Detection of Methicillin Resistance and Various Virulence Factors in Staphylococcus aureus Strains Isolated from Nasal Carriers

Yıl 2015, Cilt: 32 Sayı: 2, 171 - 175, 01.04.2015

Hatice Türk Dağı Duygu Fındık Gamze Demirel Uğur Arslan

Öz

Background: Staphylococus aureus can be found as a commensal on skin and nasal flora or it may cause local and invasive infections. S. aureus has a large number of virulence factors. Aims: To investigate the methicillin resistance and frequency of various virulence factors in S. aureus nasal isolates. Study Design: Descriptive study. Methods: Nasal samples collected from university students were cultured in media. S. aureus was identified by conventional methods and the Staphyloslide latex test (Becton Dickinson, Sparks, USA). Antibiotic susceptibility tests were conducted, and the methicillin resistance was determined. The mecA, nuc, pvl and staphylococcal toxin genes were examined by polymerase chain reaction (PCR). Results: S. aureus was isolated in 104 of 600 (17.3%) nasal samples. In total, 101 (97.1%) S. aureus isolates were methicillin-sensitive and the remaining 3 (2.9%) were methicillin-resistant. Furthermore, all but five isolates carried at least one staphylococcal enterotoxin gene, with seg being predominant. The tst and eta genes were determined in 29 (27.9%), and 3 (2.9%) isolates,  respectively. None of the S. aureus isolates harbored see, etb, and pvl genes. Conclusion: A moderate rate of S. aureus carriage and low frequency of MRSA were detected in healthy students. S. aureus isolates had a high prevalence of staphylococcal enterotoxin genes and the tst gene. In this study, a large number of virulence factors were examined in S. aureus nasal isolates, and the data obtained from this study can be used for monitoring the prevalence of virulence genes in S. aureus strains isolated from nasal carriers.

Anahtar Kelimeler

Methicillin resistance, Staphylococcus aureus, virulence factors

Kaynakça

• 1. Miller LG, Perdreau-Remington F, Rieg G, Mehdi S, Perlroth J, Bayer AS, et al. Necrotizing fasciitis caused by communityassociated methicillin-resistant Staphylococcus aureus in Los Angeles. N Engl J Med 2005;352:1445-53. [CrossRef]
• 2. Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 2005;5:751-62. [CrossRef]
• 3. van Belkum A, Verkaik NJ, de Vogel CP, Boelens HA, Verveer J, Nouwen JL, et al. Reclassification of Staphylococcus aureus nasal carriage types. J Infect Dis 2009;199:1820-6. [CrossRef]
• 4. von Eiff C, Becker K, Machka K, Stammer H, Peters G. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N Engl J Med 2001;344:11-6. [CrossRef]
• 5. Rebollo-Perez J, Ordonez-Tapia S, Herazo-Herazo C, ReyesRamos N. Nasal carriage of Panton Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus in healthy preschool children. Rev Salud Publica (Bogota) 2011;13:824- 32. [CrossRef]
• 6. Bloomfield SF, Cookson BD, Falkiner FR, Griffith C, Cleary V. Methicillin-resistant Staphylococcus aureus, Clostridium difficile, and extended-spectrum β-lactamase-producing Escherichia coli in the community: assessing the problem and controlling the spread. Am J Infect Control 2007;35:86-8. [CrossRef]
• 7. Sakwinska O, Kuhn G, Balmelli C, Francioli P, Giddey M, Perreten V, et al. Genetic diversity and ecological success ofcolonizing Staphylococcus aureus. Appl Environ Microbiol 2009;75:175-83. [CrossRef]
• 8. Mertz D, Frei R, Periat N, Zimmerli M, Battegay M, Flückiger U, et al. Exclusive Staphylococcus aureus throat carriage: at-risk populations. Arch Intern Med 2009;169:172-8. [CrossRef]
• 9. Ben Slama K, Gharsa H, Klibi N, Jouini A, Lozano C, GómezSanz E, et al. Nasal carriage of Staphylococcus aureus in healthy humans with different levels of contact with animals in Tunisia: genetic lineages, methicillin resistance, and virulence factors. Eur J Clin Microbiol Infect Dis 2011;30:499-508. [CrossRef]
• 10. Jarraud S, Mougel C, Thioulouse J, Lina G, Meugnier H, Forey F, et al. Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease. Infect Immun 2002;70:631-41. [CrossRef]
• 11. Nhan TX, Leclercq R, Cattoir V. Prevalence of toxin genes in consecutive clinical isolates of Staphylococcus aureus and clinical impact. Eur J Clin Microbiol Infect Dis 2011;30:719-25. [CrossRef]
• 12. Xu SX, McCormick JK. Staphylococcal superantigens in colonization and disease. Front Cell Infect Microbiol 2012;2:52. [CrossRef]
• 13. Clinical and Laboratory Standards Institute (CLSI). 2011. Performance standards for antimicrobial susceptibility testing. Twenty-first informational supplement, M100-S21, National Committee for Clinical Laboratory Standards, Wayne PA.
• 14. Oliveira DC, De Lencastre H. Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2002;46:2155-61. [CrossRef]
• 15. Kim CH, Khan M, Morin DE, Hurley WL, Tripathy DN, Kehrli Jr M, et al. Optimization of the PCR for detection of Staphylococcus aureus nuc gene in bovine milk. J Dairy Sci 2001;84:74- 83. [CrossRef]
• 16. Lina G, Piemont Y, Godail-Gamot F, Bes M, Peter MO, Gauduchon V, et al. Involvement of Panton-Valentine leukocidinproducing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 1999;29:1128-32. [CrossRef]
• 17. Monday SR, Bohach, GA. Use of multiplex PCR to detect classical and newly described pyrogenic toxin genes in staphylococcal isolates. J Clin Microbiol 1999;37:3411-4.
• 18. Sila J, Sauer P, Kolar M. Comparison of the prevalence of genes coding for enterotoxins, exfoliatins, Panton-Valentine leukocidin and tsst-1 between methicillin-resistant and methicillin-susceptible isolates of Staphylococcus aureus at the university hospital in Olomouc. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2009;153:215-8. [CrossRef]
• 19. Manious AG, Hueston WJ, Everett CJ, Diaz VA. Nasal carriage of Staphylococcus aureus and methicillin-resistant S. aureus in the United States, 2001-2002. Ann Fam Med 2006;4:132-7. [CrossRef]
• 20. Zanelli G, Sansoni A, Zanchi A, Cresti S, Pollini S, Rossolini GM, et al. Staphylococcus aureus nasal carriage in the community: A survey from central Italy. Epidemiol Infect 2002;129:417-20. [CrossRef]
• 21. Kiliç A, Mert G, Senses Z, Bedir O, Aydogan H, Basustaoglu AC, Appelbaum PC. Molecular characterization of methicillin resistant Staphylococcus aureus nasal isolates from Turkey. Antonie Van Leeuwenhoek 2008;94:615-9. [CrossRef]
• 22. Adhikari RP, Ajao AO, Aman MJ, Karauzum H, Sarwar J, Lydecker AD, et al. Lower antibody levels to Staphylococcus aureus exotoxins are associated with sepsis in hospitalized adults with invasive S. aureus infections. J Infect Dis 2012;206:915-23. [CrossRef]
• 23. Dinic M, Vukovic S, Kocic B, Stankovic Dordevic D, Bogdanovic M. Nasal carriage of Staphylococcus aureus in healthy adults and in school children. Acta Fac Med Naiss 2013;30:31-6.
• 24. DeLeo FR, Diep BA, Otto M. Host defense and pathogenesis in Staphylococcus aureus infections. Infect Dis Clin North Am 2009;23:17-34. [CrossRef]
• 25. Lozano C, Gomez-Sanz E, Benito D, Aspiroz C, Zarazaga M, Torres C. Staphylococcus aureus nasal carriage, virulence traits, antibiotic resistance mechanisms, and genetic lineages in healthy humans in Spain, with detection of CC398 and CC97 strains. Int J Med Microbiol 2011;301:500-5. [CrossRef]
• 26. Duman Y, Tekeroğlu MS, Otlu B. Investigation of the Presence of Panton-Valentine Leukocidin and Clonal Relationship of Community- and Hospital-Acquired Clinical Isolates of Staphylococcus aureus. Mikrobiyol Bul 2013;47:389-400. [CrossRef]
• 27. Pinchuk IV, Beswick EJ, Reyes VE. Staphylococcal enterotoxins. Toxins (Basel) 2010;2:2177-97. [CrossRef]
• 28. Yılmaz S, Kılıç A, Karagöz A, Bedir O, Uskudar Guclu A, Başustaoglu AC. Investigation of various virulence factors among the hospital and community-acquired Staphylococcus aureus isolates by real-time PCR method. Mikrobiyol Bul 2012;46:532-45.
• 29. Becker K, Friedrich AW, Lubritz G, Weilert M, Peters G, Von Eiff C. Prevalence of genes encoding pyrogenic toxin superantigens and exfoliative toxins among strains of Staphylococcus aureus isolated from blood and nasal specimens. J Clin Microbiol 2003;41:1434-9. [CrossRef]
• 30. Shukla SK, Karow ME, Brady JM, Stemper ME, Kislow J, Moore N, et al. Virulence genes and genotypic associations in nasal carriage, community-associated methicillin susceptible and methicillin-resistant USA400 Staphylococcus aureus isolates. J Clin Microbiol 2010;48:3582-92. [CrossRef]
• 31. Schaumburg F, Ateba Ngoa U, Kösters K, Köck R, Adegnika AA, Kremsner PG. Virulence factors and genotypes of Staphylococcus aureus from infection and carriage in Gabon. Clin Microbiol Infect 2011;17:1507-13. [CrossRef]
• 32. Megevand C, Gervaix A, Heininger U, Berger C, Aebi C, Vaudaux B, et al. Molecular epidemiology of the nasal colonization by methicillin-susceptible Staphylococcus aureus in Swiss children. Clin Microbiol Infect 2010;16:1414-20. [CrossRef]
• 33. Balci DD, Duran N, Ozer B, Gunesacar R, Onlen Y, Yenin JZ. High prevalence of Staphylococcus aureus cultivation and superantigen production in patients with psoriasis. Eur J Dermatol 2009;19:238-42.