Dissemination Of t437-SCCmecIV And Coagulase-Negative t037-SCCmecIII Types Among Borderline Oxacillin-Resistant Staphylococcus aureus Isolated From Skin Infections And Diabetic Foot Ulcers

Figures & data

Table 1 Characteristics Of Borderline Oxacillin-Resistant S. aureus

Patient No.	spa Type	Year	Origin	MIC Of Oxacillin (µg/mL)		Resistance To (DD, mm)		Phenotype Of Resistance	Coagulase Production
				AD	E-Test	OX	FOX
1	t037	1998	Wound	4	2	12 R	25 S	OX, E, CC, DX, GE, CIP, C	−
2	t037	2000	Foot ulcer	2	1	12 R	26 S	OX, E, CC, DX, GE	−
3	t037	2000	Wound	2	1	11 R	23 S	OX, E, DX, GE	−
4	t437	2013	Furuncle	4	2	14 S	19 R	FOX, E, CC, TE, C	+
5	t437	2013	Wound	4	2	15 S	19 R	FOX, E, CC, TE, C	+
6	t437	2013	Wound	4	2	14 S	19 R	FOX, E, CC, TE, C	+
7	t437	2016	Foot ulcer	2	1	15 S	18 R	FOX, E, CC, TE, C	+
8	t437	2017	Wound	4	2	13 S	17 R	FOX	+
9	t437	2018	Foot ulcer	4	1.5	17 S	19 R	FOX, E, CC, C	+
10	t216	2013	Nose	4	1.5	14 S	16 R	FOX, E, CIP	+
11	t267	2016	Blood	4	4	15 S	19 R	FOX, E	+
12	t015	2018	Catheter	4	2	18 S	18 R	FOX, E, CIP	+

Abbreviations: AD, agar dilution; DD, disk diffusion; OX, oxacillin; FOX, cefoxitin; E, erythromycin; CC, clindamycin; DX, doxycycline; TE, tetracycline; GE, gentamycin; CIP, ciprofloxacin; C, chloramphenicol; R, resistant; S, sensitive.

Table 2 The Presence Of Virulence And Resistance Genes To β–Lactams Antibiotics In Different spa And SCCmec Types Of Borderline Oxacillin-Resistant S. aureus

Patient No.	spa Type	Repeat Succession	SCCmec Type	Genetic Profile
				mecA	mecC	blaZ	lukF-lukS-PV	sea	seb	sec	sed	tst	eta	etb
1	t037	15-12-16-02-25-17-24	III	+	−	+	−	+	−	−	−	−	−	−
2	t037	15-12-16-02-25-17-24	–	−	−	+	−	+	−	−	−	+	−	−
3	t037	15-12-16-02-25-17-24	III	+	−	+	−	+	−	−	−	−	−	−
4	t437	04-20-17-20-17-25-34	IV	+	−	+	+	−	−	−	−	−	−	−
5	t437	04-20-17-20-17-25-34	IV	+	−	+	+	−	+	−	−	−	−	−
6	t437	04-20-17-20-17-25-34	IV	+	−	+	+	−	+	−	−	−	−	−
7	t437	04-20-17-20-17-25-34	IV	+	−	+	−	−	−	−	−	−	−	−
8	t437	04-20-17-20-17-25-34	IV	+	−	+	+	−	+	−	−	−	−	−
9	t437	04-20-17-20-17-25-34	IV	+	−	+	+	−	+	−	−	−	−	−
10	t216	04-20-17-20-17-31-16-34	IV	+	−	+	−	−	+	−	−	−	−	−
11	t267	07-23-12-21-17-34-34-34-33-34	IV	+	−	+	−	−	−	−	−	−	−	−
12	t015	08-16-02-16-34-13-17-34-16-34	IV	+	−	+	−	−	−	−	−	−	−	−

Figure 1 Agarose gel image of lukS-PV/lukF-PV PCR amplicon (433 bp). Lane M – molecular size marker (pUC19 DNA/MspI enzyme, Fermentas, Lithuania); lanes 1-5 – representative PVL-positive S. aureus strains of spa type t437, lane 6 – negative control; lane 7 – positive control.

Table 3 Characteristics Of Borderline Oxacillin-Resistant S. aureus spa Types t037 And t437

Parameter	spa Type t037	spa Type t437	p-Value
Year of isolation	1998–2000	2013–2018
Prevalence	3/12	6/12	0.400
Skin infection	2/3	4/6	1.000
Foot ulcer	1/3	2/6	1.000
SCCmecIII	3/3	0/6	0.012
SCCmecIV	0/3	6/6	0.012
sea	3/3	0/6	0.012
seb	0/3	4/6	0.167
lukF-lukS-PV	0/3	5/6	0.048
tst	1/3	0/6	0.333
Clindamycin/erythromycin resistance	2/3	5/6	1.000
Gentamicin/doxycycline resistance	3/3	0/6	0.012
Production of coagulase	0/3	6/6	0.012

Note: Bold values indicate statistical significance.