The Comparison of cefoxitin disk disffusion method with other phenotypic and molecular methods in identification of methicillin-resistant Staphylococcus aureus in clinical specimens of patients admitted to Ahvaz educational hospitals

Document Type : Original Article

Authors

1 phd

2 Department of Microbiology, Iran University of Medical Sciences

3 Islamic Azad University of Tehran Research Sciences

Abstract

Background and Objective: Staphylococcus aureus is one of the few bacteria that can infect all organs of the body. The aim of this study was to evalluate the cefoxitin disk diffusion method with other phenotypic and molecular methods in the detection of methicillin-resistant Staphylococcus aureus designed and adjusted in clinical specimens of admitted patients in Ahvaz educational hospitals, thereby followed by S.aureus relative prevalence and antibiotic susceptibility determination.
Subjects and Methods: A total of 280 S. aureus isolates from clinical specimens were collected. Tests were performed using Cefoxitin disc diffusion, Oxacillin screening agar and Oxacillin disk diffusion methods. The PCR method was used to determine the mec A gene.
Results: 0ut of a total of 693 specimens, 280 specimens were confirmed as S. aureus, 123 strains of which were detected as MRSA. The comparison of Oxacillin disk diffusion and oxacillin screening methods is indicative of 121 (43.2%) and 122 (40.6%) antibiotic susceptibilities, respectively, while isolates of MRSA were detected by disc diffusion cefoxitin and PCR 123 (43.9%). In determining the antibiotic susceptibility pattern, erythromycin (98.3%), ciprofloxacin (97.5%), clindamycin (94.3%), tetracycline (90.2%), gentamicin (83.7%) and rifampin (41.4%) were noticed. Also, low resistance to teicoplanin (0%), linzolide (0%), vancomycin (0%) was observed.
Conclusion: The prevalence of methicillin resistant Staphylococci in our region was relatively high, but these strains were totally sensitive to vancomycin, teicoplanin and and linzolide antibiotics and cefoxitin disk test was the reliable method for detection of methicillin resistant Staphylococci.
Keyword: Staphylococcus aureus, MRSA, Antibiotic resistance, Genotype

Keywords

References

1-Gordon RJ, Lowy FD. Pathogenesis of methicillin-resistant Staphylococcus aureus infection. clinic.infect. dis. 2008; 46: 350-9.
2-Shittu AO, Okon K, Adesida S, Oyedara O, Witte W, Strommenger B, Layer F, Nübel U. Antibiotic resistance and molecular epidemiology of Staphylococcus aureus in Nigeria. BMC MICROBIOL. 2011; 11(1): 92.
3-Mathews AA, Thomas M, Appalaraju B, Jayalakshmi J. Evaluation and comparison of tests to detect methicillin resistant S. aureus. Idian J Pathol Microbiol. 2010; 53(1): 79-82.
4-CHAMBERS HF. Community-associated MRSA: Resistance and virulence converge. N. Engl. J. Med. 2005; 352(14):1485-7.
5-Carvalho MJ, Pimenta FC, Hayashida M, Gir E, Silva AM, Barbosa CP, Canini SR, Santiago S. Prevalence of methicillin-resistant and methicillin-susceptible S. aureus in the saliva of health professionals. Med. Clin. 2009 Apr; 64(4): 295-302.
6-Deurenberg RH, Stobberingh EE. The evolution of Staphylococcus aureus. INFECT GENET EVOL. 2008; 8: 747-63.
7-Kaczmarek A, Budzyńska A, Mikołajczyk D, Gospodarek E. Comparison of disk-diffusion method and PCR for detection of methicillin resistance in Staphylococcus aureus strains. Med Dosw Mikrobiol. 2006; 58(2): 87-93.
8-Song JH, Hsueh PR, Chung DR, Ko KS, Kang CI, Peck KR, Yeom JS, Kim SW, Chang HH, Kim YS, Jung SI. Spread of methicillin-resistant Staphylococcus aureus between the community and the hospitals in Asian countries: an ANSORP study. Antimicrob Chemother J. 2011; 66(5): 1061-9.
9-Stefani S, Varaldo PE. Epidemiology of methicillin-resistant staphylococci in Europe. Clin Microbiol Infect. 2003; 9(12): 1179-86.
10-John MA, Burden J, Stuart JI, Reyes RC, Lannigan R, Milburn S, Diagre D, Wilson B, Hussain Z. Comparison of three phenotypic techniques for detection of methicillin resistance in Staphylococcus spp. reveals a species-dependent performance. Antimicrob Chemother J. 2009; 63(3): 493-6.
11-Turlej AG, Hryniewicz WA, Empel J. Staphylococcal cassette chromosome mec (Sccmec) classification and typing methods: an overview. Pol J Microbiol. 2011;60(2):95-103.
12-Ender M, Burger S, Sokoli A, Zbinden R, Berger-Bächi B, Heusser R, Senn MM, McCallum N. Variability of SCCmec in the Zurich area. Eur J Clin Microbiol Infect Dis. 2009; 28(6): 647.
13-Tsubakishita S, Kuwahara-Arai K, Sasaki T, Hiramatsu K. Origin and molecular evolution of the determinant of methicillin resistance in staphylococci. Antimicrob Agents Chemother. 2010; 54(10): 4352-9.
14-Liakopoulos A, Foka A, Vourli S, Zerva L, Tsiapara F, Protonotariou E, Dailiana Z, Economou M, Papoutsidou E, Koutsia-Carouzou C, Anastassiou ED. Aminoglycoside-resistant staphylococci in Greece: prevalence and resistance mechanisms. Eur J Clin Microbiol Infect Dis. 2011; 30(5): 701-5.
15-Skov R, Smyth R, Larsen AR, Bolmstrom A, Karlsson A, Mills K, Frimodt-Moller N, Kahlmeter G. Phenotypic detection of methicillin resistance in Staphylococcus aureus by disk diffusion testing and Etest on Mueller-Hinton agar. Clin Microbiol J. 2006; 44(12): 4395-9.
16-Robinson DA, Enright MC. Multilocus sequence typing and the evolution of methicillin‐resistant Staphylococcus aureus. Clin Microbiol Infect. 2004; 10(2): 92-7.
17- Matos PD, Schuenck RP, Cavalcante FS, Caboclo RM, dos Santos KR. Accuracy of phenotypic methicillin susceptibility methods in the detection of Staphylococcus aureus isolates carrying different SCCmec types. Mem Inst Oswaldo Cruz J. 2010; 105(7): 931-934.
18-Skov R, Smyth R, Clausen M, Larsen AR, Frimodt-Møller N, Olsson-Liljequist B, Kahlmeter G. Evaluation of a cefoxitin 30 µg disc on Iso-Sensitest agar for detection of methicillin-resistant Staphylococcus aureus. Antimicrob Chemother J. 2003; 52(2): 204-7.
19-Anand KB, Agrawal P, Kumar S, Kapila K. Comparison of cefoxitin disc diffusion test, oxacillin screen agar, and PCR for mecA gene for detection of MRSA. Indian J Med Microbiol. 2009; 27(1): 27.
20-Pramodhini S, Thenmozhivalli PR, Selvi R, et al. Comparison of Various Phenotypic Methods and mecA Based PCR for the Detection of MRSA. J Clin Diagn Res 2011; 5: 1359-62.
21-Zhang K, Sparling J, Chow BL, Elsayed S, Hussain Z, Church DL, Gregson DB, Louie T, Conly JM. New quadriplex PCR assay for detection of methicillin and mupirocin resistance and simultaneous discrimination of Staphylococcus aureus from coagulase-negative staphylococci. J Clin Microbiol. 2004; 42(11): 4947-55.
22-Brown DF, Edwards DI, Hawkey PM, Morrison D, Ridgway GL, Towner KJ, Wren MW. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). J. Antimicrob. Chemother. 2005; 56(6): 1000-18.
23-Wayne P (2014). Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing.
24-Ercis S, Sancak B, Hascelik G. A comparison of PCR detection of mecA with oxacillin disk susceptibility testing in different media and sceptor automated system for both Staphylococcus aureus and coagulase-negative staphylococci isolates. Indian J Med Microbiol. 2008; 26(1): 21.
25-Felten A, Grandry B, Lagrange PH, Casin I. Evaluation of three techniques for detection of low-level methicillin-resistant Staphylococcus aureus (MRSA): a disk diffusion method with cefoxitin and moxalactam, the Vitek 2 system, and the MRSA-screen latex agglutination test. J Clin Microbiol. 2002; 40(8): 2766-71.
26-Ghaznavi-Rad E. Comparison of molecular methods in epidemiological typing of Methicillin Resistant Staphylococcus aureus. ISMJ. 2014; 17(3): 326-35.
27-Iraz M, Tekerekoglu MS, Otlu B, Ay S. Comparison of an automated system with four phenotypic methods for the detection of methicillin-resistant Staphylococcus aureus. Afr J Microb Res. 2012; 6(4): 764-9.
28-El Kholy A, Baseem H, Hall GS, Procop GW, Longworth DL. Antimicrobial resistance in Cairo, Egypt 1999–2000: a survey of five hospitals. J. Antimicrob. Chemother. 2003; 51(3): 625-30.
29-Shittu AO, Lin J. Antimicrobial susceptibility patterns and characterization of clinical isolates of Staphylococcus aureus in KwaZulu-Natal province, South Africa. BMC Infect. Dis. 2006; 6(1): 125.
30-Jain A, Agarwal A, Verma,RK. Cefoxitin disk diffusion test for detection of meticillin-resistant staphylococci. J. Med. Microbiol. 2008; 57: 957-61.
31-Akanbi BO, Mbe JU. Occurrence of methicillin and vancomycin resistant Staphylococcus aureus in University of Abuja Teaching Hospital, Abuja, Nigeria. Afr J Clin Exper Microbiol. 2013;14(1):10-13.
32-Tiwari HK, Sen MR. Emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India. BMC Infect. Dis. 2006; 6(1): 156
33-García MS, De la Torre MÁ, Morales G, Peláez B, Tolón MJ, Domingo S, Candel FJ, Andrade R, Arribi A, García N, Sagasti FM. Clinical outbreak of linezolid-resistant Staphylococcus aureus in an intensive care unit. Jama. 2010; 303(22): 2260-4.
34-Ko KS, Lee JY, Suh JY, Oh WS, Peck KR, Lee NY, Song JH. Distribution of major genotypes among methicillin-resistant Staphylococcus aureus clones in Asian countries. J Clin Microbiol. 2005; 43(1): 421-6.
35-Kalorey DR, Shanmugam Y, Kurkure NV, Chousalkar KK, Barbuddhe SB. PCR-based detection of genes encoding virulence determinants in Staphylococcus aureus from bovine subclinical mastitis cases. J. Vet. Sci. 2007; 8(2): 151-4.
36-Japoni A, Jamalidoust M, Farshad S, Ziyaeyan M, Alborzi A, Japoni S, Rafaatpour N. Characterization of SCCmec types and antibacterial susceptibility patterns of methicillin-resistant Staphylococcus aureus in Southern Iran. JPN J INFECT DIS. 2011; 64(1): 28-33.
37-McClure JA, Conly JM, Lau V, Elsayed S, Louie T, Hutchins W, Zhang K. Novel multiplex PCR assay for detection of the staphylococcal virulence marker Panton-Valentine leukocidin genes and simultaneous discrimination of methicillin-susceptible from-resistant staphylococci. J Clin Microbiol. 2006; 44(3): 1141-4.
38-Wayne P (2011). Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing.
39-Sultana H, Sarker JN, Yusuf A, Bhuiyan TH, Rahman M, Tarafder S. Validity of Cefoxitin Disc Diffusion Test for the Detection of Methicillin-resistant Staphylococcus aureus. Am J Infect Dis Microbiol. 2018; 6: 26-29.
Jundishapur Scientific Medical Journal
Volume 19, Issue 3 - Serial Number 126
September and October 2020
Pages 253-266

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History

  • Receive Date: 16 September 2019
  • Revise Date: 01 July 2020
  • Accept Date: 12 July 2020

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