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Vancomycin-Resistant Staphylococcus aureus Isolates from HIV Positive Patients in Imo State, Nigeria
Science Journal of Public Health
Volume 3, Issue 5-1, September 2015, Pages: 1-7
Received: May 21, 2015; Accepted: Jun. 26, 2015; Published: Sep. 2, 2015
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Emeka-Nwabunnia , Ijeoma, Department of Biotechnology, Federal University of Technology, Owerri, Nigeria
Chiegboka, Nneamaka Alice, Department of Biology, Federal University of Technology, Owerri, Nigeria
Udensi, Ugochi Justina, Department of Biotechnology, Federal University of Technology, Owerri, Nigeria
Nwaokorie, Francisca Obigaeri, Division of Molecular Biology and Biotechnology, Nigeria Institute of Medical Research, Lagos, Nigeria
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Vancomycin continues to be an important antimicrobial agent for treating infections caused by Staphylococcus aureus strains that are resistant to oxacillin (MRSA) and other antimicrobial agents. Vancomycin-resistant Staphylococcus aureus (VRSA) isolates were obtained from HIV-positive patients already on HAART treatment but were not admitted in the hospital. Species identification was confirmed by standard biochemical tests and PCR amplification of the 16S rRNA gene. Vancomycin resistance was determined using the Kirby-Bauer diffusion method and confirmed by Brain Heart Infusion (BHI) vancomycin screen agar plate containing 6µg/ml vancomycin. A total of 8 VRSA were identified from the 59 isolates obtained from the patients. Five out of the eight VRSA isolates were resistant to all the antibiotics tested. However, one unusual strain which was resistant to all the antimicrobial agents tested contained no plasmid, Mec A gene and PVL toxin gene. One VRSA isolate contained a large plasmid (~21.2 kb) and four small plasmids of ~5, 2.5, 1.2 and 0.8 kb respectively. The minimum inhibitory concentration (MIC) for vancomycin susceptibility was >15 µg/ml at disk potency of 30µg. The reduced susceptibility of S. aureus strains to vancomycin leaves clinicians with relatively few therapeutic options for treating these infections and therefore emphasizes the importance of prudent use of antibiotics and the use of infection-control precautions to prevent their transmissions.
Antibiotic Susceptibility, VRSA, MRSA, HIV Positive Patients, Staphylococcus aureus, Plasmid Profile, MecA Gene, Haemolytic Activities
To cite this article
Emeka-Nwabunnia , Ijeoma, Chiegboka, Nneamaka Alice, Udensi, Ugochi Justina, Nwaokorie, Francisca Obigaeri, Vancomycin-Resistant Staphylococcus aureus Isolates from HIV Positive Patients in Imo State, Nigeria, Science Journal of Public Health. Special Issue: Who Is Afraid of the Microbes. Vol. 3, No. 5-1, 2015, pp. 1-7. doi: 10.11648/j.sjph.s.2015030501.11
J. Chacko, M. Kuruvila, and A.K. Bhat, “Factors affecting the nasal carriage of MRSA in human immunodeficiency Virus- infected patients,” Indian J. Med. Microbiol., 2009, vol. 25, pp. 146–148.
A. Hidron, R. Kempker, A. Moanna and D. Rimland, “Methicillin resistant Staphylococcus aureus in HIV-infected patients,” Infect. Drug. Res., 2010, vol. 3, pp. 73–86.
G. Y. Liu, “Molecular Pathogenesis of Staphylococcus aureus Infection,” Int. Ped. Res. Found., 2009, vol. 65, pp. 71–77.
A. I. Hidron, E. V. Kourbatova, J. S. Halvosa, B. J. Terrell, L. K. McDougal, F. C. Tenover, H. M. Blumberg and M. D. King, “Risk Factors for Colonization with Methicillin-Resistant Staphylococcus aureus (MRSA) in patients admitted to an Urban Hospital: Emergence of Community-Associated MRSA Nasal Carriage,” Clin. Infect. Dis., 2005, vol. 41, pp. 159–166.
M. Tumbarello, E. Tacconelli, M. B. Lucia, R. Cauda and L. Ortona, “Predictors of Staphylococcus aureus pneumonia associated with human immunodeficiency virus infection,” Resp. Med., 1996, vol. 90, pp. 531–537.
K. Shigemura, K. Tanaka, H. Okada, Y. Nakano, S. Kinoshita, A. Gotoh, S. Arakawa and M. Fujisawa, “Pathogen occurrence and antimicrobial susceptibility of urinary tract infection cases during a 20-year period (1983-2002) at a single institution in Japan,” Jpn. J. Infect. Dis., 2005, vol. 58, pp. 303–308.
F. Franzetti, A. Grassini, M. Piazza, M. Degl’Innocenti, A. Bandera, L. Gazzola, G. Marchetti, and A. Gori, “Nosocomial Bacterial Pneumonia in HIV-Infected Patients: Risk Factors for Adverse Outcome and Implications for Rational Empiric Antibiotic Therapy,” Infection, 2006, vol. 34, pp. 9–16.
R. R. Muder, C. Brennen, J. D. Rihs, M. M. Wagener, A. Obman, J. E. Stout and V.L. Yu, “Isolation of Staphylococcus aureus from the urinary tract: association of isolation with symptomatic urinary tract infection and subsequent staphylococcal bacteraemia,” Clin. Infect. Dis., 2006, vol. 15, pp. 1504–1505.
L. Baba-Moussa, L. Anani, J. M. Scheftel, M. Couturier, P. Riegel, N. Haıkou, F. Hounsou, H. Monteil, A. Sanni and G. Pre´vost, “Virulence factors produced by strains of Staphylococcus aureus isolated from urinary tract infections,” J. Hos. Infect., 2007, vol. 68, pp. 32–38.
K. Flemming and G. Ackermann, “Prevalence of Enterotoxin Producing Staphylococcus aureus in Stools of Patients with Nosocomial Diarrhoea,” Infection, 2007, vol. 35, pp. 356–358.
P. J. Huggan, D. R. Murdoch, K. Gallagher and S. T. Chambers, “Concomitant Staphylococcus aureus bacteriuria is associated with poor clinical outcome in adults with S. aureus bacteraemia,” J. Hos. Infect., 2008, 69, pp. 345–349.
C. Kesah, S. Ben Redjeb, T. O. Odugbemi, C. S. B. Boye, M. Dosso, A. J. O. Ndinya, S. Koulla-Shiro, M. Benbachir, K. Rahal, and M. Borg, “Prevalence of methicillin-resistant Staphylococcus aureus in eight African hospitals and Malta,” Clin. Microbiol. Infect., 2003, vol. 9, pp. 153–156.
J. Ojulong, T. P. Mwambu, M. Jolobo, E Agwu, F. Bwanga, C. Najjuka, and M. Kaddu-Mulindwa, “Relative prevalence of Methicillin resistant Staphylococcus aureus (MRSA) and its susceptibility pattern in Mulago hospital- Kampala, Uganda,” Int. J. Infect. Dis., 2009, vol. 11, pp. 87-89.
L. Saikia, R. Nath, B. Choudhury and M. Sarkar, “Prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus in Assam,” Indian J. Crit. Care. Med., 2009, vol. 13, pp. 156–158.
C. J. Uneke, A. Ogbonna, P. G. Oyibo and C. M. Onu, “Bacterial contamination of stethoscopes used by health workers: public health implications,” J. Infect. Dev. Ctries, 2010, vol. 4, pp. 436–441.
M. Bassetti, E. Nicco and M. Mikulska, “Why is community-associated MRSA spreading across the world and how will it change clinical practice?” Int. J. Antimicrob. Agents, 2009, vol. 34, pp.15–19.
T. L. Bannerman, “Staphylococcus, Micrococcus, other catalase positive cocci that grow aerobically,” in: Manual of Clinical Microbiology, P. R. Murray, E. J. Baron, J. H. Jorgensen, M. A. Pfaller and R. H. Yolken, Eds. Washington, DC: ASM Press, 2003, pp. 384–404.
K. Zhang, J. Sparling, B. L. Chow, S. Elsayed, Z. Hussain, D. L. Church, D. B. Gregson, T. Louie and J. M. Conly, “New quadriplex PCR assay for detection of methicillin and mupirocin resistance and simultaneous discrimination of Staphylococcus aureus from coagulase-negative staphylococci,” Journal of Clinical Microbiology, 2004, vol. 42, pp. 4947–4955.
J. McClure, J. M. Conly, V. Lau, S. Elsayed, T. Louie, W. Hutchins and K. Zhang, “Novel multiplex PCR assay for detection of the staphylococcal virulence marker Panton-Valentine Leukocidin genes and simultaneous discrimination of methicillin susceptible from resistant staphylococci,” Journal of Clinical Microbiology, 2006, vol. 44, pp. 1141–1144.
Clinical and Laboratory Standards Institute (CLSI), “Methods for dilution antimicrobial susceptibility test for bacteria that grow aerobically: Approved Standards,” Wayne, PA, USA: Clinical and Laboratory Standards Institute, 2006, M7–A7.
M. Cheesebrough, “Biochemical Tests to Identify Bacteria,” in: Laboratory Practice in Tropical Countries, M. Cheesebrough, Eds. Cambridge edn. pp. 2002, 63–70.
E. E. Ehrenfeld and D. B. Clewell, “Transfer functions of the Streptococcus faecalis plasmid pADI: Organization of plasmid DNA encoding response to sex pheromones,” Journal of Bacteriology, 1987, vol. 169, pp. 3473–3481.
E. Jimenez, S. Delgado, L. Fernandez, N. Garcia, M. Albujar, A. Gomez and J. M. Rodriguez, “Assessment of the bacterial diversity of human colostrums and screening of Staphylococcal and Enterococcal population for potential virulence factors.” Res. Microbiol., 2008, vol. 159, pp. 595–601.
T. T. Ouke, J. N. Ngerenwa, G. O. Orinda, C. C. Bii, E. Amukoye, M. Lucy and C. N. Wamae, “Oxacillin resistant Staphylococcus aureus among HIV infected and non-infected Kayan patients,” East Africa Medical Journal, 2010, vol. 87, pp. 179–186.
B. P. Howden, J. K. Davis, P. D. Johnson, T. P. Stinear and M. L. Grayson, “Reduced vancomycin susceptibility in Staphylococcus aureus, including vancomycin –intermediate and heterogenous vancomycin –intermediate strains: resistance mechanisms, laboratory detection and clinical implications,” Clin. Microbiol. Rev., 2010, vol. 23, issue 1, pp. 99–139.
A. Azimian, H. S. Asghar, H. Fazeli, M. Naderi, K. Ghazvini, S. S. Mirab, M. Soleimani and P. S. Najar, “Genetic analysis of vancomycin –resistant Staphylococcus aureus strain isolated in Iran,” mBio, 2012, vol. 3, issue 6, pp. 442–454.
O. S. Olanitola, H. I. Iyabo, B. O. Olayinka and I. D. Bugo, “Nasal carriage of methicillin-resistant Staphylococcus aureus by primary school pupils in a university staff school, Zaria, Nigeria,” International Journal of Biological and Chemical Sciences, 2007, vol. 1, issue 1, pp. 71–75.
A. Onanuga and T. C. Temedia, “Nasal carriage of healthy in habitants of Amassoma in Niger Delta region of Nigeria,” African Health Sciences, 2011, vol. 11, issue 2, pp. 176–181.
A. Srinivasan, S. Seifried and L. Zhu, “Short communication: methicillin-resistant Staphylococcus aureus infections in children and young adults infected with HIV,” AIDS Res Hum Retroviruses, 2009, vol. 25(12), pp. 1219–1224.
S. D. Kobayashi, J. M. Musser and F. R. DeLeo, “Genomic analysis of the emergence of vancomycin –resistant Staphylococcus aureus,” mBio, 2012, vol. 3, issue 4, pp. 170–182.
A. O. Shittu, K. Okon, S. Adesida, O. Oyedara, W. Witte, B. Strommenger, F. Layer and U. Nubel, “Antibiotic resistance and molecular epidemiology of Staphylococcus aureus in Nigeria,” BMC Microbiology, 2011, vol. 11, pp.92–99.
V. N. Kos, C. A. Desjardins, A. Griggs, G. Cerqueira, A. Van Tonder, M. T. G. Holden, P. Godfrey, K. L. Palmer, K. Bodi, E. F. Mongodin, J. Wortman, M. Feldgarden, T. Lawley, S.R. Gill, B. J. Haas, B. Birren and M. S. Gilmore, “Comparative genomics of vancomycin-resistant staphylococcus aureus strains and their positions within the clade most commonly associated with methicillin-resistant S. aureus hospital-acquired infection in the United States,” mBio, 2012, vol. 3, issue 3, pp. 112–122.
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