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CORRESPONDENCE
Year : 2011  |  Volume : 29  |  Issue : 3  |  Page : 318-319
 

Antibiotic resistance and molecular subtypes of clinical methicillin-resistant Staphylococcus aureus in a teaching hospital


Departments of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan; Department of Biostatic, School of Health, Kashan University of Medical Sciences, Kashan, Iran

Date of Submission14-Mar-2011
Date of Acceptance13-Jun-2011
Date of Web Publication17-Aug-2011

Correspondence Address:
R Moniri
Departments of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, Kashan; Department of Biostatic, School of Health, Kashan University of Medical Sciences, Kashan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.83926

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How to cite this article:
Zeinali E, Moniri R, Musavi G H. Antibiotic resistance and molecular subtypes of clinical methicillin-resistant Staphylococcus aureus in a teaching hospital. Indian J Med Microbiol 2011;29:318-9

How to cite this URL:
Zeinali E, Moniri R, Musavi G H. Antibiotic resistance and molecular subtypes of clinical methicillin-resistant Staphylococcus aureus in a teaching hospital. Indian J Med Microbiol [serial online] 2011 [cited 2019 Jun 24];29:318-9. Available from: http://www.ijmm.org/text.asp?2011/29/3/318/83926


Dear Editor,

Emergence of multi-drug resistant methicillin resistant Staphylococcus aureus (MDR-MRSA) has profoundly affected the choice of empirical treatment for staphylococcal infection. This descriptive study was done on 87 MRSA isolates which were collected from the clinical samples of patients from a tertiary teaching hospital in Kashan, Iran, in 2010. The isolates were tested for antibiotic resistance by the disc diffusion method for 10 antimicrobials. The MRSA genotypes were determined by a multiplex polymerase chain reaction (PCR) based on the staphylococcal cassette chromosome mec (SCCmec).

All the isolates remained susceptible to vancomycin and low resistance rates were noted for amikacin (13.8%). Three (3.4%) of MRSA strains were SCCmec type I, 12 (13.8%) SCCmec type II, 8 (9.2%) SCCmec type IVb, 4 (4.6%) SCCmec type IVd and 3 (3.4%) SCCmec type V. Interestingly, there was also a high frequency of non-typeable strains 51 (58.6%) as they did not show any characteristic bands.

The resistance rates of the isolates to 10 antimicrobial agents are summarised in [Table 1]. The SCCmec type II is harboured by hospital acquired MRSA (HA-MRSA) and usually presents multi-drug resistant MRSA strains. [1] Other studies reported a higher prevalence of SCCmec type II in MRSA isolates. [2] No SCCmec type III element was detected in the MRSA isolates in this study in contrast to other reports of SCCmec type III (HA-MRSA) prevalence from 14 to 52%. [3],[4]
Table 1: The resistance rates of the 87 MRSA isolates to 10 antimicrobial agents

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The second most common type was SCCmec type IVb which were all sensitive to amikacin but showed high resistance rates to erythromycin, clindamycin, tetracycline and sulfamethoxazole-trimethoprim. CA-MRSA is typically characterised by the presence of SCCmec IV, V or VII which is susceptible to non-β-lactams.[5]

In conclusion, all MRSA isolates from the teaching hospital were multi-drug-resistant, and SCCmec type II and type IV predominated. Effective hospital control practices need to be reinforced to avoid transmission of multi-drug resistant organisms.

 
 ~ References Top

1.File TM. Methicillin-resistant Staphylococcus aureus (MRSA): Focus on community-associated MRSA. South Afr J Epidemiol Infect 2008;23:13-5.  Back to cited text no. 1
    
2.Kilic A, Haijing L, Stratton C. Antimicrobial susceptibility patterns and Staphylococcal cassette chromosome mec types of, as well a Panton-Valentine leukocidin occurrence among, methicillin-resistant Staphylococcus aureus isolates from children and adults in middle Tennessee. J Clin Microbiol 2006;44:4436-40.  Back to cited text no. 2
    
3.Machado AB, Reiter KC, Paiva RM. Distribution of staphylococcal cassette chromosome mec (SCCmec) types I, II, III and IV in coagulase-negative staphylococci from patients attending a tertiary hospital in southern Brazil. J Med Microbiol 2007;56:1328-33.  Back to cited text no. 3
    
4.Makgotlho PE, Kock MM, Hoosen A, Lekalakala R, Omar S, Dove M, et al. Molecular identification and genotyping of MRSA isolates. FEMS Immunol Med Microbiol 2009;57:104- 15.  Back to cited text no. 4
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5.Takano T, Higuchi W, Otsuka T, Baranovich T, Enany S, Saito K, et al. Novel characteristics of community-acquired methicillin-resistant Staphylococcus aureus belonging to multilocus sequence type 59 in Taiwan. Antimicrob Agents Chemother 2008;52:837-45.  Back to cited text no. 5
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