Purpose: Vancomycin is treatment of choice in MRSA infection. In the last years there is increasing incidence of vancomycin resistance either vancomycin intermediate S. aureus (VISA) or vancomycin-resistant staphylococci (VRSA). This increasing in resistance strains is challenging problem especially in hospital acquired infection. The present study was carried out to find the incidence of(VISA)and(VRSA) among MRSA in children hospital in Egypt with correlation of molecular study for mec A gene and Vancomycin resistance gene Van A, Van B and Van C genes by multiplex PCR.
Method: Out of 678 hospital acquired infection (365) staphylococcal isolates was obtained in which coagulase negative were (152) (41.6%) and positive (213) (58.4%) were isolated from various samples which confirmed to be hospital acquired infection according to CDC guidelines. All Staphylococcal aureus isolates and coagulase negative (CoNS) were suspected to antibiotic disc diffusion. MRSA strain were subjected to MIC for vancomycine and molecular study for detection mec A and Van A, Van B and Van C genes by multiplex PCR
Results: MRSA was reported in (103) staphylococcal and (10) CONS mec gene was present in all MRSA stain. Vancomycine resistance gene was not found in any of CoNS. While in staphylococcal aureus vanA was present in 2 VRSA and 4 VISA isolates and van B was present in 6 VISA and in one VRSA isolates vanC gene was not found either in Staphylococcus aureus nor CoNS.
Conclusion: The results of the current study illustrate the emergence of vancomycin resistance among methicillin-resistant S. aureus isolated from children with healthcare-associated infections. The majority revealed the occurrence of vanA and vanB as an accountable mechanism for this resistance.
Maysaa El-Sayed Zaki, Aalaa Abouelnour, Sherif MH El-Kannishy and Rasha Hassan