Resistance pattern to macrolides and tetracyclines and detection of ermA, ermB, emrC and mphc genes in clinical isolates of Staphylococcus aureus producing toxic shock syndrome toxin-1

authors:

avatar Hamed Tahmasebi , avatar Sanaz Dehbashi , avatar mohammad reza arabestani , *

Koomesh: Vol.21, issue 1; 188-194
published online: March 05, 2019
article type: Research Article
received: February 01, 2018
accepted: September 05, 2019

how to cite: Tahmasebi H, Dehbashi S, arabestani M R. Resistance pattern to macrolides and tetracyclines and detection of ermA, ermB, emrC and mphc genes in clinical isolates of Staphylococcus aureus producing toxic shock syndrome toxin-1. koomesh. 2019;21(1):e153056. 

Abstract

Introduction: The excessive use of Macrolide-Lincosamide-Streptogramin B (MLSB) to treat infections caused by Staphylococcus aureus (S. aureus,) the producer of toxic shock syndrome toxin-1 (TSST-1), can provide the basis for the emergence of resistant strains. The purpose of this study was to determine the pattern of antibiotic resistance to macrolides and tetracyclines and the genes involved in the occurrence of these resistance in S. aureus strains with TSST-1 toxin. Materials and Methods: In this descriptive cross-sectional study, 113 isolates of S. aureus were studied. Determination of pattern of resistance to macrolides and tetracyclines and different induction phenotypes was performed using disk diffusion method and D test. PCR was used to determine the presence of ermA, ermB, ermC, mphC and tsst gene. Results: Of 113 isolates of S. aureus, 13 isolates (11.5%) were phenotypic D and 11 isolates (9.7%) were a phenotype R. Based on the resistance to clindamycin-erythromycin, 69 isolates (61.66%) were identified as S-phenotype. Tetracycline-resistant isolates (59.29%) had the highest frequency, and isolates resistant to minosilicon, dithromycin and tritromycin had the lowest abundance. In addition, 16 isolates (15.14%) were tst gene, 15 isolates (13.27%) were ermA gene, 6 isolates (5.3%) were ermB gene, 14 isolates (12.38%) were genes ermC and 1 isolate (0.88%) were also carriers of the aphC gene. There was a significant relationship between S. aureus MLSB strains and tst gene presence (p≥0.05). Conclusion: Induced resistance to clindamycin and tetracycline had a significant relationship with the presence of tsst gene in S. aureus strains producing TSST-1 toxin.  

References

  • 1.

    Formosa-Dague C, Speziale P, Foster TJ, Geoghegan JA, Dufrene YF. Zinc-dependent mechanical properties of Staphylococcus aureus biofilm-forming surface protein SasG.Proc Natl Acad Sci U S A2016; 113: 410-415.

  • 2.

    Bokaiean M, Tahmasebi H, Shahraki Zahedani S, Adabi J. An investigation of toxic shock syndrome toxin-1 gene in methicillin-resistant clinical strains of staphylococcus aureus using multiplex PCR method. Qom Univ Med Sci J 2017; 11: 57-67. (Persian).

  • 3.

    Arabestani MR, Rastiany S, Mousavi SF, Ghafel S, Alikhani MY.Identification of toxic shock syndrom and exfoliative toxin genes of Staphylococcus aureus in carrier persons, resistant and susceptible methicillin. Tehran Univ Med J 2015; 73: 554-560. (Persian).

  • 4.

    Vafaee Mehr M, Alikhani M, Tahmasebi H, Arabestani M. Identification and determination of the relationship between ccr alleles and antibiotic resistance in clinical isolates of methicillin resistant staphylococcus aureus. J Babol Univ Med Sci 2017; 19: 28-35. (Persian).

  • 5.

    Adaleti R, Nakipoglu Y, Ceran N, Tasdemir C, Kaya F, Tasdemir S. Prevalence of phenotypic resistance of Staphylococcus aureus isolates to macrolide, lincosamide, streptogramin B, ketolid and linezolid antibiotics in Turkey. Braz J Infect Dis 2010; 14: 11-14.

  • 6.

    Kilany A. Inducible clindamycin resistance among clinical isolates of Staphylococcus aureus. Menoufia Med J 2016; 29: 228-233.

  • 7.

    Heydari N, Alikhani MY, Azizi Jalilian F, Tahmasebi H, Arabestani MR. Evaluation of real time PCR for detection of clinical isolates of Staphylococcus aureus and methicillin-resistance strains based on melting curve analysis method. Koomesh 2017; 19: 877-886. (Persian).

  • 8.

    Tahmasebi H, Bokaeian M. The study of pantone valentin leukocidin (PVL) gene in methicillin-resistant staphylococcus aureus isolated from blood and wound in Zahedan, Iran. Armaghane Danesh 2016; 21: 591-604. (Persian).

  • 9.

    Bahraminia F, Emadi SR, Emaneini M, Farzaneh N, Rad M, Khoramian B. A high prevalence of tylosin resistance among Staphylococcus aureus strains isolated from bovine mastitis. Vet Res Forum 2017; 8: 121-125.

  • 10.

    Teeraputon S, Santanirand P, Wongchai T, Songjang W, Lapsomthob N, Jaikrasun D, et al. Prevalence of methicillin resistance and macrolide-lincosamide-streptogramin B resistance in Staphylococcus haemolyticus among clinical strains at a tertiary-care hospital in Thailand. New Microbes New Infect 2017; 19: 28-33.

  • 11.

    Tahmasebi H, Zeiyni B, Dehbashi S, Motamedi H, Vafaeifar M, Keramat F, Arabestani MR. The study of blaZ and mecA gene expression in methicillin-resistant staphylococcus aureus strains and the relationship between the gene expression patterns. 2017; 2017: 6. (Persian).

  • 12.

    Saderi H, Emadi B, Owlia P. Phenotypic and genotypic study of macrolide, lincosamide and streptogramin B (MLS(B)) resistance in clinical isolates of Staphylococcus aureus in Tehran, Iran. Med Sci MonitorInt Med J Exp Clin Res 2011; 17: BR48-BR53. (Persian).

  • 13.

    Vallianou N, Evangelopoulos A, Hadjisoteriou M, Avlami A, Petrikkos G. Prevalence of macrolide, lincosamide, and streptogramin resistance among staphylococci in a tertiary care hospital in Athens, Greece. J Chemother 2015; 27: 319-323.

  • 14.

    Sedaghat H, Nasr Esfahani B, Mobasherizadeh S, Sallari Jazi A, Halaji M, Sadeghi P, et al. Phenotypic and genotypic characterization of macrolide resistance among Staphylococcus aureus isolates in Isfahan, Iran. 2017; 9: 7.(Persian).

  • 15.

    Martineau F, Picard FJ, Lansac N, Menard C, Roy PH, Ouellette M, Bergeron MG. Correlation between the resistance genotype determined by multiplex PCR assays and the antibiotic susceptibility patterns of Staphylococcus aureus and Staphylococcus epidermidis. Antimicrob Agents Chemother 2000; 44: 231-238.

  • 16.

    Abdal N, Ghaznavirad E, Hamidi A, Hosseini D. Prevalence of genes encoding aminoglycoside resistant in methicillin-sensitive Staphylococcus aurous and coagulase-negative staphylococci isolated from hospital infectious. Koomesh 2014; 16:82-89. (Persian).

  • 17.

    Lewis JS 2nd, Jorgensen JH. Inducible clindamycin resistance in Staphylococci: should clinicians and microbiologists be concerned? Clin Infect Dis 2005; 40: 280-285.

  • 18.

    Daurel C, Huet C, Dhalluin A, Bes M, Etienne J, Leclercq R. Differences in potential for selection of clindamycin-resistant mutants between inducible erm(A) and erm(C) Staphylococcus aureus genes. J Clin Microbiol 2008; 46: 546-550.

  • 19.

    Mahon, Connie R., Donald C Lehman, and George Manuselis. Textbook of Diagnostic Microbiology. 3rd ed. St. Louis, Mo.: Saunders Elsevier, 2007.

  • 20.

    Clinical and Laboratory Standards Institute. 2014. Performance standards for antimicrobial susceptibility testing; 24th informational supplement.CLSI M100-S24. Clinical and Laboratory Standards Institute, Wayne, PA.

  • 21.

    NCCLS. Performance standards for antimicrobial susceptibility testing: 12th informational supplement. NCCLS document M100S14. Wayne, PA: NCCLS, 2004.

  • 22.

    Lim JA, Kwon AR, Kim SK, Chong Y, Lee K, Choi EC. Prevalence of resistance to macrolide, lincosamide and streptogramin antibiotics in Gram-positive cocci isolated in a Korean hospital.J Antimicrob Chemother2002; 49: 489-495.

  • 23.

    Nada HA, Gomaa NIM, Elakhras A, Wasfy R, Baker RA. Skin colonization by superantigen-producing Staphylococcus aureus in Egyptian patients with atopic dermatitis and its relation to disease severity and serum interleukin-4 level. Int J Infect Dis 2012; 16: 29-33.

  • 24.

    Luthje P, Schwarz S. Antimicrobial resistance of coagulase-negative staphylococci from bovine subclinical mastitis with particular reference to macrolide-lincosamide resistance phenotypes and genotypes. J Antimicrob Chemother 2006; 57: 966-969.

  • 25.

    Parsonnet J, Hansmann MA, Seymour JL, Delaney ML, DuBois AM, Modern PA, et al. Persistence survey of Toxic Shock Syndrome toxin-1 producing Staphylococcus aureusand serum antibodies to this superantigen in five groups of menstruating women. BMC Infect Dis 2010; 10: 249.

  • 26.

    Gupta S, Laskar N, Kadouri DE. Evaluating the effect of oxygen concentrations on antibiotic sensitivity, growth, and biofilm formation of human pathogens.Microbiol Insights2016; 9: 37-46.

  • 27.

    Yang L, Wang K, Li H, Denstedt JD, Cadieux PA. The influence of urinary pH on antibiotic efficacy against bacterial uropathogens. Urology 2014; 84: 731.e1-7.

  • 28.

    Matsushima A, Kuroki Y, Nakajima S, Sakai T, Kojima H, Ueyama M. Low level of TSST-1 antibody in burn patients with toxic shock syndrome caused by methicillin-resistant staphylococcus aureus. J Burn Care Res 2015; 36: e120-124.

  • 29.

    Corredor Arias LF, Luligo Espinal JS, Moncayo Ortiz JI, Santacruz Ibarra JJ, lvarez Aldana A. Relationship between super antigenicity, antimicrobial resistance and origin of Staphylococcus aureus isolated. Colomb Med (Cali) 2016; 47: 15-20.

  • 30.

    Seyed javadi SS, Alebouyeh M, Nazem Alhosseini Mojarad E, Zali MR. Frequency of class 1 integron and multidrug resistance pattern among isolates of Staphylococcus aureus from hospitalized patients and environmental samples in an intensive care unit in Tahran, Iran. Koomesh 2014; 15:341-348.(Persian).##.