PCR-based rapid identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patients
Background: Bloodstream infections (BSI) in immunocompromised patients suffering from hematological malignancies continue to be an essential cause of morbidity and mortality. Methicillin-resistant Staphylococcus aureus (MRSA)-related BSI in patients with febrile neutropenia (FN) is a life-threatenin...
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| Format: | Article |
| Language: | English |
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Zagazig University, Faculty of Medicine
2023-11-01
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| Series: | Microbes and Infectious Diseases |
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| Online Access: | https://mid.journals.ekb.eg/article_311146_ae70caefe966781775a452fe980548b2.pdf |
| _version_ | 1827767241506029568 |
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| author | Maggie Ibrahim Enas Deaf Rania Hafez Safinaz Hussein Radwa Essam Amal Elkhawaga |
| author_facet | Maggie Ibrahim Enas Deaf Rania Hafez Safinaz Hussein Radwa Essam Amal Elkhawaga |
| author_sort | Maggie Ibrahim |
| collection | DOAJ |
| description | Background: Bloodstream infections (BSI) in immunocompromised patients suffering from hematological malignancies continue to be an essential cause of morbidity and mortality. Methicillin-resistant Staphylococcus aureus (MRSA)-related BSI in patients with febrile neutropenia (FN) is a life-threatening bacterial infection and extremely challenging to treat. Methods: Blood samples were collected from febrile neutropenic patients. Conventional blood culture and direct PCR identification of 16S rRNA, mecA, femA, nuc, and lukS genes were performed for detection of MRSA. Antibiotic sensitivity profiles of the isolates were investigated using disc diffusion and minimum inhibitory concentration methods. Results: Among 24 positive blood cultures isolates, MRSA (12/24, 50%) was the predominant bacteria followed by coagulase negative staphylococci (CoNS) (6/24, 33.3%). All MRSA isolates were resistant to cefoxitin (MIC ≥ 8 μg/ml), and oxacillin (MIC ≥ 4 μg/ml) and harbored mecA gene. 10/12 MRSA isolates were vancomycin resistant (VRSA) (MIC ≥ 16 μg/ml). PCR for 16S rRNA and mecA genes yielded positive results in 14 negative blood culture samples. Conclusions: We cannot rely on blood culture as a reliable method for BSI diagnosis in patients with FN. 16S rRNA and characteristic MRSA genes PCR showed important role for diagnosis of culture-negative MRSA BSI particularly in patients with preceding prophylactic or empirical antibiotics. |
| first_indexed | 2024-03-11T11:56:01Z |
| format | Article |
| id | doaj.art-990b5c459f2a4cc89d9c0779c41139cb |
| institution | Directory Open Access Journal |
| issn | 2682-4132 2682-4140 |
| language | English |
| last_indexed | 2024-03-11T11:56:01Z |
| publishDate | 2023-11-01 |
| publisher | Zagazig University, Faculty of Medicine |
| record_format | Article |
| series | Microbes and Infectious Diseases |
| spelling | doaj.art-990b5c459f2a4cc89d9c0779c41139cb2023-11-08T19:05:38ZengZagazig University, Faculty of MedicineMicrobes and Infectious Diseases2682-41322682-41402023-11-01441198120910.21608/mid.2023.218210.1546311146PCR-based rapid identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patientsMaggie Ibrahim0Enas Deaf1Rania Hafez2Safinaz Hussein3Radwa Essam4Amal Elkhawaga5Medical Microbiology and Immunology Department, Faculty of Medicine, Assuit University, EgyptMedical Microbiology and Immunology Department, Faculty of Medicine, Assuit University, EgyptHematology and Internal medicine Department, Faculty of Medicine, Assiut UniversityHematology and Internal medicine Department, Faculty of Medicine, Assiut UniversityPharmaceutical Sciences, Faculty of Pharmacy, Assiut UniversityMedical Microbiology and Immunology Department, Faculty of Medicine, Assuit University, EgyptBackground: Bloodstream infections (BSI) in immunocompromised patients suffering from hematological malignancies continue to be an essential cause of morbidity and mortality. Methicillin-resistant Staphylococcus aureus (MRSA)-related BSI in patients with febrile neutropenia (FN) is a life-threatening bacterial infection and extremely challenging to treat. Methods: Blood samples were collected from febrile neutropenic patients. Conventional blood culture and direct PCR identification of 16S rRNA, mecA, femA, nuc, and lukS genes were performed for detection of MRSA. Antibiotic sensitivity profiles of the isolates were investigated using disc diffusion and minimum inhibitory concentration methods. Results: Among 24 positive blood cultures isolates, MRSA (12/24, 50%) was the predominant bacteria followed by coagulase negative staphylococci (CoNS) (6/24, 33.3%). All MRSA isolates were resistant to cefoxitin (MIC ≥ 8 μg/ml), and oxacillin (MIC ≥ 4 μg/ml) and harbored mecA gene. 10/12 MRSA isolates were vancomycin resistant (VRSA) (MIC ≥ 16 μg/ml). PCR for 16S rRNA and mecA genes yielded positive results in 14 negative blood culture samples. Conclusions: We cannot rely on blood culture as a reliable method for BSI diagnosis in patients with FN. 16S rRNA and characteristic MRSA genes PCR showed important role for diagnosis of culture-negative MRSA BSI particularly in patients with preceding prophylactic or empirical antibiotics.https://mid.journals.ekb.eg/article_311146_ae70caefe966781775a452fe980548b2.pdfhematologicalmalignancybloodstreaminfection |
| spellingShingle | Maggie Ibrahim Enas Deaf Rania Hafez Safinaz Hussein Radwa Essam Amal Elkhawaga PCR-based rapid identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patients Microbes and Infectious Diseases hematological malignancy bloodstream infection |
| title | PCR-based rapid identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patients |
| title_full | PCR-based rapid identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patients |
| title_fullStr | PCR-based rapid identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patients |
| title_full_unstemmed | PCR-based rapid identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patients |
| title_short | PCR-based rapid identification of methicillin-resistant Staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patients |
| title_sort | pcr based rapid identification of methicillin resistant staphylococcus aureus strains and their antibiotic resistance profiles in febrile neutropenic patients |
| topic | hematological malignancy bloodstream infection |
| url | https://mid.journals.ekb.eg/article_311146_ae70caefe966781775a452fe980548b2.pdf |
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