Prevalence of blaZ in Clinical Isolates of Staphylococcus aureus Isolated from Hamedan Hospitals

Authors
Romina Kakaei
AmirHossein Momen
Hossein Vazini
Department of Microbiology, School of Basic Sciences, Hamedan Branch, Islamic Azad University, Hamedan, Iran
Abstract
Introduction

Staphylococcus aureus (S. aureus) has been recognized as a powerful pathogen that causes numerous infections. Today, S.aureus has acquired multiple resistance to a wide range of antibiotics, including beta-lactams. Beta-lactamases hydrolyze beta-lactam antibiotics and are expressed through activation of the blaZ gene. The aim of this study was to evaluate the frequency of blaZ gene in clinical isolates of S.aureus isolated from Hamadan hospitals.

Materials and Methods

In this descriptive cross-sectional study, all S.aureus strains were randomly selected and transferred to the laboratory. In clinical isolates confirmed by biochemical tests of genomic DNA extraction procedures using CinnaGen extraction kit) was performed according to the manufacturer's protocol and 1% agarose gel was used to view the PCR product. Data were analyzed by SPSS software.

Results

From 50 hospitalized patients in Fatemieh and Sina hospitals, 32 men (64%), and 18 women (36%), isolates of S.aureus were isolated. The pattern of antibiotic resistance obtained was that penicillin (10 µg) with 100% resistance and cefazolin (30 µg) with 5% resistance had the highest and lowest resistance, respectively. Also, 94% of isolates were resistant to cefoxitin (30 µg) and 90% of isolates were resistant to oxacillin (1 µg). Of 50 S.aureus isolated from clinical isolates, 44 (88 %) contained the blaZ beta-lactamase gene.

Conclusion

Based on the findings of this study, isolates isolated from clinical specimens showed the same pattern of abundance. Therefore, it is likely that more or more drug resistance will be transmitted to hospitals.
Keywords
Gene blaZ
Staphylococcus
Clinical Isolate
Drug resistance
1. Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler VG, Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015; 28(3): 603-61.
2. Raei F, Eftekhar F. Studying the presence of blaZ gene and b-lactamase production in clinical isolates of Staphylococcus epidermidis. Iran J Med Microbiol. 2008; 2(2): 35-41. [Persian]
3. Livorsi DJ, Crispell E, Satola SW, Burd EM, Jerris R, Wang YF, et al. Prevalence of blaZ gene types and the inoculum effect with cefazolin among bloodstream isolates of methicillin-susceptible staphylococcus aureus. Antimicrob Agents Chemother. 2012; 56(8): 4474-7.
4. Pereira LA, Harnett GB, Hodge MM, Cattell JA, Speers DJ. Real-time PCR assay for detection of blaZ genes in Staphylococcus aureus clinical isolates. J Clin Microbiol. 2014; 52(4): 1259-61.
5. Bokaeian M, Tahmasebi H, Adabi J, Mohammad Zadeh A, Mardaneh J. Molecular study of the blaZ Staphylococcus aureus gene isolated from clinical samples. JSUMS 2018; 25(1):31-37. [Persian]
6. Khaleghi M,Zarei H, Bokaeian M, Saeidi S. Evaluation of colonization of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals of Zabol city in 2010. Applied Biology, 2015; 28(1): 51-58. [Persian]
7. Kaspar DL, Braunwald E, Fauci AS, Lauser SL, Longo DL, Jameson JL. Harrisons Principles of Internal Medicine. 16thed. (2005), Volume 1, chapter116, P: 775-781.
8. Kateete DP, Kimani CN, Katabazi FA, Okeng A, Okee MS, Nanteza A, et al. Identification of Staphylococcus aureus: DNase and Mannitol salt agar improve the efficiency of the tube coagulase test. Ann Clin Microbiol Antimicrob. 2010; 9(1): 23.
9. Sidhu MS, Heir E, Leegaard T, Wiger K, Holck A. Frequency of disinfectant resistance genes and genetic linkage with β-Lactamase transposon Tn552 among clinical staphylococci. Antimicrobial Agents and Chemotherapy. 2002; 46(9): 2797-803.
10. Safdari H, Sadeghian A, Tahaghogi S. The Antibiotic Resistance Pattern of Staphylococcus aureus Isolated From Patients in Quaem University Hospital During 2009- 2011. Mashhad Med J. 2012; 1(1): 39- 41.
11. Tavakoli A, Yazdani R, Bakaeiyan M. Comparison of coagulase- positive staphylococci resistant to beta- lactam antibiotics. Zahedan Univ Med J. 2002; 3(10): 1-5.[Persian]
12. Ghassemian R, Najafi N, Shojaeifar A. The prevalence of Staphylococcus aureus nasal carriers and pattern Antibiotic resistance in the Employee Training Center –Razi Ghaem Shahr City in fall 2004. Mazandaran Univ Med J. 2004; 14 (44): 79- 86.
13. Hisatsune J, Hirakawa H, Yamaguchi T, Fudaba Y, Oshima K, Hattori M, et al. Emergence of staphylococcus aureus carrying multiple drug resistance genes on a plasmid encoding exfoliative toxin B. Antimicrob Agents Chemother. 2013; 57(12): 6131-40.
14. Rosato AE, Kreiswirth BN, Craig WA, Eisner W, Climo MW, Archer GL. mecA-blaZ corepressors in clinical staphylococcus aureus isolates. Antimicrob Agents Chemother. 2003; 47(4): 1460-3.
15. Chong Y, Park S, Kim E, Bang K, Kim M, Kim SH, et al. Prevalence of blaZ gene types and the cefazolin inoculum effect among methicillin-susceptible Staphylococcus aureus blood isolates and their association with multilocus sequence types and clinical outcome. Eur J Clin Microbiol Infect Dis. 2015; 34(2):349-55.
16. Assant S, Valour F, Mouton W, Martins-Simões P, Lustig S, Laurent F, et al. 2016. Methicillin-susceptible strains responsible for postoperative orthopedic infection are not selected by the use of cefazolin in prophylaxis. Diagn Microbiol Infect Dis. 2015; 84(3):266-7.
17. Li J, Echevarria KL, Hughes DW, Cadena JA, Bowling JE, Lewis JS. Comparison of cefazolin versus oxacillin for treatment of complicated bacteremia caused by methicillin-susceptible staphylococcus aureus. Antimicrob Agents Chemother. 2014; 58(9): 5117-24.
18. Fessler A, Billerbeck C, Kadlec K. Identification and characterization of methicillin-resistant coagulase-negative staphylococci from bovine mastitis. J Antimicrob Chemother. 2010; 65(8):1576-82.
19. Kitao T. Survey of methicillin-resistant coagulasenegative staphylococci isolated from the fingers of nursing students. J Infect Chemother. 2003; 9(1):30-4.
20. Rahimi F, Bouzari M, Katouli M, Pourshafie MR. Antibiotic resistance pattern of methicillin resistant and methicillin sensitive staphylococcus aureus isolates in Tehran, Iran. Jundishapur J Microbiol. 2013; 6:144-149.
21. Hassanzadeh S, Pourmand MR, Hadadi A, Nourijeylani K, Yousefi M, Mashhadi R. Frequency and antimicrobial resistance patterns of methicillin resistant staphylococcus aureus in Tehran. J Med Bacteriol. 2013; 2:41-46.
22. Haddad Sabzevar A, Abdollahzadeh H. Prevalence of aac (6')-Ie-aph (2%)-Ia gene among clinical isolates of methicillin resistant Staphylococcus aureus isolated from selected hospitals in Mashha. JSUMS,2017;23(1),31-39. [Persian
23. Qian M, Tang S, Wu C, Wang Y, He T, Chen T, et al. Synergy between baicalein and penicillins against penicillinase-producing Staphylococcus aureus. IJMM. 2015; 305(6):501-4.
24. Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard, 9th ed. CLSI M07-A9. Clinical and Laboratory Standards Institute, Wayne, PA. 2018.
25. Khalili H, Soltani R, Negahban S, Abdollahi A, Gholami K. Reliability of disk diffusion test results for the antimicrobial susceptibility testing of nosocomial gram-positive microorganisms: Is E-test Method Better? IJPR. 2012; 11(2): 559-63.
26. King M, Humphrey B, Wang Y, Kourbatova EV, Ray S, Blumberg HM. Emergence of Community-Acquired Methicillin-Resistant Staphylococcus aureus USA 300 Clone as the Predominant Cause of Skin and Soft-Tissue Infections. Ann Intern Med. 2006; 144:309-317.