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Antibiotic resistance profile and molecular characterization of Staphylococcus aureus strains isolated in hospitals in Kabul, Afghanistan

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Abstract

The aim of this study was to investigate the molecular features and the antibiotic resistance profile of 98 clinical Staphylococcus aureus isolates collected during 6 months in two hospitals of Kabul, Afghanistan. For all isolates, antimicrobial resistance patterns were determined by the disc diffusion method (including methicillin resistance which was detected using cefoxitin). The presence of the mecA/mecC genes was detected by PCR. Strains were then extensively characterized using microarray analysis. Of the 98 S. aureus isolates, methicillin-resistant S. aureus (MRSA) prevalence was high at 66.3%. Antibiotic susceptibility testing also revealed a high resistance rate to penicillin (100%), erythromycin (66.3%), ciprofloxacin (55.1%), and cotrimoxazole (40.8%). Resistance to tobramycin was detected in 25.5%, to gentamicin in 16.3%, to chloramphenicol in 34.7%, and to doxycycline in 23.5% of the isolates. All the MRSA isolates were mecA-positive and none of them harbored mecC. Isolates were grouped into twelve clonal complexes and twenty-seven distinct clones. The most frequently detected clones were the Southwest Pacific clone (CC30-MRSA-IV PVL+) (21/65 MRSA, 32.3%), the CC22-MRSA-IV TSST-1+ clone (11/65 MRSA, 16.9%), and the Bengal Bay clone (ST772-MRSA-V PVL+) (11/65 MRSA, 16.9%). The PVL genes were found in 59.2% (46/65 MRSA and 12/33 methicillin-susceptible S. aureus, MSSA) and tst1 gene in 16.3% of isolates. This molecular study highlights the high prevalence of MRSA and the large genetic diversity of the S. aureus isolates circulating and detected in two hospitals of Kabul, with the presence of multiple virulence and antibiotic resistance genes.

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Acknowledgments

The authors would like to thank Christine GARDON and all the technicians of the French National Reference Center for staphylococci for technical assistance for PCR and microarray.

Funding

This work was financially supported by Santé Publique France and the French Ministry of Foreign Affairs.

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Author notes

  1. Frédéric Laurent and Céline Dupieux contributed equally to this work.

Authors and Affiliations

  1. Department of Microbiology, Faculty of Pharmacy, Kabul University, Kabul, Afghanistan

    Haji Mohammad Naimi & Qand Agha Nazari

  2. CIRI – Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS UMR5308, ENS de Lyon, Lyon, France

    Haji Mohammad Naimi, Camille André, Michèle Bes, Anne Tristan, Claude-Alexandre Gustave, François Vandenesch, Frédéric Laurent & Céline Dupieux

  3. Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France

    Michèle Bes, Anne Tristan, Claude-Alexandre Gustave, François Vandenesch, Frédéric Laurent & Céline Dupieux

  4. Laboratoire de Bactériologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France

    Camille André, Michèle Bes, Anne Tristan, Claude-Alexandre Gustave, François Vandenesch, Frédéric Laurent & Céline Dupieux

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  1. Haji Mohammad Naimi
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  2. Camille André
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Contributions

Frédéric Laurent and François Vandenesch were involved in the conception of the study, and in analysis and interpretation of data. Haji Mohammad Naimi was involved in conducting the study, statistically analyzing the data, and drafting the manuscript. Camille André was involved in antibiotic susceptibility testing. Céline Dupieux was involved in interpretation of data and revising and editing the manuscript. Michèle Bes, Anne Tristan, and Claude-Alexandre Gustave were involved in the interpretation of DNA microarray. Qand Agha Nazari conducted preliminary identifications of strains. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Céline Dupieux.

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Naimi, H.M., André, C., Bes, M. et al. Antibiotic resistance profile and molecular characterization of Staphylococcus aureus strains isolated in hospitals in Kabul, Afghanistan. Eur J Clin Microbiol Infect Dis 40, 1029–1038 (2021). https://doi.org/10.1007/s10096-020-04130-0

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