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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
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.
Abstract:
Few studies describe the molecular characterization of mupirocin resistance in Staphylococcus aureus strains. In this study, we evaluated the characteristics of mupirocin resistance in S. aureus isolates for 1-year period in Tehran, Iran. In a cross-sectional study, we collected 51 unique mupirocin-resistant strains obtained from 648 S. aureus isolates. High- and low-level resistance were determined by minimum inhibitory concentration with broth microdilution method. Presence of the genes for resistance to antibiotics and toxins was detected by polymerase chain reaction assays. Genotyping was performed by S. aureus protein A (spa) and staphylococcal cassette chromosome mec (SCCmec) typing, whereas clones were determined by multilocus sequence typing. Among mupirocin-resistant isolates, methicillin-resistant S. aureus (MRSA) 23 (45.1%) and 28 (54.9%) isolates were classified as high- and low-level mupirocin resistance, respectively. Among the 51 tested strains 25 (49%) isolates were positive for mupA genes. Seven different clones were detected in this study. High-level mupirocin-resistant (HLMUPR) strains belonged to ST8-SCCmec IV/t064 (n = 10, 19.6%), ST5-SCCmec IV/t002 (n = 5, 9.8%), ST8-SCCmec IV/t008 (n = 4, 7.8%), and ST239-SCCmec III/t631 (n = 4, 7.8%) clones, while low-level mupirocin-resistant (LLMUPR) strains belonged to ST22-SCCmec IV/t790 (n = 11, 21.6%), ST239-SCCmec III/t860 (n = 9, 17.7%), and ST15-SCCmec IV/t084 (n = 8, 15.7%) clones. Two strains belonged to ST22-SCCmec IV/t790 clone, despite carrying mupA gene, and demonstrated LLMUPR phenotype. One ST8-SCCmecIV/t008 strain with HLMUPR was confirmed as Vancomycin-intermediate S. aureus strain. Our data demonstrated the need for thorough epidemiological monitoring and a routine mupirocin testing program to prevent and detect mupirocin resistance in MRSA.
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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