections in Shiraz, Iran. Turkish J Med Sci 2017; 47:180-187.
13. Shokravi Z, Mehrad L, Ramazani A. Detecting the frequency of aminoglycoside modifying enzyme encoding genes among clinical isolates of methicillin-resistant Staphylococcus aureus. BioImpacts: BI 2015; 5:87-91.
14. Vaez H, Ghalehnoo ZR. Molecular characteristics of Staphylococcus aureus nasal carriage among health care workers at a Referral Hospital in Zabol, Iran. Pan Afr Med J 2019; 34:196-201.
15. Goudarzi M, Razeghi M, Dadashi M, Miri M, Hashemi A, Amirpour A, et al. Distribution of SCCmec types, tetracycline and aminoglycoside resistance genes in hospital-associated methicillin-resistant Staphylococcus aureus strains. Gene Reports 2019; 16:100454-100460.
16. Pourmand MR, Abdossamadi Z, Salari MH, Hosseini M. Slime layer formation and the prevalence of mecA and aap genes in Staphylococcus epidermidis isolates. J Infect Dev Ctries 2011; 5:34-40.
17. Khashei R, Sedigh H, Alfatemi MH, Zomorodian K. Antimicrobial resistance patterns of colonizing microflora on the personnel hands and noses working in the Neonatal Intensive Care Unit (NICU). World Appl Sci J 2014; 30:1232-1237.
18. Agarwal L, Singh AK, Agarwal A, Agarwal A. Methicillin and mupirocin resistance in nasal colonizers coagulase-negative Staphylococcus among health care workers. Med J Dr DY Patil Univ 2016; 9:479-483.
19. Kulshrestha N, Ghatak T, Gupta P, Singh M, Agarwal J. Surveillance of health-care workers for nasal carriage to detect multidrug-resistant Staphylococcus spp. in a tertiary care center: An observational study. Med J Dr DY Patil Vidyapeeth 2019; 12:39-43.
20. Vannuffel P, Laterre PF, Bouyer M, Gigi J, Vandercam B, Reynaert M, et al. Rapid and specific molecular identification of methicillin-resistant Staphylococcus aureus in endotracheal aspirates from mechanically ventilated patients. J Clin Microbiol 1998; 36:2366-2368.
21. Zhang K, McClure JA, Elsayed S, Louie T, Conly JM. Novel multiplex PCR assay for characterization and concomitant subtyping of Staphylococcal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus. J Clin Microbiol 2005; 43:5026-5033.
22. Choi SM, Kim S-H, Kim H-J, Lee D-G, Choi J-H, Yoo J-H, et al. Multiplex PCR for the detection of genes encoding aminoglycoside modifying enzymes and methicillin resistance among Staphylococcus species. J Korean Med Sci 2003; 18:631-636.
23. Patel JB. Performance standards for antimicrobial susceptibility testing: Clinical and Laboratory Standards Institute; 2017.
24. Cockerill F, Patel J, Alder J, Bradford P, Dudley M, Eliopoulos G. Performance standards for antimicrobial susceptibility testing: twenty-third informational supplement; M100-S23. Wayne, PA: CLSI 2013.
25. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. J Clin Microbiol 2012; 18:268-281.
26. Poormohammadi S, Farahani A, Mohajeri P. Genomic diversity and antimicrobial susceptibility profiling of nasal carriage Staphylococcus aureus isolated from pediatric ward in Western Iran. Saudi J Biol Sci 2019; 26:1-7.
27. Halaji M, Karimi A, Shoaei P, Nahaei M, Khorvash F, Ataei B, et al. Distribution of SCCmec elements and presence of Panton-Valentine Leukocidin in methicillin-resistant Staphylococcus epidermidis isolated from clinical samples in a University Hospital of Isfahan City, Iran. J Clin Diagnostic Res 2017; 11:DC27-DC31.
28. Chen X-P, Li W-G, Zheng H, Du H-Y, Zhang L, Zhang L, et al. Extreme diversity and multiple SCC mec elements in coagulase-negative Staphylococcus found in the Clinic and Community in Beijing, China. Ann Clin Microbiol Antimicrob 2017; 16:57-68.
29. Murugesan S, Perumal N, Dass BS, Vijayakumar R, Krishnan P. Prevalence and molecular characterisation of methicillin-resistant coagulase negative Staphylococci (MR-CoNS) isolated from nasal carriers of end stage renal disease patients-A prospective study. J Clin Diag Res 2019; 13: DC10-DC15.
30. Ghaznavi-Rad E, Fard-Mousavi N, Shahsavari A, Japoni-Nejad A, Van Belkum A. Distribution of Staphylococcal cassette chromosome mec types among methicillin-resistant coagulase negative Staphylococci in central Iran. Iran J Microbiol 2018; 10:7-13.
31. Abadi MIM, Moniri R, Khorshidi A, Piroozmand A, Mousavi SGA, Dastehgoli K, et al. Molecular characteristics of nasal carriage methicillin-resistant coagulase negative Staphylococci in school students. Jundishapur J Microbiol 2015; 8: e18591.
32. Razavi S, Dadashi M, Pormohammad A, Khoramrooz SS, Mirzaii M, Gholipour A, et al. Methicillin-resistant staphylococcus epidermidis in Iran: A systematic review and meta-analysis. Arch Clin Infect Dis 2018; 13:e58410.
33. Ghosh A, Singh Y, Kapil A, Dhawan B. Staphylococcal cassette chromosome mec (SCCmec) typing of clinical isolates of coagulase-negative Staphylocci (CoNS) from a tertiary care hospital in New Delhi, India. Indian J Med Res 2016; 143:365-370.
34. Seyedi-Marghaki F, Kalantar-Neyestanaki D, Saffari F, Hosseini-Nave H, Moradi M. Distribution of aminoglycoside-modifying enzymes and molecular analysis of the coagulase gene in clinical isolates of methicillin-resistant and methicillin-susceptible Staphylococcus aureus. Microb Drug Resist 2019; 25:47-53.
35. Ghotaslou R, Aghazadeh M, Rezaee MA, Moshafi MH, Forootanfar H, Hojabri Z, et al. The prevalence of aminoglycoside-modifying enzymes among coagulase negative Staphylococci in Iranian pediatric patients. J Infect Chemother 2014; 20:569-573.
36. Sabzehali F, Goudarzi M, Goudarzi H, Azimi H. Distribution of aminoglycoside resistance genes in coagulase-negative Staphylococci isolated from hospitalized patients. Arch Pediatr Infect Dis 2017; 5:e57297.
37. Emaneini M, Taherikalani M, Eslampour MA, Sedaghat H, Aligholi M, Jabalameli F, et al. Phenotypic and genotypic evaluation of aminoglycoside resistance in clinical isolates of Staphylococci in Tehran, Iran. Microb Drug Resist 2009; 15:129-132.
38. Ardic N, Sareyyupoglu B, Ozyurt M, Haznedaroglu T, Ilga U. Investigation of aminoglycoside modifying enzyme genes in methicillin-resistant Staphylococci. Microbiol Res 2006; 161:49-54.
39. Duran N, Ozer B, Duran GG, Onlen Y, Demir C. Antibiotic resistance genes & susceptibility patterns in Staphylococci. Indian J Med Res 2012; 135:389-396.
Iranian Journal of Basic Medical Sciences
Volume 23, Issue 11
November 2020
Pages 1489-1493

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