Genetic diversity of macrolides resistant Staphylococcus aureus clinical isolates and the potential synergistic effect of vitamins, C and K3.

BACKGROUND: Macrolide antibiotics have been extensively used for the treatment of Staphylococcus aureus infections. However, the emergence of macrolide-resistant strains of S. aureus has become a major concern for public health. The molecular mechanisms underlying macrolide resistance in S. aureus are complex and diverse, involving both target site modification and efflux pump systems. In this study, we aim to overcome the molecular diversity of macrolide resistance mechanisms in S. aureus by identifying common molecular targets that could be exploited for the development of novel therapeutics. METHODS: About 300 Staphylococcus aureus different isolates were recovered and purified from 921 clinical specimen including urine (88), blood (156), sputum (264), nasal swabs (168), pus (181) and bone (39) collected from different departments in Tanta University Hospital. Macrolide resistant isolates were detected and tested for Multi Drug Resistant (MDR). Gel electrophoresis was performed after the D test and PCR reaction for erm(A), (B), (C), msr(A), and mph(C) genes. Finally, we tried different combinations of Erythromycin or Azithromycin antibiotics with either vitamin K3 or vitamin C. RESULTS: Macrolide resistance S. aureus isolates exhibited 7 major resistance patterns according to number of resistance markers and each pattern included sub patterns or subgroups. The PCR amplified products of different erm genes; analysis recorded different phenotypes of the Staphylococcus aureus isolates according to their different genotypes. In addition, our new tested combinations of Erythromycin and vitamin C, Erythromycin, and vitamin K3, Azithromycin and vitamin C and Azithromycin and vitamin K3 showed significant antibacterial effect when using every antibiotic alone. Our findings provide new insights into the molecular mechanisms of macrolide resistance in S. aureus and offer potential strategies for the development of novel protocols to overcome this emerging public health threat.

Correlation between antibiotic resistance and virulence of Pseudomonas aeruginosa clinical isolates.

BACKGROUND/AIM: Virulent Pseudomonas aeruginosa. is frequently life-threatening and often challenging to treat, and the emergence of multidrug-resistant isolates presents a critical problem for patients. The aim of the study was concerned with molecular analysis of the virulence factors and antimicrobial resistance profile of multidrug-resistant P. aeruginosa (MDRPA). MATERIALS AND METHODS: Out of 44 MDRPA isolates, 12 isolates representing different resistance profiles and sources of samples were selected for further molecular studies. Polymerase chain reaction (PCR) approaches were applied to identify the genes implicated in antimicrobial resistance or virulence factors in the selected MDRPA isolates. RESULTS: Multidrug-resistance (pstS), ß-lactamase (IMP7, IMP10, IMP13, and IMP25), and extended spectrum ß-lactamase (blaOXA50) genes were detected in all of the selected MDRPA isolates. However, only 4 (33%) MDRPA isolates were positive for the presence of the extended spectrum ß-lactamase (blaOXA2) gene. Furthermore, the hemolytic phospholipase C precursor gene (plcH) was detected in all PCR products of the tested MDRPA isolates while the exotoxin A (toxA) gene was absent. Other virulence genes were detected with variable percentage in tested isolates. CONCLUSION: The statistical analysis revealed a significantly positive correlation (r = 0.779, P = 0.002) between virulence factors and antimicrobial resistance marker profiles of the tested MDRPA isolates.