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Review paper
Received: 28.08.2020. >> Accepted: 23.11.2020. >> Published: 09.12.2020. Biochemistry
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https://doi.org/10.17392/1265-21

Characterization and clonal representation of MRSA strains in Tuzla Canton, Bosnia and Herzegovina, from 2009 to 2017

By
Fatima Numanović Orcid logo ,
Fatima Numanović
Contact Fatima Numanović

Institute of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

School of Medicine, University of Tuzla , Tuzla , Bosnia and Herzegovina

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Urška Dermota ,
Urška Dermota

National Laboratory for Health, Environment and Food (NLZOH), Centre for Medical Microbiology Slovenia

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Jasmina Smajlović ,
Jasmina Smajlović

Institute of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

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Sandra Janežič ,
Sandra Janežič

National Laboratory for Health, Environment and Food (NLZOH), Centre for Medical Microbiology Slovenia

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Nijaz Tihić ,
Nijaz Tihić

Institute of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

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Zineta Delibegović ,
Zineta Delibegović

Institute of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

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Amela Bećirović ,
Amela Bećirović

Institute of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

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Edina Muratović ,
Edina Muratović

Department of Microbiology, Primary Health Care Centre , Tuzla , Bosnia and Herzegovina

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Merima Gegić
Merima Gegić

Institute of Microbiology, Polyclinic for Laboratory Diagnostics, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

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Abstract

Aim
To characterize methicillin-resistant S. aureus (MRSA) strains phenotypically and genotypically and to determine their clonal affiliation, representation and antibiotic resistance profile.
Methods
 A total of 62 randomly selected MRSA isolates of different clinical samples collected from 2009 to 2017 were phenotypically and genotypically analysed. Phenotypic analyses were performed by standard microbiological procedures, and using VITEK 2/AES instrument as well as MALDI-TOF (matrix-assisted laser desorption/ionization) technology. Genotypic characterization included spa, MLST (multilocus sequence typing) and SCCmec typing, and detection of the Panton-Valentine leukocidin (PVL) and other enterotoxin encoding genes.
Results
The largest number of isolates, 21 (33.87%) belonged to ST228-MRSA-I, spa type t041, t1003 and t001. Other major
clones were: ST239-MRSA-III, spa type t037 and t030 (27.41%); ST8-MRSA-IV, spa type t008 and t121 (12.9%); ST247-MRSA-I, spa type t051 (4.83%). PVL was detected in 10 isolates (SCCmec IV/V). During 2009 and 2010 the most frequent MRSA strain was South German clone, ST228-MRSA-I (80% and 90%, respectively), while in later years it was replaced with Brazilian-Hungarian clone ST239-MRSA-III (75% in 2015 and 2016). The South German clone, spa type t041 in 90.48% of cases was resistant to clindamycin, ciprofloxacin, erythromycin, cefoxitin, gentamicin, kanamycin, tobramycin and penicillin, while 70.58% samples of the Brazilian-Hungarian clone spa type t037 were additionally resistant to tetracycline and rifampicin.
Conclusion
This research can supplement the existing knowledge about the clonal distribution of MRSA in Bosnia and Herzegovina
and their sensitivity to antibiotics in order to improve the national control of these infections

Keywords:

antibiotic resistance,
multi-locus sequence typing (MLST),
SCCmec,
spa typing

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