Abstract
We sought to study antibiotic resistance and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) from lower respiratory tracts of patients in Shanghai Pulmonary Hospital. Hundred and seven strains of MRSA were isolated from the patients of nine wards. The tests for antibiotic resistance (Kirby–Bauer paper dispersion method), the Panton–Valentine Leukocidin (PVL) and Staphyloccoccal Cassette Chromosome mec (SCCmec) genes (PCR), and homology analysis (32 randomly selected MRSA strains; pulsed-field gel electrophoresis) were carried out. All 107 strains were susceptible to vancomycin, teicoplanin, and linezolid, but highly or completely resistant to tetracycline, gentamicin, clindamycin, levofloxacin, azithromycin, erythromycin, trimethoprim/sulphamethoxazole, and ciprofloxacin. All 107 strains were negative for PVL gene. Most of the strains (81.3 %) were SCCmec III type, while the SCCmec II and IV types were less frequent (15.9 and 2.8 %, respectively). No SCCmec I or V types were detected. The homology analysis test showed that 32 MRSA strains could be divided into 4 groups: type A (25 strains), type B (5 strains), type C (1 strain), and type D (1 strain). The type A included 3 subtypes: A1 (17 strains), A2 (1 strain), and A3 (7 strains). Further, most of the strains were isolated from the same wards or units (e.g., intensive care unit or tuberculosis wards) within a short period of time, indicating an outbreak status. In conclusion, the observed MRSA from low respiratory tracts from patients at Shanghai Pulmonary Hospital were multiple-resistant, with the SCCmec III being the main documented genotype.
Similar content being viewed by others
References
Rice, L. B. (2006). Antimicrobial resistance in gram-positive bacteria. American Journal of Medicine, 2006(119), S11–S19.
Udou, T. (2004). Dissemination of nosocomial multiple-aminoglycoside-resistant Staphylococcus aureus caused by horizontal transfer of the resistance determinant (aacA/aphD) and clonal spread of resistant strains. American Journal of Infection Control, 32, 215–219.
CLSI. (2003). Clinical and Laboratory Standards Institute Quality Manual. Third edition. CLSI, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087-1898, USA.
European Centre for Disease Control and Prevention, European Medicines Agency (2009) The bacterial challenge: Time to react. Stockholm: European Centre for Disease Prevention and Control.
Ho, P. L., Cheung, C., Mak, G. C., Tse, C. W., Ng, T. K., Cheung, C. H., et al. (2007). Molecular epidemiology and household transmission of community-associated methicillin-resistant Staphylococcus aureus in Hong Kong. Diagnostic Microbiology and Infectious Disease, 57, 145–151.
Lina, G., Piemont, Y., Godail-Gamot, F., Bes, M., Peter, M. O., Gauduchon, V., et al. (1999). Involvement of Panton–Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clinical Infectious Diseases, 29, 1128–1132.
Zhang, K., McClure, J. A., Elsayed, S., Louie, T., & Conly, J. M. (2005). Novel multiplex PCR assay for characterization and concomitant subtyping of staphylococcal cassette chromosome mec types I to V in methicillin-resistant Staphylococcus aureus. Journal of Clinical Microbiology, 43, 5026–5033.
Oliveira, D. C., & de Lencastre, H. (2002). Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrobial Agents and Chemotherapy, 46, 2155–2161.
Turkyilmaz, S., Tekbiyik, S., Oryasin, E., & Bozdogan, B. (2010). Molecular epidemiology and antimicrobial resistance mechanisms of methicillin-resistant Staphylococcus aureus isolated from bovine milk. Zoonoses Public Health, 57, 197–203.
Aires de Sousa, M., Crisostomo, M. I., Sanches, I. S., Wu, J. S., Fuzhong, J., Tomasz, A., et al. (2003). Frequent recovery of a single clonal type of multidrug-resistant Staphylococcus aureus from patients in two hospitals in Taiwan and China. Journal of Clinical Microbiology, 2003(41), 159–163.
Centers for Disease Control and Prevention (CDC). (2002). Staphylococcus aureus resistant to vancomycin—United States. Morbidity and Mortality Weekly Report, 51(26), 565–567.
Johnson, A. P. (2011). Methicillin-resistant Staphylococcus aureus: The European landscape. Journal of Antimicrobial Chemotherapy, 66(Suppl 4), iv43–iv48.
Paterson, D. L. (2004). “Collateral damage” from cephalosporin or quinolone antibiotic therapy. Clinical Infectious Diseases, 38(Suppl 4), S341–S345.
Gould, I. M. (2006). Costs of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) and its control. International Journal of Antimicrobial Agents, 2006(28), 379–384.
Webster, D., Rennie, R. P., Brosnikoff, C. L., Chui, L., & Brown, C. (2007). Methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin in Canada. Diagnostic Microbiology and Infectious Disease, 57, 177–181.
Ito, T., Katayama, Y., Asada, K., Mori, N., Tsutsumimoto, K., Tiensasitorn, C., et al. (2001). Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureus. Antimicrobial Agents and Chemotherapy, 45, 1323–1336.
Ma, X. X., Ito, T., Tiensasitorn, C., Jamklang, M., Chongtrakool, P., Boyle-Vavra, S., et al. (2002). Novel type of staphylococcal cassette chromosome mec identified in community-acquired methicillin-resistant Staphylococcus aureus strains. Antimicrobial Agents and Chemotherapy, 46, 1147–1152.
Chongtrakool, P., Ito, T., Ma, X. X., Kondo, Y., Trakulsomboon, S., Tiensasitorn, C., et al. (2006). Staphylococcal cassette chromosome mec (SCCmec) typing of methicillin-resistant Staphylococcus aureus strains isolated in 11 Asian countries: A proposal for a new nomenclature for SCCmec elements. Antimicrobial Agents and Chemotherapy, 50, 1001–1012.
Ouyang, F. X., Bu, P. F., Huang, H. Q., & Bao, S. X. (2007). Seven kinds of new SCCmec type in methicillin-resistant Staphylococcus aureus and their susceptibility to the antibiotics. Wei Sheng Wu Xue Bao, 47, 201–207. in Chinese.
Onodera, S., Hosobe, T., Machida, T., Kurosaka, K., & Oomayu, S. (1991). A study of methicillin-resistant Staphylococcus aureus (MRSA) infection in the urological field. Kansenshogaku Zasshi, 65, 311–318. in Japanese.
Reichman, O., & Sobel, J. D. (2009). MRSA infection of buttocks, vulva, and genital tract in women. Current Infectious Disease Reports, 11, 465–470.
Noguchi, N., Okihara, T., Namiki, Y., Kumaki, Y., Yamanaka, Y., Koyama, M., et al. (2005). Susceptibility and resistance genes to fluoroquinolones in methicillin-resistant Staphylococcus aureus isolated in 2002. International Journal of Antimicrobial Agents, 25, 374–379.
Gastmeier, P., Sohr, D., Geffers, C., Nassauer, A., Dettenkofer, M., & Ruden, H. (2002). Occurrence of methicillin-resistant Staphylococcus aureus infections in German intensive care units. Infection, 30, 198–202.
Cruz, C., Moreno, J., Renzoni, A., Hidalgo, M., Reyes, J., Schrenzel, J., et al. (2005). Tracking methicillin-resistant Staphylococcus aureus clones in Colombian hospitals over 7 years (1996–2003): Emergence of a new dominant clone. International Journal of Antimicrobial Agents, 26, 457–462.
Diep, B. A., Sensabaugh, G. F., Somboonna, N., Carleton, H. A., & Perdreau-Remington, F. (2004). Widespread skin and soft-tissue infections due to two methicillin-resistant Staphylococcus aureus strains harboring the genes for Panton–Valentine leucocidin. Journal of Clinical Microbiology, 42, 2080–2084.
Nimmo, G. R., Coombs, G. W., Pearson, J. C., O’Brien, F. G., Christiansen, K. J., Turnidge, J. D., et al. (2006). Methicillin-resistant Staphylococcus aureus in the Australian community: An evolving epidemic. Medical Journal of Australia, 184, 384–388.
Author information
Authors and Affiliations
Corresponding author
Additional information
Haiqing Chu and Lan Zhao contributed equally to the study and should be considered co-first authors.
Rights and permissions
About this article
Cite this article
Chu, H., Zhao, L., Zhang, Z. et al. Antibiotic Resistance and Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus from Lower Respiratory Tract: Multi-resistance and High Prevalence of SCCmec III Type. Cell Biochem Biophys 67, 795–801 (2013). https://doi.org/10.1007/s12013-013-9542-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12013-013-9542-7