Monitoring of multiresistant community-associated MRSA strains from patients with pathological processes of different localization

  • T. V. Sklyar Oles Honchar Dnipro National University
  • K. V. Lavrentievа Oles Honchar Dnipro National University
  • V. G. Gavrilyuk Oles Honchar Dnipro National University
  • N. V. Kurahina Oles Honchar Dnipro National University
  • M. O. Vereshchaha University of Customs and Finance
  • O. A. Lykholat University of Customs and Finance
Keywords: Staphylococcus aureus; rifampicin; vancomycin; fusidic acid; co-trimoxazole; linezolid


The therapy of infections, caused by methicillin-resistant Staphylococcus aureus (MRSA) with multiple resistance to antibiotics remains one of the most acute problems all over the world. It is all the more complicated since a priori the MSRA strains are not sensitive to the group of β-lactam antibiotics and multiresistant isolates are resistant to other groups of antimicrobial preparations, including antibiotics of choice (rifampicin, vancomycin, fusidic acid, co-trimoxazole and linezolid). From the samples of biomaterials of patients with pathological processes of different localization, we isolated 335 strains of bacteria, which were identified as Staphylococcus aureus, 169 (50.4%) of which were methicillin-resistant variants: 57.5% cultures were isolated from the nasal discharge; 50.7% – from faeces at intestinal dysbioses; by 40.0% – from conjunctival discharge, pharyngeal swab, outer ear swab and sputum; 33.3% – from urine samples. Antibiotic susceptibility of the isolated cultures was estimated by the disc-diffusion method and the method of serial dilution. The MRSA strains appeared to be most resistant to gentamycin, erythromycin (by 59.5% of cultures) and ciprofloxacin (53.3% of isolates), most sensitive – to vancomycin, co-trimoxazole and fusidic acid. The frequency of isolation of the cultures that are resistant to antibiotics did not exceed 4.1%. Rifampicin suppressed the growth of 75.8% and linezolid – of 100.0% of strains. Depending on the kind of biomaterial taken, MRSA strains, isolated from the nasal cavity, outer ear, urine samples, samples of sputum and faeces at intestinal dysbioses proved to be most resistant to the tested antimicrobial preparations. Rifampicin- and vancomycin-resistant strains of methicillin-resistant staphylococci made up 21.3% of the total number of the detected MRSA. They were most often isolated from the clinical samples taken from the nasal cavity and faeces. When determining minimal inhibitory concentration (MIC) of rifampicin and vancomycin, which are antibiotics of choice for treatment of infections caused by multiresistant MRSA, it was found that for 55.5% of the MRSA strains isolated from faeces, MIC of rifampicin coincided with the threshold value for this antibiotic and for 44.5%, it exceeded the threshold value by 2 times (4 µg/ml). 22.2% of them were characterized by the critical value of susceptibility to vancomycin (MIC ≥ 2 µg/ml). From rifampicin- and vancomycin-resistant MRSA stains, isolated from the nasal cavity, MIC of rifampicin coincided with the threshold value for this antibiotic for 66.7% of cultures, and exceeded it at least by 2 times for 33.3%. 11.1% of them were characterized by the critical level of susceptibility to vancomycin (MIC ≥ 2 µg/ml) and by 3.7% of strains exceeded MIC by 2 and 4 times respectively (4 and 8 µg/ml).


Aguayo-Reyes, A., Quezada-Aguiluz, M., Mella, S., Riedel, G., Opazo-Capurro, A., Bello-Toledo, H., Dominguez, M., & González-Rocha, G. (2018). Molecular basis of methicillin-resistance in Staphylococcus aureus. Revista Chilena de Infectología, 35(1), 7–14.

Appelbaum P. (2007). Reduced glycopeptide susceptibility in methicillin-resistant Staphylococcus aureus (MRSA). International Journal of Antimicrobial Agent, 30(5), 398–408.

Bakthavatchalam, Y., Veeraraghavan, B., Devanga Ragupathi, N., Babu, P., Munuswamy, E., & David, T. (2017). Draft genome sequence of reduced teicoplanin-susceptible and vancomycin-heteroresistant methicillin-resistant Staphylococcus aureus from sepsis cases. Journal of Global Antimicrobial Resistance, 8, 169–171.

Bakthavatchalam, Y., Veeraraghavan, B., Peter, J., Rajinikanth, J., Inbanathan, F., Devanga Ragupathi, N., & Rajamani Sekar, S. (2016). Novel observations in 11 heteroresistant vancomycin-intermediate methicillin-resistant Staphylococcus aureus strains from South India. Genome Announcements, 4(6), e01425-16.

Becker, K., van Alen, S., Idelevich, E., Schleimer, N., Seggewiß, J., Mellmann, A., Kaspar, U., & Peters, G. (2018). Plasmid-encoded transferable mecB-mediated methicillin resistance in Staphylococcus aureus. Emerging Infectious Diseases, 24(2), 242–248.

Brinkman, C., Schmidt-Malan, S., Mandrekar, J., & Patel, R. (2017). Rifampin-based combination therapy is active in foreign-body osteomyelitis after prior rifampin monotherapy. Antimicrobial Agents and Chemotherapy, 61(2), e01822-16.

DeLeo, F., Otto, M., Kreiswirth, B., & Chambers, H. (2010). Community-associated meticillin-resistant Staphylococcus aureus. Lancet, 375(9725), 1557–1568.

Dhanoa, A., Singh, V. A., Mansor, A., Yusof, M. Y., Lim, K. T., & Thong, K. L. (2012). Acute haematogenous community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in an adult: Сase report and review of literature. BMC Іnfectious Diseases, 12, 270.

Ehelepola, N., Rajapaksha, R., Dhanapala, D., Thennekoon, T., & Ponnamperuma, S. (2018). Concurrent methicillin-resistant Staphylococcus aureus septicemia and pyomyositis in a patient with dengue hemorrhagic fever: A case report. BMC Іnfectious Diseases, 18(1), 99.

García-Garrote, F., Cercenado, E., Marín, M., Bal, M., Trincado, P., Corredoira, J., Ballesteros, C., Pita, J., Alonso, P., & Vindel, A. (2014). Methicillin-resistant Staphylococcus aureus carrying the mecC gene: Еmergence in Spain and report of a fatal case of bacteraemia. Journal of Antimicrobial Chemotherapy, 69(1), 45–50.

Gomes, D., Ward, K., & LaPlante, K. (2015). Clinical implications of vancomycin heteroresistant and intermediately susceptible Staphylococcus aureus. Pharmacotherapy, 35(4), 424–432.

Hamdan-Partida, A., González-García, S., de la Rosa García, E., & Bustos-Martínez, J. (2018). Community-acquired methicillin-resistant Staphylococcus aureus can persist in the throat. International Journal of Medical Microbiology, in press.

Hibbitts, A., & O'Leary, C. (2018). Emerging nanomedicine therapies to counter the rise of methicillin-resistant Staphylococcus aureus. Materials, 11(2), e321.

Howden, B. (2005). Recognition and management of infections caused by vancomycin-intermediate Staphylococcus aureus (VISA) and heterogenous VISA (hVISA). Internal Medicine Journal, 35(2), 136–140.

Howden, B., Peleg, A., & Stinear, T. (2014). The evolution of vancomycin intermediate Staphylococcus aureus (VISA) and heterogenous-VISA. Infection, Genetics and Evolution, 21, 575–582.

Jang, H., Kim, S., Kim, K., Kim, C., Lee, S., Song, K., Jeon, J., Park, W., Kim, H., Park, S., Kim, N., Kim, E., Oh, M., & Choe, K. (2009). Salvage treatment for persistent methicillin-resistant Staphylococcus aureus bacteremia: Efficacy of linezolid with or without carbapenem. Clinical Infectious Diseases, 49(3), 395–401.

Khan, A., Wilson, B., & Gould, I. (2018). Current and future treatment options for community-associated MRSA infection. Expert Opinion on Pharmacotherapy, 19(5), 457–470.

Lawes, T., Lopez-Lozano, J., Nebot, C., Macartney, G., Subbarao-Sharma, R., Dare, C., Wares, K., & Gould, I. (2015). Effects of national antibiotic stewardship and infection control strategies on hospital-associated and community-associated meticillin-resistant Staphylococcus aureus infections across a region of Scotland: A non-linear time-series study. The Lancet. Infectious Diseases, 15(12), 1438–1449.

Li, J., Feßler, A., Jiang, N., Fan, R., Wang, Y., Wu, C., Shen, J., & Schwarz S. (2016). Molecular basis of rifampicin resistance in multiresistant porcine livestock-associated MRSA. Antimicrobial Agents and Chemotherapy, 71(11), 3313–3315.

Marimuthu, K., & Harbarth, S. (2014). Screening for methicillin-resistant Staphylococcus aureus… all doors closed? Current Opinion in Infectious Diseases, 27(4), 356–362.

Miller, W., Bayer, A., & Arias, C. (2016). Mechanism of action and resistance to daptomycin in Staphylococcus aureus and enterococci. Cold Spring Harbor Perspectives in Medicine, 6(11), a026997.

How to Cite
Sklyar, T. V., LavrentievаK. V., Gavrilyuk, V. G., Kurahina, N. V., Vereshchaha, M. O., & Lykholat, O. A. (2018). Monitoring of multiresistant community-associated MRSA strains from patients with pathological processes of different localization. Regulatory Mechanisms in Biosystems, 9(2), 281-286.

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