Detection of Efflux Pump Genes Mediating Ciprofloxacin Resistance in Staphylococcus Aureus Isolates in Sohag University Hospitals
Primary Purpose
Patients withInfections Caused by S.Aureus Like Skin Infections , Chest Infections , Surgical Site Infections , and Urinary Tract Infections
Status
Not yet recruiting
Phase
Not Applicable
Locations
Egypt
Study Type
Interventional
Intervention
antibiotic sensitivity
Sponsored by
About this trial
This is an interventional diagnostic trial for Patients withInfections Caused by S.Aureus Like Skin Infections , Chest Infections , Surgical Site Infections , and Urinary Tract Infections
Eligibility Criteria
Inclusion Criteria: Infections caused by S.aureus like skin infections , chest infections , surgical site infections , and urinary tract Infections Exclusion Criteria: Infections caused by any organisms other than S.aureus
Sites / Locations
- Sohag University Hospital
Outcomes
Primary Outcome Measures
Ciprofloxacin Resistance in Staphylococcal strains isolated
resistance pattern of the isolates will be detected by disc diffusion method
presence of Efflux pump genes ( norA , norB , norC ) mediating Resistance in such strains
Detection of efflux pump genes responsible for the resistance ( norA , norB , norC ) by PCR
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05828550
Brief Title
Detection of Efflux Pump Genes Mediating Ciprofloxacin Resistance in Staphylococcus Aureus Isolates in Sohag University Hospitals
Official Title
Detection of Efflux Pump Genes Mediating Ciprofloxacin Resistance in Staphylococcus Aureus Isolates in Sohag University Hospitals
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
May 2023 (Anticipated)
Primary Completion Date
November 2023 (Anticipated)
Study Completion Date
November 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sohag University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Among multidrug-resistant bacteria, Methicillin-resistant Staphylococcus aureus (MRSA) isolates were recognized to be an important mortality factor in hospital infections and a major concern in health-care and community settings . The antibiotic-resistant of S. aureus is extended by various bacterial strategies, including limiting uptake of the drug, alteration of the drugtargets, production of druginactivating enzymes and the activation of efflux pumps that effectively remove antibiotics . Relying on the type of antibiotics, bacteria can apply one or more strategies. Specifically, localization of resistance genes in transferable genetic elements, such as plasmid and transposons , causing Horizontal transfer of resistance genes between bacterial strains . MRSA strains are resistant to nearly all beta-lactam antibiotics by producing an alternative penicillin-binding protein known as PBP2a . This protein is encoded by the mecA gene and has a low affinity to manybeta-lactam antibiotics. Furthermore, these strains often show resistance to a wide range of antibiotics . The use of fluoroquinolone for the effective infectious therapy is limited by presence of fluoroquinolone resistance . There are two mechanisms causing resistance to fluoroquinolone. The first one is attributed to mutations occurring in the quinolone-resistance determining region (QRDR) of topoisomerase IV encoded by grlA/grlB and DNA gyrase encoded by gyrA/gyrB; these mutations decrease the affinity ofthe drug. The other mechanism is mediated by efflux pumps which is less recognized . Recently, several efflux pumps have been identified for S. aureus including efflux pumps encoded by chromosome or plasmids. The efflux pumps norA, norB, norC, mdeA, sepA, mepA, sdrM and lmrS are encoded by chromosome while qacA/B, qacG, qacH, qacJ and smr are plasmid-encoded . Efflux pumps could be specialized for specific substrate or mobilized a wide varieties of different antibiotic classes . Despite, efflux pumps can potentially increase resistance to antibiotics in clinical isolates of S. aureus, few studies have been evaluated the individual and collective participation of the efflux system in resistant isolates . Therefore the aim of the study is to detect ciprofloxacin resistant strains of staphylococcus aureus isolates and to detect efflux pump genes ( norA , norB and norC ) mediating resistance in such strains.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Patients withInfections Caused by S.Aureus Like Skin Infections , Chest Infections , Surgical Site Infections , and Urinary Tract Infections
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)
8. Arms, Groups, and Interventions
Intervention Type
Diagnostic Test
Intervention Name(s)
antibiotic sensitivity
Other Intervention Name(s)
polymerase chain reaction
Intervention Description
The resistance pattern of the isolates will be detected by disc diffusion method.
Detection of efflux pump genes responsible for the resistance ( norA , norB , norC ) by PCR
Primary Outcome Measure Information:
Title
Ciprofloxacin Resistance in Staphylococcal strains isolated
Description
resistance pattern of the isolates will be detected by disc diffusion method
Time Frame
6 months
Title
presence of Efflux pump genes ( norA , norB , norC ) mediating Resistance in such strains
Description
Detection of efflux pump genes responsible for the resistance ( norA , norB , norC ) by PCR
Time Frame
6 months
10. Eligibility
Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Infections caused by S.aureus like skin infections , chest infections , surgical site infections , and urinary tract Infections
Exclusion Criteria:
Infections caused by any organisms other than S.aureus
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
esraa e farag, demonstrator
Phone
01090926328
Email
esraaesam@med.sohag.edu.eg
First Name & Middle Initial & Last Name or Official Title & Degree
asmaa n thabet, Assistant professor
Facility Information:
Facility Name
Sohag University Hospital
City
Sohag
Country
Egypt
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Magdy m Amin, professor
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Citations:
PubMed Identifier
23112984
Citation
Havaei S, Moghadam SO, Pourmand M, Faghri J. Prevalence of Genes Encoding Bi-Component Leukocidins among Clinical Isolates of Methicillin Resistant Staphylococcus aureus. Iran J Public Health. 2010;39(1):8-14. Epub 2010 Mar 31.
Results Reference
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PubMed Identifier
12727914
Citation
Lowy FD. Antimicrobial resistance: the example of Staphylococcus aureus. J Clin Invest. 2003 May;111(9):1265-73. doi: 10.1172/JCI18535. No abstract available.
Results Reference
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PubMed Identifier
25130148
Citation
Pourmand MR, Yousefi M, Salami SA, Amini M. Evaluation of expression of NorA efflux pump in ciprofloxacin resistant Staphylococcus aureus against hexahydroquinoline derivative by real-time PCR. Acta Med Iran. 2014;52(6):424-9.
Results Reference
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PubMed Identifier
29203102
Citation
Yilmaz ES, Aslantas O. Antimicrobial resistance and underlying mechanisms in Staphylococcus aureus isolates. Asian Pac J Trop Med. 2017 Nov;10(11):1059-1064. doi: 10.1016/j.apjtm.2017.10.003. Epub 2017 Nov 8.
Results Reference
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Detection of Efflux Pump Genes Mediating Ciprofloxacin Resistance in Staphylococcus Aureus Isolates in Sohag University Hospitals
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