Antibiotic resistance and mecA gene characterization of Staphylococcus epidermidis isolated from some hospitals in Gaza strip

Alnajar, Mohanad Abd Alfattah; Abdelsalam, Shimaa M.; El Aila, Nabil A.; Ayesh, Basim M.; Fahd, Mona I.

doi:10.21608/jsrs.2020.129931

Antibiotic resistance and mecA gene characterization of Staphylococcus epidermidis isolated from some hospitals in Gaza strip

Document Type : Original Article

Authors

¹ Medical Sciences department, University Collage of Science and Technology, Gaza Strip, Palestine.

² Botany department, Faculty of Women for Arts, Sciences and Education, Ain Shams University, Cairo, Egypt.

³ Laboratory Medical Sciences department, Faculty of Medical Sciences, Al-Aqsa University, Gaza Strip, Palestine.

10.21608/jsrs.2020.129931

Abstract

Antibiotic resistance of S. epidermidis isolated from biological specimens is a global problem to public health. In this study a total of 256 S. epidermidis isolates (128 clinical isolates and 128 nasal isolates) from Gaza strip, Palestine were investigated. All isolates were tested for its antimicrobial susceptibilities and carriage of the mecAgene. Out of the 256 isolates, 184 (71.9%) were resistant to multiple antibiotics with all displaying increased susceptibility toward rifampicin (100%), doxycycline (98.4%) and vancomycin (98%). Ninety-six isolates (37.5%) were multidrug resistant (MDR) while, 99 isolates (38.7%) were mecApositive. A significant difference was demonstrated between clinical and nasal isolates. Clinical isolates were significantly more resistant for 8/12 tested antibiotics including resistance to cefoxitin (30μg) (p=0.000) and significantly (p=0.000) represents the MDR isolates while nasal isolates were significantly (p=0.000) sensitive for all tested antibiotics. No significant difference between the two groups in carrying mecA. We find that clinical isolates gain an extra-feature that qualify it to cause a disease and methicillin resistance (MR) was not mecA dependent in all MR isolates.

Keywords

References

[1] M. Brescó, L. Harris, K. Thompson, B. Stanic, M. Morgenstern, L. O’Mahony, R. Geoff, T. Moriarty, "Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection", Front Microbiol 8: (2017), https://doi.org/10.3389/fmicb.2017.01401.

[2] M. Eladli, N. Alharbi, J. Khaled, S. Kadaikunnan, A. Alobaidi, S. Alyahya, "Antibiotic-resistant Staphylococcus epidermidis isolated from patients and healthy students comparing with antibiotic-resistant bacteria isolated from pasteurized milk", Saudi Journal of Biological Sciences 26: (2019), https://doi.org/10.1016/j.sjbs.2018.05.008.

[3] A. Namvar, S. Bastarahang, N. Abbasi, G. Ghehi, S. Farhadbakhtiarian, P. Arezi, M. Hosseini S. Baravati, J. Zahra, S. Chermahin, "Clinical characteristics of Staphylococcus epidermidis: a systematic review", GMS Hyg Infect Control 9: (2014), https://doi.org/10.3205/dgkh000243.

[4] G. Choi, M. van den Borne, C. Visser, M. Kersten, A. Kater, "Invasive infections with a coagulase-negative Staphylococcus in an immunocompromised patient: case report and review of the literature", Ann Hematol 87: (2008), https://doi.org/10.1007/s00277-008-0476-x.

[5] M. Szemraj, T. Czekaj, J. Kalisz, E. Szewczyk, "Differences in distribution of MLS antibiotics resistance genes in clinical isolates of staphylococci belonging to species: Staphylococcus epidermidis, S. hominis, S. haemolyticus, S. simulans and S. warneri", BMC Microbiol 19: (2019), https://doi.org/10.1186/s12866-019-1496-5.

[6] K. Becker, C. Heilmann, G. Peters, "Coagulase-Negative Staphylococci", Clin Microbiol Rev 27: (2014), https://doi.org/10.1128/CMR.00109-13.

[7] L. Wang, J. Li, W. Ma, J. Li, "Drug resistance analysis of 1914 bacterial strains isolated from burn patients", Genet Mol Res 13: (2014), https://doi.org/10.4238/2014.January.22.10.

[8] J. Grace, B. Olayinka, J. Onaolapo, F. Hassan-Hanga, H. Munir, P. Fey, S. Obaro, Methicillin Resistance and Biofilm "Formation of Staphylococcus epidermidis in Blood Culture Isolates from Children under Five: A Multicenter Study in Nigeria", Clin Microbio 7: (2018), https://doi.org/10.4172/2327-5073.1000321.

[9] I. Loncaric, A. Tichy, S. Handler, M. Szostak, M. Tickert, M. Elschahawi, J. Spergser, F. Künzel "Prevalence of Methicillin-Resistant Staphylococcus sp. (MRS) in different companion animals and determination of risk factors for colonization with MRS", Antibiotics 8: (2019), https://doi.org/10.3390/antibiotics8020036.

[10] M. Fergestad, G. Stamsås, D. Angeles, Z. Salehian, Y. Wasteson, M. Kjos, "Penicillin‐binding protein PBP2a provides variable levels of protection toward different β‐lactams in Staphylococcus aureus RN4220" MicrobiologyOpen 9: (2020), https://doi.org/10.1002/mbo3.1057.

[11] T. Horan, M. Andrus, M. Dudeck, "CDC/NHSN surveillance definition of healthcare–associated infection and criteria for specific types of infections in the acute care setting", Am J Infect Control 36: (2008), https://doi.org/10.1016/j.ajic.2008.03.002.

[12] I. Līduma, T. Tračevska, U. Bērs, A. Žileviča, "Phenotypic and genetic analysis of biofilm formation by Staphylococcus epidermidis", Medicina (Kaunas, Lithuania) 48: (2012), https://doi.org/10.3390/medicina4806004.

[13] B. Hellmark, B. Söderquist, M. Unemo, Å. Nilsdotter-Augustinsson, "Comparison of Staphylococcus epidermidis isolated from prosthetic joint infections and commensal isolates in regard to antibiotic susceptibility, agr type, biofilm production, and epidemiology", Int J Med Microbiol 303: (2013), https://doi.org/10.1016/j.ijmm.2012.11.001.

[14] V. Salgueiro, N. Iorio, M. Ferreira, R. Chamon, K. dos Santos, "Methicillin resistance and virulence genes in invasive and nasal Staphylococcus epidermidis isolates from neonates", BMC Microbiol 17: (2017), https://doi.org/10.1186/s12866-017-0930-9.

[15] J. Waller, S. Hodel, A. Nuti, "Improvement of Two Toluidine Blue O-Mediated Techniques for DNase Detection", J Clin Microbiol 21: (1985), https://doi.org/10.1128/JCM.21.2.195-199.1985.

[16] J. Morello, P. Granato, M. Eckel, Laboratory Manual and Workbook in Microbiology; Applications to Patient Care, McGraw-Hill, (2003), USA.

[17] N. El Aila, N. Al Laham, B. Ayesh, "Nasal carriage of methicillin resistant Staphylococcus aureus among healthcare workers at Al Shifa hospital in Gaza strip", BMC Infect Dis 17: (2017), https://doi.org/10.1186/s12879-016-2139-1.

[18] E. Pereira, R. Schuenck, K. Malvar, N. Iorio, P. Matos, A. Olendzki, W. Oelemann, K. dos Santos, "Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus haemolyticus: methicillin-resistant isolates are detected directly in blood cultures by multiplex PCR", Microbiol Res 165: (2010), https://doi.org/10.1016/j.micres.2009.03.003.

[19] S. Havaei, A. Namvar, S. Moghim, A. Lari, "Evaluation of various staphylococcal cassette chromosome mec (SCCmec) types in Staphylococcus epidermidis invasive strains from hospitalized patients in Iran", Infez Med 23: (2015), PMID: 25819046.

[20] M. Al-Tamimi, J. Abu-Raideh, N. Himsawi, A. Khasawneh, H. Hawamdeh, "Methicillin and vancomycin resistance in coagulase-negative Staphylococci isolated from the nostrils of hospitalized patients", J Infect Dev Ctries 14: (2020), https://doi.org/10.3855/jidc.11025.

[21] Y. Guo, Y. Ding, L. Liu, X. Shen, Z. Hao, J. Duan, Y. Jin, Z. Chen, F. Yu, "Antimicrobial susceptibility, virulence determinants profiles and molecular characteristics of Staphylococcus epidermidis isolates in Wenzhou, eastern China", BMC Microbiol 19: (2019), https://doi.org/10.1186/s12866-019-1523-6.

[22] L. Salih, S. Tevell, E. Månsson, Å. Augustinsson, B. Hellmark, B. Söderquist, "Staphylococcus epidermidis isolates from nares and prosthetic joint infections are mupirocin susceptible", J Bone Jt Infect 3: (2018), https://doi.org/10.7150/jbji.22459.

[23] S. Peerayeh, A. Moghadas, M. Behmanesh, Antibiotic "Susceptibility and mecA Frequency in Staphylococcus epidermidis, Isolated from Intensive Care Unit Patients", Jundishapur J Microbiol 7: (2014), https://doi.org/10.5812/jjm.11188.

[24] R. Zhang, K. Eggleston, V. Rotimi, R. Zeckhauser, "Antibiotic resistance as a global threat: Evidence from China, Kuwait and the United States Global Health", 2: (2006), https://doi.org/10.1186/1744-8603-2-6.

[25] J. Stedt, J. Bonnedahl, J. Hernandez, B. McMahon, B. Hasan, B. Olsen, M. Drobni, J. Waldenstro¨m, "Antibiotic resistance patterns in Escherichia coli from gulls in nine European countries", Infect Ecol Epidemiol 4: (2014), http://dx.doi.org/10.3402/iee.v4.21565.

[26] A. Reta, A. Kifilie, A. Mengist, Bacterial Infections and Their "Antibiotic Resistance Pattern in Ethiopia: A Systematic Review", Advances in Preventive Medicine (2019), https://doi.org/10.1155/2019/4380309.

[27] R. Chabi, H. Momtaz, "Virulence factors and antibiotic resistance properties of the Staphylococcus epidermidis strains isolated from hospital infections in Ahvaz, Iran", Tropical Medicine and Health 47: (2019), https://doi.org/10.1186/s41182-019-0180-7.

[28] N. Venugopal, S. Mitra, R. Tewari, F. Ganaie, R. Shome, H. Rahman, B. Shome, "Molecular detection and typing of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci isolated from cattle, animal handlers, and their environment from Karnataka, Southern Province of India", Vet World 12: (2019), https://doi.org/10.14202/vetworld.2019.1760-1768.

[29] S. Ahrabi, L. Rahbarnia, A. Dehnad, B. Naghili, M. Agdam, A. Nazari, "Incidence of Oxacillin-Susceptible mecA-Positive Staphylococcus aureus (OS-MRSA) Isolates and TSST-1 Virulence Factor Among High School Students in Tabriz, Northwest of Iran", Arch Clin Infect Dis 14: (2019), https://doi.org/10.5812/archcid.85341.

[30] A. Klibi, A. Maaroufi, C. Torres, A. Jouini, "Detection and characterization of methicillin-resistant and susceptible coagulase-negative staphylococci in milk from cows with clinical mastitis in Tunisia", Int J Antimicrob Agents 52: (2018), https://doi.org/10.1016/j.ijantimicag.2018.07.026.

[31] M. Elhassan, H. Ozbak, H. Hemeg, M. Elmekki, L. Ahmed, "Absence of the mecA gene in methicillin resistant Staphylococcus aureus isolated from different clinical specimens in Shendi City, Sudan", BioMed Research International 2015: (2015), http://dx.doi.org/10.1155/2015/895860.

[32] A. Cikmana, M. Aydina, B. Gulhana, F. Karakecilic, M. Kurtoglud, S. Yuksekkayae, M. Parlakf, B. Gultepeg, A. Cicekh, F. Bilmani, I. Ciftcij, M. Karaa, S. Atmacak, T. Ozekinci, "Absence of the mecC gene in methicillin-resistant Staphylococcus aureus isolated from various clinical samples: The first multi-centered study in Turkey", J Infect Public Health 12: (2019), https://doi.org/10.1016/j.jiph.2019.01.063 .

[33] E. Pishva, S. Havaei, F. Arsalani, T. Narimani, A. Azimian, M. Akbari, "Detection of methicillin‑resistance gene in Staphylococcus epidermidis strains isolated from patients in Al‑Zahra Hospital using polymerase chain reaction and minimum inhibitory concentration methods", Adv Biomed Res 2: (2013), https://doi.org/10.4103/2277-9175.108008.