Molecular Characterization of Exotoxin Genes in Staphylococcus aureus Recovered From Hospitalized Patients
,
Abstract
Background: Staphylococcus aureus is considered as a major cause of skin and soft tissue infections, arthritis, osteomyelitis, infective endocarditis, and pneumoniae though community or nosocomial transmission. In this study, attempts were made to investigate the distribution of some important exotoxin genes, including hla, hlb, tsst-1, eta, etb, and etd among methicillin-resistant S. aureus (MRSA) isolated from a hospital patients in Tabriz, Iran.
Methods: In the present cross-sectional study, a total of 90 S. aureus were isolated from children who admitted to a hospital during six-month in 2017. Isolates were identified using biochemical tests and then, using PCR, the isolates were tested for the presence of, hla, hlb, tsst-1, eta, etb, and etd genes.
Results: It was found that 40% of the S. aureus were considered as MRSA strains by biochemical and molecular tests. The results of molecular detection of virulence determinants showed that eta, hla, etb, tsst-1, hlb and etd were detected in 86.1%, 80.5%, 30.5%, 27.7%, 22.2%, and 19.4% of isolates, respectively.
Conclusion: Our findings clarify characterization of toxin production status of S. aureus isolates from patients in Iran. The current study showed that a majority of S. aureus isolates harbored eta and hla virulence gene.
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2. Bouvet C, Gjoni S, Zenelaj B, et al. Staphylococcus aureus soft tissue infection may increase the risk of subsequent staphylococcal soft tissue infections. Int J Infect Dis 2017; 60:44-8.
3. Tong SY, Davis JS, Eichenberger E, et al. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev 2015; 28(3):603-61.
4. Kaplan SL. Staphylococcus aureus infections in children: the implications of changing trends. Pediatrics. 2016; 137(4):e20160101.
5. Oogai Y, Matsuo M, Hashimoto M, et al. Expression of virulence factors by Staphylococcus aureus grown in serum. Applied Environment Microbiol 2011; 77(22):8097-105.
6. Thomer L, Schneewind O, Missiakas D. Pathogenesis of Staphylococcus aureus bloodstream infections. Annu Rev Pathol 2016; 11:343-64.
7. Naber CK. Staphylococcus aureus bacteremia: epidemiology, pathophysiology, and management strategies. Clin Infect Dis : an official publication of the Infectious Diseases Society of America 2009;48 Suppl 4:S231-7.
8. Ferry T, Perpoint T, Vandenesch F, et al. Virulence determinants in Staphylococcus aureus and their involvement in clinical syndromes. Current Infect Dis Reports 2005; 7(6):420-8.
9. Tappe D, Schulze MH, Oesterlein A, et al. Panton-Valentine leukocidin-positive Staphylococcus aureus infections in returning travelers. Am J Tropical Medicine Hygiene 2010; 83(4):748-50.
10. Diep BA, Palazzolo-Ballance AM, Tattevin P, et al. Contribution of Panton-Valentine leukocidin in community-associated methicillin-resistant Staphylococcus aureus pathogenesis. PloS one 2008; 3(9):e3198.
11. Kobayashi SD, Malachowa N, DeLeo FR. Pathogenesis of Staphylococcus aureus abscesses. Am J Pathol 2015; 185(6):1518-27.
12. Dantes R, Mu Y, Belflower R, et al. National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011. JAMA Intern Med 2013; 173(21):1970-8.
13. Elhassan MM, Ozbak HA, Hemeg HA, et al. Absence of the mecA gene in methicillin resistant Staphylococcus aureus isolated from different clinical specimens in Shendi city, Sudan. BioMed Res Inter 2015; 2015:895860-.
14. Mahdiyoun SM, Kazemian H, Ahanjan M, et al. Frequency of aminoglycoside-resistance genes in methicillin-resistant Staphylococcus aureus (MRSA) isolates from hospitalized patients. Jundishapur J Microbiol 2016; 9(8):e35052.
15. Schmitz FJ, Fluit AC, Gondolf M, et al. The prevalence of aminoglycoside resistance and corresponding resistance genes in clinical isolates of staphylococci from 19 European hospitals. J Antimicrobial Chemother 1999; 43(2):253-9.
16. Houri H, Kazemian H, Sedigh Ebrahim-Saraie H, et al. Linezolid activity against clinical Gram-positive cocci with advanced antimicrobial drug resistance in Iran. J Glob Antimicrob Resist 2017; 10:200-3.
17. Sina H, Ahoyo TA, Moussaoui W, et al. Variability of antibiotic susceptibility and toxin production of Staphylococcus aureus strains isolated from skin, soft tissue, and bone related infections. BMC Microbiol 2013; 13:188.
18. Otto M. Staphylococcus aureus toxins. Current Opinion Microbiol 2014; 17:32-7.
19. Argudin MA, Mendoza MC, Vazquez F, et al. Exotoxin gene backgrounds in bloodstream and wound Staphylococcus aureus isolates from geriatric patients attending a long-term care Spanish hospital. J Med Microbiol 2011; 60(Pt 11):1605-12.
20. Francis JS, Doherty MC, Lopatin U, et al. Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. Clin Infect Dis: an official publication of the Infectious Diseases Society of America 2005; 40(1):100-7.
21. Benvidi ME, Houri H, Ghalavand Z, et al. Toxin production and drug resistance profiles of pediatric methicillin-resistant Staphylococcus aureus isolates in Tehran. J Infect Develop Countries 2017; 11(10):759-65.
22. Emaneini M, Beigverdi R, van Leeuwen WB, et al. Prevalence of Methicillin-Resistant Staphylococcus aureus isolated from burn patients: A systematic review and meta-analysis. J Glob Antimicrob Resist 2017; 12:202-6.
23. Mahdiyoun SM, Kazemian H, Ahanjan M, et al. Frequency of aminoglycoside-resistance genes in methicillin-resistant Staphylococcus aureus (MRSA) isolates from hospitalized patients. Jundishapur J Microbiol 2016; 9(8):e35052.
24. Sabouni F, Mahmoudi S, Bahador A, et al. Virulence factors of Staphylococcus aureus isolates in an Iranian referral children's hospital. Osong Public Health Res Perspectives 2014; 5(2):96-100.
25. Mishra AK, Yadav P, Mishra A. A systemic review on staphylococcal scalded skin syndrome (SSSS): A rare and critical disease of neonates. Open Microbiol J 2016; 10:150-9.
26. Jeyakumari D, Gopal R, Eswaran M, et al. Staphylococcal scalded skin syndrome in a newborn. J Global Infect Dis 2009; 1(1):45-7.
27. Yamasaki O, Tristan A, Yamaguchi T, et al. Distribution of the exfoliative toxin D gene in clinical Staphylococcus aureus isolates in France. Clin Microbiol Infect: the official publication of the European Society of Clinical Microbiology and Infectious Diseases 2006; 12(6):585-8.
28. Mohseni M, Rafiei F, Ghaemi EA. High frequency of exfoliative toxin genes among Staphylococcus aureus isolated from clinical specimens in the north of Iran: Alarm for the health of individuals under risk. Iran J Microbiol 2018; 10(3):158-65.
29. Abimanyu N, Murugesan S, Krishnan P. High prevalence of exfoliative toxins among carrier isolates of Staphylococcus aureus from healthy individuals from various communities in Chennai, south India. Indian J Microbiol 2013; 53(3):288-90.
30. Arabestani MR, Kazemian H, Tabar ZK, et al. Prevalence of virulence genes, agr and antimicrobial resistance of Staphylococcus aureus isolated from food and dairy products
in Hamadan, Iran. Der Pharmacia Lettre 2016; 8(8):62-7.
31. Sina H, Ahoyo TA, Moussaoui W, et al. Variability of antibiotic susceptibility and toxin production of Staphylococcus aureus strains isolated from skin, soft tissue, and bone related infections. BMC Microbiol 2013; 13:188.
32. Strom MA, Hsu DY, Silverberg JI. Prevalence, comorbidities and mortality of toxic shock syndrome in children and adults in the USA. Microbiol Immunol 2017; 61(11):463-73.
33. Quan L, Morita R, Kawakami S. Toxic shock syndrome toxin-1 (TSST-1) antibody levels in Japanese children. Burns : Journal of the International Society for Burn Injuries 2010; 36(5):716-21.
34. Roy P, Sahni AK, Kumar A. A fatal case of staphylococcal toxic shock syndrome. Med J, Armed Forces India 2015; 71(Suppl 1):S107-S10.
35. Aglua I, Jaworski J, Drekore J, et al. Methicillin resistant Staphylococcus aureus in Melanesian children with haematogenous osteomyelitis from the central highlands of Papua New Guinea. Int J Pediatr 2018; 6(10):8361-70.
36. Yu F, Liu Y, Lv J, et al. Antimicrobial susceptibility, virulence determinant carriage and molecular characteristics of Staphylococcus aureus isolates associated with skin and soft tissue infections. Brazilian J Infect Dis 2015; 19(6):614-22.
37. Futagawa-Saito K, Makino S, Sunaga F, et al. Identification of first exfoliative toxin in Staphylococcus seudintermedius. FEMS Microbiol letters 2009; 301(2):176-80.
2. Bouvet C, Gjoni S, Zenelaj B, et al. Staphylococcus aureus soft tissue infection may increase the risk of subsequent staphylococcal soft tissue infections. Int J Infect Dis 2017; 60:44-8.
3. Tong SY, Davis JS, Eichenberger E, et al. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev 2015; 28(3):603-61.
4. Kaplan SL. Staphylococcus aureus infections in children: the implications of changing trends. Pediatrics. 2016; 137(4):e20160101.
5. Oogai Y, Matsuo M, Hashimoto M, et al. Expression of virulence factors by Staphylococcus aureus grown in serum. Applied Environment Microbiol 2011; 77(22):8097-105.
6. Thomer L, Schneewind O, Missiakas D. Pathogenesis of Staphylococcus aureus bloodstream infections. Annu Rev Pathol 2016; 11:343-64.
7. Naber CK. Staphylococcus aureus bacteremia: epidemiology, pathophysiology, and management strategies. Clin Infect Dis : an official publication of the Infectious Diseases Society of America 2009;48 Suppl 4:S231-7.
8. Ferry T, Perpoint T, Vandenesch F, et al. Virulence determinants in Staphylococcus aureus and their involvement in clinical syndromes. Current Infect Dis Reports 2005; 7(6):420-8.
9. Tappe D, Schulze MH, Oesterlein A, et al. Panton-Valentine leukocidin-positive Staphylococcus aureus infections in returning travelers. Am J Tropical Medicine Hygiene 2010; 83(4):748-50.
10. Diep BA, Palazzolo-Ballance AM, Tattevin P, et al. Contribution of Panton-Valentine leukocidin in community-associated methicillin-resistant Staphylococcus aureus pathogenesis. PloS one 2008; 3(9):e3198.
11. Kobayashi SD, Malachowa N, DeLeo FR. Pathogenesis of Staphylococcus aureus abscesses. Am J Pathol 2015; 185(6):1518-27.
12. Dantes R, Mu Y, Belflower R, et al. National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011. JAMA Intern Med 2013; 173(21):1970-8.
13. Elhassan MM, Ozbak HA, Hemeg HA, et al. Absence of the mecA gene in methicillin resistant Staphylococcus aureus isolated from different clinical specimens in Shendi city, Sudan. BioMed Res Inter 2015; 2015:895860-.
14. Mahdiyoun SM, Kazemian H, Ahanjan M, et al. Frequency of aminoglycoside-resistance genes in methicillin-resistant Staphylococcus aureus (MRSA) isolates from hospitalized patients. Jundishapur J Microbiol 2016; 9(8):e35052.
15. Schmitz FJ, Fluit AC, Gondolf M, et al. The prevalence of aminoglycoside resistance and corresponding resistance genes in clinical isolates of staphylococci from 19 European hospitals. J Antimicrobial Chemother 1999; 43(2):253-9.
16. Houri H, Kazemian H, Sedigh Ebrahim-Saraie H, et al. Linezolid activity against clinical Gram-positive cocci with advanced antimicrobial drug resistance in Iran. J Glob Antimicrob Resist 2017; 10:200-3.
17. Sina H, Ahoyo TA, Moussaoui W, et al. Variability of antibiotic susceptibility and toxin production of Staphylococcus aureus strains isolated from skin, soft tissue, and bone related infections. BMC Microbiol 2013; 13:188.
18. Otto M. Staphylococcus aureus toxins. Current Opinion Microbiol 2014; 17:32-7.
19. Argudin MA, Mendoza MC, Vazquez F, et al. Exotoxin gene backgrounds in bloodstream and wound Staphylococcus aureus isolates from geriatric patients attending a long-term care Spanish hospital. J Med Microbiol 2011; 60(Pt 11):1605-12.
20. Francis JS, Doherty MC, Lopatin U, et al. Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. Clin Infect Dis: an official publication of the Infectious Diseases Society of America 2005; 40(1):100-7.
21. Benvidi ME, Houri H, Ghalavand Z, et al. Toxin production and drug resistance profiles of pediatric methicillin-resistant Staphylococcus aureus isolates in Tehran. J Infect Develop Countries 2017; 11(10):759-65.
22. Emaneini M, Beigverdi R, van Leeuwen WB, et al. Prevalence of Methicillin-Resistant Staphylococcus aureus isolated from burn patients: A systematic review and meta-analysis. J Glob Antimicrob Resist 2017; 12:202-6.
23. Mahdiyoun SM, Kazemian H, Ahanjan M, et al. Frequency of aminoglycoside-resistance genes in methicillin-resistant Staphylococcus aureus (MRSA) isolates from hospitalized patients. Jundishapur J Microbiol 2016; 9(8):e35052.
24. Sabouni F, Mahmoudi S, Bahador A, et al. Virulence factors of Staphylococcus aureus isolates in an Iranian referral children's hospital. Osong Public Health Res Perspectives 2014; 5(2):96-100.
25. Mishra AK, Yadav P, Mishra A. A systemic review on staphylococcal scalded skin syndrome (SSSS): A rare and critical disease of neonates. Open Microbiol J 2016; 10:150-9.
26. Jeyakumari D, Gopal R, Eswaran M, et al. Staphylococcal scalded skin syndrome in a newborn. J Global Infect Dis 2009; 1(1):45-7.
27. Yamasaki O, Tristan A, Yamaguchi T, et al. Distribution of the exfoliative toxin D gene in clinical Staphylococcus aureus isolates in France. Clin Microbiol Infect: the official publication of the European Society of Clinical Microbiology and Infectious Diseases 2006; 12(6):585-8.
28. Mohseni M, Rafiei F, Ghaemi EA. High frequency of exfoliative toxin genes among Staphylococcus aureus isolated from clinical specimens in the north of Iran: Alarm for the health of individuals under risk. Iran J Microbiol 2018; 10(3):158-65.
29. Abimanyu N, Murugesan S, Krishnan P. High prevalence of exfoliative toxins among carrier isolates of Staphylococcus aureus from healthy individuals from various communities in Chennai, south India. Indian J Microbiol 2013; 53(3):288-90.
30. Arabestani MR, Kazemian H, Tabar ZK, et al. Prevalence of virulence genes, agr and antimicrobial resistance of Staphylococcus aureus isolated from food and dairy products
in Hamadan, Iran. Der Pharmacia Lettre 2016; 8(8):62-7.
31. Sina H, Ahoyo TA, Moussaoui W, et al. Variability of antibiotic susceptibility and toxin production of Staphylococcus aureus strains isolated from skin, soft tissue, and bone related infections. BMC Microbiol 2013; 13:188.
32. Strom MA, Hsu DY, Silverberg JI. Prevalence, comorbidities and mortality of toxic shock syndrome in children and adults in the USA. Microbiol Immunol 2017; 61(11):463-73.
33. Quan L, Morita R, Kawakami S. Toxic shock syndrome toxin-1 (TSST-1) antibody levels in Japanese children. Burns : Journal of the International Society for Burn Injuries 2010; 36(5):716-21.
34. Roy P, Sahni AK, Kumar A. A fatal case of staphylococcal toxic shock syndrome. Med J, Armed Forces India 2015; 71(Suppl 1):S107-S10.
35. Aglua I, Jaworski J, Drekore J, et al. Methicillin resistant Staphylococcus aureus in Melanesian children with haematogenous osteomyelitis from the central highlands of Papua New Guinea. Int J Pediatr 2018; 6(10):8361-70.
36. Yu F, Liu Y, Lv J, et al. Antimicrobial susceptibility, virulence determinant carriage and molecular characteristics of Staphylococcus aureus isolates associated with skin and soft tissue infections. Brazilian J Infect Dis 2015; 19(6):614-22.
37. Futagawa-Saito K, Makino S, Sunaga F, et al. Identification of first exfoliative toxin in Staphylococcus seudintermedius. FEMS Microbiol letters 2009; 301(2):176-80.
| Files | ||
| Issue | Vol 8 No 5-6 (2019) | |
| Section | Original Articles | |
| Keywords | ||
| Exotoxins Methicillin-resistant Staphylococcus aureus6 toxic shock syndrome toxin-1 Pediatrics Staphylococcal exfoliative toxin. | ||
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How to Cite
1.
Valadan Tahbaz S, Fallah F, Nowroozi J, Armin S, Azimi L. Molecular Characterization of Exotoxin Genes in Staphylococcus aureus Recovered From Hospitalized Patients. J Med Bacteriol. 2019;8(5-6):21-29.
