Youssef Christiana Rezk Bottros, Kadry Ashraf Ahmed, El-Ganiny Amira Mohammed
Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt.
Iran J Microbiol. 2022 Feb;14(1):56-66. doi: 10.18502/ijm.v14i1.8802.
MRSA became a widely recognized cause of mortality worldwide with necessity of its epidemiological pattern study. Typing of MRSA isolates was performed molecularly based on SCC type and relation to resistance pattern was investigated.
Out of 200 clinical specimens, was detected phenotypically and confirmed as MRSA by PCR in 124 isolates obtained from associated laboratories of different hospitals of Zagazig, during 2018-2019. Antimicrobial resistance pattern was detected and MRSA SCC was typed by two methods.
rate was high in wounds, sputum, blood, and urine isolates. Antimicrobial resistance rates against cefotaxime, tetracycline, gentamicin, ciprofloxacin, erythromycin, azithromycin, clindamycin, chloramphenicol, sulfamethoxazole-trimethoprim, linezolid and vancomycin were 82.3%, 65.3%, 56.4%, 45.1%, 37.1%, 32.3%, 32.3%, 25%, 7.3%, 2.4% and 0%, respectively. Multiplex-PCR(M-PCR) was able to detect SCC element among 57% of isolates classified as SCC II (n=40), III (n=21), IVa (n=3), IVd (n=2), V(n=1), and four isolates contain both SCC II and SCC IV. Traditional typing by PCR for and gene complexes was almost concordant with M-PCR. Furthermore, it was able to identify SCC types VI, IX, and XIV among 1, 3 and 18 isolates, respectively. No Statistical correlation was established between type of cassette and rate of antimicrobial resistance. Phylogenetic analysis reveals that all types were related to each other and no significant variation in the same type of different SCC cassettes.
Most MRSA isolates were MDR reflecting antimicrobials misuse. Detection of various SCC types among MRSA isolates indictae the complexity of MRSA epidemiology and increase chance for gene sharing creating new types. The presented investigation was important in understanding MRSA epidemiology and diversity in Egypt providing advice for improving therapeutic protocols.
耐甲氧西林金黄色葡萄球菌（MRSA）已成为全球范围内广泛认可的致死原因，因此有必要对其流行病学模式进行研究。基于葡萄球菌染色体盒式（SCC）分型对MRSA分离株进行分子分型，并研究其与耐药模式的关系。
在2018 - 2019年期间，从扎加齐格不同医院的相关实验室获得的200份临床标本中，通过表型检测并经PCR确认为MRSA的有124株。检测抗菌药物耐药模式，并通过两种方法对MRSA的SCC进行分型。
伤口、痰液、血液和尿液分离株中的检出率较高。对头孢噻肟、四环素、庆大霉素、环丙沙星、红霉素、阿奇霉素、克林霉素、氯霉素、磺胺甲恶唑 - 甲氧苄啶、利奈唑胺和万古霉素的抗菌药物耐药率分别为82.3%、65.3%、56.4%、45.1%、37.1%、32.3%、32.3%、25%、7.3%、2.4%和0%。多重PCR（M-PCR）能够在57%归类为SCC II（n = 40）、III（n = 21）、IVa（n = 3）、IVd（n = 2）、V（n = 1）的分离株中检测到SCC元件，还有4株同时含有SCC II和SCC IV。通过PCR对和基因复合体进行的传统分型与M-PCR结果基本一致。此外，它还能够分别在1株、3株和18株分离株中鉴定出SCC VI型、IX型和XIV型。盒式类型与抗菌药物耐药率之间未建立统计学相关性。系统发育分析表明，所有类型相互关联，同一SCC盒式的不同类型之间无显著差异。
大多数MRSA分离株为多重耐药，反映了抗菌药物的滥用。在MRSA分离株中检测到多种SCC类型，表明MRSA流行病学的复杂性以及基因共享产生新类型的可能性增加。本研究对于了解埃及的MRSA流行病学和多样性、为改进治疗方案提供建议具有重要意义。
