Evaluation of Antibiotic Susceptibility Pattern and Distribution of coa Genes in Coagulase-negative S. aureus from Ahvaz, Iran

Author(s): Saeed Shahmohammadi, Ahmad Farajzadeh Sheikh*, Mojtaba Shahin, Iman Mir.

Journal Name: Infectious Disorders - Drug Targets
(Formerly Current Drug Targets - Infectious Disorders)

Volume 19 , Issue 4 , 2019

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Graphical Abstract:


Background: Staphylococcus aureus is one of the important causes of clinical infections that can be more destructive by its antibiotic resistant strains.

Objective: This study aimed to determine the antibiotic susceptibility pattern and distribution of mecA and coa genes in clinical isolates of S. aureus.

Methods: Two hundred seventy-three specimens suspected to S. aureus were taken from hospitals of Ahvaz, southwest of Iran. Isolates were identified by standard microbiologic tests and confirmed by the molecular method. Antimicrobial susceptibility testing was carried out by disk diffusion method. The presence of mecA and coa genes was determined by PCR method.

Results: Of a total of 200 isolates which were tested for coagulase tube test, 143 (71.5%) showed coagulase positive, and 57 (28.5%) showed a coagulase-negative reaction. Antibacterial susceptibility pattern of 200 S. aureus isolates showed the highest and lowest susceptibility rate to linezolid (98%) and ciprofloxacin (42%), respectively. The prevalence of methicillin-resistant S. aureus (MRSA) by detection of mecA gene was estimated as 47.5 % (95/200), of which the rate of MRSA in coagulase positive and negative isolates was 35% (50/143), and 65% (45/57), respectively. Meanwhile, coa gene was detected in 100% of coagulase positive and 28.1% of coagulasenegative isolates.

Conclusion: The results of this study showed that the number of atypical CNSA in our area is high. Since the coagulase test is an essential test for diagnosis of S. aureus, our findings regarding the emergence of CNSA are a warning about the misdiagnosis and selection of appropriate treatment approach for S. aureus isolates.

Keywords: Staphylococcus aureus, antibiotic resistance, Coagulase, MRSA, pathogens, fibrin.

Motamedifar, M.; Ebrahim-Saraie, H.S.; Alfatemi, S.M.; Zalipour, M.; Kaveh, M.; Khoshkharam-Roodmajani, H. Frequency of the toxic shock syndrome toxin-1 gene in methicillin-susceptible and -resistant Staphylococcus aureus isolates from teaching hospitals in Shiraz, Iran. Rev. Soc. Bras. Med. Trop., 2015, 48(1), 90-93.
[http://dx.doi.org/10.1590/0037-8682-0142-2014] [PMID: 25860471]
Karimi, M.; Esfahani, B.N.; Halaji, M.; Mobasherizadeh, S.; Shahin, M.; Havaei, S.R.; Shokri, D.; Havaei, S.A. Molecular characteristics and antibiotic resistance pattern of Staphylococcus aureus nasal carriage in tertiary care hospitals of Isfahan, Iran. Infez. Med., 2017, 25(3), 234-240.
[PMID: 28956540]
Ebrahim-Saraie, H.S.; Motamedifar, M.; Sarvari, J.; Hoseini Alfatemi, S.M. Emergence of SCCmec Type I Obtained From Clinical Samples in Shiraz Teaching Hospitals, South-West of Iran. Jundishapur J. Microbiol., 2015, 8(6)e16998
[http://dx.doi.org/10.5812/jjm.16998v2] [PMID: 26322200]
Roberson, J.R.; Fox, L.K.; Hancock, D.D.; Besser, T.E. Evaluation of methods for differentiation of coagulase-positive staphylococci. J. Clin. Microbiol., 1992, 30(12), 3217-3219.
[PMID: 1452705]
McAdow, M.; Missiakas, D.M.; Schneewind, O. Staphylococcus aureus secretes coagulase and von Willebrand factor binding protein to modify the coagulation cascade and establish host infections. J. Innate Immun., 2012, 4(2), 141-148.
[http://dx.doi.org/10.1159/000333447] [PMID: 22222316]
Havaei, S.A.; Halaji, M.; Vidovic, S.; Dillon, J.A.R.; Karbalaei, M.; Ghanbari, F. Prevalence and genotyping of methicillin-resistant and-susceptible Staphylococcus aureus strains isolated from patients in a university hospital, Isfahan, Iran. Jundishapur J. Microbiol, 2017. 10(5), [e13571].
Halaji, M.; Karimi, A.; Shoaei, P.; Nahaei, M.; Khorvash, F.; Ataei, B.; Yaran, M.; Havaei, S.A. Distribution of SCCmec Elements and Presence of Panton-Valentine Leukocidin in Methicillin-Resistant Staphylococcusepidermidis Isolated from Clinical Samples in a University Hospital of Isfahan City, Iran. J. Clin. Diagn. Res., 2017, 11(7), DC27-DC31.
[PMID: 28892893]
Wayne, P. Performance Standards for Antimicrobial Susceptibility Testing. Clinical and Laboratory Standards Institute; CLSI, 2016.
Pu, W.; Su, Y.; Li, J.; Li, C.; Yang, Z.; Deng, H.; Ni, C. High incidence of oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) associated with bovine mastitis in China. PLoS One, 2014, 9(2)e88134
[http://dx.doi.org/10.1371/journal.pone.0088134] [PMID: 24523877]
Momtaz, H.; Tajbakhsh, E.; Rahimi, E.; Momeni, M. Coagulase gene polymorphism of Staphylococcus aureus isolated from clinical and sub-clinical bovine mastitis in Isfahan and Chaharmahal va Bakhtiari provinces of Iran. Comp. Clin. Pathol., 2011, 20(5), 519-522.
[http://dx.doi.org/10.1007/s00580-010-1029-y] [PMID: 21949498]
Adwan, K. Fast DNA isolation and PCR protocols for detection of methicillin-resistant staphylococci. Folia Microbiol. (Praha), 2014, 59(1), 5-8.
[http://dx.doi.org/10.1007/s12223-013-0259-1] [PMID: 23715895]
Kateete, D.P.; Kimani, C.N.; Katabazi, F.A.; Okeng, A.; Okee, M.S.; Nanteza, A.; Joloba, M.L.; Najjuka, F.C. Identification of Staphylococcus aureus: DNase and Mannitol salt agar improve the efficiency of the tube coagulase test. Ann. Clin. Microbiol. Antimicrob., 2010, 9, 23.
[http://dx.doi.org/10.1186/1476-0711-9-23] [PMID: 20707914]
Shuttleworth, R.; Colby, W.D. Staphylococcus lugdunensis endocarditis. J. Clin. Microbiol., 1992, 30(8), 1948-1952.
[PMID: 1500497]
Hébert, G.A. Hemolysins and other characteristics that help differentiate and biotype Staphylococcus lugdunensis and Staphylococcus schleiferi. J. Clin. Microbiol., 1990, 28(11), 2425-2431.
[PMID: 2254418]
Schnitzler, N.; Meilicke, R.; Conrads, G.; Frank, D.; Haase, G. Staphylococcus lugdunensis: report of a case of peritonitis and an easy-to-perform screening strategy. J. Clin. Microbiol., 1998, 36(3), 812-813.
[PMID: 9508319]
Emslie, K.R.; Townsend, D.E.; Grubb, W.B. A resistance determinant to nucleic acid-binding compounds in methicillin-resistant Staphylococcus aureus. J. Med. Microbiol., 1985, 20(2), 139-145.
[http://dx.doi.org/10.1099/00222615-20-2-139] [PMID: 3850128]
Udo, E.E.; Grubb, W.B. Genetic analysis of methicillin-resistant Staphylococcus aureus from a Nigerian hospital. J. Med. Microbiol., 1993, 38(3), 203-208.
[http://dx.doi.org/10.1099/00222615-38-3-203] [PMID: 8095986]
Al Obaid, I.A.; Udo, E.E.; Jacob, L.E.; Johny, M. Isolation and Characterization of Coagulase-Negative Methicillin-Resistant Staphylococcus aureus from Patients in an Intensive Care Unit. Med. Princ. Pract., 1999, 8, 230-236.
Fung, J.C.; Kaplan, M.H.; Hsieh, H.C.; Stephens, A.; Tyburski, M.B.; Tenenbaum, M.J. Two coagulase-variant forms of Staphylococcus aureus isolated from blood cultures. J. Clin. Microbiol., 1984, 20(1), 115-117.
[PMID: 6746882]
Wanger, A.R.; Morris, S.L.; Ericsson, C.; Singh, K.V.; LaRocco, M.T. Latex agglutination-negative methicillin-resistant Staphylococcus aureus recovered from neonates: epidemiologic features and comparison of typing methods. J. Clin. Microbiol., 1992, 30(10), 2583-2588.
[PMID: 1400957]
Mackay, A.D.; Quick, A.; Gillespie, S.H.; Kibbler, C.C. Coagulase-negative methicillin-resistant Staphylococcus aureus infection. Lancet, 1993, 342(8869), 492.
[http://dx.doi.org/10.1016/0140-6736(93)91615-S] [PMID: 8102442]
Musher, D.M.; Baughn, R.E.; Templeton, G.B.; Minuth, J.N. Emergence of variant forms of Staphylococcus aureus after exposure to gentamicin and infectivity of the variants in experimental animals. J. Infect. Dis., 1977, 136(3), 360-369.
[http://dx.doi.org/10.1093/infdis/136.3.360] [PMID: 903674]
Vandenesch, F.; Lebeau, C.; Bes, M.; McDevitt, D.; Greenland, T.; Novick, R.P.; Etienne, J. Coagulase deficiency in clinical isolates of Staphylococcus aureus involves both transcriptional and post-transcriptional defects. J. Med. Microbiol., 1994, 40(5), 344-349.
[http://dx.doi.org/10.1099/00222615-40-5-344] [PMID: 8176721]
Moshtagheian, S.; Halaji, M.; Sedaghat, H.; Shahin, M.; Esfahani, B.N.; Havaei, S.R.; Havaei, S.A. Molecular characteristics of methicillin-resistant Staphylococcus aureus nasal carriage from hospitalized patients and medical staff in Isfahan, Iran. Ann. Ig., 2018, 30(3), 237-244.
[PMID: 29670993]
Sedaghat, H.; Esfahani, B.N.; Halaji, M.; Jazi, A.S.; Mobasherizadeh, S.; Havaei, S.R.; Emaneini, M.; Havaei, S.A. Genetic diversity of Staphylococcus aureus strains from a teaching hospital in Isfahan, Iran: The emergence of MRSA ST639- SCCmec III and ST343- SCCmec III. Iran. J. Microbiol., 2018, 10(2), 82-89.
[PMID: 29997747]
Sedaghat, H.; Esfahani, B.N.; Mobasherizadeh, S.; Jazi, A.S.; Halaji, M.; Sadeghi, P.; Emaneini, M.; Havaei, S.A. Phenotypic and genotypic characterization of macrolide resistance among Staphylococcus aureus isolates in Isfahan, Iran. Iran. J. Microbiol., 2017, 9(5), 264-270.
[PMID: 29296270]
Isik, A.; Firat, D.; Yilmaz, I.; Peker, K.; Idiz, O.; Yilmaz, B. A survey of current approaches to thyroid nodules and thyroid operations. International Journal of Surgery (London, England), 2018, 54, 100-104.

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Year: 2019
Page: [383 - 387]
Pages: 5
DOI: 10.2174/1871526518666180816101629
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