Infection with enterotoxigenic Staphylococcus aureus as a concern in patients with gastroenteritis.

J Glob Antimicrob Resist

Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Published: June 2017

Objectives: Intestinal overgrowth of Staphylococcus aureus may promote unpleasant disorders in the human intestinal tract. This study assessed the prevalence of enterotoxigenic multidrug-resistant S. aureus (MDR-SA) in patients with gastroenteritis.

Methods: Microbiological analysis of 345 faecal samples from patients with gastroenteritis was performed to detect infection with S. aureus in the absence of common enteric pathogens. Methicillin-resistant S. aureus (MRSA) was characterised by the cefoxitin disk diffusion method. PCR amplification of enterotoxin genes (sea, seb, sec, sed and see) was carried out on all S. aureus strains, and association of resistance patterns with the toxigenicity of strains was determined statistically.

Results: Infection with S. aureus was detected in 64 samples (18.6%), of which 51 (79.7%) and 41 (64.1%) were determined as MRSA and MDR-SA, respectively. Resistance to six antibiotic classes was the most common MDR pattern (48.8%; 20/41). In total, 50% of the strains (32/64) carried the studied enterotoxin genes; the most common was sea (56.1%), followed by sec (4.9%) and see (4.9%). These genes were more prevalent among MDR-MRSA (58.8%) compared with methicillin-sensitive S. aureus (15.4%) strains.

Conclusions: These results confirmed the involvement of enterotoxigenic MRSA in the occurrence of gastroenteritis.

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http://dx.doi.org/10.1016/j.jgar.2017.02.009DOI Listing

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