Infection Control of Spatial Disseminated Multi-Antibiotics Resistant And Phylo- Diverse Staphylococcus Aureus Pathotypes
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Europe PMC
Abstract
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Focal dissemination of multi-antibiotic resistant (MAR) Staphylococci pathotypes
regulated by agr functionalities was investigated and evaluated for infection control.
Non-repetitive Staphylococcus aureus strains from soft and skin infections disseminated
in several communities were recovered and biotyped, assayed for biofilm and profiled for
antibiotic resistance. Strains were further genotyped for spa types, virulence and
resistant genes; and mapped for geospatial distribution. Clonal diversity and functional
accessory gene regulators ( agr ) were also evaluated. Staphylococcal infection was not
significant with age group (p>0.05), but high rate of MSSA (53.0%) and MRSA (1.5%)
was observed. Median resistance rates were significantly differ (p=0.001) but highest 75
th percentile and media resistance rates were observed in wound infection. Resistance
rate of 78.8% at MIC 50 32μg/ml and MIC 90 128μg/ml to amoxicillin-clavulanate, and
more than 40% resistance to ceftazidime, ciprofloxacin, gentamycin, ofloxacin,
sulfamethoxazole and tetracycline with MIC 90 and MIC 50 at 32 μg/ml were observed.
More than 0.83 multi-antibiotic resistance index (MARI) were observed among the
strains that clustered into separate phylo-group expressing high beta- lactamase and
strong biofilm production. Heterogeneous spa types t442 (wound and pus), t657
(wound), t091 (ear) and t657 (ear and wound) revealed high phylo- diversity. Only 4.6%
pvl + MSSA-CC1 agr I, pvl + MSSA-CC5 (13.6%) and pvl + MRSA-CC7 agr II (4.6%),
expressed enterotoxin; sea, sec, sed, sej, Leukocidins ( LukF-PV, lukD, lukE ),
proteases ( aur, slpA sspB, sspE ) and resistance genes ( fosB, msr (A), bla
mph(C),aphA3, sat, fosB, sdrM, Q7A4X2) . Phylogenetic related spa types of livestock
origin, specifically bovine milk clustered with detected strains that were prevalent in
urban communities with focal dissemination to other nearest suburbs. Clonal
dissemination resistant pvl+ MAR MSSA-CC1 and MRSA- CC5 encoding agr were
predominant in several peri-urban communities. This require adequate genosurveillance,
population-target antimicrobial stewardship, extensive community health
care intervention policy and well-structured infection control programs to prevent further
focal dissemination.
Keywords
QH301 Biology