Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
Arch Microbiol. 2021 Aug;203(6):3295-3303. doi: 10.1007/s00203-021-02314-6. Epub 2021 Apr 16.
Methicillin-resistant Staphylococcus aureus is one of the major clinical problems in hospitals because of its resistance to many antimicrobials. Biocides are used in hospitals to control nosocomial infections. This work aimed to investigate the relationship between the presence of integrons and reduced susceptibility to both biocides and antimicrobials in nosocomial multidrug-resistant (MDR)-MRSA isolates. A total of 114 clinical and eight environmental MRSA isolates were collected from Zagazig University Hospitals and El-Ahrar Educational Hospital, Egypt. These isolates were identified as MRSA by disk diffusion method (DDM) and confirmed by PCR. Susceptibility profile against 12 antibiotics and five biocides was determined by DDM and agar dilution method, respectively. Presence of integrons was investigated by PCR in MDR isolates. Seventy-five clinical and six environmental isolates were MDR and had reduced susceptibility to biocides. Class I integron was detected in plasmid DNA of 34 isolates and genomic DNA of 14 isolates. Meanwhile, class II integron was only detected in plasmid DNA of 10 clinical isolates. This study revealed a high prevalence of MDR-MRSA clinical and environmental isolates, both had reduced susceptibility to investigated biocides. Class I integron was more predominant in plasmid DNA of isolates, indicating that plasmid is a major carrier for integrons that transfer resistance genes. In conclusion, the association between antibiotic resistance and biocides reduced susceptibility is alarming. The selection of curative antibiotic should depend on the antimicrobial susceptibility profile. Furthermore, biocides should always be used at appropriate concentrations to prevent the evolution of resistance and to control the hospital-transmission of MRSA.
耐甲氧西林金黄色葡萄球菌（MRSA）是医院面临的主要临床问题之一，因为它对许多抗菌药物具有耐药性。消毒剂在医院中被用于控制医院获得性感染。本研究旨在调查医院获得性多药耐药（MDR）-MRSA 分离株中整合子的存在与消毒剂和抗菌药物敏感性降低之间的关系。从 Zagazig 大学医院和 El-Ahrar 教育医院收集了 114 株临床和 8 株环境 MRSA 分离株。这些分离株通过圆盘扩散法（DDM）鉴定为 MRSA，并通过 PCR 确认。通过 DDM 和琼脂稀释法分别确定了对 12 种抗生素和 5 种消毒剂的药敏谱。通过 PCR 检测 MDR 分离株中整合子的存在。75 株临床分离株和 6 株环境分离株为 MDR，对消毒剂的敏感性降低。在 34 株分离株的质粒 DNA 和 14 株分离株的基因组 DNA 中检测到 I 类整合子。同时，仅在 10 株临床分离株的质粒 DNA 中检测到 II 类整合子。本研究显示，MDR-MRSA 临床和环境分离株的流行率很高，对所研究的消毒剂均具有较低的敏感性。I 类整合子在分离株的质粒 DNA 中更为普遍，表明质粒是携带耐药基因的整合子的主要载体。总之，抗生素耐药性和消毒剂敏感性降低之间的关联令人警惕。治疗性抗生素的选择应取决于抗菌药物敏感性谱。此外，消毒剂应始终在适当的浓度下使用，以防止耐药性的进化，并控制 MRSA 在医院中的传播。
