Antibiotic resistance and Staphylococcal super antigenic determinants in methicillin resistant Staphylococcus aureus isolated from anterior nares of dental students

Jebadass Jasmine  Vinshia; Kesavaram  Padmavathy; Jimson  Sudha; Baskaran  Sathyapriya

doi:10.18231/j.joapr.2023.11.5.52.58

Authors

Jebadass Jasmine Vinshia Department of Microbiology, Rajas Dental College & Hospital, Kavalkinaru, Tirunelveli
Kesavaram Padmavathy Department of Microbiology, Research Laboratory for Oral and Systemic Health, Sree Balaji Dental College & Hospital, Bharath Institute of Higher Education & Research, Chennai
Jimson Sudha Department of Oral Pathology and Microbiology, Sree Balaji Dental College & Hospital, Bharath Institute of Higher Education & Research, Chennai
Baskaran Sathyapriya Department of Anatomy, Sree Balaji Dental College & Hospital, Bharath Institute of Higher Education & Research, Chennai

DOI:

https://doi.org/10.18231/j.joapr.2023.11.5.52.58

Keywords:

HCWs, MRSA, Nasal carriage, PCR, Virulence determinants

Abstract

Background: Staphylococcus aureus primarily inhabits the human anterior nares. Asymptomatic Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in healthcare professionals makes them potential MRSA reservoirs. Since identification and decolonization would promote cross-contamination reduction and curb communal transmission, this study was designed to identify MRSA nasal carriers among dental students and detect staphylococcal super antigenic determinants among them. Methods: Staphylococci isolates (n=52) from dental students(n=42) were investigated in the study. Following initial microbial speciation and antimicrobial susceptibility determination using standard identification methods, the MRSA strains were identified phenotypically using cefoxitin disc (30 µg). Genes encoding the virulence determinants, namely, TSST (test), enterotoxins (sea and seb), and cytotoxin (pvl), were looked for by PCR. Results: Only 15.09% of isolates were identified as Staphylococcus aureus, and all of them (n=8) were scored as MRSA using the cefoxitin disc diffusion method. None of the tested isolates showed the presence of virulence determinants in standard molecular techniques. Conclusion: Lower prevalence of S. aureus, MRSA, coupled with the absence of virulence determinants in the strains, suggests strategies for better surveillance. Tracking virulence-causing genes in nasal carrier S. aureus strains could enhance efforts to prevent infection outbreaks.

Downloads

Download data is not yet available.

References

Fard-Mousavi N, Mosayebi G, Amouzandeh-Nobaveh A, Japouni-Nejad A, Ghaznavi-Rad E. The Dynamic of Staphylococcus aureus Nasal Carriage in Central Iran. Jundishapur J Microbiol 8, e20760 (2015)

Perez-Vazquez M, Vindel A, Marcos C, Oteo J, Cuevas O, Trincado P et al. Spread of invasive Spanish Staphylococcus aureus spa-type t067 associated with a high prevalence of the aminoglycoside-modifying enzyme gene and (4′)-Ia and the efflux pump genes msrA/msrB. Journal of antimicrobial chemotherapy 63(1), 21-31 (2009).

Chen BJ, Xie XY, Ni LJ, Dai XL, Lu Y, Wu XQ, Li HY, Yao YD, Huang SY. Factors associated with Staphylococcus aureus nasal carriage and molecular characteristics among the general population at a Medical College Campus in Guangzhou, South China. Ann Clin Microbiol Antimicrob 16, 28 (2017)

Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, Nouwen JL. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 5, 751-62 (2005)

van Belkum A, Verkaik NJ, de Vogel CP, Boelens HA, Verveer J, Nouwen JL, Verbrugh HA, Wertheim HF. Reclassification of Staphylococcus aureus nasal carriage types. J Infect Dis 199, 1820-6 (2009)

Dağı HT, Fındık D, Demirel G, Arslan U. Detection of Methicillin Resistance and Various Virulence Factors in Staphylococcus aureus Strains Isolated from Nasal Carriers. Balkan Med J 32, 171-5 (2015)

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 344, 11-6 (2001)

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) 13, 824-32 (2011)

Livermore DM. Antibiotic resistance in staphylococci. Int J Antimicrob Agents 16 Suppl 1, S3-10 (2000)

Li S, Skov RL, Han X, Larsen AR, Larsen J, Sørum M, Wulf M, Voss A, Hiramatsu K, Ito T. Novel types of staphylococcal cassette chromosome mec elements identified in clonal complex 398 methicillin-resistant Staphylococcus aureus strains. Antimicrob Agents Chemother 55, 3046-50 (2011)

Ben Slama K, Gharsa H, Klibi N, Jouini A, Lozano C, Gómez-Sanz E, Zarazaga M, Boudabous A, Torres C. 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 30, 499-508 (2011)

Jarraud S, Mougel C, Thioulouse J, Lina G, Meugnier H, Forey F, Nesme X, Etienne J, Vandenesch F. Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease. Infect Immun 70, 631-41 (2002)

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 30, 719-25 (2011)

Xu SX, McCormick JK. Staphylococcal superantigens in colonization and disease. Front Cell Infect Microbiol 2, 52 (2012)

Chambers HF, Deleo FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol 7, 629-41 (2009)

Feng Y, Chen CJ, Su LH, Hu S, Yu J, Chiu CH. Evolution and pathogenesis of Staphylococcus aureus: lessons learned from genotyping and comparative genomics. FEMS Microbiol Rev 32, 23-37 (2008)

Enright MC, Robinson DA, Randle G, Feil EJ, Grundmann H, Spratt BG. The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA). Proc Natl Acad Sci U S A 99, 7687-92 (2002)

Liu Y, Wang H, Du N, Shen E, Chen H, Niu J, Ye H, Chen M. Molecular evidence for spread of two major methicillin-resistant Staphylococcus aureus clones with a unique geographic distribution in Chinese hospitals. Antimicrob Agents Chemother 53, 512-8 (2009)

Performance Standards for Antimicrobial Susceptibility Testing, 33rd ed. CLSI supplement M100. Clinical and Laboratory Standards Institute, 2020.

Al-Haqan A, Boswihi SS, Pathan S, Udo EE. Antimicrobial resistance and virulence determinants in coagulase-negative staphylococci isolated mainly from preterm neonates. PLoS One 15, e0236713 (2020)

Boye K, Bartels MD, Andersen IS, Møller JA, Westh H. A new multiplex PCR for easy screening of methicillin-resistant Staphylococcus aureus SCCmec types I-V. Clin Microbiol Infect 13, 725-7 (2007)

Mustafa NR, Abdullah IT, Jabbar S. Phenotypic detection of virulence determinants and antibiotics resistance in Staphylococcus aureus from different clinical isolates in Kirkuk city. HIV Nursing 23(1), 891-9 (2023).

Bhowmik D, Chetri S, Das BJ, Dhar Chanda D, Bhattacharjee A. Distribution of virulence genes and SCCmec types among methicillin-resistant Staphylococcus aureus of clinical and environmental origin: a study from community of Assam, India. BMC Res Notes 14, 58 (2021)

Vaez H, Ghalehnoo ZR. Molecular characteristics of Staphylococcus aureus nasal carriage among health care workers at a Referral Hospital in Zabol, Iran. Pan Afr Med J 34, 196 (2019)

Pakbaz Z, Sahraian MA, Sabzi S, Mahmoodi M, Pourmand MR. Prevalence of sea, seb, sec, sed, and tsst-1 genes of Staphylococcus aureus in nasal carriage and their association with multiple sclerosis. Germs 7, 171-7 (2017)