الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Staphylococcus aureus (S. aureus) is a leading nosocomial pathogen of major worldwide importance. Furthermore, it has been recently implicated in serious community-acquired infections, especially in children. This problem is further confounded by the appearance of S. aureus strains exhibiting reduced susceptibility to vancomycin. The aim of this study was to detect the resistance to oxacillin and vancomycin in S. aureus strains isolated in Cairo University Hospitals, and to study the virulence genes and the resistance genes of methicillin-resistant S. aureus (MRSA) with particular emphasis on Panton-Valentine leucocidin. We studied a total of 121 isolates, 77 healthcare associated isolates and 44 community-associated isolates from 2005 to 2006. Identification of the isolates was done by mannitol salt agar together with DNase, Staphaurex (the gold standard), BBL Crystal gram-positive (GP) identification (ID) System, and PCR for 16S rRNA. Antimicrobial Susceptibility Testing was done by disk diffusion test, E test for oxacillin and vancomycin, latex agglutination test for PBP 2a, and PCR for mec A. Detection pf PVL and SCC mec type IV was attempted in community-acquired isolates by PCR. Taking Staphaurex as the gold standard for identification, mannitol salt agar together with DNase had a sensitivity of 80%, PCR for 16S rRNA had a sensitivity of 88.8%. Among the 77 nosocomial isolates, 67.8% were resistant to methicillin. Among the 44 community-acquired isolates, 61.3% were resistant to methicillin. Only one isolate showed increased vancomycin MIC than 2 ug/ml, suggesting heterogenous resistance to vancomycin. PVL and SCC mec were detected in 12% and 10% of community-acquired isolates, respectively. In conclusion: strict measures of infection control should be applied to limit the spread of HA-MRSA infections. Increased awareness of the physicians and the public is essential to combat the spread of CA-MRSA.