Phenotypic detection of methicillin resistance, biofilm production, and inducible clindamycin resistance in Staphylococcus aureus clinical isolates in Kathmandu, Nepal

Mycosynthesis of zinc oxide nanoparticles using Mucor racemosus with their antimicrobial, antibiofilm, anticancer and antioxidant activities

The unregulated administration of currently available antimicrobial agents resulted in overspreading of resistant microbial phenotypes. In this study, Mucor racemosus was used for biosynthesis of zinc oxide nanoparticles (ZnO NPs) through fungi-based ecofriendly approach. The biosynthesized of ZnO NPs was initially considered based on analytical practices including UV-vis spectroscopy and transmission electron microscopy (TEM). Additionally, their cytotoxicity and anticancer activity were analyzed using suitable cell lines and their antioxidant effect was also assessed. Microbiologically, their inhibitory activity was comparatively evaluated against various methicillinresistant Staphylococcus aureus (MRSA) and methicillinsensitive Staphylococcus aureus (MSSA). Characterization of ZnO NPs displayed a distinct maximum absorption peak at 320 nm appeared in the UV-vis. Also, TEM revealed predominantly spherical ZnO NPs with particle size distribution ranging from 15 to 55 nm (mean size ≃ 40 nm). The normal cell line (Wi-38) illustrated the biosafety of ZnO NPs, where results showed IC50 of 197.2 µg/mL. Furthermore, ZnO NPs exhibited promising suppressive activity on Hep-G2 cancerous cell with IC50 of 51.4 µg/mL. Besides, ZnO NPs displayed antioxidant activity where IC50 was 69.2 µg/mL. As well, the minimum inhibitory concentrations of ecofriendly ZnO NPs against the tested MRSA and MSSA isolates were ranged from 32 to 512 µg/mL. Also, their minimum bactericidal concentrations against the tested MSSA was in lower range, 32-1024 µg/mL, than the recorded range, 128-1024 µg/mL, against the MSSA. Also, the crystal violet (CV) assay showed an eradication potential of the biosynthesized ZnO NPs on MRSA and MSSA biofilm in a range of 23.24-73.96% and 6.63-74.1%, respectively. In conclusion, the ecofriendly synthesized ZnO NPs with antioxidant and anticancer activities demonstrated promising inhibitory effect on planktonic growth form of MRSA and MSSA clinical isolates with capability to eradicate their preformed biofilm. To achieve their full potential, future research needs to enhance the synthesis process to make ZnO NPs more uniform and scalable, as well as investigate their action mechanisms at the molecular level.

Biofilm formation, methicillin resistance and SCCmec types among Staphylococcus aureus isolated from clinical samples from a tertiary care hospital, in Nepal

BACKGROUND

Methicillin resistant Staphylococcus aureus (MRSA) is a human pathogen that can cause hospital and community acquired infections. Biofilm formation is a major virulence factor contributing to its pathogenicity. This study aimed to detect biofilm formation ability among methicillin resistant Staphylococcus aureus (MRSA) clinical isolates and determine SCCmec types.

METHODS

A total of 115 S. aureus were isolated from various clinical samples collected at Nepal Armed Police Hospital from August 2022 to February 2023. The antibiotic susceptibility test was performed via a modified Kirby Bauer disc diffusion method following CLSI guidelines. Phenotypic detection of biofilm formation was performed by microtiter plate assay. Polymerase chain reaction was performed to detect mecA, icaA and SCCmec types.

RESULTS

More than 90% of the isolates were resistant to cefixime and penicillin. Among the total isolates, 66% were multidrug resistant. The disc diffusion method detected 60% of the isolates as MRSA, with 15 isolates lacking the mecA gene. Different levels of biofilm biomass were observed among 86 (75%) of the isolates by microtiter plate method. PCR revealed the presence of the icaA gene in a low number of the isolates (16%). Compared with biofilm nonproducer isolates, biofilm producing S. aureus isolates presented a greater incidence of antibiotic resistance with multi drug resistance (MDR). SCCmec type V (21%) predominated, followed by type II (13%) and most of them were MDR and biofilm producers.

CONCLUSIONS

Our results indicate a relatively high incidence of community acquired S. aureus circulating in the hospital setting. This study is the first to explore the associations between SCCmec types and biofilm formation among clinical isolates in Nepal. Monitoring the prevalence of biofilm producing S. aureus provides valuable insights into the evolving epidemiology of healthcare associated infections, facilitating the development of targeted infection control strategies.

Molecular and phenotypic characterization of biofilm formation and antimicrobial resistance patterns of uropathogenic staphylococcus haemolyticus isolates in Casablanca, Morocco

This study aimed to establish the correlation between antibiotic resistance and biofilm formation by Staphylococcus haemolyticus and to examine the impact of sub-inhibitory concentrations of antibiotics (sub-MICs) on biofilm formation. Antibiotic susceptibility testing was conducted using the disk diffusion method, and biofilm formation was determined using Congo red agar and microtiter plate methods. Antibiotic resistance and biofilm-associated genes were detected using polymerase chain reaction. The majority of the twenty-one S. haemolyticus isolates were multidrug-resistant, methicillin-resistant (MRSH) and biofilm producers, including 43 % of moderate biofilm producers. A significant correlation was observed between MRSH and MSSH isolates in terms of biofilm production. Vancomycin, gentamicin, and ciprofloxacin at their sub-MICs tended to promote biofilm formation. The eno gene was present in 76.2 % of strains, followed by aap, and atlE. This study revealed a strong correlation between the biofilm-forming ability and antibiotic resistance in S. haemolyticus, which underlines a crucial public health issue.

Recent development and fighting strategies for lincosamide antibiotic resistance

SUMMARYLincosamides constitute an important class of antibiotics used against a wide range of pathogens, including methicillin-resistant Staphylococcus aureus. However, due to the misuse of lincosamide and co-selection pressure, the resistance to lincosamide has become a serious concern. It is urgently needed to carefully understand the phenomenon and mechanism of lincosamide resistance to effectively prevent and control lincosamide resistance. To date, six mobile lincosamide resistance classes, including lnu, cfr, erm, vga, lsa, and sal, have been identified. These lincosamide resistance genes are frequently found on mobile genetic elements (MGEs), such as plasmids, transposons, integrative and conjugative elements, genomic islands, and prophages. Additionally, MGEs harbor the genes that confer resistance not only to antimicrobial agents of other classes but also to metals and biocides. The ultimate purpose of discovering and summarizing bacterial resistance is to prevent, control, and combat resistance effectively. This review highlights four promising strategies, including chemical modification of antibiotics, the development of antimicrobial peptides, the initiation of bacterial self-destruct program, and antimicrobial stewardship, to fight against resistance and safeguard global health.

Detection of mecA Genes in Hospital-Acquired MRSA and SOSA Strains Associated with Biofilm Formation

Methicillin-resistant (MR) Staphylococcus aureus (SA) and others, except for Staphylococcus aureus (SOSA), are common in healthcare-associated infections. SOSA encompass largely coagulase-negative staphylococci, including coagulase-positive staphylococcal species. Biofilm formation is encoded by the icaADBC operon and is involved in virulence. mecA encodes an additional penicillin-binding protein (PBP), PBP2a, that avoids the arrival of β-lactams at the target, found in the staphylococcal cassette chromosome mec (SCCmec). This work aims to detect mecA, the bap gene, the icaADBC operon, and types of SCCmec associated to biofilm in MRSA and SOSA strains. A total of 46% (37/80) of the strains were S. aureus, 44% (35/80) S. epidermidis, 5% (4/80) S. haemolyticus, 2.5% (2/80) S. hominis, 1.25% (1/80) S. intermedius, and 1.25% (1/80) S. saprophyticus. A total of 85% were MR, of which 95.5% showed mecA and 86.7% β-lactamase producers; thus, Staphylococcus may have more than one resistance mechanism. Healthcare-associated infection strains codified type I-III genes of SCCmec; types IV and V were associated to community-acquired strains (CA). Type II prevailed in MRSA mecA strains and type II and III in MRSOSA (methicillin-resistant staphylococci other than Staphylococcus aureus). The operon icaADBC was found in 24% of SA and 14% of SOSA; probably the arrangement of the operon, fork formation, and mutations influenced the variation. Methicillin resistance was mainly mediated by the mecA gene; however, there may be other mechanisms that also participate, since biofilm production is related to genes of the icaADBC operon and methicillin resistance was not associated with biofilm production. Therefore, it is necessary to strengthen surveillance to prevent the spread of these outbreaks both in the nosocomial environment and in the community.

Differences in Biofilm Formation by Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Strains

Staphylococcus aureus (S. aureus) is a common pathogen involved in community- and hospital-acquired infections. Its biofilm formation ability predisposes it to device-related infections. Methicillin-resistant S. aureus (MRSA) strains are associated with more serious infections and higher mortality rates and are more complex in terms of antibiotic resistance. It is still controversial whether MRSA are indeed more virulent than methicillin-susceptible S. aureus (MSSA) strains. A difference in biofilm formation by both types of bacteria has been suggested, but how only the presence of the SCCmec cassette or mecA influences this phenotype remains unclear. In this review, we have searched for literature studying the difference in biofilm formation by MRSA and MSSA. We highlighted the relevance of the icaADBC operon in the PIA-dependent biofilms generated by MSSA under osmotic stress conditions, and the role of extracellular DNA and surface proteins in the PIA-independent biofilms generated by MRSA. We described the prominent role of surface proteins with the LPXTG motif and hydrolases for the release of extracellular DNA in the MRSA biofilm formation. Finally, we explained the main regulatory systems in S. aureus involved in virulence and biofilm formation, such as the SarA and Agr systems. As most of the studies were in vitro using inert surfaces, it will be necessary in the future to focus on biofilm formation on extracellular matrix components and its relevance in the pathogenesis of infection by both types of strains using in vivo animal models.