ABSTRACT
Aims@#Staphylococcus aureus is an important opportunistic human pathogen. The emergence of macrolide and vancomycin resistant S. aureus is of great concern for treatment of S. aureus infections. The current study aimed to investigate the pattern of antibiotic resistance in S. aureus clinical isolates recovered from El Boos Students’ hospital in Cairo, Egypt.@*Methodology and results@#Sixty unduplicated S. aureus isolates were recovered from El Boos Students’ hospital in Cairo, Egypt for 11 months period. The antibiotic susceptibility test revealed that all isolates were resistant to eleven antibiotics, but only 49 S. aureus isolates were resistant to cefoxitin. The minimum inhibitory concentrations (MIC) of both erythromycin and vancomycin were determined by broth microdilution method. Two methicillin resistant S. aureus (MRSA) isolates showing tolerance to both erythromycin and vancomycin at high concentration were selected for further characterization. One isolate was recovered from eye infection and had MIC at 256 µg/mL of both erythromycin and vancomycin. While another isolate was recovered from throat infection and had MIC of erythromycin and vancomycin up till 512 µg/mL. The presence of resistance genes (ermA, ermB, ermC, mef, msrA, vanA and vanB) were confirmed by polymerase chain reaction (PCR). Both MRSA isolates carried all tested resistance genes.@*Conclusion, significance and impact of study@#This study highlights the concern of presence of multidrug-resistant S. aureus which showed resistance to high concentrations of erythromycin, vancomycin and carried ermA, ermB, ermC, mef, msrA, vanA and vanB genes, therefore imposes risk of failure to treat such infections.
Subject(s)
Vancomycin-Resistant Staphylococcus aureus , ErythromycinABSTRACT
Cystatin C is a cysteine proteinase inhibitor with widespread distribution in body fluids and tissues. Physiologically relevant polymorphisms have been identified in the promoter region and the signal peptide of the cystatin C gene. However, the final importance of cystatin C polymorphisms in human diseases is still discussed controversially and the prognostic value in different conditions is unknown. In this study, in order to assess the significance of the polymorphic genotypes at positions -82, -5 and +4 of the 5' flanking region of the CST3 gene in case of heart, kidney and/or diabetic disorders in Egyptian patients, we compared frequencies of these polymorphisms in various groups of Egyptian patients with different conditions and controls. Genotyping analysis of all subjects revealed that these polymorphisms are in strong-linkage disequilibrium. Notably, no statistically significant differences in the allele or haplotype frequencies were observed for the investigated polymorphisms between patient and control groups. Moreover, haplotype differences within each group had no visible impact on plasma cystatin C levels which were significantly elevated for all groups compared to the control group. The observed elevation in cystatin C levels was probably a reflection of reduced glomerular filtration rate in these patients. Finally, our results suggest that in this population the haplotype alone was not associated with prognosis and that other, unknown environmental or genetic, factors may be of relevance