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Virulence Factors of Staphylococcus aureus Isolates in an Iranian Referral Children's Hospital
Authors:Farah Sabouni  Shima Mahmoudi  Abbas Bahador  Babak Pourakbari  Reihaneh Hosseinpour Sadeghi  Mohammad Taghi Haghi Ashtiani  Bahram Nikmanesh  Setareh Mamishi
Institution:aDepartment of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;bPediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran;cDepartment of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;dPediatrics Center of Excellence, Children''s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract:

Objectives

The clinical importance of Staphylococcus aureus (S. aureus) is attributed to notable virulence factors, surface proteins, toxins, and enzymes as well as the rapid development of drug resistance. The aim of this study was to compare the occurrence of virulence factors produced by S. aureus strains isolated from children in an Iranian referral children''s hospital.

Methods

The presence of genes encoding for the enterotoxins A (sea), B (seb), C (sec), D (sed), TSST-1 (tsst), exfoliative toxin A (eta), and exfoliative toxin B (etb) were detected by Multiplex polymerase chain reaction (PCR) using specific primers. In addition, the standardized Kirby-Bauer disc-diffusion method was performed on Mueller-Hinton agar.

Results

In total, 133 S. aureus isolates were obtained from different patients. Of these S. aureus isolates, 64 (48%) were methicillin-resistant S. aureus (MRSA), and all of these tested positive for the mecA gene. Regarding the classical enterotoxin genes, sea gene (40.6%) was the most prevalent followed by seb (19.6%), tsst (12.8%), eta (11.3%), etb (9%), sed (4.5%), and sec (3%). Among methicillin-susceptible S. aureus (MSSA) isolates, seb and tsst were the more prevalent toxins in comparison with MRSA isolates (p < 0.05), while the frequency of sea, sed, eta, and etb genes were higher among MRSA isolates (p > 0.05).

Conclusion

In our study enterotoxin A was produced by 40.6% of the isolates (48% from MRSA and 33% from MSSA isolates) which was higher than in previous reports. According to our results, strict hygiene and preventative measures during food processing are highly recommended.
Keywords:enterotoxins  exfoliative toxins  Staphylococcus aureus  toxin of toxic shock syndrome-1
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