Molecular characterization of Staphylococcus aureus isolates causing skin and soft tissue infections in patients from Malakand, Pakistan

Eur J Clin Microbiol Infect Dis. 2016 Sep;35(9):1541-7. doi: 10.1007/s10096-016-2695-8. Epub 2016 Jun 4.

Abstract

Comparatively few studies have been published describing Staphylococcus aureus/MRSA epidemiology in Central Asia including Pakistan. Here, we report the genotyping of Staphylococcus aureus strains (that include both methicillin-susceptible and methicillin-resistant Staphylococcus aureus) from community- and hospital-acquired skin and soft-tissue infections in a tertiary care hospital in the Malakand district of the Khyber Pakhtunkhwa Province of Pakistan. Forty-five isolates of Staphylococcus aureus were characterized by microarray hybridization. Twenty isolates (44 %) were MRSA, whereas 22 (49 %) were PVL-positive. Fourteen isolates (31 %) harboured both mecA and PVL genes. The dominant clones were CC121-MSSA (n = 15, 33 %) and the PVL-positive "Bengal Bay Clone" (ST772-MRSA-V; n = 13, 29 %). The PVL-positive CC8-MRSA-IV strain "USA300" was found once. The pandemic ST239-MRSA-III strain was absent, although it has previously been observed in Pakistan. These observations require a re-assessment of schemes for initial antibiotic therapy to cover MRSA and they emphasise the need for a rapid and non-molecular test for PVL.

MeSH terms

  • Bacterial Proteins / genetics
  • Bacterial Toxins / genetics
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Exotoxins / genetics
  • Genotype
  • Genotyping Techniques
  • Humans
  • Leukocidins / genetics
  • Microarray Analysis
  • Molecular Epidemiology
  • Nucleic Acid Hybridization
  • Pakistan / epidemiology
  • Penicillin-Binding Proteins / genetics
  • Soft Tissue Infections / epidemiology
  • Soft Tissue Infections / microbiology*
  • Staphylococcal Skin Infections / epidemiology
  • Staphylococcal Skin Infections / microbiology*
  • Staphylococcus aureus / classification*
  • Staphylococcus aureus / genetics*
  • Staphylococcus aureus / isolation & purification
  • Tertiary Care Centers

Substances

  • Bacterial Proteins
  • Bacterial Toxins
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin
  • Penicillin-Binding Proteins
  • mecA protein, Staphylococcus aureus