The Link between Occurrence of Class I Integron and Acquired Aminoglycoside Resistance in Clinical MRSA Isolates

Abstract

Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) is a major cause of nosocomial infections because of its high resistance. Here, we study the antibiotic resistance in MRSA clinical isolates and their relation to integron I occurrence. A total of 88 clinical <i>Staphylococcus</i><i>aureus</i> isolates were collected. MRSA were identified by the disk diffusion method (DDM) and confirmed by PCR, and antibiogram was determined by DDM. Integron I, II and the <i>aacA4</i> gene were investigated by PCR. Integrase-positive strains were analyzed for the presence of resistance gene cassettes by sequencing. All isolates were identified as MRSA by DDM and confirmed by PCR. All isolates were resistant to ampicillin and cefoxitin. Concerning aminoglycosides, the frequency of resistance was reported for streptomycin (60.7%), tobramycin (37.1%) gentamicin (36%), and for amikacin (15.9%). Integron I was detected in 41 isolates (46.6%), while integron II was detected in three isolates (3.4%). Sequencing of the integron I-cassette indicated the exclusive prevalence of <i>addA</i> gene variants mediating aminoglycoside resistance. The <i>aacA4</i> gene was found in DNA of 31 isolates (35.22%). This study revealed the high existence of MRSA. Furthermore, the <i>AacA4</i> gene and class I integron harboring <i>aadA</i> gene were predominant in MRSA isolates.