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Co-colonization of methicillin-resistant Staphylococcus aureus and Candida spp. in children with malignancies

Raziyeh Baharvand1, Fatemeh Fallah2, Parvaneh Jafari3

  • 1Department of Microbiology, Faculty of Science, Islamic Azad University, Arak branch, Arak, Iran.

AMB Express
|February 13, 2024
PubMed

Insights

Oral co-colonization of methicillin-resistant Staphylococcus aureus (MRSA) and Candida species in children undergoing chemotherapy increases the expression of key virulence genes. This suggests Candida may facilitate MRSA infections, potentially leading to systemic complications.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Pediatric Oncology

Background:

  • Children undergoing chemotherapy are susceptible to opportunistic infections.
  • Polymicrobial interactions, particularly involving Staphylococcus aureus and Candida species, are increasingly recognized in clinical settings.
  • The oral cavity serves as a reservoir for pathogens, and co-colonization can alter virulence factor expression.

Purpose of the Study:

  • To investigate the interaction between methicillin-resistant Staphylococcus aureus (MRSA) and Candida species in the oral cavity of pediatric cancer patients.
  • To evaluate the expression levels of the mecA gene in MRSA and the Als3p gene in Candida species under single and co-colonization conditions.
  • To determine if Candida species facilitate MRSA colonization or infection in this vulnerable population.

Main Methods:

  • Collection of oral and nasal samples from pediatric patients undergoing chemotherapy using sterile sponge swabs.
  • Confirmation of MRSA and Candida species using Polymerase Chain Reaction (PCR) targeting the mecA and Als3p genes, respectively.
  • Quantitative real-time PCR (SYBR Green-based) to measure the relative expression levels of mecA and Als3p genes in both single and co-colonization scenarios.

Main Results:

  • Staphylococcus aureus was detected in 14.1% of samples, with MRSA accounting for 58.3% of oral isolates.
  • Candida albicans was the most frequent Candida species (16.5%).
  • Oral co-colonization of MRSA and Candida species occurred in 4.7% of patients. Gene expression analysis revealed a significant upregulation: mecA expression increased sixfold and Als3p expression increased twofold in co-colonization compared to single colonization.

Conclusions:

  • The study highlights the clinical significance of polymicrobial infections in immunocompromised children.
  • Candida species may play a role in facilitating Staphylococcus aureus infections, potentially increasing the risk of systemic disease in co-colonized patients.
  • Monitoring and understanding these microbial interactions are crucial for managing infections in pediatric oncology patients.
Keywords:
Candida Spp.ChildrenIranMalignancyMethicillin-resistant Staphylococcus aureusStaphylococcus aureus

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