Study of Prevalence and Characteristics of Staphylococcus aureus and CA-MRSA Nasal Colonization in 2-5 Years Old Children in Isfahan

Dibaj, Ramin; Shoaei, Parisa; ,; Daei nasser, Abbas; Shojaei, Hasan

year 8, Issue 3 (Fall 2014) Iran J Med Microbiol 2014, 8(3): 22-30 | Back to browse issues page

Mendeley

Zotero

RefWorks

Dibaj R, Shoaei P, Daei nasser A, Shojaei H. Study of Prevalence and Characteristics of Staphylococcus aureus and CA-MRSA Nasal Colonization in 2-5 Years Old Children in Isfahan. Iran J Med Microbiol 2014; 8 (3) :22-30
URL: http://ijmm.ir/article-1-342-en.html

Study of Prevalence and Characteristics of Staphylococcus aureus and CA-MRSA Nasal Colonization in 2-5 Years Old Children in Isfahan

Ramin Dibaj

, Parisa Shoaei

, Abbas Daei nasser

, Hasan Shojaei

1- Isfahan university of medical sciences , hasanshojaei@msn.com

Abstract: (14473 Views)

Background and Aim: We carried out a descriptive study to determine the extent of nasal colonization and characteristics of Staphylococcus aureus and CA-MRSA isolates in 2-5 year old children of day care centers in Isfahan.

Materials and Methods: The characteristics of isolates were determined using standard phenotypic profiles including colony morphology, Gram staining, catalase, hyaluronidase, coagulase and Dnase tests as well as mannitol fermentation. The MRSA detection was carried out according to CLSI guidelines with oxacillin agar screen test. Methicillin resistance was further confirmed by detection of a 310 bp fragment of mecA gene of MRSA by PCR. Drug susceptibility testing to antibiotics other than methicillin was conducted by disk diffusion. The Beta-lactamase production and inducible clindamycin resistance were also determined by performing the double-disc diffusion(D-test).

Results: Out of 323 children, 115 (35.6%) carried S. aureus and 11 (9.5%) carried MRSA. All MRSA strains were found to contain mecA gene. The susceptibility of strains to vancomycin, rifampicin and Linezolid were 100%. The susceptibility of strains to gentamicin, clindamycin, erythromycin, co-trimoxazole, amoxiclav, ciprofloxacin, tetracycline and penicillin were 99%, 97%, 94%, 94%, 93%, 88%, 44.4% and 1.8% respectively. Beta-lactamase production was seen in 19 (16.5%) of staphylococcal strains. Inducible clindamycin resistance was seen in 4 (3.5%) of the isolates.

Conclusions: Our data indicates that the spread of CA-MRSA within Iranian population is worthy of consideration and merits further molecular investigation to determine the source and mode of transmission.

Keywords: Beta-lactamase, inducible clindamycin resistance, methicillin resistant Staphylococcus aureus, mecA gene

Full-Text [PDF 583 kb] (4191 Downloads)

Type of Study: Original Research Article | Subject: Medical Bacteriology
Received: 2014/09/16 | Accepted: 2014/10/7 | ePublished: 2014/11/19

References

1. Hiramatsu K, Hanaki H, Ino T, Yabuta K, Oguri T, Tenover FC. Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J Antimicrob Chemother. 1997; 40:135-6. [DOI:10.1093/jac/40.1.135] [PMID]

2. Jevons MP. 'Celbenin'-resistant staphylococci. Br Med J. 1961; 1:124-5. [DOI:10.1136/bmj.1.5219.124-a] [PMCID]

3. Ito T, Katayama Y, Asada K. Structural comparison of three types of staphylococcal cassette chromosome mec in the chromosome of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2001; 45:1323-36. [DOI:10.1128/AAC.45.5.1323-1336.2001] [PMID] [PMCID]

4. Deresinski S. Methicillin-resistant Staphylococcus aureus: an evolutionary, epidemiologic, and therapeutic odyssey. Clin Infect Dis. 2005; 40:562-73. [DOI:10.1086/427701] [PMID]

5. Salgado CD, Farr BM, Calfee DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis. 2003; 36:131-9. [DOI:10.1086/345436] [PMID]

6. Diederen BM, Kluytmans JA. The emergence of infections with community-associated methicillin resistant Staphylococcus aureus. J Infect. 2006; 52(3):157-68. [DOI:10.1016/j.jinf.2005.09.001] [PMID]

7. Turnidge JD, Bell JM. Methicillin-resistant Staphylococcus aureus evolution in Australia over 35 years. Microb Drug Resist. 2000; 6:223-9. [DOI:10.1089/mdr.2000.6.223] [PMID]

8. Boyce JM. Are the epidemiology and microbiology of methicillin resistant Staphylococcus aureus changing? JAMA. 1998; 279:623-24. [DOI:10.1001/jama.279.8.623] [PMID]

9. Nickerson EK, Wuthiekanun V, Day NP, Chaowagul W, Peacock SJ. Meticillin-resistant Staphylococcus aureus in rural Asia. Lancet Infect Dis. 2006; 6(2):70-1. [DOI:10.1016/S1473-3099(06)70363-2]

10. Patricia T. Bailey & Scott's Diagnostic Microbiology. 13rd ed. St. Louis, Missouri: Mosby, Inc; 2013.

11. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement: M100-S24. CLSI, Wayne, PA, USA, 2014.

12. Brown DF, Edwards DI, Hawkey PM, Morrison D, Ridgway GL, Towner KJ, et al. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). J Antimicrob Chemother. 2005; 56(6):1000-18. [DOI:10.1093/jac/dki372] [PMID]

13. Pitcher D G, Saunders N A& Owen R J. Rapid extraction of bacterial genomic DNA with guanidium thiocyanate. Letters in Applied Microbiol. 1989; pp. 151-6. [DOI:10.1111/j.1472-765X.1989.tb00262.x]

14. Geha DJ, Uh JR, Gustaferro CA, Persing DH. Multiplex PCR for identification of methicillin-resistant staphylococci in the clinical laboratory. J Clin Microbiol. 1994; 32:1768-72. [DOI:10.1128/jcm.32.7.1768-1772.1994] [PMID] [PMCID]

15. Lowy FD. Staphylococcus aureus infections. N Engl J Med. 1998; 339(8):520-32. [DOI:10.1056/NEJM199808203390806] [PMID]

16. Archer GL. Staphylococcus aureus: a well-armed pathogen. Clin Infect Dis. 1998; 26(5):1179-81. [DOI:10.1086/520289] [PMID]

17. Donnio PY, Preney L, Gautier-Lerestif AL, Avril JL, Lafforgue N. Changes in staphylococcal cassette chromosome type and antibiotic resistance profile in methicillin-resistant Staphylococcus aureus isolates from a French hospital over an 11 year period. J Antimicrob Chemother. 2004; 53(5):808-13. [DOI:10.1093/jac/dkh185] [PMID]

18. Carleton HA, Diep BA, Charlebois ED, Sensabaugh GF, Perdreau-Remington F. Community-adapted methicillin-resistant Staphylococcus aureus (MRSA): population dynamics of an expanding community reservoir of MRSA. J Infect Dis. 2004; 190(10):1730-8. [DOI:10.1086/425019] [PMID]

19. Palavecino E. Community-acquired methicillin-resistant Staphylococcus aureus infections. Clin Lab Med. 2004; 24(2):403-18. [DOI:10.1016/j.cll.2004.03.007] [PMID]

20. Jonas D, Speck M, Daschner FD, Grundmann H. Rapid PCR-based identification of methicillin-resistant Staphylococcus aureus from screening swabs. J Clin Microbiol. 2002; 40(5):1821-3. [DOI:10.1128/JCM.40.5.1821-1823.2002] [PMID] [PMCID]

21. Siripornmongcolchai T, Chomvarin C, Chaicumpar K, Limpaiboon T, Wongkhum C. Evaluation of different primers for detecting mecA gene by PCR in comparison with phenotypic methods for discrimination of methicillin-resistant Staphylococcus aureus. Southeast Asian J Trop Med Public Health. 2002; 33(4):758-63.

22. Saderi H, Owlia P, Nadoushan MRJ. Difference in epidemiology and antibiotic susceptibility of methicillin resistant and methicillin susceptible Staphylococcus aureus isolates. IJCID. 2009; 4(4):219-23.

23. Frebourg NB, Nouet D, Lemée L, Martin E, Lemeland JF. Comparison of ATB staph, rapid ATB staph, Vitek, and E-test methods for detection of oxacillin hetero resistance in staphylococci possessing mecA. J Clin Microbiol. 1998; 36(1):52-7. [DOI:10.1128/JCM.36.1.52-57.1998] [PMID] [PMCID]

24. Kobayashi N, Wu H, Kojima K, Taniguchi K, Urasawa S, Uehara N, et al. Detection of mecA, femA, and femB genes in clinical strains of staphylococci using polymerase chain reaction. Epidemiol Infect. 1994; 113(2):259-66. [DOI:10.1017/S0950268800051682] [PMID] [PMCID]

25. Bignardi GE, Woodford N, Chapman A, Johnson AP, Speller DC. Detection of the mecA gene and phenotypic detection of resistance in Staphylococcus aureus isolates with borderline or low-level methicillinresistance. J Antimicrob Chemother. 1996; 37(1):53-63. [DOI:10.1093/jac/37.1.53] [PMID]

26. Moghadami M, Japoni A, Karimi A, Mardani M. Comparison of community and healthcare-associated MRSA in Iran. IJCID. 2010; 5(4):206-12.

27. Oguzkaya-Artan M, Baykan Z, Artan C. Nasal carriage of Staphylococcus aureus in healthy preschool children. Jpn J Infect Dis. 2008; 61(1):70-2.

28. Miller MB1, Weber DJ, Goodrich JS, Popowitch EB, Poe MD, Nyugen V, et al.Prevalence and risk factor analysis for methicillin resistant Staphylococcus aureus nasal colonization in children attending child care centers. J Clin Microbiol. 2011; 49:1041-47. [DOI:10.1128/JCM.02235-10] [PMID] [PMCID]

29. Hewlett AL, Falk PS, Hughes KS, Mayhall CG. Epidemiology of methicillin-resistant Staphylococcus aureus in university medical center day care facility. Infect Control Hosp Epidemiol. 2009; 30:985-92. [DOI:10.1086/605721] [PMID]

30. Lee J, Sung JY, Kim YM, Oh CE, Kim HB, Choi EH, et al. Molecular characterization of methicillin-resistant Staphylococcus aureus obtained from the anterior nares of healthy Korean children attending daycare centers. Int J Infect Dis. 2011; 15:558-63. [DOI:10.1016/j.ijid.2011.04.010] [PMID]

31. Ho PL, Chiu SS, Chan MY, Gan Y, Chow KH, Lai EL, et al. Molecular epidemiology and nasal carriage of Staphylococcus aureus and methicillin-resistant S. aureus among young children attending day care centers and

32. kindergartens in Hong Kong. J Infect. 2012; 64:500-6. [DOI:10.1016/j.jinf.2012.02.018] [PMID]

33. Blumental S, Deplano A, Jourdain S, De Mendonça R, Hallin M, Nonhoff C,et al. Dynamic pattern and genotypic diversity of Staphylococcus aureus nasopharyngeal carriage in healthy pre-school children. J Antimicrob

34. Chemother. 2013;68(7):1517-23.

35. Tavares DA, Sá-Leão R, Miragaia M, de Lencastre H. Large screening of CA-MRSA among Staphylococcus aureus colonizing healthy young children living in two areas (urban and rural) of Portugal. BMC Infect Dis. 2010; 10:110. [DOI:10.1186/1471-2334-10-110] [PMID] [PMCID]

36. Gardella N, Murzicato S, Di Gregorio S, Cuirolo A, Desse J, Crudo F,et al. Prevalence and characterization of methicillinresistant Staphylococcus aureus among healthy children in a city of Argentina. Infect Genet Evol.

37. 2011; 11:1066-71.

38. Rebollo-Pérez J, Ordoñez-Tapia C, Herazo-Herazo C, Reyes-Ramos N. Nasal carriage of Panton Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus in healthy preschool children. Rev Salud Publica (Bogota). 2011; 13:824-32. [DOI:10.1590/S0124-00642011000500011] [PMID]

39. Nickerson EK, Wuthiekanun V, Kumar V, Amornchai P, Wongdeethai N, Chheng K, et al. Emergence of community-associated methicillin resistant Staphylococcus aureus carriage in children in Cambodia. Am J Trop Med Hyg. 2011;84:313-17. [DOI:10.4269/ajtmh.2011.10-0300] [PMID] [PMCID]

40. Moyo SJ, Aboud S, Blomberg B, Mkopi N, Kasubi M, Manji K and et al. High nasal carriage of methicillin-resistant Staphylococcus aureus among healthy Tanzanian under-5 children.Microb Drug Resist. 2014; 20(1):82-8. [DOI:10.1089/mdr.2013.0016] [PMID]

41. Sedighi I, Jafari Moez H, Alikhani MY. Nasal Carriage of methicillin resistant Staphylococcus aureus and their antibiotic susceptibility patterns in children attending day-care centers. Acta Microbiol Immunol Hung 2011: 58; (3), 227-34. [DOI:10.1556/amicr.58.2011.3.6] [PMID]