Molecular genetic features of MRSA and their role in the development infections in HIV-infected

Khokhlova O.E.,Akusheva D.N., Kamshilova V.V., Peryanova O.V., Teplyakova O.V., Upirova A.A.,Zdzitovetsky D.E. , Potkina N.K., Skazka T.B., Udalova A.A., Tsybin V.A., Yamamoto T.

Krasnoyarsk State Medical University named after professor V.F.Voyno-Yasenetsky, Krasnoyarsk, 660022, Russian Federation
Russia-Japan Center of Microbiology, Мetagenomics and Infectious Diseases, Krasnoyarsk State Medical University, Krasnoyarsk, 660022, Russian Federation
3 Krasnoyarsk State Emergency Hospital named after N.S. Karpovich, Krasnoyarsk, 660062, Russian Federation
Krasnoyarsk Clinical Hospital №7, Krasnoyarsk, 660003, Russian Federation
International Medical Education and Research Center, Niigata, Japan

HIV-infected people are at increased risk of contracting MRSA. The role of MRSA and their molecular genetic features in the development of infections of the skin and soft tissues (abscesses, cellulitis) in HIV-infected individuals were studied. The material for the study - purulent discharge, biopsy. Sowing material was carried out on a complex of culture media. Antibiotic resistance in microorganisms was determined by methods in accordance with international recommendations. For genetic studies, MRSA received a daily culture and DNA was isolated. For the genotyping of strains (SCCmec, spa; ST, agr) and the determination of virulence genes (42 genes), PCR and/or sequencing was used. In this research we revealed the proportion of Gr- bacteria in abscesses and cellulitis in patients without HIV was 29.3% and 30.3%, respectively. The proportion of Gr + bacteria in abscesses in in patients without HIV 70.7%, including S. aureus, was isolated in 39%, the proportion of MRSA was 0%. The proportion of Gr+ bacteria with cellulitis in patients without HIV is 69.7%, including S. aureus – 27.3%, the proportion of MRSA - 0%. The proportion of Gr- bacteria in abscesses and cellulitis in HIV-infected was 23.3% and 23.1%, respectively. The proportion of Gr+ bacteria in abscesses in HIV-infected 76.7%, including S. aureus, was isolated in 40%, the proportion of MRSA was 16.7% (2 strains). The proportion of Gr+ bacteria with cellulitis in HIV-infected is 76.9%, including S. aureus - 46.2%, the proportion of MRSA - 33.3% (3 strains). All 5 strains of MRSA belonged to ST239 clone, variant ST239/spa3(t037)/agr1/SCCmecIII.1.1.2(IIIA)/CoaIV, characterized by the presence of leukocidin, hemolysins, TSST-1, enterotoxins SEK, SEQ, adhesins (except BBP). The MRSA strains isolated from HIV-infected with cellulitis/abscesses were characterized by multidrug resistance. In the course of the work done, it was established that the isolated MRSA strains from HIV-infected people with abscesses and cellulitis belong to the genetic variant of ST239Kras, characterized by a high level of virulence and antibiotic resistance.