Genetic Diversity Analysis of Mupirocin-Resistant Staphylococcus aureus Clinical Isolates in Tehran Hospitals, Iran

Mehdi Goudarzi1, Maryam Fazeli2, Gita Eslami1

  • 11 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Microbial Drug Resistance (Larchmont, N.Y.)
|December 1, 2018
PubMed

Insights

This study investigated mupirocin resistance in Staphylococcus aureus strains in Iran. Molecular characterization revealed the prevalence of resistance genes and identified specific clones, highlighting the need for monitoring.

Area of Science:

  • Microbiology
  • Molecular Biology
  • Epidemiology

Background:

  • Mupirocin is a crucial antibiotic for treating Staphylococcus aureus infections.
  • Limited data exists on the molecular mechanisms of mupirocin resistance in S. aureus.
  • Understanding resistance patterns is vital for effective treatment strategies.

Purpose of the Study:

  • To characterize the molecular basis of mupirocin resistance in S. aureus isolates from Tehran, Iran.
  • To determine the prevalence of high-level and low-level mupirocin resistance.
  • To identify the genetic determinants and clonal types associated with mupirocin resistance.

Main Methods:

  • Cross-sectional study of 648 S. aureus isolates over one year.
  • Minimum inhibitory concentration (MIC) determination for mupirocin resistance levels.
  • Polymerase chain reaction (PCR) for detecting resistance genes (e.g., mupA).
  • Genotyping using S. aureus protein A (spa) and staphylococcal cassette chromosome mec (SCCmec) typing.
  • Multilocus sequence typing (MLST) for clonal analysis.

Main Results:

  • 51 mupirocin-resistant S. aureus strains were identified.
  • 23 isolates (45.1%) showed high-level mupirocin resistance (HLMUPR), and 28 (54.9%) showed low-level mupirocin resistance (LLMUPR).
  • The mupA gene was detected in 25 isolates (49%).
  • Seven distinct clones were identified, with specific ST-SCCmec-spa combinations associated with HLMUPR and LLMUPR phenotypes.
  • Two strains with the mupA gene exhibited LLMUPR, and one HLMUPR strain was Vancomycin-intermediate S. aureus (VISA).

Conclusions:

  • The study identified key molecular characteristics and clonal lineages of mupirocin-resistant S. aureus in Iran.
  • The presence of the mupA gene and specific clones are associated with mupirocin resistance.
  • Epidemiological monitoring and routine mupirocin susceptibility testing are essential for controlling resistance in methicillin-resistant S. aureus (MRSA).

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