Inducible Clindamycin Resistance in Staphylococcus aureus Isolates in Kermanshah, Iran

Journal of Clinical Research in Paramedical Sciences Pub Date : 2024-01-12 DOI:10.5812/jcrps-143681

Zahra Jahanbakhshi, J. Nowroozi, Zahra Kahrarian, Azin Tariniya Gilani, Mohadeseh Ahmadvand, N. Sohrabi

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Abstract

Background: Staphylococcus aureus is the most common agent of nosocomial infections. Macrolide Lincosamide-Streptogramin B (MLSB) antibiotics are the therapeutic choices for treatment of infections due to methicillin resistant S. aureus (MRSA) isolates. The most frequent mechanism for inducible resistance in S. aureus is modification in target site by erm (erythromycin ribosome methylase) genes. Objectives: The aim of this research was to determine inducible MLSB (iMLSB) and detection the erm genes in clinical samples of S. aureus isolated from hospitalized patients in the Imam Reza hospital of Kermanshah, west of Iran. Methods: This study performed on 126 samples of S. aureus. Identification of isolates were performed using microbiological and biochemical procedures. Inducible resistance to clindamycin was tested by D-test. The prevalence of genes, such as femB, mecA, ermA and ermB was assessed by polymerase chain reaction (PCR). Results: Eighty-three cases (65.9%) of isolates were methicillin resistant S. aureus (MRSA). The resistance rate against erythromycin and clindamycin was 67.4% and 52.2%, respectively. Totally, 49 cases (38.9%) of isolates were resistant to both erythromycin and clindamycin indicating constitutive MLSB phenotype (cMLSB); 20 cases (15.9%) isolates showed positive D test indicating inducible MLSB phenotype (iMLSB), while 16 cases (12.7%) were negative for D test indicating MS phenotype. Among 20 cases with iMLSB phenotype, ermC and ermA genes were showed in 7 cases (35%) and 4 cases (20%) isolates, respectively. The ermB gene is not detected in any cases and 9 cases (45%) isolates did not have any erm genes. Conclusions: In general, findings of this study showed high frequency of resistance to clindamycin and erythromycin among S. aureus isolates and cMLSB to be the most pattern phenotype and ermC gene is the most common gene in iMLSB phenotype. Because variation of antimicrobial resistance pattern in geographic regions obtaining local results is useful for detecting and more appropriate control of nosocomial infection due to S. aureus isolates.

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伊朗克尔曼沙赫的金黄色葡萄球菌对克林霉素的诱导性抗药性

背景：金黄色葡萄球菌是最常见的院内感染病原体。大环内酯类林可霉素-链霉亲和素 B（MLSB）抗生素是治疗耐甲氧西林金黄色葡萄球菌（MRSA）感染的首选药物。诱导金黄色葡萄球菌产生耐药性的最常见机制是红霉素核糖体甲基化酶（erm）基因对目标位点的修饰。研究目的本研究旨在确定诱导性 MLSB（iMLSB），并检测从伊朗西部克尔曼沙伊玛目礼萨医院住院患者中分离的金黄色葡萄球菌临床样本中的 erm 基因。方法：本研究对 126 份金黄色葡萄球菌样本进行了检测。采用微生物学和生物化学方法对分离菌进行鉴定。对克林霉素的诱导耐药性通过 D 测试进行检测。聚合酶链式反应 (PCR) 评估了 femB、mecA、ermA 和 ermB 等基因的流行情况。结果显示83例（65.9%）分离菌为耐甲氧西林金黄色葡萄球菌（MRSA）。对红霉素和克林霉素的耐药率分别为 67.4% 和 52.2%。49例（38.9%）分离菌株对红霉素和克林霉素均产生耐药性，表明其为组成型MLSB表型（cMLSB）；20例（15.9%）分离菌株的D测试结果呈阳性，表明其为诱导型MLSB表型（iMLSB）；16例（12.7%）分离菌株的D测试结果呈阴性，表明其为MS表型。在具有 iMLSB 表型的 20 个病例中，分别有 7 个病例（35%）和 4 个病例（20%）检出了 ermC 和 ermA 基因。在所有病例中均未检测到ermB基因，9例（45%）分离株中没有任何erm基因。结论：总体而言，本研究结果显示，金黄色葡萄球菌分离株对克林霉素和红霉素的耐药性频率较高，cMLSB 是最常见的表型，ermC 基因是 iMLSB 表型中最常见的基因。由于不同地理区域的抗菌药耐药性模式存在差异，因此获得当地的结果有助于检测金黄色葡萄球菌分离物引起的院内感染，并对其进行更适当的控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of Clinical Research in Paramedical Sciences

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