Genetic diversity of methicillin resistant Staphylococcus aureus strains isolated from burn patients in Iran: ST239-SCCmec III/t037 emerges as the major clone.

Methicillin-resistant Staphylococcus aureus (MRSA) as a major cause of infection in health care, hospital and community settings is a global health concern. The purpose of this study was to determine the antibiotic susceptibility pattern and distribution of circulating molecular types of MRSA in a burn hospital in Tehran, the capital of Iran. During a 10-month study period, 106 Staphylococcus aureus isolates were assessed. Isolates were subjected to susceptibility testing using the disk diffusion method and Polymerase Chain Reaction (PCR) for detection of mecA, fem and nuc genes. The presence of PVL and tst encoding genes were determined by PCR method. All the MRSA isolates were genotyped by multilocus sequence typing (MLST), spa typing, SCCmec typing and agr typing. The presence of mecA gene was confirmed in all the Staphylococcus aureus isolates. Antimicrobial susceptibility testing revealed a high resistance rate (90.6%) to ampicillin, tetracycline, and erythromycin. The rates of resistance to remaining antibiotics tested varied between 18.9% and 84.9%. The high- level of resistance to mupirocin was confirmed in 19.8% of MRSA strains isolated from burn patients. Multi-drug resistance was observed in 90.6% of isolates. Sixteen of the 106 MRSA isolates (15.1%) harbored PVL-encoding genes. The majority of our MRSA strains carried SCCmec III (71.7%). ST239-SCCmec III/t037 (34%) was the most common genotype followed by ST239-SCCmec III/t030 (24.5%), ST15-SCCmec IV/t084 (15.1%), ST22-SCCmec IV/t790 (13.2%), and ST239-SCCmec III/t631 (13.2%). Mupirocin resistant MRSA isolates belonged to ST15-SCCmec IV/t084 (40%), ST22-SCCmec IV/t790 (23.3%), ST239-SCCmec III/t631 (20%), and ST239-SCCmec III/t030 (16.7%) clones. The results showed that genetically diverse strains of MRSA are circulating in our burn hospitals with relatively high prevalence of ST239-SCCmec III/t037 clone. The findings support the need for regular surveillance of MRSA to determine the distribution of existing MRSA clones and to detect the emergence of new MRSA clones.

Effect of sticky mat usage in control of nosocomial infection in Motahary Burn Hospital.

BACKGROUND AND OBJECTIVES: Infection is the most common cause of death among burnt patients and infection control decrease the rate of mortality. The use of sticky mat can control contamination by preventing the entrance microorganisms into the hospital wards. This study was designed to evaluate the sticky mats effect in reduction of microorganism's entry by personnel shoes to burn intensive care unit (BICU). MATERIALS AND METHODS: This is a simple cross sectional study. We tested outer soles of personnel's shoes with swap and cultured them before and after sticky mat contact in the entrance of BICU. Results were analyzed with IBM SPSS version 22 software. McNemar and Wilcoxon Signed Ranks tests were used. RESULTS: We analyzed 60 outer soles of the shoes before and after contact with sticky mats. Coagulase negative Staphylococci, Gram positive bacilli, Staphylococcus aureus, Aspergillus fumigatus, Pseudomonas aeruginosa and Acinetobacter baumannii were isolated before contact from 57 (95%), 32 (53%), 4 (6.7%) and 3 (5%) cases, respectively. Coagulase negative Staphylococci, Gram positive bacilli, Staphylococcus aureus, Aspergillus fumigatus, Pseudomonas aeruginosa were isolated after contact from 36 (60%), 30 (50%), 16 (26.6%), 2 (3.3%) and 3 (5%) cases, respectively. No Acinetobacter was isolated after contact with sticky mat. Total isolated colonies before and after contact with sticky mats were 2573 and 830, respectively. There were significant statistically differences between the colony counts of coagulase ngative staphylococci, Gram positive bacilli, and Staphylococci aureus before and after contact with sticky mats (P. < 0.001). CONCLUSION: Regarding to statistical analysis, the effect of mat in removing the microorganisms was 56%. It confirms the effectiveness of sticky mat controlling the infection and reducing the amount of hospital contamination.