Volume 13, Issue 2 (Vol.13 No.2 Jul 2024)                   rbmb.net 2024, 13(2): 196-203 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Amelia S, Zein-Hamid R, Kusumawati L, Yamamoto Z, Santosaningsih D, Eyanoer P C, et al . Mec-A Positive Methicillin-Susceptible Staphylococcus Aureus as a Public Health Concern: A Case Series. rbmb.net 2024; 13 (2) :196-203
URL: http://rbmb.net/article-1-1389-en.html
Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Abstract:   (541 Views)
Background: Staphylococcus aureus, an opportunistic microorganism, is the leading cause of severe bloodstream infections, including sepsis and endocarditis, which can be life-threatening. Therefore, S. aureus infection poses a significant public health challenge, particularly in developing nations. mec-a is a genetic element commonly found in Methicillin-resistant Staphylococcus aureus (MRSA) strains that characterises the S. aureus resistance phenotype.

Methods: Clinical infection samples obtained from blood were collected and categorised as MRSA or Methicillin-sensitive Staphylococcus aureus (MSSA) using the VITEK-2 compact device. Subsequently, specific samples were gathered as case series owing to their unique characteristics. Resistance genes were detected using conventional polymerase chain reaction (PCR), followed by visualisation through electrophoresis.

Results: Our findings were based on the identification of five instances of MSSA among samples obtained from a tertiary hospital’s microbiology laboratory. Using the VITEK-2 antimicrobial susceptibility profile, these cases were determined to be MSSA. Subsequently, we conducted PCR, which revealed the presence of a mec-a-positive strain. Upon re-examination using Mueller–Hinton agar, the five strains were confirmed to be MSSA. Further analysis demonstrated that all strains were positive for Panton-Valentine leucocidin (pvl) and exfoliative toxin A (eta) gens.

Conclusions: The positive mec-A MSSA results should serve as a warning to clinicians that a resistant strain is forthcoming. mec-A continues to be the benchmark for confirming the resistance phenotype. Additional research is essential to explore this strain.
Full-Text [PDF 321 kb]   (205 Downloads)    
Type of Article: Case Report | Subject: Microbiology
Received: 2024/05/7 | Accepted: 2024/06/23 | Published: 2025/01/4

References
1. Murray PR, Rosenthal KS, Pfaller MA. Medical Microbiology. Elsevier Health Sciences. 8th Edition. 2015.
2. Taylor TA, Unakal CG. Staphylococcus aureus (S. aureus) infection. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2023.
3. Abraham L, Bamberger DM. Staphylococcus aureus bacteremia: temporary management. Mol Med. 2020;117(4):341-345.
4. van Hal SJ, Jensen SO, Vaska VL, Espedido BA, Paterson DL, Gosbell IB. Predictors of mortality in Staphylococcus aureus Bacteremia. Clin Microbiol Rev. 2012;25(2):362-86. [DOI:10.1128/CMR.05022-11] [PMID] []
5. Turner NA, Sharma-Kuinkel BK, Maskarinec SA, Eichenberger EM, Shah PP, Carugati M, Holland TL, Fowler VG Jr. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nat Rev Microbiol. 2019;17(4):203-218. [DOI:10.1038/s41579-018-0147-4] [PMID] []
6. Wielders CL, Fluit AC, Brisse S, Verhoef J, Schmitz FJ. The mecA gene is widely disseminated in Staphylococcus aureus populations. J Clin Microbiol.2002;40(11):3970-3975. [DOI:10.1128/JCM.40.11.3970-3975.2002] [PMID] []
7. Nasution GS, Suryanto D, Kusumawati RL. Detection of the meca gene from methicillin-resistant Staphylococcus aureus isolates from northern sumatera. IOP Conference Series: Earth and Environmental Science 2018 ;130(1):012026). IOP Publishing. [DOI:10.1088/1755-1315/130/1/012026]
8. Felten A, Grandry B, Lagrange PH, Casin I. Evaluation of three techniques for detection of low-level methicillin-resistant Staphylococcus aureus (MRSA): a disk diffusion method with cefoxitin and moxalactam, the Vitek 2 system, and the MRSA-screen latex agglutination test. J Clin Microbiol. 2002;40(8):2766-71. [DOI:10.1128/JCM.40.8.2766-2771.2002] [PMID] []
9. Kumar VA, Steffy K, Chatterjee M, Sugumar M, Dinesh KR, Manoharan A, et al. Detection of oxacillin-susceptible mecA-positive Staphylococcus aureus isolates by use of chromogenic medium MRSA ID. J Clin Microbiol. 2013;51(1):318-9. [DOI:10.1128/JCM.01040-12] [PMID] []
10. Kamberović F, Ibrahimagić A, Uzunović S, Budimir A, Rijnders MI, Stobberingh EE. mecA-positive methicillin-sensitive Staphylococcus aureus clinical isolates in Zenica-Doboj Canton, Bosnia and Herzegovina. J Chemother. 2015;27(6):330-6. [DOI:10.1179/1973947814Y.0000000207] [PMID]
11. Proulx MK, Palace SG, Gandra S, Torres B, Weir S, Stiles T, et al. Reversion From Methicillin Susceptibility to Methicillin Resistance in Staphylococcus aureus During Treatment of Bacteremia. J Infect Dis. 2016;213(6):1041-8. [DOI:10.1093/infdis/jiv512] [PMID] []
12. Rasmi AH, Ahmed EF, Darwish AMA, Gad GFM. Virulence genes distributed among Staphylococcus aureus causing wound infections and their correlation to antibiotic resistance. BMC Infect Dis. 2022;22(1):652. [DOI:10.1186/s12879-022-07624-8] [PMID] []
13. Shallcross LJ, Fragaszy E, Johnson AM, Hayward AC. The role of the Panton-Valentine leucocidin toxin in staphylococcal disease: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(1):43-54. [DOI:10.1016/S1473-3099(12)70238-4] [PMID]
14. Imanishi I, Nicolas A, Caetano AB, Castro TLP, Tartaglia NR, Mariutti R, et al. Exfoliative toxin E, a new Staphylococcus aureus virulence factor with host-specific activity. Sci Rep. 2019;9(1):16336. [DOI:10.1038/s41598-019-52777-3] [PMID] []
15. Susanti MA, Mahardhika GS, Rujito L, Darmawan AB, Anjarwati DU. The Examination of mecA gene in Methicillin-Resistant Staphylococcus aureus (MRSA) and inappropriate antibiotic uses of healthcare workers and communities in Banyumas. J Kedokteran dan Kesehatan Indonesia. 2020;11(2):257-265. [DOI:10.20885/JKKI.Vol11.Iss3.art7]
16. Shopsin B, Gomez M, Montgomery SO, Smith DH, Waddington M, Dodge DE, et al. Evaluation of protein A gene polymorphic region DNA sequencing for typing of Staphylococcus aureus strains. J Clin Microbiol. 1999;37(11):3556-63. [DOI:10.1128/JCM.37.11.3556-3563.1999] [PMID] []
17. Hesari MR, Salehzadeh A, Darsanaki RK. Prevalence and molecular typing of methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin gene. Acta Microbiol Immunol Hung. 2018;65(1):93-106. [DOI:10.1556/030.64.2017.032] [PMID]
18. 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):158-165.
19. Chen FJ, Huang IW, Wang CH, Chen PC, Wang HY, Lai JF, et al. mecA-positive Staphylococcus aureus with low-level oxacillin MIC in Taiwan. J Clin Microbiol. 2012;50(5):1679-83. [DOI:10.1128/JCM.06711-11] [PMID] []
20. Liu JL, Li TM, Zhong N, Wang X, Jiang J, Zhang WX, et al. Current status of oxacillin-susceptible mecA-positive Staphylococcus aureus infection in Shanghai, China: A multicenter study. J Microbiol Immunol Infect. 2021;54(6):1070-1077. [DOI:10.1016/j.jmii.2020.07.021] [PMID]
21. Broekema NM, Van TT, Monson TA, Marshall SA, Warshauer DM. Comparison of cefoxitin and oxacillin disk diffusion methods for detection of mecA-mediated resistance in Staphylococcus aureus in a large-scale study. J Clin Microbiol. 2009;47(1):217-9. [DOI:10.1128/JCM.01506-08] [PMID] []
22. Al-Amara SSM. Constitutive and Inducible Clindamycin Resistance Frequencies among Staphylococcus sp. Coagulase Negative Isolates in Al-Basrah Governorate, Iraq. Rep Biochem Mol Biol. 2022;11(1):30-35. [DOI:10.52547/rbmb.11.1.30] [PMID] []
23. Torki A, Amirmozafari N, Talebi M, Talebi A. Using the PCR and Blood Agar in Diagnosis of Semen Bacterial Contamination of Fertile and Infertile Men. Rep Biochem Mol Biol. 2021;10(3):402-411. [DOI:10.52547/rbmb.10.3.402] [PMID] []

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2015 All Rights Reserved | Reports of Biochemistry and Molecular Biology

Designed & Developed by : Yektaweb