Genetic Polymorphism of agr Locus and Antibiotic Resistance of Staphylococcus aureus at two hospitals in Pakistan

Article (PDF Available)inPakistan Journal of Medical Sciences Online 30(1):172-6 · March 2014with47 Reads
DOI: 10.12669/pjms.301.4124 · Source: PubMed
Abstract
Objective: The accessory gene regulator (agr) locus in Staphylococcus aureus (S. aureus) is a global regulator of quorum sensing and controls the production of virulence factors. This study was carried out to investigate the agr specific groups both in methicillin resistant and sensitive Staphylococcus aureus (MRSA and MSSA) and their relation with antibiotic resistance. Methods: A total of 90 clinical S. aureus isolates were studied from two tertiary care hospitals. The isolates were identified by standard biochemical tests. Methicillin resistance was confirmed by oxacillin and cefoxitin resistance. Multiplex PCR was used to determine the agr groups. Results: MRSA prevalence was found to be 53.3%.The agr groups’ distribution in MRSA was as follows: 22 (45.8%) belonged to group I, 14 (29.1%) belonged to group III and 2 (4.1%) belonged to group II. agrIV was not detected in MRSA. For 17 isolates, the agr group was not detected.agr III isolates showed higher antibiotic resistance than agrI isolates except in case of oxacillin and linezolid. Conclusions: Strict infection control policy and antibiotic guidelines should be adopted to control the problem of MRSA. Higher prevalence of agr I and agr III shows that they are dominant agr groups of our area.

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Available from: Rabaab Zahra, Dec 30, 2014
    • "No statistically significant differences were found regarding frequency of MRSA in gender or group of infection origin (hospital acquired vs community acquired). MRSA infection was higher among the age group 50–59 years (60.71 %), which is in line with another study conducted in Pakistan which reported high prevalence of MRSA in age group +44 years (Khan et al. 2014). The multi-drug resistance in MRSA isolates has been a major problem worldwide which leads to ineffective therapy and increase in treatment expenses (Köck et al. 2010). "
    [Show abstract] [Hide abstract] ABSTRACT: Staphylococcus aureus is an increasing problem in clinical practice because of reduced susceptibility to available antibiotics. The objective of the study was to determine the frequency of Methicillin-resistant S. aureus (MRSA) in Peshawar, Pakistan. Clinical isolates of S. aureus were subjected to determination of antibiotic resistance, MICs and inducible clindamycin resistance (ICR). Out of total 280 S. aureus isolates, the frequency of MRSA was 36.1 % (n = 101). MRSA infection was found higher among the age group 50-59 years (60.71 %, OR 3.09), followed by 20-29 years (47.5 %, OR 1.74). Frequency of MRSA in female and male was 39.8 and 34 % respectively. MRSA was more frequent in blood specimens (48.7 %, OR 2.14). The frequency of community and hospital acquired MRSA was 42 and 34.8 % respectively. MRSA showed high resistance (100 %) to penicillin and cefoxitin followed by erythromycin (99 %). While MRSA exhibited 100 % susceptibility to vancomycin and linezolid. We have also found 7 vancomycin intermediate sensitive S. aureus (VISA) isolates. ICR was observed in 15.84 % (n = 16) of MRSA isolates. It is concluded that MRSA is potential threat to public health in Peshawar. Vancomycin and linezolid could be prescribed as a drug of choice in treating MRSA associated infections. In addition, ICR should be routinely checked to avoid clindamycin treatment failure.
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    • "(MRSA) are the most common accounting for about 50% of hospital acquired infections in many countries(Khan et al 2014). In Pakistan, the infections due to MRSA have greatly increased over the years. "
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