Cent Eur J Public Health 2019, 27(1):58-63 | DOI: 10.21101/cejph.a4979

Panton-Valentine leukocidin and staphylococcal cassette chromosome mec characterization of community acquired methicillin-resistant Staphylococcus aureus

Velma Rebić1, Ana Budimir2, Mufida Aljicević1, Sabina Mahmutović Vranić1, Damir Rebić3
1 Institute of Microbiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
2 Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
3 Clinic for Nephrology, University Clinical Centre of Sarajevo, Sarajevo, Bosnia and Herzegovina

Objectives: Staphylococcus aureus (SA) represents one of the most important microorganism that is part of the normal microflora of humans, but in certain conditions can cause very serious infections. Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for a wide spectrum of nosocomial and community associated infections worldwide. The aim of this study was to determine community acquired MRSA (CA-MRSA), as well as the frequency of Panton-Valentine leukocidin (PVL) genes and staphylococcal cassette chromosome mec (SCCmec) types in isolates obtained from outpatients in the region of 700,000 people (Canton Sarajevo, Bosnia and Herzegovina) Methods: Our investigation included phenotypic and genotypic markers such as antimicrobial resistance, pulsed-field gel electrophoresis (PFGE), SCC typing, and PVL detection.

Results: Antimicrobial susceptibility: all MRSA isolates were resistant to the β-lactam antibiotics tested, and all isolates were susceptible to trimethoprim sulphamethoxazole, rifampicin, fusidic acid, linezolid, and vancomycin. After the PFGE analysis, the isolates were grouped into five similarity groups: A-E. The largest number of isolates belonged to one of two groups: C - 60% and D - 27%. In both groups C and D, SCCmec type IV was predominant (60% and 88.8%, respectively). A total of 24% of the isolates had positive expression of PVL genes, while 76% showed a statistically significantly greater negative expression of PVL genes.

Conclusions: Using combination techniques, we were able to investigate the origin and genetic background of the strains. PFGE analysis revealed two large, genetically related groups of strains consisting of 87 isolates. Our results suggest failure to apply the screening policy, and a lack of knowledge about multiresistant MRSA strains. This study showed the local epidemiological situation which should be the basis of antimicrobial empiric therapy for non-hospitalized patients.

Keywords: methicillin resistance, Panton-Valentine leukocidin, outpatients, types

Received: August 3, 2016; Revised: December 14, 2018; Published: March 30, 2019  Show citation

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Rebić V, Budimir A, Aljicević M, Mahmutović Vranić S, Rebić D. Panton-Valentine leukocidin and staphylococcal cassette chromosome mec characterization of community acquired methicillin-resistant Staphylococcus aureus. Cent Eur J Public Health. 2019;27(1):58-63. doi: 10.21101/cejph.a4979. PubMed PMID: 30927399.
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