title: mecA-positive methicillin-sensitive Staphylococcus aureus clinical isolates in Zenica-Doboj Canton, Bosnia and Herzegovina.
abstract: Forty-four mecA-positive and eight mecA-negative Staphylococcus aureus isolates confirmed by PCR were further tested by disc-diffusion (DD) oxacillin and cefoxitin, oxacillin Epsilon (E)-test, and oxacillin and cefoxitin minimal inhibitory concentration (MIC) Strip methicillin-resistant phenotype in S. aureus (MRSA) tests. Among 44 mecA-positive S. aureus isolates, two (4·5%) were detected as MRSA by DD-oxacillin, 17 (38·6%) by DD-cefoxitin test, and seven (15·9%) by the E-test. In the cefoxitin MIC Strip MRSA test, 19 (43·2%) isolates were resistant. In the oxacillin MIC Strip MRSA test, 18 (40·9%) isolates were resistant and 26 (59·1%) were sensitive, i.e. oxacillin-sensitive MRSA (OS-MRSA) (MIC range 0·25-≤0·25 mg/l). Fifteen out of 26 OS-MRSA (57·7%) belonged to spa-CC 355/595, 78% of which belonged to the largest PFGE clone. Some discrepancies between the phenotypic methods for MRSA identification obtained in this study were caused by large proportion of OS-MRSA. Misidentification of OS-MRSA as MSSA might result in an appearance of highly resistant MRSA in patients treated with beta-lactam antibiotics.
authors.affiliation: University of Ljubljana, Biotechnical Faculty, Microbiology Department , Ljubljana, Slovenia.
authors.forename: Farah
authors.initials: F
authors.lastname: Kamberović
authors.forename: Amir
authors.initials: A
authors.lastname: Ibrahimagić
authors.forename: Selma
authors.initials: S
authors.lastname: Uzunović
authors.forename: Ana
authors.initials: A
authors.lastname: Budimir
authors.forename: Michelle I A
authors.initials: MI
authors.lastname: Rijnders
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Stobberingh
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics* / Q000302:isolation & purification; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D002440:Cefoxitin / Q000494:pharmacology; D052978:Disk Diffusion Antimicrobial Tests; D005189:False Positive Reactions; D005798:Genes, Bacterial; D006801:Humans; D016106:Methicillin Resistance / Q000235:genetics*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010068:Oxacillin / Q000494:pharmacology*; D046915:Penicillin-Binding Proteins / Q000235:genetics* / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000235:genetics / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D046915:Penicillin-Binding Proteins; C487789:mecA protein, Staphylococcus aureus; D002440:Cefoxitin; D010068:Oxacillin
keywords: Antimicrobial resistance; MRSA; spa-CC