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Open Access Highly Accessed Research article

Staphylococcus aureus nasal carriage in Ukraine: antibacterial resistance and virulence factor encoding genes

Irina Netsvyetayeva1, Mariusz Fraczek2, Katarzyna Piskorska1, Marlena Golas1, Magdalena Sikora3, Andrzej Mlynarczyk3, Ewa Swoboda-Kopec3, Wojciech Marusza4, Beniamino Palmieri5 and Tommaso Iannitti6*

Author Affiliations

1 Department of Medical Microbiology, Warsaw Medical University, Warsaw, Poland

2 Chair and Department of General,Transplant and Liver Surgery, Warsaw Medical University, Warsaw, Poland

3 Department of Dentistry Microbiology, Warsaw Medical University, Warsaw, Poland

4 Academy of Face Sculpturing, Warsaw, Poland

5 Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, Italy

6 School of Biomedical Sciences, University of Leeds, Mount Preston Street, Garstang building, LS2 9JT Leeds, UK

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BMC Infectious Diseases 2014, 14:128  doi:10.1186/1471-2334-14-128

Published: 5 March 2014

Abstract

Background

The number of studies regarding the incidence of multidrug resistant strains and distribution of genes encoding virulence factors, which have colonized the post-Soviet states, is considerably limited. The aim of the study was (1) to assess the Staphylococcus (S.) aureus nasal carriage rate, including Methicillin Resistant S. aureus (MRSA) strains in adult Ukrainian population, (2) to determine antibiotic resistant pattern and (3) the occurrence of Panton Valentine Leukocidine (PVL)-, Fibronectin-Binding Protein A (FnBPA)- and Exfoliative Toxin (ET)-encoding genes.

Methods

Nasal samples for S. aureus culture were obtained from 245 adults. The susceptibility pattern for several classes of antibiotics was determined by disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The virulence factor encoding genes, mecA, lukS-lukF, eta, etb, etd, fnbA, were detected by Polymerase Chain Reaction (PCR).

Results

The S. aureus nasal carriage rate was 40%. The prevalence of nasal MRSA carriage in adults was 3.7%. LukS-lukF genes were detected in over 58% of the strains. ET-encoding genes were detected in over 39% of the strains and the most prevalent was etd. The fnbA gene was detected in over 59% of the strains. All MRSA isolates tested were positive for the mecA gene. LukS-lukF genes and the etd gene were commonly co-present in MRSA, while lukS-lukF genes and the fnbA gene were commonly co-present in Methicillin Sensitive S. aureus (MSSA) isolates. No significant difference was detected between the occurrence of lukS-lukF genes (P > 0.05) and the etd gene (P > 0.05) when comparing MRSA and MSSA. The occurrence of the fnbA gene was significantly more frequent in MSSA strains (P < 0.05).

Conclusions

In Ukraine, S. aureus is a common cause of infection. The prevalence of S. aureus nasal carriage in our cohort of patients from Ukraine was 40.4%. We found that 9.1% of the strains were classified as MRSA and all MRSA isolates tested positive for the mecA gene. We also observed a high prevalence of PVL- and ET- encoding genes among S. aureus nasal carriage strains. A systematic surveillance system can help prevent transmission and spread of drug resistant toxin producing S. aureus strains.

Keywords:
Staphylococcus aureus; Methicillin Sensitive S. aureus; Methicillin Resistant S. aureus; Panton-Valentine Leukocidin; Exfoliative Toxins