Epidemiology of efflux pumps genes mediating resistance among Staphylococcus aureus; A systematic review. (February 2020)

• Record Type: Journal Article
• Authors: Hassanzadeh, Sepideh; ganjloo, Sara; Pourmand, Mohammad Reza; Mashhadi, Rahil; Ghazvini, Kiarash
• Is Part Of: Microbial pathogenesis. Volume 139(2020)
• Publication Date: 2020-02
• Subjects: Staphylococcus aureus -- Efflux pumps -- Polymerase chain reaction -- Multi-drug resistance -- Over-expression; Pathogenic microorganisms -- Periodicals; Pathology, Molecular -- Periodicals; Communicable Diseases -- microbiology -- Periodicals; Communicable Diseases -- parasitology -- Periodicals; Micro-organismes pathogènes -- Périodiques; Pathologie moléculaire -- Périodiques; Electronic journals; 616.9041
• DOI: 10.1016/j.micpath.2019.103850
• Languages: English
• ISSNs: 0882-4010

Abstract

Abstract: Background: Efflux of antibiotics is an effective resistance mechanism among antibiotic-resistant Staphylococcus aureus. This systematic review aims to evaluate the frequency and expression of efflux pump genes in S.aureus around the world. Method: A comprehensive literature search of several databases (Medline Pub Med, ISI, Scopus, Google Scholar, ISC, Science direct and Persian Journals Online, and citation lists) was performed. We considered published studies from 2001 to 2018. Articles reporting the prevalence and expression of efflux pump genes were selected. Result: Among 183 articles, 36 studies were selected. Of the 36, 23 articles were conducted in Asia.6 in Europe, 5 in America and 2 in African countries. In most of these studies norA, norB, qacA / B genes were commonly evaluated by molecular methods. The presence of efflux pump genes such as norA, norB, norC, mepA, mdeA, qacA / B was detected by PCR in 21 studies and over-expression of genes were reported in 13 studies. The most frequently reported genes in Asia were norA (75%), norB (60%), mepA (35%), mdeA (33%) and qacA/B (20.8%). In European studies, the prevalence of norB was mostly reported among S.aureus isolates and norA and qacA/B were commonly found in similar studies in America. The investigation of gene expression patterns showed that norA was most frequent single-pattern in Asia and America, norB or mdeA in Europe. Conclusion: According to this study MDR efflux pumps not only cause high-level resistance but also it considerably associated with over-expression of these genes. Due to the selective pressure on MRSA isolate, the enormous diversity of plasmid-encoded genes had been recorded in different regions, owing to the various numbers and types of isolates in each study or types of disinfectants for general use. Highlights: The prevalence of norB was mostly reported among European isolates. The prevalence of norA and qacA/B were commonly in America. The most frequently genes in Asia were norA, norB . Gene expression patterns showed that norA was most frequent single-pattern in Asia and America, norB or mdeA in Europe.