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Fulltext The occurrence of enterotoxigenic strains of Staphylococcus aureus in foods

Lim YS, Jegathesan M, Koay AS, Kang SH

Med J Malaysia, 1983 Mar;38(1):27-30.
PMID: 6633330

Enterotoxin production by strains of Staphylococcus aureus isolated from foods unconnected with outbreaks offood poisoning was investigated. Twenty-three percent of 217 strains examined produced enterotoxins A, B, C, D or E. Enterotoxin C was found to occur most frequently. Enterotoxin A was not detected alone from any of the strains examined, but occurred together with other enterotoxins. The overall number of strains isolated from raw foods which produced one or more enterotoxins was higher than that for cooked foods. Antibiotic sensitivities were unrelated to enterotoxin production and no correlation could be found between methicillin resistance and enterotoxigenicity.

Matched MeSH terms: Enterotoxins/biosynthesis*
Fulltext Serological detection of enterotoxin from food poisoning strains of Staphylococcus aureus isolated in Malaysia

Lim YS, Jegathesan M, Koay AS

Singapore Med J, 1985 Jun;26(3):304-6.
PMID: 4048994

Cultures of Staphylococcus aureus from eight food poisoning incidents in Malaysia were examined for their ability to produce enterotoxins. Five of the eight strains were found to be enterotoxigenic, the enterotoxins detected being A and E (three strains), A and C (one strain), and C (one strain). Penicillinase production was observed in four of the five enterotoxigenic strains; the penicillin·sensitive strain was also found to be coagulase-negative. The bacteriological and epidemiological investigations for confirming staphylococcal food poisoning are presented. The preventive measures to be taken in reducing such outbreaks are emphasized.

Matched MeSH terms: Enterotoxins/biosynthesis*
Cloning and expression of Vibrio cholerae virulence gene, accessory cholera enterotoxin (ace)

Somarny WM, Mariana NS, Rozita R, Raha AR

Southeast Asian J Trop Med Public Health, 2004 Dec;35(4):856-62.
PMID: 15916081

The cholera enterotoxin (CT) has been considered a major virulence factor of Vibrio cholerae. The accessory cholera enterotoxin (ace) gene is the third gene of V. cholerae virulence cassette. The gene coding for the Ace toxin was amplified from V. cholerae isolates producing a single band of 314 bp. The presence of ace gene was confirmed by hybridization as well as by sequencing. The gene was successfully expressed in Escherichia coli (LMG194) using expression, pBAD/Thio-TOPO vector. Optimal conditions for expression included choice of host strain, temperature used for culturing, and concentration of antibiotic and arabinose inducer. The Ace protein was obtained from the cell supernatant as a fusion protein with a molecular mass 34 kDa which was detected using an anti V5-HRP epitope tagged antibody.

Matched MeSH terms: Enterotoxins/genetics*
Bacillus cereus: A review of "fried rice syndrome" causative agents

Leong SS, Korel F, King JH

Microb Pathog, 2023 Dec;185:106418.
PMID: 37866551 DOI: 10.1016/j.micpath.2023.106418

"Fried rice syndrome" originated from the first exposure to a fried rice dish contaminated with Bacillus cereus. This review compiles available data on the prevalence of B. cereus outbreak cases that occurred between 1984 and 2019. The outcome of B. cereus illness varies dramatically depending on the pathogenic strain encounter and the host's immune system. B. cereus causes a self-limiting, diarrheal illness caused by heat-resistant enterotoxin proteins, and an emetic illness caused by the deadly toxin named cereulide. The toxins together with their extrinsic factors are discussed. The possibility of more contamination of B. cereus in protein-rich food has also been shown. Therefore, the aim of this review is to summarize the available data, focusing mainly on B. cereus physiology as the causative agent for "fried rice syndrome." This review emphasizes the prevalence of B. cereus in starchy food contamination and outbreak cases reported, the virulence of both enterotoxins and emetic toxins produced, and the possibility of contaminated in protein-rich food. The impact of emetic or enterotoxin-producing B. cereus on public health cannot be neglected. Thus, it is essential to constantly monitor for B. cereus contamination during food handling and hygiene practices for food product preparation.

Matched MeSH terms: Enterotoxins/analysis
Fulltext Colonisation factors amongst clinical isolates of enterotoxigenic Escherichia coli

Iyer L, Vadivelu J, Parasakthi N

Singapore Med J, 1995 Oct;36(5):495-7.
PMID: 8882532

The production of heat-labile (LT) and heat-stable (ST) enterotoxins, colonisation factor antigens (CFAs) and haemagglutinins was investigated amongst 310 Escherichia coli (E. coli) isolates obtained from 62 children under the age of five, with diarrhoea. Twenty-one isolates were found to produce enterotoxins, of which fifteen (71%) isolates produced ST only, 2 (10%) produced LT only and 4 (19%) produced both LT and ST. However, none of the isolates demonstrated any of the common CFAs identified to date, but 8 out of the 21 isolates demonstrated haemagglutination with rabbit, sheep or human group A erythrocytes, suggesting the presence of putative CFAs, yet unidentified.

Matched MeSH terms: Enterotoxins/analysis*
Enterotoxin production by Staphylococcus aureus strains isolated from humans, foods and animals in Malaysia

Lim YS, Jegathesan M, Koay AS

Southeast Asian J Trop Med Public Health, 1982 Mar;13(1):133-7.
PMID: 7112212

Enterotoxin production by strains of Staphylococcus aureus isolated from human, food and animal sources was investigated. Of the 130 isolates studied, 27 (20.8%) were found to be enterotoxigenic. The most common enterotoxin detected from human sources was enterotoxin C whereas enterotoxin B occurred more frequently in staphylococcal strains of food origin. The 2 enterotoxigenic strains, from animals isolated from a dog and a goat, produced enterotoxins A and C, respectively. Enterotoxin E was not detected alone from any of the enterotoxigenic strains studied, but occurred together with other enterotoxins. The need to detect enterotoxin in staphylococcal strains and in suspected foods for the confirmation of staphylococcal food poisoning is discussed.

Matched MeSH terms: Enterotoxins/biosynthesis*
Fulltext Molecular surveillance of methicillin-susceptible Staphylococcus aureus (MSSA) isolated over a one-year period from a Malaysian Teaching Hospital

Sapri HF, Ismail MAH, Sani NAM, Noordin A, Tan TL, Hussin S, et al.

Germs, 2020 Jun;10(2):104-111.
PMID: 32656107 DOI: 10.18683/germs.2020.1191

Introduction: We report the results of a molecular surveillance study carried out on methicillin-susceptible Staphylococcus aureus (MSSA) isolated in a one-year duration from Hospital Canselor Tuanku Muhriz (HCTM), a tertiary hospital located in Kuala Lumpur, Malaysia.
Methods: The first strain isolated from each MSSA infection in HCTM during the year 2009 was included into the study. Antimicrobial susceptibility testing and agr group typing were carried out for all strains; virulence gene (cna, seh, TSST-1 and PVL) typing results of the strains were obtained from a previous study. Pulsed-field gel electrophoresis (PFGE) was done on selected strains from the orthopedic ward. Relationship(s) between different typing methods used in the study was investigated, where a p value of <0.05 indicated significant association between typing methods.
Results: A total of 880 MSSA strains were included into the study. The strains were generally susceptible to most antibiotics, with most of them carrying cna and agr-I (51.6%, n=454; 39.8%, n=350, respectively). A total of 17 PFGE pulsotypes were identified using an 80% similarity cut-off value, where the main pulsotype (pulsotype E) consisted of 24 isolates (23.5%). agr-III strains were found to be usually positive for both cna and seh (p<0.05). In addition, some PFGE pulsotypes were also characteristic of certain virulence genes or agr groups.
Conclusions: We did not identify a dominant MSSA clone circulating in HCTM in 2009. Nevertheless, results from this molecular surveillance will provide good baseline data for the hospital's second S. aureus surveillance planned for the year 2020.

Matched MeSH terms: Enterotoxins
Prevalence of Bacillus cereus in selected foods and detection of enterotoxin using TECRA-VIA and BCET-RPLA

Rusul G, Yaacob NH

Int J Food Microbiol, 1995 Apr;25(2):131-9.
PMID: 7547144

Enterotoxigenic Bacillus cereus was detected in cooked foods (17), rice noodles (3), wet wheat noodles (2), dry wheat noodles (10), spices (8), grains (4), legumes (11) and legume products (3). One hundred ninety-four (42.3%), 70 (15.3%) and 23 (5.2%) of the 459 presumptive B. cereus colonies isolated from PEMBA agar were identified as B. cereus, Bacillus thuringiensis and B. mycoides, respectively. B. cereus isolates were examined for growth temperature, pH profile and enterotoxin production using both TECRA-VIA and BCET-RPLA kits. One hundred seventy-eight (91.8%) and 164 (84%) of the strains were enterotoxigenic as determined using TECRA-VIA and BCET-RPLA, respectively. Eighty-two (50%) of the enterotoxigenic strains were capable of growing at 5 degrees C, and 142 (86.6%) grew at 7 degrees C within 7 days of incubation. The enterotoxigenic strains did not grow at pH 4.0 but 69 (42.0%) of the strains were able to grow at pH 4.5 within 7 days at 37 degrees C. The isolates were resistant to ampicillin (98.8%), cloxallin (100%) and tetracycline (61.0%), and susceptible to chloroamphenicol (87%), erythromycin (77.4%), gentamycin (100%) and streptomycin (98.7%).

Matched MeSH terms: Enterotoxins/analysis*
Fulltext Comparison of methods in the detection of enterotoxigenic Escherichia coli in a Malaysian laboratory

Cheong YM, Jegathesan M, Ansary A, Othman M

Med J Malaysia, 1990 Mar;45(1):42-8.
PMID: 2152068

The prevalence of Enterotoxigenic Escherichia coli (ETEC) in 433 stool samples from diarrhoeal cases of all ages was studied using two commercially available test kits for the detection of heat labile toxin (LT) and the infant mouse assay for the heat stable toxin (ST). 16 samples (3.7%) were positive for ETEC, of which nine were producing ST alone, six LT alone and only one was producing both LT and ST. Although the percentage of isolation rate was low, its occurrence was almost as common as the Shigella spp and Salmonella spp in the same study. Of the two test kits examined, the Phadebact ETEC-LT Test 50 (Pharmacia Diagnostics, Uppsala, Sweden) was found to be more suitable for use in a routine diagnostic laboratory. Ten out of 12 (83%) of the strains tested were resistant to one or more antibiotics.

Matched MeSH terms: Enterotoxins/biosynthesis*
Comparison of methicillin-resistant and methicillin-sensitive Staphylococcus aureus strains isolated from a tertiary hospital in Terengganu, Malaysia

Lim KT, Yeo CC, Suhaili Z, Thong KL

Jpn J Infect Dis, 2012;65(6):502-9.
PMID: 23183202

Staphylococcus aureus is a persistent human pathogen responsible for a variety of infections ranging from soft-tissue infections to bacteremia. The objective of this study was to determine genetic relatedness between methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) strains. We isolated 35 MRSA and 21 MSSA strains from sporadic cases at the main tertiary hospital in Terengganu, Malaysia, screening them for the presence of virulence genes. Their genetic relatedness was determined by accessory gene regulator (agr) types, PCR-restriction fragment length polymorphism (RFLP) of the coa gene, pulsed-field gel electrophoresis (PFGE), S. aureus protein A (spa), and multilocus-sequence typing (MLST). We found that 57% of MRSA and 43% of MSSA strains harbored enterotoxin genes. The majority (87.5%) of the strains were agr type I. PCR-RFLP and PFGE genotyping of the coa gene revealed that MRSA strains were genetically related, whereas MSSA strains had higher heterogeneity. The combined genotype, MLST-spa type ST239-t037, was shared among MRSA and MSSA strains, indicating that MRSA strains could have evolved from MSSA strains. Two combined MLST-spa types were present in MRSA strains, whereas 7 different MLST-spa types were detected in MSSA strains, including 2 combined types (ST779-t878 and ST1179-t267) that have not been reported in Malaysia. In conclusion, enterotoxin genes were more prevalent in MRSA than in MSSA strains in the Terengganu hospital. The MSSA strains were genetically more diverse than the MRSA strains.

Matched MeSH terms: Enterotoxins/genetics
Fulltext Single-molecule sequencing reveals the molecular basis of multidrug-resistance in ST772 methicillin-resistant Staphylococcus aureus

Steinig EJ, Andersson P, Harris SR, Sarovich DS, Manoharan A, Coupland P, et al.

BMC Genomics, 2015;16:388.
PMID: 25981586 DOI: 10.1186/s12864-015-1599-9

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of hospital-associated infection, but there is growing awareness of the emergence of multidrug-resistant lineages in community settings around the world. One such lineage is ST772-MRSA-V, which has disseminated globally and is increasingly prevalent in India. Here, we present the complete genome sequence of DAR4145, a strain of the ST772-MRSA-V lineage from India, and investigate its genomic characteristics in regards to antibiotic resistance and virulence factors.

Matched MeSH terms: Enterotoxins/genetics
Additional oligofructose/inulin does not increase faecal bifidobacteria in critically ill patients receiving enteral nutrition: a randomised controlled trial

Majid HA, Cole J, Emery PW, Whelan K

Clin Nutr, 2014 Dec;33(6):966-72.
PMID: 24290345 DOI: 10.1016/j.clnu.2013.11.008

Patients with diarrhoea during enteral nutrition (EN) have been shown to have low faecal bifidobacteria concentrations. Oligofructose/inulin selectively stimulate the growth of bifidobacteria in healthy humans. This study investigates the effect of additional oligofructose/inulin on the gastrointestinal microbiota, short-chain fatty acids (SCFA) and faecal output in patients receiving EN.

Matched MeSH terms: Enterotoxins/analysis
Fulltext Prevalence of Clostridium difficile toxin in diarhoeal stool samples of patients from a tertiary hospital in North Eastern Penisular Malaysia

Hassan SA, Othman N, Idris FM, Abdul Rahman Z, Maning N, Abdul Rahman R, et al.

Med J Malaysia, 2012 Aug;67(4):402-5.
PMID: 23082450 MyJurnal

This study describes the prevalence of Clostridium difficile toxin (CDT) in loose stool samples from inpatients aged more than two years of a tertiary hospital. A total of 175 samples that had been examined were from stool samples that were sent to the Medical Microbiology & Parasitology Laboratory for various clinical indications. The toxin was detected by a commercial immunochromatograhic test, and the patients' demography, clinical features, treatment and outcomes were analyzed from their medical records. Clostridium difficile toxin was positive in 24 (13.7%) of the stool samples. Male and female were 11 (45.8%) and 13 (54.2%) respectively, with the majority of them aged more than 50 years. Most were from medical wards (n = 21, 87.5%), with the rest from surgical wards (n = 2, 8.3%) and intensive care units (n = 1, 3.4%). All the CDT positive patients had history of prior antibiotic usage within 6 weeks before the detection of the toxin. The mean duration of antibiotics usage was 17.75 (+/- 13.75) days, while the mean duration of diarrhea was 5.21((+/- 5.85) days. Eighteen patients had underlying medical illnesses that were diabetes mellitus, chronic renal disease, hypertension, ischaemic heart disease, cerebrovascular disease and malignancy; with seven of them being CDT positive while on chemotherapy. Stool occult blood test was positive in 15 patients whereas presence of pus cells in the CD positive stool samples were detected in 21 patients. The duration of hospitalization among the patients was 27.96 (+/- 23.22) days.

Matched MeSH terms: Enterotoxins/analysis*
Enterotoxigenic Escherichia coli in the domestic environment of a Malaysian village

Vadivelu J, Feachem RG, Drasar BS, Harrison TJ, Parasakthi N, Thambypillai V, et al.

Epidemiol Infect, 1989 Dec;103(3):497-511.
PMID: 2691267

The membrane-filter assay, GM1-ELISA, and DNA-DNA hybridization assay, were used to detect enterotoxigenic Escherichia coli (ETEC) in samples of water, weaning food, food preparation surface swabs, fingerprints of mothers, and the fingerprints and stools of children under 5 years of age, in 20 households in a Malaysian village. Weaning food and environmental samples were frequently contaminated by faecal coliforms, including ETEC. The membrane-filter assay detected and enumerated faecal coliforms and LT-ETEC in all types of water and weaning food samples. Highest concentrations of faecal coliforms and LT-ETEC were found in weaning food, followed by well-water, stored water and stored drinking water. The GM1-ELISA detected LT-ETEC in weaning food, food preparation surfaces, fingerprints and stool samples. The DNA-DNA hybridization assay detected a larger proportion of STa2-ETEC than the other toxotypes, either singly or in combination. All the assays in combination detected the presence of ETEC in all types of samples on at least one occasion in each household. It was not possible to classify households as consistently more or less contaminated with ETEC. On individual occasions it was possible to show a significant association of the presence of LT-ETEC between the fingerprints of children and their stools, fingerprints of mothers and children, and weaning food and the stools of the child consuming the food.

Matched MeSH terms: Enterotoxins/biosynthesis*
Possible virulence factors involved in bacteraemia caused by Aeromonas hydrophila

Vadivelu J, Puthucheary SD, Phipps M, Chee YW

J Med Microbiol, 1995 Mar;42(3):171-4.
PMID: 7884797

Eighteen strains of Aeromonas hydrophila from patients with bacteraemia were investigated for possible virulence factors. Cytotoxin and haemolysin were produced by all strains, whereas cholera toxin-like factor was produced by 33% of strains only. Enterotoxin production was not detected. Haemagglutination of guinea-pig, fowl and rabbit erythrocytes was demonstrated by 83%, 67% and 61% of strains, respectively. Fucose- and mannose-sensitive haemagglutinins were predominant. None of the strains agglutinated sheep erythrocytes. Extrachromosomal DNA was detected in 17 strains, 16 of which had a plasmid (3.6-5.1 MDa), the majority being between 4.6 and 5.1 MDa.

Matched MeSH terms: Enterotoxins/biosynthesis
Fulltext Seafood poisoning symptom, treatment and prevention

Yoshida, Teruaki, Zarinah Waheed, Mohd Yusof Ibrahim, Mohammad Illzam Elahee, Shahjee Hussain, Sharifa Mariam Uma Abdullah, et al.

Borneo Journal of Marine Science and Aquaculture, 2018;2(1):64-69.
MyJurnal

Food related disease or food poisoning is prevalent worldwide and is associated with high mortality. It can be caused by bacteria, viruses, parasites, enterotoxins, mycotoxins, chemicals, histamine poisoning (scombroid) ciguatera and harmful algal bloom (HAB). Illness can also result by red tide while breathing in the aerosolized brevitoxins (i.e. PbTx or Ptychodiscus toxins). Bacterial toxin food poisoning can affect within 1-6 hours and 8-16 hours, and illness can be with or without bloody diarrhea. The common symptoms of food poisoning include abdominal cramps, vomiting and diarrhea. Diagnosis includes examination of leftover food, food preparation environment, food handlers, feces, vomitus, serum and blood. Treatment involves oral rehydration, antiemetic, and anti-peristaltic drugs. Antimicrobial agents may be needed in the treatment of shigellosis, cholera, lifesaving invasive salmonellosis and typhoid fever. Proper care in handling and cooking is important to prevent any food borne diseases.

Matched MeSH terms: Enterotoxins
Enterotoxigenicity, distribution of enterotoxigenic genes and antibiotic resistance pattern of Staphylococcus aureus isolated from traditional sweet

Ghazavi N, Rahimi E, Esfandiari Z, Shakerian A

Trop Biomed, 2018 Dec 01;35(4):880-892.
PMID: 33601838

Resistant and enterotoxigenic Staphylococcus aureus strains are considered to be one of the major causes of foodborne diseases due to the consumption of sweet. The present research was done to study the distribution of enterotoxin types, enterotoxigenic genes and antibiotic resistance pattern of S. aureus strains isolated from traditional sweet samples. Eight-hundred and fifteen sweet samples were cultured and S. aureus strains were identified. Antibiotic resistance, enterotoxigenicity and enterotoxigenic gene profile were studied using disk diffusion, Enzyme Link Immunosorbent Assay and PCR, respectively. One-hundred and seven out of 815 (13.12%) sweet samples were positive for S. aureus. Prevalence of S. aureus in dried and semi-dried sweet samples were 15.08% and 11.13%, respectively (P <0.05). Forty-six out of 107 S. aureus strains (42.99%) were determined as enterotoxigenic. A (41.30%) and C (17.39%) were the most commonly detected enterotoxin types. Sea (20.56%), sec (14.95%) and seb (11.21%) were the most commonly detected enterotoxigenic genes. There were no positive sample for the sej enterotoxin gene. S. aureus strains harbored the highest prevalence of resistance against penicillin (88.78%), tetracycline (83.17%), ceftaroline (75.70%) and doxycycline (71.02%). Simultaneous presence of enterotoxins and enterotoxigenic genes in multi-drug resistant S. aureus strains indicates important public health issue regarding the consumption of contaminated traditional sweet samples.

Matched MeSH terms: Enterotoxins
Fulltext Detection of enterotoxin targeted entFM and hblA genes by inoculating Bacillus cereus (Strain BC1) into ready-to-eat food (RTF) and drink samples using polymerase chain reaction (PCR)

Nooratiny, I., Sahilah, A.M.

International Food Research Journal, 2013;20(4):1895-1899.
MyJurnal

Detection of enterotoxin by targeting entFM and hblA genes in Bacillus cereus BC1 strain inoculated into ready to eat food (RTF) and drink samples using polymerase chain reaction (PCR) was conducted. The B. cereus BC1 strain was confirmed as a Bacillus diarrhoeal enterotoxin (BDE) when tested by a commercially available Enzyme-linked immunosorbent assay-BDE immunoassay (ELISA-BDE immunoassay, TECRA). In the specificity study, both enterotoxin genes were detected on chromosomal DNA of B. cereus BC1 strain by showing a specific band of 1269 bp (entFM) and 874 bp (hblA), respectively. However, none of the target genes were detected for the other 15 genomic DNA bacteria (B. cereus (ATCC 11779), B. subtilis (ATCC 6633), Campylobacter jejuni (ATCC 29428), C. coli (Jabatan Kimia Malaysia, JKM), Clostridium perfringen (ATCC 13124), Enterobacter sakazaki (ATCC 51329), Escherichia coli (ATCC 43888), E. coli (ATCC 11735), Legionella pneumophila (ATCC 33152), Listeria monocytogenes (ATCC 35967), Salmonella typhi (IMR), S. enteritidis (ATCC 13076), S. typhimurium (ATCC 14028), Shigella flexeneri (ATCC 12022) and Vibrio cholerae bengal (Institute Medical Research (IMR), Malaysia) examined. The detection limit of both genes was 0.1 ng of genomic DNA. Thus, in the presence study it is evidence that the PCR analysis targeting enterotoxin of entFM and hblA genes are suitable and useful in detecting enterotoxic B. cereus in RTFs and drinks contaminated sample.

Matched MeSH terms: Enterotoxins
Hospital-acquired Clostridium difficile infection among patients with type 2 diabetes mellitus in acute medical wards

Hassan SA, Rahman RA, Huda N, Wan Bebakar WM, Lee YY

J R Coll Physicians Edinb, 2013;43(2):103-7.
PMID: 23734349 DOI: 10.4997/JRCPE.2013.203

Clostridum difficile (C. difficile) infection is increasingly seen among hospitalised patients with type 2 diabetes mellitus but its rate and associated risk factors are not known. We aimed to determine the rate and characteristics of hospital-acquired C. difficile infection in subjects with type 2 diabetes mellitus admitted into acute medical wards.

Matched MeSH terms: Enterotoxins/analysis
Fulltext Predominance of ST22-MRSA-IV Clone and Emergence of Clones for Methicillin-Resistant Staphylococcus aureus Clinical Isolates Collected from a Tertiary Teaching Hospital Over a Two-Year Period

Niek WK, Teh CSJ, Idris N, Thong KL, Ponnampalavanar S

Jpn J Infect Dis, 2019 Jul 24;72(4):228-236.
PMID: 30814457 DOI: 10.7883/yoken.JJID.2018.289

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens, causing mild to severe infections. This study aimed to determine the genotypic and phenotypic characteristics of clinical MRSA isolates collected from a teaching hospital from 2014 - 2015. These isolates were genotyped by multilocus sequence typing, staphylococcal cassette chromosomal mec (SCCmec) typing, virulence genes detection, and pulsed-field gel electrophoresis; they were phenotyped based on their antibiotics susceptibility profiles. The most prevalent sequence type was ST22. ST3547 was identified from a blood isolate from 2015. Three SCCmec types (III in 26.26%, IV in 70.71%, and V in 3.03% isolates) were detected. Agr type I, II, and III were also detected among the isolates. The most prevalent virulence genes found were hemolysin (100%) and intracellular adhesion (91.9%). At least one staphylococcal enterotoxin was detected in 83 (83.8%) isolates. All the isolates were susceptible to vancomycin (minimum inhibitory concentration ≤ 2 μg/mL). Statistical analysis revealed a significant increase in hypertension (p = 0.035), dyslipidemia and obesity (p = 0.046), and previous exposure to any quinolone (p = 0.010) cases over the two-year period. The emergence and circulation of community-associated MRSA variants were observed in our hospital.

Matched MeSH terms: Enterotoxins/genetics

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