Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, 1 Khartoum Sq., Alexandria, 21521, Egypt.
Division of Medical Microbiology, Stellenbosch University, Cape Town, South Africa and National Health Laboratory Service, Tygerberg Hospital, Francie van Zijl Drive, PO Box 241, Cape Town, 8000, Tygerberg, South Africa.
Sci Rep. 2021 Feb 19;11(1):4253. doi: 10.1038/s41598-021-83578-2.
Antimicrobial stewardship isn't strictly observed in most Egyptian hospitals, raising antibiotic resistance. Epidemiology of Egyptian MRSA isolates, or associations with resistance to other antibiotics remain largely unknown. We identified MRSA genotypes in Alexandria Main University Hospital (AMUH) and investigated rates of moxifloxacin resistance, an alternative MRSA treatment, among different genotypes. Antibiotic susceptibility of 72 MRSA clinical isolates collected in 2015 from AMUH was determined by disc diffusion and broth microdilution. spa- and Staphylococcal Cassette Chromosome mec (SCCmec) typing were performed; with multi-locus sequence typing conducted on isolates representing major genotypes. Resistance to moxifloxacin, levofloxacin and ciprofloxacin were 69%, 78% and 96%, respectively. spa type t037 (57%) was commonest, followed by t127 (12.5%), t267 (8%) and t688 (6%). SCCmec III predominated (57%), all of these were moxifloxacin resistant and 97.6% t037 (ST241). SCCmec IV, IV E and V represented 15%, 7% and 11% of the isolates, respectively, 79% of these were moxifloxacin susceptible and of different spa types. t127 (ST-1) was associated with SCCmec V in 56% of the isolates, mostly moxifloxacin susceptible. Moxifloxacin resistance was high, most resistant isolates belonged to t037 and SCCmec III, suggesting local dissemination and antibiotic pressure. We recommend caution in treating MRSA infections with moxifloxacin.
在大多数埃及医院，抗菌药物管理并不严格，导致抗生素耐药性增加。埃及耐甲氧西林金黄色葡萄球菌（MRSA）分离株的流行病学或与其他抗生素耐药性的关联在很大程度上尚不清楚。我们在亚历山大大学医院（AMUH）鉴定了 MRSA 基因型，并研究了不同基因型中莫西沙星耐药率，这是一种替代 MRSA 的治疗方法。 2015 年从 AMUH 采集的 72 株 MRSA 临床分离株的药敏试验采用纸片扩散法和肉汤微量稀释法进行。 spa 和葡萄球菌盒染色体 mec（SCCmec）分型；对代表主要基因型的分离株进行多位点序列分型。莫西沙星、左氧氟沙星和环丙沙星的耐药率分别为 69%、78%和 96%。 spa 型 t037（57%）最常见，其次是 t127（12.5%）、t267（8%）和 t688（6%）。 SCCmec III 占主导地位（57%），均对莫西沙星耐药，97.6%的 t037 （ST241）。 SCCmec IV、IV E 和 V 分别占分离株的 15%、7%和 11%，其中 79%的莫西沙星敏感， spa 型不同。 t127（ST-1）与 SCCmec V 相关，56%的分离株为莫西沙星敏感。莫西沙星耐药率较高，大多数耐药分离株属于 t037 和 SCCmec III，提示存在局部传播和抗生素压力。我们建议在治疗 MRSA 感染时谨慎使用莫西沙星。
