Detection of Efflux Pumps by mdeA gene, a Chromosomally-Encoded from Multidrug Staphylococcus aureus isolates

Authors

  • Shaymaa Majeed AL-Dahlaki
  • Shahad Saad Alwan

Keywords:

Staphylococcus aureus, mdeA gene, PCR Detection, Ethidium Bromide

Abstract

Objective: Isolation and Identification of S.aureus and study their susceptibility, study mdeA gene, a Chromosomally-Encoded Multidrug Efflux Pump, from Staphylococcus aureus in patient of Baquba city. Materials and Methods: A total of 25 clinical specimens of Staphylococcus aureus isolates were collected from Baquba Teaching Hospital between June,1, 2022 to August,1, 2022. The isolates were identified based on their cultural characteristics, microscopic examination of cells, and biochemical tests. Antibiotic susceptibility testing was performed using an antibiotic diffusion disc assay to determine the sensitivity of the isolates to Staphylococcus aureus. The mdeA gene from S. aureus was also studied using the PCR technique.

Results: The results show that the Staphylococcus aureus distributed as (4)(16%) samples from blood, 4(16%) samples from urinary tract infections,  6(24%) from wound infections , 2(8%) samples  from burn infections, 3(12%) from ear swabs and 6(16%) samples from nasal swabs. The collected isolates were initially diagnosed in hospitals as Staphylococcus aureus that resistant to methicillin formed 100% ,The result revealed that MRSA isolates appeared completely resistant (100%) to Ceftazidime and Cefepime, the results showed that the resistance rate of MRSA isolate to Amikacin, Genetamicin and Kanamycin was 10\18(55.6%), 12\18 (66.6%)and 16 (88.9%)respectively and quinolone antibiotic such as Levofloxacin 14/18( 77.7%), Norfloxacin 12/18 (66.6%) , Ofloxacin 12/18( 66.6 %) ,Ciprofloxacin4/18(22.2%). The presence of the mdeA gene in the isolates was verified using uniplex PCR, which is considered the gold standard approach. A solitary band was detected at a specific molecular weight of 677  (bp). Our findings demonstrated that (16) MRSA isolates Thus, the prevalence of mdeA in patients of Baquba hospital was (88.8%). The remaining 2(12.2%) isolates were mdeA-negative. Staphylococcus aureus exhibits a significant level of resistance to quinolone antibiotics.

Conclusion: This resistance is further enhanced by the presence of the model gene in the isolates, contributing to bacterial resistance against the antibiotics often used in our local area.

Downloads

Download data is not yet available.

References

Sheykhsaran E, Sadeghi J, Memar MY, Ghotaslou R, Baghi HB, Sharifi Y, et al. Epidemiological characterization of clinical isolates of meticillin resistant Staphylococcus aureus through multilocus sequence typing and staphylococcal cassette chromosome mec typing in Northwest Iran. Molecular Biology Reports. 2024;51(1):58.

Costa SS, Sobkowiak B, Parreira R, Edgeworth JD, Viveiros M, Clark TG, et al. Genetic diversity of norA, coding for a main efflux pump of Staphylococcus aureus. Frontiers in genetics. 2019;9:710.

Jawetz E, Brooks GF, Carroll KC, Butel JS, Morse SA, Mietzner TA. Jawetz, Melnick, & Adelberg's medical microbiology. (No Title). 1991.

Afshari A, Taheri S, Hashemi M, Norouzy A, Nematy M, Mohamadi S. Methicillin-and vancomycin-resistant Staphylococcus aureus and vancomycin-resistant enterococci isolated from hospital foods: Prevalence and antimicrobial resistance patterns. Current microbiology. 2022;79(11):326.

Javed M, Arshad M, Khan MA. 69. Pathogenic bacteria profile and antimicrobial susceptibility patterns of ear infection at Ayub Medical Complex Abbottabad, Pakistan. Pure and Applied Biology (PAB). 2020;9(1):714-9.

Benoit JB, Frank DN, Bessesen MT. Genomic evolution of Staphylococcus aureus isolates colonizing the nares and progressing to bacteremia. PLoS One. 2018;13(5):e0195860.

Ahmed ZF, Al-Daraghi WAH. Molecular detection of medA virulence gene in Staphylococcus aureus isolated from Iraqi patients. Iraqi journal of biotechnology. 2022;21(1).

Hassanzadeh S, Pourmand MR, Mashhadi R, Ghazvini K. Epidemiology of efflux pumps genes mediating resistance among Staphylococcus aureus; A systematic review. Microbial pathogenesis. 2020;139:103850.

Kumar P. A review on quinoline derivatives as anti-methicillin resistant Staphylococcus aureus (MRSA) agents. BMC chemistry. 2020;14(1):17.

Butler C, Cheng J, Correa L, Preciado-Rivas MR, Ríos-Gutiérrez A, Montalvo C, et al. Comparison of Screening for Methicillin-Resistant Staphylococcus Aureus at Hospital Admission and Discharge. Letters in Biomathematics. 2021;8(1):151-66.

Tacconelli E, Carrara E, Savoldi A, Harbarth S, Mendelson M, Monnet DL, et al. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. The Lancet infectious diseases. 2018;18(3):318-27.

Young BC, Wu C-H, Charlesworth J, Earle S, Price JR, Gordon NC, et al. Antimicrobial resistance determinants are associated with Staphylococcus aureus bacteraemia and adaptation to the healthcare environment: a bacterial genome-wide association study. Microbial Genomics. 2021;7(11):000700.

Bergey DH. Bergey's manual of determinative bacteriology: Lippincott Williams & Wilkins; 1994.

Martins M, Viveiros M, Couto I, Costa SS, Pacheco T, Fanning S, et al. Identification of efflux pump-mediated multidrug-resistant bacteria by the ethidium bromide-agar cartwheel method. In vivo. 2011;25(2):171-8.

Humphries R, Ambler J, Mitchell S, Castanheira M, Dingle T, Hindler J, et al. on behalf of the CLSI Methods Development and Standardization Working Group of the Subcommittee on Antimicrobial Susceptibility Testing. 2018. CLSI Methods Development and Standardization Working Group best practices for evaluation of antimicrobial susceptibility tests. J Clin Microbiol. 2018;56:01934.

Couto I, Costa SS, Viveiros M, Martins M, Amaral L. Efflux-mediated response of Staphylococcus aureus exposed to ethidium bromide. Journal of antimicrobial chemotherapy. 2008;62(3):504-13.

JF M. Biochemical tests for identification of medical bacteria. Lippinccot, Williams & Williams, Baltimore. 2000.

Pagès J-M, Kascàkovà S, Maigre L, Allam A, Alimi M, Chevalier J, et al. New peptide-based antimicrobials for tackling drug resistance in bacteria: single-cell fluorescence imaging. ACS medicinal chemistry letters. 2013;4(6):556-9.

Viveiros M, Martins A, Paixão L, Rodrigues L, Martins M, Couto I, et al. Demonstration of intrinsic efflux activity of Escherichia coli K-12 AG100 by an automated ethidium bromide method. International journal of antimicrobial agents. 2008;31(5):458-62.

Sun DD, Ma XX, Hu J, Tian Y, Pang L, Shang H, et al. Epidemiological and molecular characterization of community and hospital acquired Staphylococcus aureus strains prevailing in Shenyang, Northeastern China. The Brazilian Journal of Infectious Diseases. 2013;17(6):682-90.

Allam A, Maigre L, Vergalli J, Dumont E, Cinquin B, Alves de Sousa R, et al. Microspectrofluorimetry to dissect the permeation of ceftazidime in Gram-negative bacteria. Scientific Reports. 2017;7(1):986.

Abbas SK, Omran DG, Abdulazeem L. Bacterial Infections and Inflammatory Markers in Diabetic Foot Ulcers: Assessing the Roles of Staphylococcus aureus, Pseudomonas aeruginosa, Vascular Endothelial Growth Factor, and Interleukin-6. Medical Journal of Babylon. 2024;21(2):330-6.

Forbes BA, Sahm DF, Weissfeld AS. Diagnostic microbiology: Mosby St Louis; 2007.

Kareem SM, Al-Jubori SS, Ali M. Prevalence of erm genes among methicillin resistant Staphylococcus aureus MRSA Iraqi isolates. Int J Curr Microbiol Appl Sci. 2015;4(5):575-85.

Ghareeb NH, Obaid SS, Jumaah IAM. The prevalence of multidrug-resistant Staphylococcus aureus isolated from different clinical samples. Medical Journal of Babylon. 2023;20(Supplement 1):S185-S7.

Abdullahi N, Iregbu KC. Methicillin-resistant Staphylococcus aureus in a central Nigeria tertiary hospital. Annals of Tropical Pathology. 2018;9(1):6-10.

Nezhad RR, Meybodi SM, Rezaee R, Goudarzi M, Fazeli M. Molecular characterization and resistance profile of methicillin resistant Staphylococcus aureus strains isolated from hospitalized patients in intensive care unit, Tehran-Iran. Jundishapur Journal of Microbiology. 2017;10(3).

Saber N, Kandala NJ. The inhibitory effect of fluphenazinedecanoate and caffeine on Staphylococcus aureus efflux pumps. Current Research in Microbiology and Biotechnology. 2018;6(2):1530-5.

Akanbi OE, Njom HA, Fri J, Otigbu AC, Clarke AM. Antimicrobial susceptibility of Staphylococcus aureus isolated from recreational waters and beach sand in Eastern Cape Province of South Africa. International journal of environmental research and public health. 2017;14(9):1001.

Hamza ENH, Fazaa SA. Molecular investigation of quinolone-resistant genes among clinical Staphylococcus aureus isolates in Babylon hospitals. Medical Journal of Babylon. 2023;20(3):553-7.

Jang S. Multidrug efflux pumps in Staphylococcus aureus and their clinical implications. Journal of Microbiology. 2016;54:1-8.

Costa SS, Junqueira E, Palma C, Viveiros M, Melo-Cristino J, Amaral L, et al. Resistance to antimicrobials mediated by efflux pumps in Staphylococcus aureus. Antibiotics. 2013;2(1):83-99.

Pourmand MR, Yousefi M, Salami SA, Amini M. Evaluation of expression of NorA efflux pump in ciprofloxacin resistant Staphylococcus aureus against hexahydroquinoline derivative by real-time PCR. Acta Medica Iranica. 2014:424-9.

Al-hamedawy, H.H.H. and Mahmoud, S.S.,( 2019). Synergistic Effect of Linezolid, Tigecycline, and Vancomycin on Staphylococcus aureus Isolated From Iraqi Patients with Diabetic Foot Ulcers. Iraqi Journal of Science, 60(1), pp.36-42.

..

Downloads

Published

2025-05-19

How to Cite

1.
AL-Dahlaki SM, Alwan SS. Detection of Efflux Pumps by mdeA gene, a Chromosomally-Encoded from Multidrug Staphylococcus aureus isolates. J Neonatal Surg [Internet]. 2025May19 [cited 2025Sep.25];14(25S):220-8. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/6103