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Adv Biomed Res. 2016 Mar 22;5:62. doi: 10.4103/2277-9175.179184. eCollection 2016.

Distribution of erm genes among Staphylococcus aureus isolates with inducible resistance to clindamycin in Isfahan, Iran.

Advanced biomedical research

Fahimeh Ghanbari, Hasan Ghajavand, Roholla Havaei, Mohammad-Saeid Jami, Farzad Khademi, Leila Heydari, Mojtaba Shahin, Seyed Asghar Havaei

Affiliations

  1. Department of Microbiology, Faculty of Bioscience, Falavarjan Branch, Islamic Azad University, Isfahan, Iran.
  2. Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
  3. Department of Endodontics, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran.
  4. Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
  5. Department of Medical Bacteriology and Virology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  6. Department of Microbiology, School of Medicine, Ahvaz University of Medical Sciences, Ahvaz, Iran.

PMID: 27135031 PMCID: PMC4832884 DOI: 10.4103/2277-9175.179184

Abstract

BACKGROUND: The rising frequency of methicillin resistant Staphylococcus aureus (MRSA) has led to an increased use of antibiotics such as macrolide, lincosamide, streptogramin B (MLSB) for the treatment of S. aureus infections. Resistance to MLSB in S. aureus is commonly encoded by erm genes, which can be constitutive MLSB (cMLSB) or inducible MLSB (iMLSB). The purpose of this study was to determine the frequency of cMLSB, iMLSB, and MS phenotypes using D-test and polymerase chain reaction (PCR) methods.

MATERIALS AND METHODS: A total of 215 isolates of S. aureus were collected from January 2010 to May 2012 from Al-Zahra Hospital in Isfahan. PCR was performed for detection of mecA gene on all isolates using specific primers. The frequency of MLSB-resistant isolates was determined using D-test, and then a multiplex PCR was performed for detection of ermA, ermB, and ermC genes.

RESULTS: Among 215 S. aureus isolates examined, 82 (40.9%) were MRSA, and iMLSB, cMLSB, and MS resistance phenotypes had a frequency of 9 (4.18%), 58 (26.9%), and 11 (5.1%), respectively. Among nine isolates with iMLSB resistance phenotype, four isolates contained ermC gene, two isolates ermB gene, and one isolate ermA gene. Two isolates did not have any erm gene.

CONCLUSION: In the current study, cMLSB was the most frequent phenotype and ermC was the most common gene in iMLSB resistant phenotypes.

Keywords: Clindamycin; D-test; Staphylococcus aureus; erm genes; inducible resistance

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