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. VETERINARSKI ARHIV 84 (3), 205-214, 2014 The prevalence of methicillin resistance and Panton-Valentine leukocidin synthesis genes in Staphylococcus aureus isolates of bovine and human origin Marija J. Pajić 1 *, Zoran B. Rašić 2, Branko M. Velebit 3, Stanko F. Boboš 1, Mira M. Mihajlović-Ukropina 4, Miodrag Ž. Radinović 1, Annamaria L. Galfi 1, Jelena M. Petković 2, and Snježana I. Trojačanec 5 1 Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Novi Sad, R. Serbia 2 Veterinary Institute Jagodina, Jagodina, R. Serbia 3 Institute of Meat Hygiene and Technology, Belgrade, R. Serbia 4 School of Medicine, University of Novi Sad, Novi Sad, R. Serbia 5 Department of Animal Physiology, Faculty of Agricultural Sciences and Food, University Ss. Cyril and Methodius, Skopje, R. Macedonia PAJIĆ, M. J., Z. B. RAŠIĆ, B. M. VELEBIT, S. F. BOBOŠ, M. M. MIHAJLOVIĆ- UKROPINA, M. Ž. RADINOVIĆ, A. L. GALFI, J. M. PETKOVIĆ, S. I. TROJAČANEC: The prevalence of methicillin resistance and Panton-Valentine leukocidin synthesis genes in Staphylococcus aureus isolates of bovine and human origin. Vet. arhiv 84, 205-214, 2014. ABSTRACT Using the California Mastitis Test (CMT), on 46 highly productive dairy farms in Serbia, cows with milk secretion disorder were identified. Milk samples were taken from cows with positive CMT and from cows with clinical mastitis. Standard microbiological analysis of milk samples and API Staph confirmed the presence of 75 isolates of Staphylococcus aureus.. Those 75 isolates, as well as 11 isolates of Staphylococcus aureus originating from humans were analyzed for the presence of genes encoding Panton-Valentine leukocidin (PVL) and PBP2A protein, responsible for methicillin resistance. The presence of gene encoding PVL was determined by PCR in 5 out of 75 (6.67%) and in 7 out of 11 (63.63%) bovine and human isolates of Staphylococcus aureus, respectively. The presence of the meca gene was determined by PCR in 1 of 75 (1.33%) and in 2 of 11 (18.18%) bovine and human isolates of Staphylococcus aureus, respectively. The presence of the mecc gene was not determined in analyzed isolates. Further research is needed to investigate the genetic relationship between *Corresponding author: Marija Pajić, DVM, Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Trg Dositeja Obradovića 8, 21000 Novi Sad, R. Serbia, Phone: +381 21 4853 366; Fax: +381 21 459 978; E-mail: marija_vet@polj.uns.ac.rs ISSN 0372-5480 Printed in Croatia 205

bovine and human Staphylococcus aureus isolates, to determine the exact impact of bovine Staphylococcus aureus strains from the cow udders on animal and public health. Key words: cows, udder, milk, Panton-Valentine leukocidin, methicillin resistance Introduction Staphylococcus aureus is a major cause of food poisoning (ANONYM., 1996; ANONYM., 2013) may also cause pneumonia, toxic shock syndrome and wound infections (VAN DEN BROEK, 2003), and it is one of the most frequently isolated pathogens from both subclinical, clinical and chronic bovine mastitis (WATTS, 1988; FOURICHON et al., 2001; ESMAT and BADER, 1996; EL-SEEDY et al., 2010). Exotoxins constitute essential components of the virulence mechanisms of Staphylococcus aureus. Some strains produce additional exoproteins that may be responsible for a particular clinical manifestation, including staphylococcal enterotoxins, the Toxic-Shock Syndrome Toxin-1, exofoliative toxins, and the Panton-Valentine leukocidin (PVL) (DINGES et al., 2000; RAHIMI and ALIAN, 2013; BENIĆ et al., 2012). PVL is a Staphylococcus aureus - specific exotoxin, which belongs to the family of bicomponent synergohymenotropic toxins (SUPERSAC et al., 1993; GRAVET et al., 1998). It is a leukocytolytic toxin, which disrupts the membranes of polymorphonuclear neutrophils, creating pores in the cell membrane. (KANEKO and KAMIO, 2004). It is encoded by two contiguous and cotranscribed genes carried on bacteriophage, causing leukocyte destruction and tissue necrosis (SZMIGIELSKI et al., 1999; MELLES et al., 2006; HOLMES et al., 2005). This cytotoxin has been associated with necrotic lesions involving severe cutaneous infections with severe necrotizing pneumonia (CRIBIER et al., 1992; LINA et al., 1999; GILLET et al., 2002). PVL may be found in both methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) strains. It is encoded by two contiguous and cotranscribed genes, designated as lukf-pv and luks-pv (PREVOST et al., 1995). During nationwide surveillance conducted in Serbia in 2008, 162 MRSA strains were collected in 26 Serbian hospitals (mostly emergency hospitals). The presence of PVL was demonstrated in four (2.5%) of these isolates. All PVL positive MRSA strains were isolated from younger patients with skin infections, and were from different hospitals (CIRKOVIC et al., 2012). TAVAKOL et al. (2012) identified PVL negative MRSA strains resistant to two or more classes of antibiotics, in 14 different dairy herds located in the provinces Overijssel and Gelderland in The Netherlands. They concluded that MRSA is transmitted between various animal species and may be considered as an etiological agent of mastitis in dairy 206 Vet. arhiv 84 (3), 205-214, 2014

cows. Many authors have examined the presence of the gene for PVL synthesis in MRSA in humans, in food as well as in hospitals, which is often associated with methicillin resistance genes (CIRKOVIC et al., 2012). On the other hand, the presence of PVL genes in Staphylococcus aureus isolates from cow udders is still insufficiently explored. The findings of BENHAMED and KIHAL (2013), showed that only one of 141 Staphylococcus aureus strains, isolated from dairy cows in West Algeria, had a PVL gene. The aim of our research was to investigate the prevalence of genes encoding PVL synthesis as well as PBP2A in Staphylococcus aureus isolates from cow udders with secretion disorders, on farms in Vojvodina and central Serbia, as well as in isolates of human origin. Materials and methods Our research involved highly productive cows that produce over 5,000 L of milk per year, from 46 dairy farms in Vojvodina and central Serbia in 2012. The farms had populations ranging from fewer than 5 cows to over 100 dairy cows. The occurrence of clinical mastitis on these farms was not frequent, however, an increased somatic cell count (over 400,000 SCC/mL) in bulk tank milk samples was recorded. All the cows were tested using the California Mastitis Test, according to the manufacturer s instructions. Isolates of Staphylococcus aureus were biochemically confirmed using API Staph (BioMérieux, France) and by a PCR targeting nuclease gene -characteristic for Staphylococcus aureus. Bacterial DNA was extracted from a single Staphylococcus aureus colony using 25 μl of nuclease-free water and 25 μl of PrepMan Ultra reagent (Applied Biosystems, Foster City CA, USA) placed in a 1.5 ml micro centrifuge tube. The samples were heated in boiling water for 10 minutes, allowed to cool to room temperature and centrifuged at 16000 g for 2 min. The supernatant (containing the DNA) was transferred to a clean 1.5 ml microcentrifuge tube. A 255-bp fragment of the nuclease gene was amplified using the following primer pair: nuc-f (TCAGCAAATGCATCACAAACAG) and nuc-r (CGTAAATGCACTTGCTTCAGG). PCR amplification was performed using a PCR kit (Invitrogen, Carlsbad, CA, USA) in a total volume of 50 μl containing 5 μl of 10 reaction buffer, 1 μl of dntps, 5 μl of each primers, 1 μl of template DNA, 0.25 μl of Taq DNA (5 U/μL) and 32.75 μl of PCR water to make up the final volume. Amplification was performed using an AB 2720 thermocycler (Applied Biosystems, CA, USA). Thermal cycling conditions was as Vet. arhiv 84 (3), 205-214, 2014 207

follows: Initial denaturation at 95 C for 5 min, followed by 30 cycles of 95 C for 30 s, 55 C for 30 s, and 72 C for 60 s with a final extension at 72 C for 5 min. Ten microliters of PCR product were used for electrophoresis in a 1.5% agarose gel at 120 V for 30 min. PCR amplification of an 85-bp fragment of the PVL gene, a 162-bp fragment of meca gene and a 138-bp fragment of mecc gene used primer pairs as follows: PVL-F (GCTGGACAAAACTTCTTGGAATAT); PVL-R (GATAGGACACCAATAAATTCTGGATTG); meca-f (TCCAGATTACAACTTCACCAGG); meca-r (CCACTTCATATCTTGTAACG); mecc-f (GAAAAAAAGGCTTAGAACGCCTC); mecc-r (GAAGATCTTTTCCGTTTTCAGC); PCR amplification was performed using a PCR kit (Invitrogen, Carlsbad, CA, USA) in a total volume of 50 μl containing 5 μl of 10 reaction buffer, 1 μl of dntps, 2 μl of each primers, 1 μl of template DNA, 0.25 μl of Taq DNA (5 U/μL) and 30.75 μl of PCR water to make up the final volume. Amplification was performed using an AB 2720 thermocycler (Applied Biosystems, CA, USA). The thermal cycling conditions were as follows: initial denaturation at 95 C for 5 min, followed by 30 cycles of 95 C for 30 s, 59 C for 30 s, and 72 C for 60 s with a final extension at 72 C for 5 min. Ten microliters of PCR product were used for electrophoresis in a 1.5% agarose gel at 120 V for 30 min. Nucleotide sequences encoding Staphylococcal protein A of isolates of Staphylococcus aureus originating from cows in our research, are deposited in GenBank under accession numbers from KJ023978 to KJ024046 at the US National Center for Biotechnology (http://www.ncbi.nlm.nih.gov). Results In our study Staphylococcus aureus was isolated, using standard microbiological analysis, API Staph and nuc gene detection, from 62 milk samples taken from CMT positive cows from Central Serbia, 13 isolates originated from cows with clinical mastitis from farms in Vojvodina and 11 isolates originated from humans from the Novi Sad City Hospital. The presence of the PVL gene was determined in 5 out of 75 (6.67%) bovine and 7 out of 11 (63.63%) human isolates of Staphylococcus aureus (Fig. 1 and 2). 5 PVLpositive bovine strains, labeled as samples 58, 59, 60, 61 and 62, were also meca and mecc negative, and they originated from imported cows, housed on 2 out of the 46 farms. The presence of the gene for the PVL synthesis was not determined in milk samples from cows with clinical mastitis. 208 Vet. arhiv 84 (3), 205-214, 2014

The presence of the meca gene was determined by PCR in 1 (1.33%) bovine isolate of Staphylococcus aureus. It originated from a cow with clinical mastitis and it was PVL negative. Fig. 1. Agarose gel electrophoresis - determination of PVL-positive Staphylococcus aureus strains (samples from 58 to 61), L-100 bp ladder Fig. 2. Agarose gel electrophoresis -determination of PVL-positive Staphylococcus aureus strains (sample 62), L-100 bp ladder The meca gene was found in 2 (18.18%) human isolates of Staphylococcus aureus. Both samples were also PVL negative. The presence of the mecc gene was not determined in the analyzed isolates (Table 1). Vet. arhiv 84 (3), 205-214, 2014 209

Table 1. Findings of PVL, meca and mecc genes in CMT positive and cows with clinical mastitis and in humans Number of Staphylococcus aureus isolates taken from Presence of gene for synthesis CMT positive cows (total of 62) Cows with clinical mastitis (total of 13) Humans from city hospital (total of 11) PVL + 5 (8.1%) / 7 (63.6%) - 57 (91.9%) 13 (100%) 4 (36.4) meca mecc + / 1 (7.7%) 2 (18.8%) - 62 (100%) 12 (92.3%) 9 (81.2%) + / / / - 62 (100%) 13 (100%) 11 (100%) Discussion Staphylococcus aureus was isolated from 56% milk samples taken from CMT positive cows with no clinical symptoms of mastitis. These results are somewhat higher than earlier findings by BOBOŠ (1985) in Vojvodina and RADINOVIĆ et al. (2009), in Vojvodina, (52% and 43%, respectively). Our results were also higher those by VIEIRA-DA-MOTTA (2001), who isolated 35% strains of S. aureus from milk samples of CMT-positive cows, and JÁNOSI and BALTAY (2004) who isolated 32.5%. On the other hand, our results correspond to the conclusions of FOX and GAY (1993), who reported Staphylococcus aureus infection in 7% to 40% of all cows (not only CMT positive). The presence of the PVL synthesis gene was not determined in milk samples from cows with clinical mastitis in our research. In samples originating from CMT positive cows, with no clinical symptoms of mastitis, the PVL synthesis gene was found in 8.1%. In research in West Algeria, the presence was found of the PVL gene in Staphylococcus aureus, from bovine mastitis cases isolates in one strain of 11 (9%) (BENHAMED and KIHAL, 2013). The presence of the gene for PVL synthesis is often associated with genes for methicillin resistance (CIRKOVIC et al., 2012). In England, in 2005, among S. aureus strains sent to the Staphylococcus Reference Unit for epidemiological purposes, 1.6% (8 of 515) were positive for the PV locus (HOLMES et al., 2005). During nationwide surveillance conducted in Serbia in 2008, 162 MRSA strains were collected in 26 Serbian hospitals (mostly emergency hospitals). The presence of PVL was demonstrated in four (2.5%) of these isolates. All PVL positive MRSA strains were isolated from younger patients with skin infections, and were from different hospitals (CIRKOVIC et al., 2012). In our research PVL positive strains of Staphylococcus aureus were meca and mecc negative. There was only one meca positive strain found which had 210 Vet. arhiv 84 (3), 205-214, 2014

been isolated from cow udders and to the best of our knowledge this is the first report of MRSA isolated from cow udders in Serbia. Conclusion The presence of gene encoding PVL was determined in 5 out of 75 (6.67%) and in 7 out of 11 (63.63%) bovine and human isolates of Staphylococcus aureus, respectively. The presence of the meca gene was determined in 1 of 75 (1.33%) and in 2 of 11 (18.18%) bovine and human isolates, respectively. Both bovine and human isolates of Staphylococcus aureus which were meca positive, were found to be PVL negative. The presence of the mecc gene was not determined in either bovine or in human isolates. Further research is needed to investigate the relationship between bovine and human Staphylococcus aureus isolates, to determine the exact impact of bovine Staphylococcus aureus strains from cow udders on animal and public health. Acknowledgements Funding for this research was provided through the project Control of animal health in the production chain in terms of food safety of the Provincial Secretariat for Science and Technological Development, the Autonomous Province of Vojvodina, the Republic of Serbia, No. 114-451-3419. The authors wish to acknowledge the help of The Institute of Meat Hygiene and Technology in Belgrade, The Veterinary Specialist Institute Jagodina in Jagodina and the Novi Sad School of Medicine. References ANONYMOUS, ICMSF (International Commission on Microbiological Specifications for Foods) (1996): Staphylococcus aureus. In: Microorganisms in Foods 5. Characteristics of Microbial pathogens. (Roberts, T. A., A. C. Baird-Parker, R. B. Tompkin, Eds.). London, UK, Blackie Academic and Professional. 299-333. ANONYMOUS, EFSA, (European Food Safety Authority), ECDC (European Centre for Disease Prevention and Control) (2013): The European Union Summary Report on Trends and Sources of Zoonoses, Zoonotic Agents and Food-borne Outbreaks in 2011. EFSA Journal 2013. 11(4). BENHAMED, N., M. KIHAL (2013): Biodiversity of molecular profile of Staphylococcus aureus isolated from bovine mastitis cases in West Algeria. J. Bacteriol. Res. 5, 41-45. BENIĆ, M., B. HABRUN, G. KOMPES, Ž. MIHALJEVIĆ, Ž. CVETNIĆ, M. CERGOLJ, N. MAĆEŠIĆ (2012): Cell content in milk from cows with S. aureus intramammary infection. Vet. arhiv 82, 411-422. BOBOŠ, S. (1985): Testing the effects of subclinical mastitis on the average milk yield in a herd of high producing dairy cows (Ispitivanje uticaja subkliničkih mastitisa na prosečnu mlečnost u jednom zapatu visoko mlečnih krava). Master Thesis. Faculty of Veterinary Medicine, University of Belgrade, Belgrade, Serbia. Vet. arhiv 84 (3), 205-214, 2014 211

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MELLES, D. C., W. B. VAN LEEUWEN, H. A. BOELENS, J. K. PEETERS, H. A. VERBRUGH, A. VAN BELKUM (2006): Panton-Valentine leukocidin genes in Staphylococcus aureus. Emerg. Infect. Dis. 12, 1174-1175. PREVOST, G., P. COUPPIE, P. PREVOST, S. GAYET, P. PETIAU, B. CRIBIER, H. MONTEIL, Y. PIEMONT (1995): Epidemiological data on Staphylococcus aureus strains producing synergohymenotropic toxins. J. Med. Microbiol. 42, 237-245. RADINOVIĆ, M., M. PAJIĆ, S. BOBOŠ (2009): Findings of Staphylococcus aureus in the udder of cows with secretion disorder. Proceedings 8 th Veterinary Congress of Serbia, 15-19 September 2009, Belgrade, Serbia. pp. 64-65. RAHIMI, E., F. ALIAN (2013): Presence of enterotoxigenic Staphylococcus aureus in cow, camel, sheep, goat, and buffalo bulk tank milk. Vet. arhiv 83, 23-30. SUPERSAC, G., G. PREVOST, Y. PIEMONT (1993): Sequencing of leucocidin R from Staphylococcus aureus P83 suggests that staphylococcal leucocidins and gamma-hemolysin are members of a single, two-component family of toxins. Infect. Immun. 61, 580-587. SZMIGIELSKI, S., G. PRÉVOST, H. MONTEIL, D. A. COLIN, J. JELJASZEWICZ (1999): Leukocidal toxins of staphylococci. Zentralbl. Bakteriol. 289, 185-201. TAVAKOL, M., R. G. M. O. RIEKERINK, O. C. SAMPIMON, W. J. B. VAN WAMEL, A. VAN BELKUM, T. J. G. M. LAM (2012): Bovine-associated MRSA ST398 in The Netherlands. Acta Vet. Scand. 54, 28. VAN DEN BROEK, P. J. (2003): Staphylococcus aureus, a successful pathogen. Ned. Tijdschr. Geneeskd. 147, 1045-1048. VIEIRA-DA-MOTTA, O., M. M. FOLLY, C. C. H. SAKYIAMA (2001): Detection of different Staphylococcus aureus strains in bovine milk from subclinical mastitis using PCR and routine techniques. Braz. J. Microbiol. 32, 27-31. WATTS, J. L. (1988): Etiological agents of bovine mastitis. Vet. Microbiol. 16, 41-66. Received: 8 July 2013 Accepted: 19 December 2013 PAJIĆ, M. J., Z. B. RAŠIĆ, B. M. VELEBIT, S. F. BOBOŠ, M. M. MIHAJLOVIĆ- UKROPINA, M. Ž. RADINOVIĆ, A. L. GALFI, J. M. PETKOVIĆ, S. I. TROJAČANEC: Prevalencija gena za rezistenciju na meticilin i Panton-Valentine leukocidin u izolatima bakterije Staphylococcus aureus podrijetlom od goveda i ljudi. Vet. arhiv 84, 205-214, 2014. SAŽETAK Uporabom kalifornijskog testa za upalu vimena na 46 visoko produktivnih mliječnih farmi u Srbiji identificirane su krave s poremećajem sekrecije mlijeka. Uzeti su uzorci mlijeka krava pozitivnih kalifornijskim testom i krava s kliničkim mastitisom. Standardnom mikrobiološkom pretragom uzoraka mlijeka i identifikacijom kompletom API Staph potvrđena je prisutnost 75 izolata bakterije Staphylococcus aureus. Tih 75 izolata, kao i 11 izolata te bakterije podrijetlom iz ljudi bili su analizirani lančanom reakcijom polimerazom na prisutnost gena koji kodiraju za Panton-Valentine leukocidin (PVL) i PBP2A protein odgovoran za meticilinsku rezistenciju. Prisutnost gena koji kodira za PVL dokazana je u pet od 75 (6,67%) izolata podrijetlom iz goveda i Vet. arhiv 84 (3), 205-214, 2014 213

u sedam od 11 (63,63%) izolata podrijetlom iz ljudi. Prisutnost meca gena dokazana je u jednog od 75 (1,33%) izolata podrijetlom iz goveda i u dva od 11 (18,18%) podrijetlom iz ljudi. Prisutnost mecc gena nije utvrđena u analiziranim izolatima. Potrebna su daljnja istraživanja kako bi se istražio odnos između izolata Staphylococcus aureus-a podrijetlom iz ljudi i iz goveda i odredio točan utjecaj sojeva vrste Staphylococcus aureus iz vimena krava na zdravlje životinja i zdravlje ljudi. Ključne riječi: krave, vime, mlijeko, Panton-Valentine leukocidin, rezistencija na meticilin 214 Vet. arhiv 84 (3), 205-214, 2014