Molecular characterization of nasal methicillin resistant Staphylococcus aureus isolates from workers of an automaker company in southeast Iran

Prevalence and risk factors for Staphylococcus aureus colonisation among healthy individuals in low- and middle-income countries: A systematic review and meta-analysis

BACKGROUND

Staphylococcus aureus is capable of asymptomatic colonisation, which can progress to opportunistic and potentially life-threatening infection. The data on S. aureus colonisation in low- and middle-income countries (LMIC) are limited. This systematic review and meta-analysis estimates the prevalence of S. aureus colonisation in asymptomatic individuals in LMIC, with secondary objectives of assessing antimicrobial resistance, colonisation risk factors, and the molecular epidemiology of colonising strains.

METHODS

Articles published up to July 2023 were identified by searching four electronic databases. Studies that presented S. aureus colonisation prevalence in healthy individuals from a community setting in LMIC were included. Data extraction was performed independently by two reviewers with disagreement resolved through consensus. Studies were critically appraised using the Joanna Briggs Institute Prevalence tool. Random effects meta-analysis was conducted where appropriate. This study was registered in advance with PROSPERO (CRD42019147780).

FINDINGS

A total of 16 610 citations were identified of which 138 studies (59 732 participants) met the eligibility criteria. The majority of studies had a low risk of bias. The pooled prevalence of S. aureus colonisation at nose and/or throat sites was 26·4% (95% CI 23·8 - 29·1%). The prevalence of methicillin-resistance in colonising S. aureus strains was 15·0% (95% CI: 11·8 to 18·6%), with a higher prevalence observed in Africa compared to Asia and South America (22·5% vs. 13·1% vs. 5·4% respectively). Panton-Valentine leukocidin genes were present in 26·4% (95% CI: 17·1% to 32·8%) of 2531 isolates.

INTERPRETATION

While the prevalence of asymptomatic S. aureus colonisation in LMIC mirrors that found in high-income countries, there was a higher prevalence of antimicrobial resistance and other virulence factors. Variability in study methods and sparsity of data from many LMIC, underscore the need for a global approach to S. aureus surveillance. This will be critical for informing effective infection prevention strategies.

Clonal diversity and genomic characterization of Panton-valentine Leukocidin (PVL)-positive Staphylococcus aureus in Tehran, Iran

Background

Some Staphylococcus aureus strains produce Panton-Valentine leukocidin (PVL), a bi-component pore-forming toxin, which causes leukocyte lysis and tissue necrosis. Currently, there is very limited information on the molecular epidemiology of PVL-encoding S. aureus strains in Iran. This study aimed to determine the molecular epidemiology and genetic background of PVL-positive S. aureus clinical strains isolated from Iranian patients.

Methods

A total of 28 PVL-positive S. aureus strains were detected from 600 S. aureus isolates between February 2015 and March 2018 from different hospitals in Tehran, Iran. Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Molecular genotyping was performed using SCCmec and accessory gene regulator (agr) typing, PVL haplotyping, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE).

Results

The highest antibiotic resistance rate was found to be against erythromycin (57.1%), followed by ciprofloxacin (42.8%) and clindamycin (35.7%). Moreover, 19 (67.9%) out of 28 S. aureus isolates were identified as MRSA, including CA-MRSA (14/19, 73.7%) and HA-MRSA (5/19, 26.3%). SCCmec type IVa was detected as the predominant type (10/19, 52.6%), followed by type III (5/19, 26.3%) and type V (4/19, 21.1%). The agr type I was identified as the most common type (14/28, 50%), and H and R haplotype groups were observed at frequencies of 67.9 and 32.1%, respectively. Among H variants, the predominant variant was H2 (78/9%). The isolates encompassed 21 different sequence types (STs), including 16 new STs (ST5147 to ST5162). Based on eBURST analysis, the isolates were clustered into five CCs, including CC30, CC22, CC1, CC8, and CC5 (ST5160), and nine singletons. PFGE typing showed that 24 isolates were clustered into A (4 pulsotypes), B (9 pulsotypes), and C (11 pulsotypes) clusters.

Conclusions

A high prevalence of PVL-positive CA-MRSA strains was detected in Iran. The majority of PVL-positive isolates were of H (mostly H2) variant, while R variant was harbored by 100% of PVL-positive MRSA strains. Also, CC8, CC22, and CC30 were identified as the dominant clones among PVL-encoding S. aureus strains. This study promotes a better understanding of the molecular epidemiology and evolution of PVL-positive S. aureus strains in Iran.

Methicillin-Resistant Staphylococcus aureus ST80 Clone: A Systematic Review

This review assessed the molecular characterization of the methicillin-resistant Staphylococcus aureus (MRSA)-ST80 clone with an emphasis on its proportion of total MRSA strains isolated, PVL production, spa-typing, antibiotic resistance, and virulence. A systematic review of the literature was conducted on MRSA-ST80 clone published between 1 January 2000 and 31 August 2019. Citations were chosen for a review of the full text if we found evidence that MRSA-ST80 clone was reported in the study. For each isolate, the country of isolation, the sampling period, the source of isolation (the type of infection, nasal swabs, or extra-human), the total number of MRSA strains isolated, number of MRSA-ST80 strains, antibiotic resistance patterns, PVL production, virulence genes, and spa type were recorded. The data from 103 articles were abstracted into an Excel database. Analysis of the data showed that the overall proportion of MRSA-ST80 has been decreasing in many countries in recent years. The majority of MRSA-ST80 were PVL positive with spa-type t044. Only six reports of MRSA-ST80 in extra-human niches were found. This review summarizes the rise of MRSA-ST80 and the evidence that suggests that it could be in decline in many countries.

Cytotoxicity, leishmanicidal, and antioxidant activity of biosynthesised zinc sulphide nanoparticles using Phoenix dactylifera

The synthesis of zinc sulphide nanoparticles (ZnS NPs) using a green approach was explored. The resulting nanoparticles (NPs) were characterised by UV–vis spectroscopy, scanning and transmission electron microscopy, X‐ray diffraction and Fourier transform infrared spectroscopy. The leishmanicidal, cytotoxic and antioxidant activity of the resulting synthesised ZnS NPs (<70 nm) were evaluated against Leishmania major (L. major ) promastigotes and amastigotes by MTT assay and using a macrophage model. The ZnS NPs were able to counteract the effects of oxidative metabolites as demonstrated by the oxidant activity. The IC50 value of butylated hydroxyanisole was 26.04 µg/ml as compared with the IC50 for ZnS NPs (90.95 µg/ml). The NPs displayed no cytotoxicity for the murine macrophaghes as the selectivity index (SI) fell into the safety range (SI ≥ 10). These nanomaterials exhibited good antileishmanial activity against the L. major stages that were comparable to that of Glucantime, the drug of choice. The IC50 values of ZnS NPs and Glucantime against amastigotes were 11.59 ± 2.51 and 4.95 ± 2.51 μg/ml, respectively. The IC50 values for ZnS NPs and Glucantime versus promastigote were 29.81 ± 3.15 and 14.75 ± 4.05 μg/ml, respectively. Further investigation is essential to explore the biological effects of ZnS NPs on animal and/or clinical models.