Antimicrobial Resistance and Molecular Characterization of
Causing Skin and Soft Tissue Infections in Greek Adults
S Mastraftsi1,2, S Sarrou1,2, K Pantelidi1,2, A Skoulakis1,2, A Roussaki3 and E Petinaki
1Department of Microbiology, University Hospital of Larissa, Larissa, Greece
2Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece
3Department of Dermatology, Medical School, University of Thessaly, Larissa, Greece
*Corresponding Author: E Petinaki, Professor, Head of Department of Microbiology, Medical School, University of Thessaly, Biopolis,
December 21, 2017; Published: January 19, 2018
During 2016, a total of one hundred twenty three
isolates were collected from adult-patients skin and soft
tissue infections (SSTIs) in Thessaly, Central Greece. The isolates were tested for susceptibility to various antimicrobial agents and
the presence of resistance and virulence determinants. Resistance rates to cefoxitin, fusidic acid, erythromycin, clindamycin, tetra-
cycline, ofloxacin and gentamycin were 22%, 36.6%, 29.3%, 26.8%, 22%, 7.3% and 4.8% respectively, whereas, all were susceptible
to vancomycin, teicoplanin, linezolid, mupirocin, trimethoprim-sulfamethoxazole and daptomycin. The presence of
genes were found in erythromycin/clindamycin, tetracycline and gentamicin-resistant isolates, respectively.
Molecular characterization of isolates revealed the presence of two clones among MRSA (ST80-IV and ST225-II), while, among MSSA
twelve different STs (ST1, 15, 45, 72, 7, 22, 728, 34, 59, 10, 398, 1153) were identified. The Panton-Valentine Leukocidin gene was de
tected in 39 strains, 18 MRSA which belonged to ST80, and 21 MSSA, which belonged to ST72 and ST728. The Toxic Shock Syndrome
Toxin gene was found in ST34 MSSA. The results highlight the importance of both MRSA and MSSA as etiological agents in SSTIs,
emphasizing the need for a close surveillance.
Keywords: Antimicrobial Resistance; Greece; Molecular Typing; Skin and Soft Tissue Infection;
- Esposito Silvano., et al. “Epidemiology and Microbiology of Skin and Soft Tissue Infections”.
Current Opinion in Infectious Diseases 29.2 (2016): 109-115.
- Montravers Philippe., et al. “Current Guidelines and Recommendations for the Management of Skin and Soft Tissue Infections”.
Current Opinion in Infectious Diseases 29.2 (2016): 131-138.
- Katopodis George D., et al. “Fusidic Acid and Clindamycin Resistance in Community-Associated, Methicillin-Resistant Staphylococcus Aureus Infections in Children of Central Greece”.
BMC Infectious Diseases 10 (2010): 351.
- Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing: twenty six Informational Supplement M100-S26. CLSI, Wayne, PA: CLSI (2016).
- Campbell Steven J., et al. “Genotypic Characteristics of Staphylococcus Aureus Isolates from a Multinational Trial of Complicated Skin and Skin Structure Infections”.
Journal of Clinical Microbiology 46.2 (2008): 678-684.
- Liu Xiaoli., et al. “Molecular Characteristics of Community-Acquired Methicillin-Resistant Staphylococcus Aureus Strains Isolated from Outpatients with Skin and Soft Tissue Infections in Wuhan, China”.
Pathogens and Disease 74.4 (2016): ftw026.
- Drougka E., et al. “A 12-Year Survey of Methicillin-Resistant Staphylococcus aureus Infections in Greece: ST80-IV Epidemic?”.
Clinical Microbiology and Infection: The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases 20.11 (2014): O796-O803.
- Enright MC., et al. “Multilocus Sequence Typing for Characterization of Methicillin-Resistant and Methicillin-Susceptible Clones of Staphylococcus aureus”.
Journal of Clinical Microbiology 38.3 (2000): 1008-1015.
- Athanasakis Kostas., et al. “Antibacterial Treatment of Meticillin-Resistant Staphylococcus Aureus Complicated Skin and Soft Tissue Infections: A Cost and Budget Impact Analysis in Greek Hospitals”.
Infectious Diseases and Therapy 3.2 (2014): 257-268.
- Doudoulakakis Anastassios., et al. “Emergence of a Staphylococcus Aureus Clone Resistant to Mupirocin and Fusidic Acid Carrying Exotoxin Genes and Causing Mainly Skin Infections”.
Journal of Clinical Microbiology 55.8 (2017): 2529-2537.
- Mine Yoshiko., et al. “Dissemination of Panton-Valentine Leukocidin-Positive Methicillin-Resistant Staphylococcus aureus in Okinawa, Japan”.
The Journal of Dermatology 40.1 (2013): 34-38.
- Yu Fangyou., et al. “Antimicrobial Susceptibility, Virulence Determinant Carriage and Molecular Characteristics of Staphylococcus Aureus Isolates Associated with Skin and Soft Tissue Infections”.
The Brazilian Journal of Infectious Diseases: An Official Publication of the Brazilian Society of Infectious Diseases 19.6 (2015): 614-622.
- Takadama Shunsuke., et al. “Prevalence of Skin Infections Caused by Panton-Valentine Leukocidin-Positive Methicillin-Resistant Staphylococcus Aureus in Japan, Particularly in Ishigaki, Okinawa”.
Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy 23.11 (2017): 800-803.
- Aung MS., et al. “Drug Resistance and Genetic Characteristics of Clinical Isolates of Staphylococci in Myanmar: High Prevalence of PVL among Methicillin-Susceptible Staphylococcus Aureus Belonging to Various Sequence Types”.
New Microbes and New Infections 10 (2016): 58-65.
- VanEperen Alison S and John Segreti. “Empirical Therapy in Methicillin-Resistant Staphylococcus Aureus Infections: An Up-To-Date Approach”.
Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy 22.6 (2016): 351-359.