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The emergence of vancomycin-resistant Staphylococcus aureus in an intensive care unit in Kerman, Iran

Aufkommen von vancomycinresistentem Staphylococcus aureus auf einer Intensivstation im iranischen Kerman

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Summary

Methicillin-resistant Staphylococcus aureus (MRSA) is a global threat to public health. This study is the first report of the emergence of vancomycin-resistant MRSA in Kerman, Iran. During a period of 15 months, a total of 205 clinical isolates of S. aureus were collected from three university hospitals affiliated with the Kerman University of Medical Science, Kerman, Iran. Screening of methicillin and vancomycin resistance was carried out by phenotypic methods. The resistance and virulence genes of vancomycin-resistant isolates were detected by polymerase chain reaction (PCR). Staphylococcal cassette chromosome mec (SCCmec) and spa typing were used for molecular typing of vancomycin-resistant isolates. Two S. aureus isolates were considered vancomycin-resistant by phenotypic and genotypic methods. Both isolates showed a minimum inhibitory concentration (MIC) ≥ 64 µg/ml and belonged to SCCmec III and spa type t030. Finding vancomycin-resistant S. aureus (VRSA) isolates represents a serious problem. More stringent infection control policies are recommended to prevent transmission of such life-threatening isolates in the hospital setting.

Zusammenfassung

Der methicillinresistente Staphylococcus aureus (MRSA) ist eine weltweite Bedrohung der öffentlichen Gesundheit. Die vorliegende Arbeit stellt den ersten Bericht über das Aufkommen vancomycinresistenter MRSA in Kerman, Iran, dar. Innerhalb von 15 Monaten wurde insgesamt 205 klinische Isolate von S. aureus aus 3 Universitätskliniken gesammelt, die der Medizinischen Fakultät der Universität Kerman angeschlossen sind. Das Screening auf Methicillin- und Vancomycinresistenz wurde anhand phänotypischer Verfahren durchgeführt. Die Resistenz- und Virulenzgene vancomycinresistenter Isolate wurden mittels Polymerasekettenreaktion („polymerase chain reaction“, PCR) nachgewiesen. Die Staphylococcal-Cassette-Chromosome-mec(SCCmec)- und -spa-Typisierung wurden zur molekularen Typisierung vancomycinresistenter Isolate eingesetzt. Anhand phänotypischer und genotypischer Verfahren wurden 2 S.-aureus-Isolate als vancomycinresistent angesehen. Beide Isolate zeigten eine minimale Hemmkonzentration („minimum inhibitory concentration“, MIC) ≥ 64 µg/ml und gehörten zum SCCmec-III- und -spa-Typ t030. Der Befund vancomycinresistenter S.-aureus(VRSA)-Isolate stellt ein ernstes Problem dar. Strengere Strategien für die Infektionsüberwachung werden zur Prävention der Übertragung derartiger lebensbedrohlicher Isolate in Krankenhäusern empfohlen.

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Acknowledgements

We specifically thank Dr. Javid Sadeghi (Department of Microbiology and Virology, Tabriz University of Medical Sciences, Tabriz, Iran) and Dr. Mohammad Emaneini (Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran) for providing standard and control positive strains in phenotypic and genotypic methods.

Funding

This work was supported by the Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran (Grant Number : IR.KMU.REC.1395.806).

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Authors and Affiliations

  1. Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

    Yasser Fasihi

  2. Department of Microbiology and Virology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

    Fereshteh Saffari, Shahla Mansouri &  Davood Kalantar-Neyestanaki

Authors
  1. Yasser Fasihi
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  2. Fereshteh Saffari
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  3. Shahla Mansouri
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  4. Davood Kalantar-Neyestanaki
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Corresponding author

Correspondence to Davood Kalantar-Neyestanaki.

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Conflict of interest

Y. Fasihi, F. Saffari, S. Mansouri, and D. Kalantar-Neyestanaki declare that they have no competing interests.

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Fasihi, Y., Saffari, F., Mansouri, S. et al. The emergence of vancomycin-resistant Staphylococcus aureus in an intensive care unit in Kerman, Iran. Wien Med Wochenschr 168, 85–88 (2018). https://doi.org/10.1007/s10354-017-0562-6

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  • DOI: https://doi.org/10.1007/s10354-017-0562-6

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