Distribution of accessory gene regulator (agr) system and the prevalence of linezolid and mupirocin resistance in biofilm producer/non producer Staphylococcus aureus in Sohag university hospitals

Document Type : New and original researches in the field of Microbiology.

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Medical Microbiology and Immunology Department, Sohag University Hospital, Faculty of Medicine, Sohag, Egypt

Abstract

Background: Staphylococcus aureus is an important human pathogen with biofilm formation that increases antimicrobial resistance which impairs successful treatment of infections. Objective: The study aimed to identify the biofilm formation of Staphylococcus aureus and its relationship with antibiotic resistance, detection of agr (accessory gene regulator) genes among them and mupirocin, linezolid resistance. Methodology: swabs from infected wounds were cultured and confirmed by vitek 2 Gram positive identification cards (GP ID), Antibiotic susceptibility was assessed using disc diffusion, biofilm development was achieved through tissue culture plate technique then molecular detection of mup A gene, agr genes. Results: Among 114 Staph aureus isolates, 88 (77.19%) were resistant to Cefoxitin, 97 (85.09%) of the isolates were positive for biofilm, with 42.11% being weak, 22.81% moderate, and 18.42% high. a significant association between Tetracycline and rifampin resistance and levels of biofilm development with (P value=0.001 and 0.036). AGR I was present in  44.74%, AGR II was in 19.3%, AGR III was in 26.32% and AGR IV was in  8.77% of the isolated bacteria, MupA was positive in 82(71.93%) of the isolates. AGR genes were significantly present in Cefoxitin-MRSA, gentamicin, and trimethoprim sulfamethoxazole resistance with p values of 0.007, 0.018 and 0.001.Conclusion: agr genes are present with a higher percentage in Staph aureus that forms biofilms, They influence the development of biofilms, which increases antibiotic resistance, studying these genes and developing antagonistic effects can regain sensitivity of antibiotics also mupirocin resistance is present which necessitate its wise description not to lose its effectiveness in eradication of staphylococci nasal carriage.

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