Characteristics of Methicillin Resistant Staphylococcus aureus Strains Isolated from Hospital Wastewater in Tehran, Iran

Hospital sewage is known as an important source of human pathogenic bacteria such as methicillin resistant Staphylococcus aureus (MRSA) strains disseminated from hospital to the environment. This study aimed to investigate the presence of MRSA in the treated outgoing wastewater collected from a referral hospital in Tehran, Iran.

During 2015, sampling was carried out at two stages from a hospital wastewater. All black colonies with halos on HiCrome aureus agar medium supplemented with oxacillin were collected and identified as MRSA using specific primers for nucA and mecA genes. Isolates susceptibility to 18 antibiotics was determined according to the recommendations of the Clinical and Laboratory Standards Institute (CLSI). Bacterial typing was performed for the isolates using a combination of Phene plate (PhP) typing, prophage typing, staphylococcal cassette chromosome mec (SCCmec) and ccr typing methods.

A total of 79 MRSA isolates were confirmed using specific primers and showed susceptibility to quinupristin-dalfopristin, vancomycin, chloramphenicol, and linezolid. High resistance to penicillin, ciprofloxacin, kanamycin, tobramycin, and erythromycin was reported. Sixteen PhP types consisting of eight common types (CTs) and eight single types (STs) were identified among the strains, among which CT1 was the dominant type. Also, two prophage patterns and four prophage types were identified, and all the strains were positive for SCCmec type III and ccr type 3.

The results of this study revealed that sewage-treatment process was able to remove community-acquired MRSA (CA-MRSA) strains; however, hospital-acquired MRSA (HA-MRSA) strains were able to survive during the treatment process in this hospital.