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Martin ET, Haider S, Palleschi M, Eagle S, Crisostomo DV, Haddox P, Harmon L, Mazur R, Moshos J, Marchaim D, Kaye KS. Bathing hospitalized dependent patients with prepackaged disposable washcloths instead of traditional bath basins: A case-crossover study. Am J Infect Control 2017; 45:990-994. [PMID: 28502637 DOI: 10.1016/j.ajic.2017.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/20/2017] [Accepted: 03/20/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Basins used for patient bathing have been shown to be contaminated with multidrug-resistant organisms (MDROs) and have prompted the evaluation of alternatives to soap and water bathing methods. METHODS We conducted a prospective, randomized, open-label interventional crossover study to assess the impact of replacing traditional bath basins with prepackaged washcloths on the incidence of hospital-associated infections (HAIs), MDROs, and secondarily, rates of skin deterioration. Unit-wide use of disposable washcloths over an 8-month period was compared with an 8-month period of standard care using basins. RESULTS A total of 2,637 patients were included from 2 medical-surgical units at a single tertiary medical center, contributing 16,034 patient days. During the study period, there were a total of 33 unit-acquired infections, the rates of which were not statistically different between study phases (incidence rate ratio, 1.05; 95% confidence interval [CI], 0.50-2.23; P = .88). However, occurrence of skin integrity deterioration was significantly less in the intervention group (odds ratio, 0.44; 95% CI, 0.22-0.88; P = .02). CONCLUSIONS Although we were unable to demonstrate a significant reduction in HAI or MDRO acquisition, we found a decrease in skin deterioration with the use of disposable washcloths and confirmed earlier findings of MDRO contamination of wash basins.
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Vanegas Múnera JM, Ocampo Ríos AM, Urrego DM, Jiménez Quiceno JN. In vitro susceptibility of methicillin-resistant Staphylococcus aureus isolates from skin and soft tissue infections to vancomycin, daptomycin, linezolid and tedizolid. Braz J Infect Dis 2017; 21:493-499. [PMID: 28432878 PMCID: PMC9425527 DOI: 10.1016/j.bjid.2017.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/21/2017] [Accepted: 03/23/2017] [Indexed: 01/12/2023] Open
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203
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Cho OH, Park KH, Song JY, Hong JM, Kim T, Hong SI, Kim S, Bae IG. Prevalence and Microbiological Characteristics of qacA/B-Positive Methicillin-Resistant Staphylococcus aureus Isolates in a Surgical Intensive Care Unit. Microb Drug Resist 2017; 24:283-289. [PMID: 28799881 DOI: 10.1089/mdr.2017.0072] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The increasing use of chlorhexidine for methicillin-resistant Staphylococcus aureus (MRSA) decolonization has raised concerns about the emergence of resistance to or tolerance of this antiseptic. We examined the frequency and characteristics of qacA/B chlorhexidine tolerance genes among MRSA isolates in a surgical intensive care unit (ICU) where MRSA-colonized patients are decolonized by chlorhexidine bathing. The MRSA isolates were evaluated for chlorhexidine susceptibility, mupirocin resistance, molecular typing, agr functionality, and the heterogeneous vancomycin-intermediate S. aureus (hVISA) phenotype according to the presence of the qacA/B genes. Overall, 119 MRSA isolates were obtained from active surveillance cultures (93, 78.2%) and clinical cultures (26, 21.8%) between 2012 and 2014. Among these isolates, 39 (32.8%) carried the qacA/B genes, and 23 (19.3%) exhibited mupirocin resistance. Most qacA/B-positive isolates (36/39, 92.3%) were identified as ST5-SCCmecII (69.2%) and ST239-SCCmecIII (23.1%), which are common healthcare-associated (HA)-MRSA strains in Korea. Multivariate analysis found that qacA/B-positive MRSA isolates were associated with agr dysfunction (OR, 4.87; 95% CI, 1.71-13.87) and the hVISA phenotype (OR, 4.09; 95% CI, 1.48-11.34). In conclusion, our study showed that qacA/B carriage was common among MRSA isolates in an ICU where chlorhexidine is commonly used for decolonization. qacA/B carriage was significantly associated with agr dysfunction and the hVISA phenotype. These features may confer a selective advantage on HA-MRSA strains, including ST5-SCCmecII and ST239-SCCmecIII, in the ICU setting.
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Affiliation(s)
- Oh-Hyun Cho
- 1 Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine , Jinju, Republic of Korea
| | - Ki-Ho Park
- 2 Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine , Seoul, Republic of Korea
| | - Ji Young Song
- 1 Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine , Jinju, Republic of Korea
| | - Jeong Min Hong
- 1 Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine , Jinju, Republic of Korea
| | - Taeeun Kim
- 1 Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine , Jinju, Republic of Korea
| | - Sun In Hong
- 3 Department of Internal Medicine, Gyeongsang National University Changwon Hospital , Changwon, Republic of Korea
| | - Sunjoo Kim
- 4 Department of Laboratory Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine , Jinju, Republic of Korea.,5 Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine , Jinju, Republic of Korea
| | - In-Gyu Bae
- 1 Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine , Jinju, Republic of Korea.,5 Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine , Jinju, Republic of Korea
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Werth BJ, Jain R, Hahn A, Cummings L, Weaver T, Waalkes A, Sengupta D, Salipante SJ, Rakita RM, Butler-Wu SM. Emergence of dalbavancin non-susceptible, vancomycin-intermediate Staphylococcus aureus (VISA) after treatment of MRSA central line-associated bloodstream infection with a dalbavancin- and vancomycin-containing regimen. Clin Microbiol Infect 2017; 24:429.e1-429.e5. [PMID: 28782651 DOI: 10.1016/j.cmi.2017.07.028] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/07/2017] [Accepted: 07/04/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Dalbavancin is a long-acting lipoglycopeptide with activity against gram-positives, including methicillin-resistant Staphylococcus aureus (MRSA). The potential for lipoglycopeptides, with half-lives greater than 1 week, to select for resistance is unknown. Here we explore a case of MRSA central line-associated bloodstream infection in which dalbavancin and vancomycin non-susceptibility emerged in a urine isolate collected after the patient was treated with vancomycin and dalbavancin sequentially. METHODS Isolates from blood and urine underwent susceptibility testing, and whole genome sequencing (WGS). The blood isolate was subjected to successive passage in vitro in the presence of escalating dalbavancin concentrations and the emergent isolate was subjected to repeat susceptibility testing and WGS. RESULTS The blood isolate was fully susceptible to vancomycin; however, MICs of the urine isolate to dalbavancin, vancomycin, telavancin, and daptomycin were at least fourfold higher than the blood-derived strain. Both strains were indistinguishable by spa and variable number tandem repeat (VNTR) typing, and WGS revealed only seven variants, indicating clonality. Four variants affected genes, including a 3bp in-frame deletion in yvqF, a gene which has been implicated in glycopeptide resistance. Vancomycin and dalbavancin non-susceptibility emerged in the blood isolate after successive passage in vitro in the presence of dalbavancin, and WGS identified a single non-synonymous variant in yvqF. CONCLUSIONS This is the first case in which VISA has emerged in the context of a dalbavancin-containing regimen. The selection for cross-resistance to vancomycin in vitro by dalbavancin exposure alone is troubling. Clinicians should be aware of the possibility for emergence of dalbavancin non-susceptibility and glycopeptide cross-resistance arising following therapy.
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Affiliation(s)
- B J Werth
- Department of Pharmacy, University of Washington School of Pharmacy, Seattle, WA, USA
| | - R Jain
- Department of Pharmacy, University of Washington School of Pharmacy, Seattle, WA, USA
| | - A Hahn
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - L Cummings
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - T Weaver
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - A Waalkes
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - D Sengupta
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - S J Salipante
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - R M Rakita
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - S M Butler-Wu
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
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205
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High prevalence of clonally diverse spa type t026 Staphylococcus aureus contaminating rural eggshells. J Med Microbiol 2017; 66:1196-1201. [DOI: 10.1099/jmm.0.000540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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206
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Seinige D, Von Altrock A, Kehrenberg C. Genetic diversity and antibiotic susceptibility of Staphylococcus aureus isolates from wild boars. Comp Immunol Microbiol Infect Dis 2017; 54:7-12. [PMID: 28916003 DOI: 10.1016/j.cimid.2017.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/30/2017] [Accepted: 07/04/2017] [Indexed: 01/22/2023]
Abstract
We here report the occurrence of S. aureus in wild boars and characterize isolates genotypically and phenotypically in order to get knowledge about the occurrence of clonal lineages and genotypes in free-living wild animals. Forty-one S. aureus isolates obtained from 111 wild boars hunted in Lower Saxony, Germany, were investigated and compared to human and livestock isolates. The S. aureus belonged to multilocus sequence types ST1, ST7, ST30, ST133, ST425, ST804, ST890 and to the new ST3237, ST3238, ST3255 and ST3369. The livestock associated CC398-MRSA lineage, however, was not found. In addition to well-known spa types, the new types t14999, t15000, t15001 and t15002 were detected. Macrorestriction analysis revealed a variety of different SmaI fragment patterns. Most isolates were susceptible to all antimicrobials tested, including methicillin, and resistance was detected only to ampicillin, penicillin and erythromycin. PCR analysis confirmed the presence of staphylococcal enterotoxin genes (seh) in all t127-ST1 isolates. A high degree of genetic diversity was detected with many spa types and clonal lineages previously reported in humans and livestock animals.
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Affiliation(s)
- D Seinige
- Institute for Food Quality and Food Safety, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - A Von Altrock
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Services, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - C Kehrenberg
- Institute for Food Quality and Food Safety, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
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207
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Khemiri M, Akrout Alhusain A, Abbassi MS, El Ghaieb H, Santos Costa S, Belas A, Pomba C, Hammami S. Clonal spread of methicillin-resistant Staphylococcus aureus-t6065-CC5-SCCmecV-agrII in a Libyan hospital. J Glob Antimicrob Resist 2017; 10:101-105. [PMID: 28729209 DOI: 10.1016/j.jgar.2017.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 03/21/2017] [Accepted: 04/28/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to characterize 32 MRSA isolates recovered from wound specimens of patients in a Hospital in Tripoli, Libya, during 2013. METHODS MRSA isolates were characterized by determining their antibiotic susceptibilities, genes encoding antibiotic resistance and virulence factors, the SCCmec class, agr type, spa typing, PFGE and MLST. RESULTS PFGE and MLST revealed that all isolates were clonal and belonged to the Clonal Complex 5 (CC5). They harboured the SCCmecV and the agrII and the spa type was t6065. The majority of isolates were resistant to cefoxitin (32, 100%), penicillin (32, 100%), ampicillin (32, 100%), enrofloxacin (32, 100%), ciprofloxacin (32, 100%), fusidic acid (32, 100%), gentamicin (32, 100%), kanamycin (32, 100%), trimethoprim (32, 100%), and erythromycin (30, 93.7%). The main genes encoding antibiotic resistance were: blaZ (31, 96.8%), ermC (30, 93.7%), aph(3')-III a (3, 9.4%), aac6-aph2 (32, 100%), InuA (3, 9.4%), tetM (3, 9.4%), tetL (3, 9.4%), dfrG (28, 87.5%), fusC (32, 100%). All isolates were PVL negative; however, exfoliative-encoding genes (eta: 25) and enterotxin genes (seb: 32, seo: 32, sei: 32, ser: 32, seu: 32, seg: 32, sej: 32, sed: 31, sen: 29, seh: 26, sec: 26, sea: 6, sek: 5), haemolysin (hla (32), hld (32), hlg (32)) and immune evasion cluster proteins (scn: 32, sak: 32) were relevant. CONCLUSION To the best of our knowledge this is the first report of a specific clonal spread of a multi-drug resistant MRSA-CC5- SCCmecV in a Libyan Hospital.
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Affiliation(s)
- Monia Khemiri
- Université de Tunis El Manar, Institut de la Recherche Vétérinaire de Tunisie, 20 rue Jebel Lakhdhar, Bab Saadoun, Tunis 1006, Tunisie; Laboratory of Antimicrobial and Biocide Resistance, CIISA, Faculty of Veterinary Medicine, University of Lisbon, Portugal
| | | | - Mohamed Salah Abbassi
- Université de Tunis El Manar, Institut de la Recherche Vétérinaire de Tunisie, 20 rue Jebel Lakhdhar, Bab Saadoun, Tunis 1006, Tunisie.
| | - Houyem El Ghaieb
- Université de Tunis El Manar, Institut de la Recherche Vétérinaire de Tunisie, 20 rue Jebel Lakhdhar, Bab Saadoun, Tunis 1006, Tunisie
| | - Sofia Santos Costa
- Laboratory of Antimicrobial and Biocide Resistance, CIISA, Faculty of Veterinary Medicine, University of Lisbon, Portugal
| | - Adriana Belas
- Laboratory of Antimicrobial and Biocide Resistance, CIISA, Faculty of Veterinary Medicine, University of Lisbon, Portugal
| | - Constança Pomba
- Laboratory of Antimicrobial and Biocide Resistance, CIISA, Faculty of Veterinary Medicine, University of Lisbon, Portugal
| | - Salah Hammami
- Université de la Manouba, IRESA, Ecole Nationale de Médecine Vétérinaire de Sidi Thabet, Tunisie.
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Abstract
The staphylococci comprise a diverse genus of Gram-positive, nonmotile commensal organisms that inhabit the skin and mucous membranes of humans and other mammals. In general, staphylococci are benign members of the natural flora, but many species have the capacity to be opportunistic pathogens, mainly infecting individuals who have medical device implants or are otherwise immunocompromised. Staphylococcus aureus and Staphylococcus epidermidis are major sources of hospital-acquired infections and are the most common causes of surgical site infections and medical device-associated bloodstream infections. The ability of staphylococci to form biofilms in vivo makes them highly resistant to chemotherapeutics and leads to chronic diseases. These biofilm infections include osteomyelitis, endocarditis, medical device infections, and persistence in the cystic fibrosis lung. Here, we provide a comprehensive analysis of our current understanding of staphylococcal biofilm formation, with an emphasis on adhesins and regulation, while also addressing how staphylococcal biofilms interact with the immune system. On the whole, this review will provide a thorough picture of biofilm formation of the staphylococcus genus and how this mode of growth impacts the host.
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209
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Aung MS, Kawaguchiya M, Urushibara N, Sumi A, Ito M, Kudo K, Morimoto S, Hosoya S, Kobayashi N. Molecular Characterization of Methicillin-ResistantStaphylococcus aureusfrom Outpatients in Northern Japan: Increasing Tendency of ST5/ST764 MRSA-IIa with Arginine Catabolic Mobile Element. Microb Drug Resist 2017; 23:616-625. [DOI: 10.1089/mdr.2016.0176] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Meiji Soe Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mitsuyo Kawaguchiya
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Noriko Urushibara
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ayako Sumi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masahiko Ito
- Sapporo Clinical Laboratory, Inc., Sapporo, Japan
| | - Kenji Kudo
- Sapporo Clinical Laboratory, Inc., Sapporo, Japan
| | | | - Shino Hosoya
- Mito Kyodo General Hospital, University of Tsukuba, Mito, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
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210
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Saab ME, Weese JS, McClure J. Direct repeat unit (dru) typing and antimicrobial resistance of methicillin-resistant Staphylococcus pseudintermedius isolated from dogs in Atlantic Canada. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2017; 81:192-198. [PMID: 28725109 PMCID: PMC5508386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/09/2017] [Indexed: 06/07/2023]
Abstract
There are few reports investigating the characterization of methicillin-resistant Staphylococcus pseudintermedius (MRSP) in dogs in Canada and none from Atlantic Canada. The objectives of this study were to strain type MRSP isolates cultured at a regional diagnostic laboratory using direct repeat unit (dru) typing and to describe their antimicrobial resistance profiles. Ninety-four isolates recovered from dogs between 2010 and 2012 had dru typing, cluster analysis, and antimicrobial susceptibility testing done. The majority of isolates belonged to type dt11a (30.9%), dt10h (24.5%), dt9a (18.1%), and dt11af (10.6%) with the remaining 15.9% of isolates distributed among 13 dru types. The predominant dru types identified were similar in Ontario; however, cluster 9a appears to be less common in Atlantic Canada. A significant difference in the distribution of clusters among Atlantic provinces was detected (P = 0.01). Resistance to ≥ 2 non-β-lactam antimicrobials was observed in 71.4% of the isolates. The MRSP isolates from this study were notably less resistant than those reported in the literature. A more comprehensive study of the MRSP dru types could help further elucidate the distribution of this pathogen in Canada.
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211
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Reduced Vancomycin Susceptibility of Methicillin-Susceptible Staphylococcus aureus Has No Significant Impact on Mortality but Results in an Increase in Complicated Infection. Antimicrob Agents Chemother 2017; 61:AAC.00316-17. [PMID: 28507105 DOI: 10.1128/aac.00316-17] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 05/07/2017] [Indexed: 01/17/2023] Open
Abstract
Methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections (BSIs) often lead to severe complications despite the availability of effective antibiotics. It remains unclear whether elevated vancomycin MICs are associated with worse outcomes. We conducted a 2-year retrospective cohort study (n = 252) of patients with MSSA BSIs at a tertiary care hospital. We defined reduced vancomycin susceptibility (RVS) as a Microscan MIC of 2 mg/liter. All strains were genotyped (spa) and assessed for agr functionality. Multivariable logistic regression models were used to examine the impact of RVS phenotype and strain genotype on 30-day all-cause mortality and complicated bacteremia (metastatic spread, endovascular infection, or duration ≥3 days). One-third of patients (84/252) were infected with RVS isolates. RVS Infections were more frequently associated with metastatic or embolic sites of infection (36% versus 17%, P < 0.001), and endovascular infection (26% versus 12%, P = 0.004). These infections occurred more often in patients with fewer underlying comorbidities (Charlson comorbidity index of ≥3 [73% versus 88%, P = 0.002]). Genotyping identified 127 spa-types and 14 Spa-clonal complexes (Spa-CCs). Spa-CC002 and Spa-CC008 were more likely to exhibit the RVS phenotype versus other Spa-CCs (OR = 2.2, P < 0.01). The RVS phenotype was not significantly associated with 30-day mortality; however, it was associated with complicated bacteremia (adjusted odds ratio of 2.35 [range, 1.26 to 4.37]; P = 0.007) in adjusted analyses. The association of RVS strains with complicated infection and fewer underlying comorbidities suggests the phenotype as a potential marker of strain virulence in MSSA BSIs. The RVS phenotype itself was not a significant predictor of mortality in this patient cohort. Further studies are necessary to explore this host-pathogen relationship.
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Thapaliya D, Dalman M, Kadariya J, Little K, Mansell V, Taha MY, Grenier D, Smith TC. Characterization of Staphylococcus aureus in Goose Feces from State Parks in Northeast Ohio. ECOHEALTH 2017; 14:303-309. [PMID: 28283923 DOI: 10.1007/s10393-017-1227-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 01/18/2017] [Accepted: 01/30/2017] [Indexed: 05/23/2023]
Abstract
Staphylococcus aureus can colonize a range of species. Although numerous studies have isolated pathogenic bacteria from wild birds, very little is known regarding S. aureus and their potential to spread methicillin-resistant (MRSA) strains. The objective of this study was to determine the presence and molecular characteristics of S. aureus in geese fecal samples collected from ten state parks across Northeast Ohio (NEO). A total of 182 fecal samples from Canada geese (Branta canadensis) were collected in April 2015. Isolates were characterized using multi-locus sequence (MLST) and spa typing, as well as PCR to detect the presence of Panton-Valentine leukocidin (PVL), mecA, and scn genes. Antibiotic susceptibility testing was done via Vitek-2 system. The overall contamination by S. aureus in fecal samples was 7.1% (13/182); 7/182 (3.8%) were MRSA and 6/182 (3.3%) were methicillin-susceptible S. aureus (MSSA). One isolate was positive for PVL. A total of eight different spa types were observed. MLST included ST5, ST8, ST291, ST298, and ST2111. One (7.7%) MSSA isolate was multi-drug resistant. The S. aureus contamination in NEO state parks ranged from 0% (park 1, 4, 8, 9) to 35% (7/20) (park 5). Parks 2, 3, 6, and 7 had 5% (1/20) positive. The results of this study indicate that the feces of geese collected at various state parks in NEO may harbor S. aureus.
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Affiliation(s)
- Dipendra Thapaliya
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH, 44242, USA
| | - Mark Dalman
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH, 44242, USA
| | - Jhalka Kadariya
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH, 44242, USA
| | - Katie Little
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH, 44242, USA
| | - Victoria Mansell
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH, 44242, USA
| | - Mohammed Y Taha
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH, 44242, USA
- Ministry of Science and Technology, Baghdad, Iraq
| | - Dylan Grenier
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH, 44242, USA
| | - Tara C Smith
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, 750 Hilltop Drive, Kent, OH, 44242, USA.
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Chang CH, Chen SY, Lu JJ, Chang CJ, Chang Y, Hsieh PH. Nasal colonization and bacterial contamination of mobile phones carried by medical staff in the operating room. PLoS One 2017; 12:e0175811. [PMID: 28562676 PMCID: PMC5450997 DOI: 10.1371/journal.pone.0175811] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/31/2017] [Indexed: 12/17/2022] Open
Abstract
Background Mobile phones (MPs) have been an essential part of the lives of healthcare professionals and have improved communication, collaboration, and sharing of information. Nonetheless, the widespread use of MPs in hospitals has raised concerns of nosocomial infections, especially in areas requiring the highest hygienic standards such as operating rooms (ORs). This study evaluated the incidence of bacterial contamination of the MPs carried by medical staff working in the OR and determined its association with bacterial colonization of this personnel. Methods This is an observational cohort study. Medical staffs working in the OR were asked to take bacterial cultures from their MPs, anterior nares, and dominant hands. To identify the relation between MP contamination and bacterial colonization of the medical staff, genotyping of Staphylococcus aureus (SA) was done via Staphylococcus protein A gene (spa) typing and pulsed-field gel electrophoresis (PFGE). Results A total of 216 swab samples taken from 72 medical-staff members were analyzed. The culture-positive rate was 98.1% (212/216). In 59 (27.3%) samples, the bacteria were possible clinical pathogens. The anterior nares were the most common site of colonization by clinical pathogens (58.3%, 42/72), followed by MPs (13.9%, 10/72) and the dominant hand (9.7%, 7/72). SA was the most commonly isolated clinical pathogen and was found in 43 (19.9%) samples. In 66 (94.3%) of the 70 staff members for whom bacteria were detected on their MPs, the same bacteria were detected in nares or hand. Among 31 medical staff who were carriers of SA in the anterior nares or dominant hand, 8 (25.8%) were found to have SA on their MPs, and genotyping confirmed the same SA strain in 7 (87.5%) of them. Conclusion A high rate of bacterial nasal colonization and MPs contamination were found among the OR medical staff. An MP may be a reservoir for pathogen contamination in the OR.
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Affiliation(s)
- Chih-Hsiang Chang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Szu-Yuan Chen
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jang-Jih Lu
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chee-Jen Chang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Yuhan Chang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Pang-Hsin Hsieh
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- * E-mail:
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214
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Schmidt T, Kock MM, Ehlers MM. Molecular Characterization of Staphylococcus aureus Isolated from Bovine Mastitis and Close Human Contacts in South African Dairy Herds: Genetic Diversity and Inter-Species Host Transmission. Front Microbiol 2017; 8:511. [PMID: 28428772 PMCID: PMC5382207 DOI: 10.3389/fmicb.2017.00511] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/13/2017] [Indexed: 11/20/2022] Open
Abstract
Staphylococcus aureus is one of the most common etiological agents of contagious bovine mastitis worldwide. The purpose of this study was to genetically characterize a collection of S. aureus isolates (bovine = 146, human = 12) recovered from cases of bovine mastitis and nasal swabs of close human contacts in the dairy environment. Isolates were screened for a combination of clinically significant antimicrobial and virulence gene markers whilst the molecular epidemiology of these isolates and possible inter-species host transmission was investigated using a combination of genotyping techniques. None of the isolates under evaluation tested positive for methicillin or vancomycin resistance encoding genes. Twenty seven percent of the bovine S. aureus isolates tested positive for one or more of the pyrogenic toxin superantigen (PTSAg) genes with the sec and sell genes predominating. Comparatively, 83% of the human S. aureus isolates tested positive for one or more PTSAg genes with a greater variety of genes being detected. Genomic DNA macrorestriction followed by pulsed-field gel electrophoresis (PFGE) of the bovine isolates generated 58 electrophoretic patterns which grouped into 10 pulsotypes at an 80% similarity level. The majority of the bovine isolates, 93.2% (136/146), clustered into four major pulsotypes. Seven sequence types (ST) were identified among the representative bovine S. aureus isolates genotyped, including: ST8 (CC8), ST97 (CC97), ST351 (CC705), ST352 (CC97), ST508 (CC45), ST2992 (CC97) and a novel sequence type, ST3538 (CC97). Based on PFGE analysis, greater genetic diversity was observed among the human S. aureus isolates. Bovine and human isolates from three sampling sites clustered together and were genotypically indistinguishable. Two of the isolates, ST97 and ST352 belong to the common bovine lineage CC97, and their isolation from close human contacts suggests zoonotic transfer. In the context of this study, the third isolate, ST8 (CC8), is believed to be a human clone which has transferred to a dairy cow and has subsequently caused mastitis. The detection of indistinguishable S. aureus isolates from bovine and human hosts at three of the sampling sites is suggestive of bacterial transmission and supports the need for vigilant monitoring of staphylococcal populations at the human-animal interface.
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Affiliation(s)
- Tracy Schmidt
- Allerton Provincial Veterinary Laboratory, KwaZulu-Natal Department of Agriculture and Rural DevelopmentPietermaritzburg, South Africa.,Department of Medical Microbiology, University of PretoriaPretoria, South Africa
| | - Marleen M Kock
- Department of Medical Microbiology, University of PretoriaPretoria, South Africa.,Tshwane Academic Division, National Health Laboratory ServicePretoria, South Africa
| | - Marthie M Ehlers
- Department of Medical Microbiology, University of PretoriaPretoria, South Africa.,Tshwane Academic Division, National Health Laboratory ServicePretoria, South Africa
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215
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Wang M, Zheng Y, Mediavilla JR, Chen L, Kreiswirth BN, Song Y, Yang R, Du H. Hospital Dissemination of tst-1-Positive Clonal Complex 5 (CC5) Methicillin-Resistant Staphylococcus aureus. Front Cell Infect Microbiol 2017; 7:101. [PMID: 28409124 PMCID: PMC5374150 DOI: 10.3389/fcimb.2017.00101] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/14/2017] [Indexed: 01/12/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA), is one of the most prevalent clinical pathogens isolated from hospital settings, and has increasingly identified in community settings. In China, the SCCmecIII-ST239 strains are disseminated in different geographic regions, accounting for >75% of all MRSA isolates in some national studies. Here we characterized 150 non-duplicate MRSA isolates collected from February 2012 to May 2013 in a tertiary hospital in Suzhou, Eastern China, to explore the molecular epidemiology. All isolates were characterized by spa typing, SCCmec typing, and detection of genes encoding Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin (TSST-1). Representative genotypes were also subjected to multilocus sequence typing (MLST). Antibiotic susceptibility testing was performed using BD Phoenix™ Automated Microbiology System. Molecular typing identified 11 clonal complex (CC) and 28 spa types, with the CC5-spa t002 (29.3%) and CC239-spa t037 (14.7%) being the most prevalent. SCCmec types II, III, IV, and V were identified in 33.3, 21.3, 23.3, and 21.3% of all isolates, respectively. PVL genes (lukF/S-PV) were detected in 11.3% of all isolates and from 6 CCs (5, 8, 59, 88, 239, and 398). The TSST-1 gene (tst) was detected in 18.0% of the all isolates, predominantly in CC5 (96.3%). All the tst-1-positve CC5 isolates were spa t002. Eighteen patients died within 30 days of hospitalization, and the in-hospital 30-day mortality was 12.0%. Multivariable analysis showed that 60 years old (odds ratio [OR] = 7.2, P = 0.026), cancer diagnosis (OR = 9.6, P = 0.022), and MRSA isolate carriage of tst-1 (OR = 62.5, P < 0.001) were independent factors associated with 30-day mortality. Our study revealed unique MRSA dissemination patterns in our hospital in comparison to those of other regions in China. The finding that tst-1-positive CC5 strains were associated with higher mortality highlights the need for strict infection control measures in order to prevent further spread of these strains in our hospital, as well as others.
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Affiliation(s)
- Min Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and EpidemiologyBeijing, China.,Clinical Laboratory, The Second Affiliated Hospital of Soochow UniversitySuzhou, China
| | - Yi Zheng
- Clinical Laboratory, The Second Affiliated Hospital of Soochow UniversitySuzhou, China
| | - Jose R Mediavilla
- New Jersey Medical School, Public Health Research Institute Tuberculosis Center, Rutgers UniversityNewark, NJ, USA
| | - Liang Chen
- New Jersey Medical School, Public Health Research Institute Tuberculosis Center, Rutgers UniversityNewark, NJ, USA
| | - Barry N Kreiswirth
- New Jersey Medical School, Public Health Research Institute Tuberculosis Center, Rutgers UniversityNewark, NJ, USA
| | - Yajun Song
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and EpidemiologyBeijing, China
| | - Ruifu Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and EpidemiologyBeijing, China
| | - Hong Du
- Clinical Laboratory, The Second Affiliated Hospital of Soochow UniversitySuzhou, China
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216
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Reynaga E, Torres C, Garcia-Nuñez M, Navarro M, Vilamala A, Puigoriol E, Lucchetti GE, Sabrià M. Clinical impact and prevalence of MRSA CC398 and differences between MRSA-Tet R and MRSA-Tet S in an area of Spain with a high density of pig farming: a prospective cohort study. Clin Microbiol Infect 2017; 23:678.e1-678.e4. [PMID: 28365311 DOI: 10.1016/j.cmi.2017.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/28/2017] [Accepted: 03/23/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Tetracycline resistance (TetR) is a phenotypic marker of the livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) CC398 clone. The aim of this study was to analyse the prevalence of MRSA CC398 in patients in contact with healthcare facilities and differences between patients with MRSA-TetR and MRSA tetracycline-susceptible (TetS) strains. METHODS Patients diagnosed with MRSA from January 2012 to December 2015 were divided into two groups, MRSA-TetR and MRSA-TetS. Epidemiologic and clinical data were evaluated. Molecular analysis was performed (multilocus sequence typing, spa typing) on MRSA-TetR strains. RESULTS Data from 288 MRSA patients were obtained, and 106 (36.8%) carried MRSA-TetR (93 typed as CC398 (87.7%); the remaining 13 isolates were ascribed to CC9, CC1, CC121, CC30, CC97, CC146 and CC152). The most frequent spa type was t011 (56.6%, 61/106). Detection of MRSA-TetR increased over the years (21.9%, 16/73, in 2012; 50.7%, 36/71, in 2015; p <0.001). Hospital acquisition was found in 16.7% (19/114) of MRSA-TetR patients vs. 83.3% (95/114) in MRSA-TetS patients (p <0.001). Frequency of MRSA-TetR patients in nursing homes was lower than in MRSA-TetS patients (4.7%, 5/106, vs. 27.5%, 50/182, p <0.001). MRSA-TetR as distinct from MRSA-TetS was associated with workers on pig farms (49.0%, 52/106, vs. 1.0%, 2/182; p <0.001), fewer admissions to hospital (46.2%, 49/106, vs. 68.1%, 124/182; p <0.001) and fewer comorbidities (81.1%, 86/106, vs. 59.9%, 109/182; p <0.001). Sixty cases of MRSA-CC398 infection were diagnosed, including, among others, endocarditis, septic arthritis, prosthetic joint infection, pneumonia and bacteraemia. CONCLUSIONS Prevalence of MRSA-TetR (especially CC398) at the hospital level in a Spanish region with intensive pig farming activity is high and is responsible for severe infections. Significant differences were detected in clinical and epidemiologic characteristics among MRSA-TetR and MRSA-TetS patients.
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Affiliation(s)
- E Reynaga
- Department of Internal Medicine, Hospital Universitari de Vic, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain.
| | - C Torres
- Area de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - M Garcia-Nuñez
- Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - M Navarro
- Microbiology Department, Hospital Universitari de Vic, Spain
| | - A Vilamala
- Microbiology Department, Hospital Universitari de Vic, Spain
| | - E Puigoriol
- Epidemiology Department, Hospital Universitari de Vic, Spain
| | - G E Lucchetti
- Department of Internal Medicine, Hospital Universitari de Vic, Spain
| | - M Sabrià
- Department of Medicine, Universitat Autònoma de Barcelona, Spain; Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Madrid, Spain
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217
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Post V, Harris LG, Morgenstern M, Geoff Richards R, Sheppard SK, Fintan Moriarty T. Characterization of nasal methicillin-resistant Staphylococcus aureus isolated from international human and veterinary surgeons. J Med Microbiol 2017; 66:360-370. [PMID: 28005521 DOI: 10.1099/jmm.0.000415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) is poorly described for surgeons, despite the increased exposure to nosocomial pathogens and at-risk patients. This study investigated the molecular epidemiology and antimicrobial resistance of 26 MRSA isolates cultured from the nares of an international cross-sectional study of 1166 human and 60 veterinary surgeons. METHODOLOGY All isolates were subjected to agr, spa and multilocus sequence typing, and the presence of 22 virulence factors was screened for by PCR. Additionally, biofilm-forming ability, haemolytic activity, staphyloxanthin production and antibiotic resistance were determined. The genome of a rifampicin-resistant MRSA was sequenced. RESULTS Approximately half of the isolates belonged to well-described clonal lineages, ST1, ST5, ST8, ST45 and ST59, that have previously been associated with severe infections and increased patient mortality. Two of the three veterinarian MRSA belonged to epidemic livestock-associated MRSA clonal lineages (ST398 and ST8) previously associated with high transmission potential between animals and humans. The isolates did not display any consistent virulence gene pattern, and 35 % of the isolates carried at least one of the Panton-Valentine leukocidin (lukFS-PV), exfoliative toxin (eta) or toxic shock syndrome (tst) genes. Resistance to rifampicin was detected in one veterinarian isolate and was found to be due to three mutations in the rpoB gene. CONCLUSION Surgeons occupy a critical position in the healthcare profession due to their close contact with patients. In this study, surgeons were found to be colonized with MRSA at low rates, similar to those of the general population, and the colonizing strains were often common clonal lineages.
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Affiliation(s)
| | - Llinos G Harris
- Department of Microbiology and Infectious Diseases, Swansea University Medical School, Swansea, UK
| | - Mario Morgenstern
- AO Research Institute Davos, Davos, Switzerland.,Department of Orthopedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland
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218
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Murugadas V, Toms CJ, Reethu SA, Lalitha KV. Multilocus Sequence Typing and Staphylococcal Protein A Typing Revealed Novel and Diverse Clones of Methicillin-Resistant Staphylococcus aureus in Seafood and the Aquatic Environment. J Food Prot 2017; 80:476-481. [PMID: 28207309 DOI: 10.4315/0362-028x.jfp-16-260] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has been a global health concern since the 1960s, and isolation of this pathogen from food-producing animals has been increasing. However, little information is available on the prevalence of MRSA and its clonal characteristics in seafood and the aquatic environment. In this study, 267 seafood and aquatic environment samples were collected from three districts of Kerala, India. Staphylococcal protein A (spa) typing and multilocus sequence typing (MLST) was performed for 65 MRSA strains isolated from 20 seafood and aquatic environment samples. The MRSA clonal profiles were t657-ST772, t002-ST5, t334-ST5, t311-ST5, t121-ST8, t186-ST88, t127-ST1, and two non-spa assignable strains. Whole spa gene sequence analysis along with MLST confirmed one strain as t711-ST6 and another as a novel MRSA clone identified for the first time in seafood and the aquatic environment with a t15669 spa type and a new MLST profile of ST420-256-236-66-82-411-477. The MRSA strains were clustered into five clonal complexes based on the goeBURST algorithm, indicating high diversity among MRSA strains in seafood and the aquatic environment. The novel clone formed a separate clonal complex with matches to three loci. This study recommends large-scale spa typing and MLST of MRSA isolates from seafood and the aquatic environment to determine the prevalence of new MRSA clones. This monitoring process can be useful for tracing local spread of MRSA isolates into the seafood production chain in a defined geographical area.
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Affiliation(s)
- V Murugadas
- MFB Division, ICAR-Central Institute of Fisheries Technology, CIFT Junction, Willingdon Island, Matsyapuri P.O., Cochin-682 029, Kerala, India
| | - C Joseph Toms
- MFB Division, ICAR-Central Institute of Fisheries Technology, CIFT Junction, Willingdon Island, Matsyapuri P.O., Cochin-682 029, Kerala, India
| | - Sara A Reethu
- MFB Division, ICAR-Central Institute of Fisheries Technology, CIFT Junction, Willingdon Island, Matsyapuri P.O., Cochin-682 029, Kerala, India
| | - K V Lalitha
- MFB Division, ICAR-Central Institute of Fisheries Technology, CIFT Junction, Willingdon Island, Matsyapuri P.O., Cochin-682 029, Kerala, India
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219
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Samutela MT, Kalonda A, Mwansa J, Lukwesa-Musyani C, Mwaba J, Mumbula EM, Mwenya D, Simulundu E, Kwenda G. Molecular characterisation of methicillin-resistant Staphylococcus aureus (MRSA) isolated at a large referral hospital in Zambia. Pan Afr Med J 2017; 26:108. [PMID: 28533831 PMCID: PMC5429407 DOI: 10.11604/pamj.2017.26.108.10982] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/31/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) is globally recognized as an important public health problem. Whereas comprehensive molecular typing data of MRSA strains is available, particularly in Europe, North America and Australia, similar information is very limited in sub-Saharan Africa including Zambia. METHODS In this study, thirty two clinical isolates of Staphylococcus aureus, collected at a large referral hospital in Lusaka, Zambia between June 2009 and December 2012 were analysed by Staphylococcal cassette chromosome mec (SCCmec), Staphylococcus protein A gene typing (spa) and detection of the Panton-Valentine Leukocidin genes (pvl). RESULTS Three SCCmec types were identified namely SCCmec type IV (65.6%), SCCmec type III (21.9%), SCCmec type I (3.1%). Nine point four percent (9.4%) of the isolates were untypable. Five spa types, which included a novel type, were detected and the most prevalent spa type was t064 (40.6%). Other spa types included spa types t2104 (31.3%), t355 (3.1%) and t1257 (21.9%). The pvl genes were detected in 3 out of 32 isolates. CONCLUSION These molecular typing data indicated that the MRSA strains collected in Lusaka were diverse. Although the source of these MRSA was not established, these results stress the need for assessing infection prevention and control procedures at this health-care facility in order to curtail possible nosocomial infections. Furthermore, country-wide surveillance of MRSA in both the community and health-care facilities is recommended for infection prevention and control. To our knowledge, this represents the first study to characterise MRSA using molecular tools in Zambia.
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Affiliation(s)
- Mulemba Tillika Samutela
- Department of Biomedical Sciences, School of Medicine, University of Zambia,P.O. Box 50110, Lusaka, Zambia
| | - Annie Kalonda
- Department of Biomedical Sciences, School of Medicine, University of Zambia,P.O. Box 50110, Lusaka, Zambia
| | - James Mwansa
- Department of Pathology and Microbiology, University Teaching Hospital, P/Bag RW X1 Lusaka, Zambia
| | - Chileshe Lukwesa-Musyani
- Department of Pathology and Microbiology, University Teaching Hospital, P/Bag RW X1 Lusaka, Zambia
| | - John Mwaba
- Department of Pathology and Microbiology, University Teaching Hospital, P/Bag RW X1 Lusaka, Zambia
| | - Enoch Mulowa Mumbula
- Department of Pathology and Microbiology, School of Medicine, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Darlington Mwenya
- Department of Pathology and Microbiology, School of Medicine, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Edgar Simulundu
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, P.O. Box 32379, Lusaka, Zambia
| | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Medicine, University of Zambia,P.O. Box 50110, Lusaka, Zambia
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220
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Chapman JR, Balasubramanian D, Tam K, Askenazi M, Copin R, Shopsin B, Torres VJ, Ueberheide BM. Using Quantitative Spectrometry to Understand the Influence of Genetics and Nutritional Perturbations On the Virulence Potential of Staphylococcus aureus. Mol Cell Proteomics 2017; 16:S15-S28. [PMID: 28196877 DOI: 10.1074/mcp.o116.065581] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/12/2017] [Indexed: 01/03/2023] Open
Abstract
Staphylococcus aureus (Sa) is the leading cause of a variety of bacterial infections ranging from superficial skin infections to invasive and life threatening diseases such as septic bacteremia, necrotizing pneumonia, and endocarditis. The success of Sa as a human pathogen is contributed to its ability to adapt to different environments by changing expression, production, or secretion of virulence factors. Although Sa immune evasion is well-studied, the regulation of virulence factors under different nutrient and growth conditions is still not well understood. Here, we used label-free quantitative mass spectrometry to quantify and compare the Sa exoproteins (i.e. exoproteomes) of master regulator mutants or established reference strains. Different environmental conditions were addressed by growing the bacteria in rich or minimal media at different phases of growth. We observed clear differences in the composition of the exoproteomes depending on the genetic background or growth conditions. The relative abundance of cytotoxins determined in our study correlated well with differences in cytotoxicity measured by lysis of human neutrophils. Our findings demonstrate that label-free quantitative mass spectrometry is a versatile tool for predicting the virulence of bacterial strains and highlights the importance of the experimental design for in vitro studies. Furthermore, the results indicate that label-free proteomics can be used to cluster isolates into groups with similar virulence properties, highlighting the power of label-free quantitative mass spectrometry to distinguish Sa strains.
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Affiliation(s)
| | | | | | | | - Richard Copin
- §Department of Microbiology.,‖Department of Medicine
| | - Bo Shopsin
- §Department of Microbiology.,‖Department of Medicine
| | | | - Beatrix M Ueberheide
- From the ‡Proteomics Laboratory, .,**Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, New York 10016
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221
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Thapaliya D, Forshey BM, Kadariya J, Quick MK, Farina S, O' Brien A, Nair R, Nworie A, Hanson B, Kates A, Wardyn S, Smith TC. Prevalence and molecular characterization of Staphylococcus aureus in commercially available meat over a one-year period in Iowa, USA. Food Microbiol 2017; 65:122-129. [PMID: 28399994 DOI: 10.1016/j.fm.2017.01.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 01/24/2017] [Accepted: 01/29/2017] [Indexed: 11/25/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of infectious disease morbidity and mortality. Previous studies have confirmed the presence of S. aureus, including MRSA, on raw meat products. We investigated the prevalence and molecular epidemiology of S. aureus and MRSA in commercially-distributed antibiotic-free and conventional raw meat products (n = 3290) purchased in 8 Iowa retail stores weekly for a period of one year. Isolates were characterized using spa typing, and PCR was used to detect the presence of the Panton-Valentine leukocidin (PVL) and mecA genes. Quantitation of S. aureus on meat products was carried out one week per month. The prevalence of S. aureus on meat samples was 27.8% (913/3290). Compared to antibiotic-free meat samples, higher prevalence of both MRSA and methicillin-susceptible S. aureus (MSSA) were found in conventional meat samples. Among the S. aureus isolates, 18 were PVL-positive (1.9%) and 41 (4.5%) carried mecA. Phenotypic oxacillin resistance was observed for 17.1% (41/239) of the isolates tested, while 23% (55/239) were multi-drug resistant. A total of 132 spa types were detected from 913 contaminated meat samples. Overall, t002 was the most common spa type identified (137; 15.0%). The number of colony-forming units (CFU) per 10 g meat ranged from 2 to 517 (median: 8 CFU per 10 g of meat; mean: 28) with the highest bacterial load observed on turkey samples. These data reinforce the need to consider meat products as potential vehicles of S. aureus transmission from farm into human households, and the potential need for public health intervention programs pre and post-slaughter in meat processing facilities.
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Affiliation(s)
- Dipendra Thapaliya
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Brett M Forshey
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Jhalka Kadariya
- Kent State University, College of Public Health, Department of Biostatistics, Environmental Health Sciences and Epidemiology, 750Hilltop Drive, Kent, OH, 44242, United States
| | - Megan K Quick
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Sarah Farina
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Ashley O' Brien
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Rajeshwari Nair
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Amos Nworie
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Blake Hanson
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Ashley Kates
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Shylo Wardyn
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States
| | - Tara C Smith
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, 52242, United States; Center for Emerging Infectious Diseases, University of Iowa College of Public Health, 2501 Crosspark Rd, Coralville, IA, 52241, United States; Kent State University, College of Public Health, Department of Biostatistics, Environmental Health Sciences and Epidemiology, 750Hilltop Drive, Kent, OH, 44242, United States.
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Dong AR, Thuy Ho VT, Lo R, Bansal N, Turner MS. A genetic diversity study of antifungal Lactobacillus plantarum isolates. Food Control 2017. [DOI: 10.1016/j.foodcont.2016.07.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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223
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Ferguson DD, Smith TC, Hanson BM, Wardyn SE, Donham KJ. Detection of Airborne Methicillin-Resistant Staphylococcus aureus Inside and Downwind of a Swine Building, and in Animal Feed: Potential Occupational, Animal Health, and Environmental Implications. J Agromedicine 2017; 21:149-53. [PMID: 26808288 DOI: 10.1080/1059924x.2016.1142917] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Aerosolized methicillin-resistant Staphylococcus aureus (MRSA) was sampled inside and downwind of a swine facility. Animal feed was sampled before and after entry into the swine facility. Aerosolized particles were detected using an optical particle counter for real-time measurement and with an Andersen sampler to detect viable MRSA. Molecular typing and antimicrobial susceptibility testing were performed on samples collected. Viable MRSA organisms isolated inside the swine facility were primarily associated with particles >5 µm, and those isolated downwind from the swine facility were associated with particles <5 µm. MRSA isolates included spa types t008, t034, and t5706 and were resistant to methicillin, tetracycline, clindamycin, and erythromycin. Animal feed both before and after entry into the swine facility tested positive for viable MRSA. These isolates were of similar spa types as the airborne MRSA organisms. Air samples collected after power washing with a biocide inside the swine facility resulted in no viable MRSA organisms detected. This pilot study showed that the ecology of MRSA is complex. Additional studies are warranted on the maximum distance that viable MRSA can be emitted outside the facility, and the possibility that animal feed may be a source of contamination.
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Affiliation(s)
- Dwight D Ferguson
- a Department of Occupational and Environmental Health , University of Iowa , Iowa City , Iowa , USA
| | - Tara C Smith
- b Department of Epidemiology , University of Iowa , Iowa City , Iowa , USA.,c Department of Biostatistics, Environmental Health Sciences, and Epidemiology , Kent State University , Kent , Ohio , USA
| | - Blake M Hanson
- b Department of Epidemiology , University of Iowa , Iowa City , Iowa , USA
| | - Shylo E Wardyn
- b Department of Epidemiology , University of Iowa , Iowa City , Iowa , USA
| | - Kelley J Donham
- a Department of Occupational and Environmental Health , University of Iowa , Iowa City , Iowa , USA
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Seidl K, Leemann M, Palheiros Marques M, Rachmühl C, Leimer N, Andreoni F, Achermann Y, Zinkernagel AS. High level methicillin resistance correlates with reduced Staphylococcus aureus endothelial cell damage. Int J Med Microbiol 2016; 307:11-20. [PMID: 27955998 DOI: 10.1016/j.ijmm.2016.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/29/2016] [Accepted: 11/27/2016] [Indexed: 11/17/2022] Open
Abstract
There has been controversy about the intrinsic virulence of methicillin-resistant Staphylococcus aureus (MRSA) as compared to methicillin-susceptible S. aureus (MSSA). To address this discrepancy, the intrinsic virulence of 42 MRSA and 40 MSSA clinical isolates was assessed by testing endothelial cell (EC) damage, a surrogate marker for virulence in blood stream infections. Since these clinical isolates represent a heterogeneous group, well characterized S. aureus laboratory strains with SCCmec loss- and gain-of-function mutations were used in addition. The clinical MRSA isolates carrying typical hospital acquired SCCmec types (I, II or III) induced significantly less damage (47.8%) as compared to isolates with other SCCmec types (62.3%, p=0.03) and MSSA isolates (64.2%, p<0.01). There was a strong inverse correlation between high-level oxacillin resistance and low EC damage induction (R2=0.4464, p<0.001). High-level oxacillin resistant strains (MIC >32μ/ml) grew significantly slower as compared to isolates with low-level resistance (p=0.047). The level of EC damage positively correlated with α- and δ-toxin production (p<0.0001 and p<0.05, respectively) but not with β-toxin production. Invasive MRSA isolates (n=21, 56.3%) were significantly less cytotoxic as compared to invasive MSSA isolates (n=20, 68.0%, p<0.05). There was no difference between EC damage induced by superficial versus invasive isolates in either MRSA or MSSA strains. Our data suggest that the intrinsic virulence of MRSA is similar or even reduced as compared to MSSA strains but is linked to the level of methicillin resistance.
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Affiliation(s)
- Kati Seidl
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Michèle Leemann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Miguel Palheiros Marques
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Carole Rachmühl
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nadja Leimer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Federica Andreoni
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Yvonne Achermann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Annelies S Zinkernagel
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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225
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Reynaga E, Navarro M, Vilamala A, Roure P, Quintana M, Garcia-Nuñez M, Figueras R, Torres C, Lucchetti G, Sabrià M. Prevalence of colonization by methicillin-resistant Staphylococcus aureus ST398 in pigs and pig farm workers in an area of Catalonia, Spain. BMC Infect Dis 2016; 16:716. [PMID: 27894267 PMCID: PMC5127002 DOI: 10.1186/s12879-016-2050-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/21/2016] [Indexed: 11/30/2022] Open
Abstract
Background A livestock-associated clonal lineage (ST398) of methicillin-resistant Staphylococcus aureus (MRSA) has been identified causing colonization or infection in farm workers. The aim of the study was to analyze the prevalence of MRSA-ST398 colonization in pigs and in pig farmers in an area with a high pig population (Osona, Barcelona province, Catalonia, Spain). Methods We performed a cross-sectional prevalence study in Osona (Catalonia, Spain), from June 2014 to June 2015. All pig farm workers from 83 farms were studied. Twenty of these farms were randomly selected for the study of both pigs and farmers: 9 fattening and 11 farrow-to-finish farms. All workers over the age of 18 who agreed to participate were included. Samples were analyzed to identify MRSA-ST398 and their spa type. Results Eighty-one of the 140 pig farm workers analyzed (57.9% (95% IC: 50.0–66.4%)) were MRSA-positive, all of them ST398. The mean number of years worked on farms was 17.5 ± 12.6 (range:1–50), without significant differences between positive and negative MRSA results (p = 0.763). Over 75% of MRSA-ST398 carriers worked on farms with more than 1250 pigs (p < 0.001). At least one worker tested positive for MRSA-ST398 on all 20 selected pig farms. Ninety-two (46.0% (95% IC: 39.0–53.0%)) of the nasal swabs from 200 pigs from these 20 farms were MRSA-positive, with 50.5% of sows and 41.4% of fattening pigs (p = 0.198) giving MRSA-positive results. All the isolates were tetracycline-resistant, and were identified as MRSA-ST398. The spa type identified most frequently was t011 (62%). Similar spa types and phenotypes of antibiotic resistance were identified in pigs and farmers of 19/20 tested farms. Conclusions The prevalence of MRSA-ST398 among pig farm workers and pigs on farms in the studied region is very high, and the size of the farm seems to correlate with the frequency of colonization of farmers. The similar spa-types and phenotypes of resistance detected in pigs and workers in most of the farms studied suggest animal-to-human transmission.
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Affiliation(s)
- Esteban Reynaga
- Department of Internal Medicine, Hospital Universitari de Vic, Barcelona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Marian Navarro
- Microbiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Anna Vilamala
- Microbiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Pere Roure
- Epidemiology Department, Hospital Universitari de Vic, Barcelona, Spain
| | - Manuel Quintana
- Epidemiology Department Hospital Vall d'Hebron, Barcelona, Spain
| | - Marian Garcia-Nuñez
- Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Raül Figueras
- Veterinary, Associació Tecnicosanitària del Porcí (ASSAPORC), Vic, Barcelona, Spain
| | - Carmen Torres
- Area de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Gianni Lucchetti
- Department of Internal Medicine, Hospital Universitari de Vic, Barcelona, Spain
| | - Miquel Sabrià
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Infectious Diseases Unit, Health Sciences Research Institute of the Germans Trias i Pujol Foundation, Badalona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain.,Infectious Diseases Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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226
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Wang X, Li X, Liu W, Huang W, Fu Q, Li M. Molecular Characteristic and Virulence Gene Profiles of Community-Associated Methicillin-Resistant Staphylococcus aureus Isolates from Pediatric Patients in Shanghai, China. Front Microbiol 2016; 7:1818. [PMID: 27895635 PMCID: PMC5108810 DOI: 10.3389/fmicb.2016.01818] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/28/2016] [Indexed: 11/13/2022] Open
Abstract
Staphylococcus aureus is a globally important human pathogen, especially among children and immunocompromised patients. The emergence and spread of community-associated methicillin-resistant S. aureus (CA-MRSA) has become a serious public health problem worldwide. The aim of this study was to investigate the prevalence, molecular characteristics and virulence profiles of CA-MRSA infections from pediatric patients in a university hospital in Shanghai, China. A total of 80 CA-MRSA isolates were collected from July 2012 to December 2013 in Shanghai Children's Medical Center and analyzed by multilocus sequence typing, staphylococcus chromosomal cassette mec (SCCmec) typing, and spa typing. The detection of Panton-Valentine Leukocidin (pvl), superantigenic and exfoliative toxins, and adhesin genes was also performed. Overall, 16 distinct sequence types (STs) were identified among the 80 isolates. Among them, ST59 was found to be the most prevalent, followed by ST398 (11.3%, 9/80) and ST88 (8.8%, 7/80). SCCmec types IV and V were observed, at 60 and 40%, respectively. Thirty spa types were identified, spa t437 (23.8%) was the most predominant type. All 80 isolates exhibited carriage of at least four virulence genes. Thirty-four (42.5%, 34/80) isolates harbored ≥10 tested virulence genes. Adhesion genes were present in most of the MRSA isolates, including the following: icaA (100%), clfA (100%), sdrC (95%), and sdrE (63.8%). The prevalence of pvl gene was 20%, and multidrug resistance was observed in 36% of all strains. In addition, ST59-MRSA-IV with t437 accounted for 21.3% of occurrences, making it the most prevalent clone. Isolates that were carriers of toxin genes, and hla (100%) and hlg (87.5%) were the most frequent. In conclusion, simultaneous carriage of multiple virulence genes and genetically considerable diversity were very common among CA-MRSA from pediatric patients in Shanghai. ST59-MRSA-IV with t437 was still the most predominant type. The combination of virulence gene profiles and antibiotic resistance may help ST59 to be successfully spread among children.
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Affiliation(s)
- Xing Wang
- Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine Shanghai, China
| | - Xia Li
- Department of Medical Microbiology and Immunology, University of California, Davis Davis, CA, USA
| | - Wei Liu
- Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine Shanghai, China
| | - Weichun Huang
- Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine Shanghai, China
| | - Qihua Fu
- Department of Laboratory Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine Shanghai, China
| | - Min Li
- Department of Laboratory Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine Shanghai, China
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227
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Ghasemzadeh-Moghaddam H, van Wamel W, van Belkum A, Hamat RA, Neela VK. Differences in humoral immune response between patients with or without nasal carriage of Staphylococcus aureus. Eur J Clin Microbiol Infect Dis 2016; 36:451-458. [PMID: 27815779 DOI: 10.1007/s10096-016-2817-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 10/16/2016] [Indexed: 12/21/2022]
Abstract
The humoral immune response against 43 staphylococcal antigens was compared among hospitalized patients where none of them had any staphylococcal infection on the day of admission with or without nasal Staphylococcus aureus carriage. Fifty-nine carriers and 59 matched non-carriers were studied. The carriers harbored S. aureus of 35 different spa types, including three t037/ST239 methicillin-resistant S. aureus (MRSA) (5.1%). Among the 118 patients, 31 acquired S. aureus during hospitalization. In colonized and non-colonized patients, unique patterns of S. aureus-specific immune responses were observed. The mean fluorescence indices (MFIs) of antibodies against 36/43 (83.7%) antigens were seen to be elevated among carriers. The MFI among carriers with acquisition was significantly higher for staphylococcal superantigen-like protein 5 (SSL5, p = 0.028) when compared to carriers without acquisition. High antibody levels against staphylococcal enterotoxin A (SEA) among carriers illustrate its role as a superantigen in both infection and colonization. We also report a dynamic immune response in S. aureus-carrying patients against the recently reported formyl peptide receptor-like inhibitory (FLIPr)-like protein. In the current study, the dynamics of antibodies against staphylococcal antigens among carrier patients seem quite similar to non-carrier patients. To better understand the dynamic immunogenicity during S. aureus infection and colonization, artificial colonization studies and investigation of the changes in the levels of antibodies against other staphylococcal antigens are recommended.
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Affiliation(s)
- H Ghasemzadeh-Moghaddam
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.,Education Development Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - W van Wamel
- Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - A van Belkum
- Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands.,Scientific Office, bioMérieux, La Balme-les-Grottes, France
| | - R A Hamat
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - V K Neela
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
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228
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Ben Said M, Abbassi MS, Bianchini V, Sghaier S, Cremonesi P, Romanò A, Gualdi V, Hassen A, Luini MV. Genetic characterization and antimicrobial resistance of Staphylococcus aureus isolated from bovine milk in Tunisia. Lett Appl Microbiol 2016; 63:473-481. [PMID: 27657910 DOI: 10.1111/lam.12672] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/05/2016] [Accepted: 09/17/2016] [Indexed: 12/11/2022]
Abstract
Staphylococcus aureus is a major agent of bovine mastitis in dairy herds, causing economic losses in dairy industry worldwide. In addition, milk and milk-products contaminated by Staph. aureus can cause harmful human diseases. The aim of this study was to characterize Staph. aureus strains isolated from dairy farms in Tunisia. Bulk tank milk (n = 32) and individual cow milk (n = 130) samples were collected during the period of 2013-2014. Forty-three Staph. aureus isolates were recovered and typed by spa typing, 16S-23S rRNA intergenic spacer (RS-PCR) and multiplex PCRs for 22 virulence genes. Antimicrobial resistance was also investigated with a disc diffusion test. A selected subsample of 22 strains was additionally genotyped by multilocus sequence typing. Seventeen spa types were recovered, and t2421 (n = 10), t521 (n = 6) and t2112 (n = 5) were the most common. Fourteen different RS-PCR genotypes grouped into 11 clusters were detected in our study, with predominance of the RVI genotype (n = 24). Eight sequence types were identified and Clonal Complex 97, corresponding to RS-PCR cluster R, was the most common (n = 10), followed by CC1 (n = 4), CC15 (n = 3) and other four accounting for one or two strains. Different combinations of virulence genes were reported, and enterotoxin genes were present in few strains (seh, n = 4; sea, n = 2; sea and seh, n = 2; sec and sel, n = 2). The majority of strains were resistant only to penicillin; only one strain was found to be multiresistant and no methicillin-resistant Staph. aureus was demonstrated. Our study reported the isolation of CC97 from bovine milk in Tunisia for the first time and confirmed the relevance of this lineage in intramammary infection in cows. SIGNIFICANCE AND IMPACT OF THE STUDY This paper describes the characteristics of Staphylococcus aureus isolated from bulk tank and individual cow milk in Tunisia. All strains were genotyped by spa typing and RS-PCR, a method based on the amplification of the 16S-23S rRNA intergenic spacer region, and multiplex PCRs for 22 virulence genes. A selected subsample of strains was also genotyped by multilocus sequence typing. All strains were tested for antimicrobial resistance. Our study evidences a predominance of strains belonging to Clonal Complex 97. Methicillin-resistant strains were not detected, and overall low level of antimicrobial resistance was reported.
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Affiliation(s)
- M Ben Said
- Université de Tunis El Manar, Institut de la Recherche Vétérinaire de Tunisie, Tunis, Tunisie.,Laboratory Wastewater Treatment, and Research Center of Water Technologies, Techno park Borj Cedria, Soliman, Tunisia
| | - M S Abbassi
- Université de Tunis El Manar, Institut de la Recherche Vétérinaire de Tunisie, Tunis, Tunisie
| | - V Bianchini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Lodi, Italy
| | - S Sghaier
- Université de Tunis El Manar, Institut de la Recherche Vétérinaire de Tunisie, Tunis, Tunisie.,Laboratory Wastewater Treatment, and Research Center of Water Technologies, Techno park Borj Cedria, Soliman, Tunisia
| | - P Cremonesi
- Institute of Agricultural Biology and Biotechnology, National Research Council, Lodi, Italy
| | - A Romanò
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Lodi, Italy
| | - V Gualdi
- Piattaforma Genomica, Parco Tecnologico Padano, Lodi, Italy
| | - A Hassen
- Laboratory Wastewater Treatment, and Research Center of Water Technologies, Techno park Borj Cedria, Soliman, Tunisia
| | - M V Luini
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Lodi, Italy
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229
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Pooled analysis of single-dose oritavancin in the treatment of acute bacterial skin and skin-structure infections caused by Gram-positive pathogens, including a large patient subset with methicillin-resistant Staphylococcus aureus. Int J Antimicrob Agents 2016; 48:528-534. [DOI: 10.1016/j.ijantimicag.2016.07.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/30/2016] [Accepted: 07/30/2016] [Indexed: 11/20/2022]
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230
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Cole AL, Muthukrishnan G, Chong C, Beavis A, Eade CR, Wood MP, Deichen MG, Cole AM. Host innate inflammatory factors and staphylococcal protein A influence the duration of human Staphylococcus aureus nasal carriage. Mucosal Immunol 2016; 9:1537-1548. [PMID: 26838052 PMCID: PMC4972712 DOI: 10.1038/mi.2016.2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Indexed: 02/07/2023]
Abstract
Human Staphylococcus aureus (SA) nasal carriage provides a reservoir for the dissemination of infectious strains; however, factors regulating the establishment and persistence of nasal colonization are mostly unknown. We measured carriage duration and nasal fluid inflammatory markers after nasally inoculating healthy participants with their previously isolated SA strains. Out of 15 studies, 10 resulted in rapid clearance (9±6 days) that corresponded with upregulated chemokines, growth factors, and predominantly Th1-type cytokines, but not interleukin (IL)-17. Nasal SA persistence corresponded with elevated baseline levels of macrophage inflammatory protein-1β, IL-1β, and IL-6, no induction of inflammatory factors after inoculation, and decreased IL-1 receptor antagonist/IL-1β ratio. SA-expressed staphylococcal protein A (SpA) levels correlated positively with carriage duration. Competitive inoculation studies revealed that isogenic SpA knockout (ΔSpA) strains were cleared faster than wild type only in participants with upregulated inflammatory markers after inoculation. The remaining participants did not mount an inflammatory response and did not clear either strain. ΔSpA strains demonstrated lower growth rates in carrier nasal fluids and lower survival rates when incubated with neutrophils. Collectively, the presented studies identify innate immune effectors that cooperatively modulate nasal carriage duration, and confirm SpA as a bacterial codeterminant of SA nasal carriage.
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Affiliation(s)
- Amy L. Cole
- Laboratory of Innate Host Defense, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Gowrishankar Muthukrishnan
- Laboratory of Innate Host Defense, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Christine Chong
- Laboratory of Innate Host Defense, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Ashley Beavis
- Laboratory of Innate Host Defense, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Colleen R. Eade
- Laboratory of Innate Host Defense, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Matthew P. Wood
- Laboratory of Innate Host Defense, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | | | - Alexander M. Cole
- Laboratory of Innate Host Defense, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA,Correspondence: Dr. Alexander M. Cole, 4110 Libra Blvd. Bldg 20, Rm 236, Orlando, FL 32816, (tel): 407-823-3633;
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231
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Yang Y, Hu Z, Shang W, Hu Q, Zhu J, Yang J, Peng H, Zhang X, Liu H, Cong Y, Li S, Hu X, Zhou R, Rao X. Molecular and Phenotypic Characterization Revealed High Prevalence of Multidrug-Resistant Methicillin-Susceptible Staphylococcus aureus in Chongqing, Southwestern China. Microb Drug Resist 2016; 23:241-246. [PMID: 27754770 DOI: 10.1089/mdr.2016.0078] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Methicillin-susceptible Staphylococcus aureus (MSSA) accounts for ∼40% of staphylococcal infections in China. However, the molecular characterization of MSSA is not well described. In this study, 124 MSSA strains collected in 2013 from a comprehensive teaching hospital in Chongqing, Southwestern China, were subjected to antibiotics susceptibility testing and molecular typing, including multilocus sequence typing, staphylococcal protein A (spa) gene typing, accessory gene regulator (agr) typing, pulsed-field gel electrophoresis (PFGE) typing, Panton-Valentine leukocidin (pvl) gene detection, and antibiotic-resistant gene detection. MSSA strains exhibited high genetic heterogeneity. A total of 10 PFGE groups, 26 sequence types, and 47 spa types were identified. Type I (62.9%) was the most frequent agr type, followed by type II (15.3%), type IV (11.3%), and type III (10.5%). The prevalence of pvl genes was 27.4% (34/124). Notably, 44.4% (55/124) of MSSA strains were multidrug resistance (MDR), and MDR isolates were mostly resistant to penicillin, erythromycin, and clindamycin. The resistance gene blaZ was present in 84.7% of strains, ermC was present in 85.5% of strains, ermA was present in 28.2% of strains, tetK was present in 16.1% of strains, tetM was present in 6.5% of strains, and aacA-aphD was present in 2.6% of strains. These data demonstrated the high prevalence of MDR MSSA in Chongqing, thereby indicating the need to control MSSA infection.
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Affiliation(s)
- Yancheng Yang
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Zhen Hu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Weilong Shang
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Qiwen Hu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Junmin Zhu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Jie Yang
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Huagang Peng
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Xiaopeng Zhang
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Hui Liu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Yanguang Cong
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Shu Li
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Xiaomei Hu
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
| | - Renjie Zhou
- 2 Department of Emergency, Xinqiao Hospital, Third Military Medical University , Chongqing, China
| | - Xiancai Rao
- 1 Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University , Chongqing, China
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232
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Xu D, Jiao N, Ren R, Warren A. Distribution and Diversity of Microbial Eukaryotes in Bathypelagic Waters of the South China Sea. J Eukaryot Microbiol 2016; 64:370-382. [PMID: 27687286 DOI: 10.1111/jeu.12372] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 09/13/2016] [Accepted: 09/22/2016] [Indexed: 11/28/2022]
Abstract
Little is known about the biodiversity of microbial eukaryotes in the South China Sea, especially in waters at bathyal depths. Here, we employed SSU rDNA gene sequencing to reveal the diversity and community structure across depth and distance gradients in the South China Sea. Vertically, the highest alpha diversity was found at 75-m depth. The communities of microbial eukaryotes were clustered into shallow-, middle-, and deep-water groups according to the depth from which they were collected, indicating a depth-related diversity and distribution pattern. Rhizaria sequences dominated the microeukaryote community and occurred in all samples except those from less than 50-m deep, being most abundant near the sea floor where they contributed ca. 64-97% and 40-74% of the total sequences and OTUs recovered, respectively. A large portion of rhizarian OTUs has neither a nearest named neighbor nor a nearest neighbor in the GenBank database which indicated the presence of new phylotypes in the South China Sea. Given their overwhelming abundance and richness, further phylogenetic analysis of rhizarians were performed and three new genetic clusters were revealed containing sequences retrieved from the deep waters of the South China Sea. Our results shed light on the diversity and community structure of microbial eukaryotes in this not yet fully explored area.
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Affiliation(s)
- Dapeng Xu
- State Key Laboratory of Marine Environmental Science, Xiamen University, Xiamen, 361102, China.,Institute of Marine Microbes and Ecospheres, Xiamen University, Xiamen, 361102, China
| | - Nianzhi Jiao
- State Key Laboratory of Marine Environmental Science, Xiamen University, Xiamen, 361102, China.,Institute of Marine Microbes and Ecospheres, Xiamen University, Xiamen, 361102, China
| | - Rui Ren
- State Key Laboratory of Marine Environmental Science, Xiamen University, Xiamen, 361102, China.,Institute of Marine Microbes and Ecospheres, Xiamen University, Xiamen, 361102, China
| | - Alan Warren
- Department of Life Sciences, Natural History Museum, London, SW7 5BD, United Kingdom
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233
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SHARMA NEHA, JANDAIK SAVITA, KUMAR SANJEEV. Synergistic activity of doped zinc oxide nanoparticles with antibiotics: ciprofloxacin, ampicillin, fluconazole and amphotericin B against pathogenic microorganisms. ACTA ACUST UNITED AC 2016; 88:1689-1698. [DOI: 10.1590/0001-3765201620150713] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 11/12/2015] [Indexed: 11/22/2022]
Abstract
ABSTRACT Combination therapy of antibiotics and nanoparticles can be used against multi drug resistant microorganisms. Nanoparticles (NPs) have been reported to show antimicrobial activity. The antimicrobial activities of doped ZnO nanoparticles (ZnO NPs) were studied against fungi, gram-positive and gram-negative bacteria using the standard microdilution method. The interaction between the nanoparticle and the antibiotic was estimated by calculating the fractional inhibitory concentration (FIC index) of the combination through checkerboard assay. Experimental results demonstrated that 10% doped zinc oxide nanoparticles (ZnO NPs) exhibited the maximum antimicrobial effect in contrast with that of the 1% loading and pure ZnO nanoparticles. The enhancement in antimicrobial effect was seen when combined with antibiotic. Synergistic and additive effects were found. No antagonistic effect was found. More synergistic effect was observed when combined with ciprofloxacin than ampicillin. Fungus showed only additive effect. The results are quite in terms with MIC clearly depicting that high doping agent is most suitable for combined therapy. 100% synergistic interaction was observed in higher doping with both ciprofloxacin and ampicillin. This study provides a preliminary report of the synergistic activity of nanoparticles with antibiotics against different pathogenic strains. This provides groundwork for further studies on the combination therapy of nanoparticles with antibiotics.
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Affiliation(s)
| | | | - SANJEEV KUMAR
- Goswamy Ganesh Dutta Satnam Dharma (GGDSD) College, India
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234
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Berla-Kerzhner E, Biber A, Parizade M, Taran D, Rahav G, Regev-Yochay G, Glikman D. Clinical outcomes and treatment approach for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in Israel. Eur J Clin Microbiol Infect Dis 2016; 36:153-162. [PMID: 27677279 DOI: 10.1007/s10096-016-2789-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 09/12/2016] [Indexed: 02/02/2023]
Abstract
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are increasingly documented worldwide. We recently identified two major CA-MRSA clones in Israel: USA300 and t991. Here, we assessed clinical outcomes by CA-MRSA clones and the physicians' treatment approach to CA-MRSA infections. All community-onset, clinical MRSA isolates detected during 2011-2013 by Maccabi Healthcare Services were collected and characterized phenotypically and genotypically; data were collected retrospectively from electronic medical records. Of 309 patients with MRSA infections, 64 were identified as CA-MRSA (21 %). Of the CA-MRSA infections, 72 % had skin and soft tissue infections (SSTIs), 38 % were Panton-Valentine leukocidin (PVL)+, the major clone being USA300 (n = 13, 54 %). Of PVL- isolates (n = 40, 62 %), t991 was the major clone. Age was the only predictor for PVL+ CA-MRSA infection (p < 0.001). Patients with PVL+ CA-MRSA had higher incidence of SSTI recurrences (1.061 vs. 0.647 events per patient/per year, p < 0.0001) and were more likely to have the SSTI drained (64 % vs. 21 %, p = 0.003) when compared to PVL- CA-MRSA. USA300 was more common among adults, while t991 was more common among children (p = 0.002). The physician's referral to culture results and susceptibility were the only predictors of appropriate antibiotic therapy (p < 0.001). However, only a minority of physicians referred to culture results, regardless of subspecialties. PVL+ CA-MRSA isolates caused significantly more recurrences of SSTIs and increased the need for drainage compared with PVL- isolates. Physicians' awareness of CA-MRSA as a cause of SSTIs in the community was suboptimal. Culturing of pus-producing SSTIs is crucial for providing adequate antimicrobials and elucidating MRSA epidemiology.
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Affiliation(s)
| | - A Biber
- Sheba Medical Center, Ramat Gan, Israel
| | - M Parizade
- Maccabi Healthcare Services, Rehovot, Israel
| | - D Taran
- Maccabi Healthcare Services, Rehovot, Israel
| | - G Rahav
- Sheba Medical Center, Ramat Gan, Israel
| | - G Regev-Yochay
- Sheba Medical Center, Ramat Gan, Israel.,Gertner Institute, Ramat Gan, Israel
| | - D Glikman
- Pediatric Infectious Diseases Service, Galilee Medical Center, Nahariya, Israel. .,The Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
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235
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Novel Structure of Enterococcus faecium-Originated ermB-Positive Tn1546-Like Element in Staphylococcus aureus. Antimicrob Agents Chemother 2016; 60:6108-14. [PMID: 27480862 DOI: 10.1128/aac.01096-16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/22/2016] [Indexed: 11/20/2022] Open
Abstract
We determined the resistance determinants in 274 erythromycin-resistant methicillin-susceptible Staphylococcus aureus (MSSA) isolates during a 13-year period, 2000 to 2012. The resistance phenotypes, inducible macrolide-lincosamide-streptogramin (iMLS), constitutive MLS (cMLS), and macrolide-streptogramin (MS) resistance phenotypes, were examined by a double-disk diffusion D test. The ermB gene was more frequent (35%; 97/274) than ermC (27%; 75/274) or ermA (21%; 58/274). All 97 ermB-positive isolates harbored Tn551 and IS1216V The majority (89/97) of ermB-positive isolates displayed the cMLS phenotype and carried mobile element structure (MES)-like structures, which has been previously reported in sequence type 59 (ST59) methicillin-resistant S. aureus (MRSA). The remaining 8 ermB-carrying isolates, belonging to ST7 (n = 4), ST5 (n = 3), and ST59 (n = 1), were sasK intact and did not carry MES-like structures. Unlike a MES-like structure that was located on the chromosome, the ermB elements on sasK-intact isolates were located on plasmids by S1 nuclease pulsed-field gel electrophoresis (PFGE) analysis and conjugation tests. Sequence data for the ermB-containing region (14,566 bp) from ST59 NTUH_3874 revealed that the best match was a Tn1546-like element in plasmid pMCCL2 DNA (GenBank accession number AP009486) of Macrococcus caseolyticus Tn1546 is recognized as an enterococcal transposon and was known from the vancomycin resistance gene cluster in vancomycin-resistant Enterococcus (VRE). So far, acquisitions of Tn1546 in S. aureus have occurred in clonal complex 5 (CC5) MRSA, but not in MSSA. This is the first report that MSSA harbors an Enterococcus faecium-originated ermB-positive Tn1546-like element located on a plasmid.
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236
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Modulation of Staphylococcus aureus Biofilm Matrix by Subinhibitory Concentrations of Clindamycin. Antimicrob Agents Chemother 2016; 60:5957-67. [PMID: 27458233 DOI: 10.1128/aac.00463-16] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/13/2016] [Indexed: 12/31/2022] Open
Abstract
Staphylococcus aureus biofilms are extremely difficult to treat. They provide a protected niche for the bacteria, rendering them highly recalcitrant toward host defenses as well as antibiotic treatment. Bacteria within a biofilm are shielded from the immune system by the formation of an extracellular polymeric matrix, composed of polysaccharides, extracellular DNA (eDNA), and proteins. Many antibiotics do not readily penetrate biofilms, resulting in the presence of subinhibitory concentrations of antibiotics. Here, we show that subinhibitory concentrations of clindamycin triggered a transcriptional stress response in S. aureus via the alternative sigma factor B (σ(B)) and upregulated the expression of the major biofilm-associated genes atlA, lrgA, agrA, the psm genes, fnbA, and fnbB Our data suggest that subinhibitory concentrations of clindamycin alter the ability of S. aureus to form biofilms and shift the composition of the biofilm matrix toward higher eDNA content. An understanding of the molecular mechanisms underlying biofilm assembly and dispersal in response to subinhibitory concentrations of clinically relevant antibiotics such as clindamycin is critical to further optimize antibiotic treatment strategies of biofilm-associated S. aureus infections.
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237
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Chaves-Moreno D, Wos-Oxley ML, Jáuregui R, Medina E, Oxley AP, Pieper DH. Exploring the transcriptome of Staphylococcus aureus in its natural niche. Sci Rep 2016; 6:33174. [PMID: 27641137 PMCID: PMC5027550 DOI: 10.1038/srep33174] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/23/2016] [Indexed: 02/07/2023] Open
Abstract
Staphylococcus aureus is an important human pathogen and commensal, where the human nose is the predominant reservoir. To better understand its behavior in this environmental niche, RNA was extracted from the anterior nares of three documented S. aureus carriers and the metatranscriptome analyzed by RNAseq. In addition, the in vivo transcriptomes were compared to previously published transcriptomes of two in vitro grown S. aureus strains. None of the in vitro conditions, even growth in medium resembling the anterior nares environment, mimicked in vivo conditions. Survival in the nose was strongly controlled by the limitation of iron and evident by the expression of iron acquisition systems. S. aureus populations in different individuals clearly experience different environmental stresses, which they attempt to overcome by the expression of compatible solute biosynthetic pathways, changes in their cell wall composition and synthesis of general stress proteins. Moreover, the expression of adhesins was also important for colonization of the anterior nares. However, different S. aureus strains also showed different in vivo behavior. The assessment of general in vivo expression patterns and commonalities between different S. aureus strains will in the future result in new knowledge based strategies for controlling colonization.
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Affiliation(s)
- Diego Chaves-Moreno
- Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124 Braunschweig, Germany
| | - Melissa L Wos-Oxley
- Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124 Braunschweig, Germany
| | - Ruy Jáuregui
- Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124 Braunschweig, Germany
| | - Eva Medina
- Infection and Immunology Research Group, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124 Braunschweig, Germany
| | - Andrew Pa Oxley
- Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124 Braunschweig, Germany
| | - Dietmar H Pieper
- Microbial Interactions and Processes Research Group, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124 Braunschweig, Germany
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238
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Molecular Epidemiology of Staphylococcus aureus in the General Population in Northeast Germany: Results of the Study of Health in Pomerania (SHIP-TREND-0). J Clin Microbiol 2016; 54:2774-2785. [PMID: 27605711 PMCID: PMC5078557 DOI: 10.1128/jcm.00312-16] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 08/24/2016] [Indexed: 01/05/2023] Open
Abstract
Population-based studies on Staphylococcus aureus nasal colonization are scarce. We examined the prevalence, resistance, and molecular diversity of S. aureus in the general population in Northeast Germany. Nasal swabs were obtained from 3,891 adults in the large-scale population-based Study of Health in Pomerania (SHIP-TREND). Isolates were characterized using spa genotyping, as well as antibiotic resistance and virulence gene profiling. We observed an S. aureus prevalence of 27.2%. Nasal S. aureus carriage was associated with male sex and inversely correlated with age. Methicillin-resistant S. aureus (MRSA) accounted for 0.95% of the colonizing S. aureus strains. MRSA carriage was associated with frequent visits to hospitals, nursing homes, or retirement homes within the previous 24 months. All MRSA strains were resistant to multiple antibiotics. Most MRSA isolates belonged to the pandemic European hospital-acquired MRSA sequence type 22 (HA-MRSA-ST22) lineage. We also detected one livestock-associated MRSA ST398 (LA-MRSA-ST398) isolate, as well as six livestock-associated methicillin-susceptible S. aureus (LA-MSSA) isolates (clonal complex 1 [CC1], CC97, and CC398). spa typing revealed a diverse but also highly clonal S. aureus population structure. We identified a total of 357 spa types, which were grouped into 30 CCs or sequence types. The major seven CCs (CC30, CC45, CC15, CC8, CC7, CC22, and CC25) included 75% of all isolates. Virulence gene patterns were strongly linked to the clonal background. In conclusion, MSSA and MRSA prevalences and the molecular diversity of S. aureus in Northeast Germany are consistent with those of other European countries. The detection of HA-MRSA and LA-MRSA within the general population indicates possible transmission from hospitals and livestock, respectively, and should be closely monitored.
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239
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Phylogenetic relationships among Staphylococcus aureus isolated from clinical samples in Mashhad, Iran. J Infect Public Health 2016; 9:639-44. [DOI: 10.1016/j.jiph.2016.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 12/15/2015] [Accepted: 01/08/2016] [Indexed: 11/20/2022] Open
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240
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Missiakas D, Schneewind O. Staphylococcus aureus vaccines: Deviating from the carol. J Exp Med 2016; 213:1645-53. [PMID: 27526714 PMCID: PMC4995089 DOI: 10.1084/jem.20160569] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/29/2016] [Indexed: 12/27/2022] Open
Abstract
Staphylococcus aureus, a commensal of the human nasopharynx and skin, also causes invasive disease, most frequently skin and soft tissue infections. Invasive disease caused by drug-resistant strains, designated MRSA (methicillin-resistant S. aureus), is associated with failure of antibiotic therapy and elevated mortality. Here we review polysaccharide-conjugate and subunit vaccines that were designed to prevent S. aureus infection in patients at risk of bacteremia or surgical wound infection but failed to reach their clinical endpoints. We also discuss vaccines with ongoing trials for combinations of polysaccharide-conjugates and subunits. S. aureus colonization and invasive disease are not associated with the development of protective immune responses, which is attributable to a large spectrum of immune evasion factors. Two evasive strategies, assembly of protective fibrin shields via coagulases and protein A-mediated B cell superantigen activity, are discussed as possible vaccine targets. Although correlates for protective immunity are not yet known, opsonophagocytic killing of staphylococci by phagocytic cells offers opportunities to establish such criteria.
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Affiliation(s)
| | - Olaf Schneewind
- Department of Microbiology, University of Chicago, Chicago, IL 60637
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241
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Herrera FC, García-López ML, Santos JA. Short communication: Characterization of methicillin-resistant Staphylococcus aureus isolated from raw milk fresh cheese in Colombia. J Dairy Sci 2016; 99:7872-7876. [PMID: 27423957 DOI: 10.3168/jds.2016-11322] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 06/08/2016] [Indexed: 11/19/2022]
Abstract
The aim of this study was the characterization of a collection of 8 methicillin-resistant Staphylococcus aureus (MRSA) isolates, obtained from samples of fresh cheese (Doble Crema) produced from raw cow milk in small dairies in Colombia. All the isolates harbored the mecA and Panton-Valentine leukocidin (PVL) genes, presented with SCCmec type IV, and belonged to multilocus sequence type 8 and spa type 024. Seven isolates presented 3 closely related pulsed-field gel electrophoresis profiles. Three of them carried the staphylococcal enterotoxin B gene. The isolates were resistant to cefoxitin, oxacillin, penicillin, and ampicillin and susceptible to all non-β-lactams antibiotics tested, with minimum inhibitory concentration values for oxacillin of 4 to 8mg/L. The isolates belonged to the community-acquired MRSA group, suggesting a human source of contamination. The risk of human infection by MRSA via contaminated foods is considered low, but contaminated food commodities can contribute to the worldwide dissemination of clones of community-acquired MRSA.
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Affiliation(s)
- Fanny C Herrera
- Department of Food Hygiene and Food Technology, Veterinary Faculty, University of León, ES24071 Spain; Grupo de Investigación en Microbiología y Biotecnología (GIMBIO), Departamento de Microbiología, Facultad de Ciencias Básicas, Universidad de Pamplona, Pamplona, Norte de Santander, Colombia
| | - María-Luisa García-López
- Department of Food Hygiene and Food Technology, Veterinary Faculty, University of León, ES24071 Spain
| | - Jesús A Santos
- Department of Food Hygiene and Food Technology, Veterinary Faculty, University of León, ES24071 Spain.
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242
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Tarekgne EK, Skjerdal T, Skeie S, Rudi K, Porcellato D, Félix B, Narvhus JA. Enterotoxin Gene Profile and Molecular Characterization of Staphylococcus aureus Isolates from Bovine Bulk Milk and Milk Products of Tigray Region, Northern Ethiopia. J Food Prot 2016; 79:1387-95. [PMID: 27497126 DOI: 10.4315/0362-028x.jfp-16-003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Staphylococcal food poisoning (SFP) is an important foodborne disease worldwide, and milk and milk products are commonly associated with SFP outbreaks. The objectives of this study were to investigate the distribution of staphylococcal enterotoxin (se) genes in Staphylococcus aureus from raw cow's milk and milk products and to assess their genetic background with the spa typing method. Of the 549 samples (297 bulk milk and 162 milk product samples) collected from Tigray region, Northern Ethiopia, 160 (29.1%) were positive for S. aureus, of which 82 (51%) were found to harbor se genes by a modified multiplex PCR. Nine se genes were identified: sea (n = 12), seb (n = 3), sec (n = 3), sed(n = 4), seg (n = 49), seh (n = 2), sei (n = 40), sej (n = 1), and tsst-1 (n = 24). The classical type of genes accounted for 27%. Of the 82 enterotoxigenic isolates, 41.5 and 12.4% harbored two or more se genes, respectively. The highest gene association was observed between sei and seg, whereas sea and seb were always found together with the new types of se genes. Altogether, 18 genotypes of toxin genes were identified, and 33% of the samples contained > 5 log CFU ml(-1) S. aureus. spa typing identified 22 spa types and three novel spa sequences, which showed the high genetic diversity of the isolates. No apparent relationship was observed between spa type and se genes. Of the 25 spa types, 13 (52%) were from raw milk, 3 (12%) from milk products, and 9 (36%) from both types of sample. Types t314 (20.7%,n = 17), t458 (18.3%, n = 15), and t6218 (9.8%, n= 8) were the most common spa types identified and were widely distributed in three of the eight studied localities. This is the first study from the Tigray region to report the high distribution of enterotoxigenic S. aureus with a diversified genetic background from dairy food. The study may provide valuable data for microbial food safety risk assessment, molecular epidemiology, and phylogenetic studies of S. aureus in Ethiopia.
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Affiliation(s)
- Enquebaher K Tarekgne
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1432 Ås, Norway; College of Veterinary Medicine, P.O. Box 1118, Mekelle University, Mekelle, Tigray, Ethiopia.
| | - Taran Skjerdal
- Norwegian Veterinary Institute (NVI), Ullevålsveien, 68, Pb 750 Sentrum, N-0106 Oslo, Norway
| | - Siv Skeie
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1432 Ås, Norway
| | - Knut Rudi
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1432 Ås, Norway
| | - Davide Porcellato
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1432 Ås, Norway
| | - Benjamin Félix
- French Agency for Food, Environmental and Occupational Health and Safety, 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort, Paris, France
| | - Judith A Narvhus
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1432 Ås, Norway
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243
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Collaborative Interferon-γ and Interleukin-17 Signaling Protects the Oral Mucosa from Staphylococcus aureus. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 186:2337-52. [PMID: 27470712 DOI: 10.1016/j.ajpath.2016.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Infections with Staphylococcus aureus are a continuing and growing problem in community and hospital settings. Preclinical animal modeling of S. aureus relies on experimental infection, which carries some limitations. We describe here a novel, spontaneous model of oral staphylococcal infection in double knockout mice, deficient in the receptors for IL-17 (IL-17RA) and interferon (IFN)-γ (IFNγRI), beginning at 6 to 8 weeks of age. IFNγRI(-/-)IL17RA(-/-) (GRAKO) mice developed progressive oral abscesses. Cytometric methods revealed extensive neutrophilic infiltration of oral tissues in GRAKO mice; further investigation evidenced that IL-17 predominated neutrophil defects in these mice. To investigate the contribution of IFN-γ signaling to this native host defense to S. aureus, we observed perturbations of monocyte recruitment and macrophage differentiation in the oral tissues of GRAKO mice, and CXCL9/chemokine ligand receptor (CXCR)3-driven recruitment of T-cell oral tissues and draining lymph nodes. To address the former finding, we depleted macrophages and monocytes in vivo from IL17RA(-/-) mice using liposomes loaded with clodronate. This treatment elicited oral abscesses, recapitulating the phenotype of GRAKO mice. From these findings, we propose novel collaborative functions of IL-17 and IFN-γ, acting through neutrophils and macrophages, respectively, in native mucocutaneous host defenses to S. aureus.
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244
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Hanley PW, Barnhart KF, Abee CR, Lambeth SP, Weese JS. Methicillin-Resistant Staphylococcus aureus Prevalence among Captive Chimpanzees, Texas, USA, 2012(1). Emerg Infect Dis 2016; 21:2158-60. [PMID: 26583847 PMCID: PMC4672451 DOI: 10.3201/eid2112.142004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infection in humans and animals is concerning. In 2012, our evaluation of a captive chimpanzee colony in Texas revealed MRSA prevalence of 69%. Animal care staff should be aware of possible zoonotic MRSA transmission resulting from high prevalence among captive chimpanzees.
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245
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Chen Z, Pan WG, Xian WY, Cheng H, Zheng JX, Hu QH, Yu ZJ, Deng QW. Identification of Infantile Diarrhea Caused by Breast Milk-Transmitted Staphylococcus aureus Infection. Curr Microbiol 2016; 73:498-502. [PMID: 27344596 DOI: 10.1007/s00284-016-1088-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/17/2016] [Indexed: 10/21/2022]
Abstract
Staphylococcus aureus is a well-known organism which is responsible for a variety of human infectious diseases including skin infections, pneumonia, bacteremia, and endocarditis. Few of the microorganisms can be transmitted from mother to the newborn or infant by milk breastfeeding. This study aims to identify transmission of S. aureus from healthy, lactating mothers to their infants by breastfeeding. Stool specimens of diarrheal infants and breast milk of their mother (totally three pairs) were collected and six Staphylococcus aureus isolates were cultured positively. Homology and molecular characters of isolated strains were tested using pulsed-field gel electrophoresis (PFGE), spa typing, and multilocus sequence typing. Furthermore, toxin genes detection was also performed. Each pair of isolates has the same PFGE type and spa type. Four Sequence types (STs) were found among all the isolates; they are ST15, ST188, and ST59, respectively. Among the strains, seb, sec, and tst genes were found, and all were negative for pvl gene. The homology of the S. aureus strains isolated from the infants' stool and the mothers' milk was genetically demonstrated, which indicated that breastfeeding may be important in the transmission of S. aureus infection, and the character of S. aureus needed to be further evaluated.
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Affiliation(s)
- Zhong Chen
- Department of Infectious Diseases and Shenzhen Key Lab for Endogenous infection, The Affiliated Shenzhen Nanshan Hospital, Guangdong Medical University, No 89, Taoyuan Road, Nanshan district, Shenzhen, 518052, China
| | - Wei-Guang Pan
- Department of Infectious Diseases and Shenzhen Key Lab for Endogenous infection, The Affiliated Shenzhen Nanshan Hospital, Guangdong Medical University, No 89, Taoyuan Road, Nanshan district, Shenzhen, 518052, China
| | - Wei-Yi Xian
- Yan-tian Community health service center, Ban'an Central Hospital of Shenzhen Affiliated to Guangdong Medical University, No 63, Yantian Road, Bao'an district, Shenzhen, 518102, China
| | - Hang Cheng
- Department of Infectious Diseases and Shenzhen Key Lab for Endogenous infection, The Affiliated Shenzhen Nanshan Hospital, Guangdong Medical University, No 89, Taoyuan Road, Nanshan district, Shenzhen, 518052, China
| | - Jin-Xin Zheng
- Department of Infectious Diseases and Shenzhen Key Lab for Endogenous infection, The Affiliated Shenzhen Nanshan Hospital, Guangdong Medical University, No 89, Taoyuan Road, Nanshan district, Shenzhen, 518052, China
| | - Qing-Hua Hu
- Department of Microbiology Laboratory, Shenzhen Center for Disease Control and Prevention, No 8, Longyuan Road, Nanshan district, Shenzhen, 518055, China
| | - Zhi-Jian Yu
- Department of Infectious Diseases and Shenzhen Key Lab for Endogenous infection, The Affiliated Shenzhen Nanshan Hospital, Guangdong Medical University, No 89, Taoyuan Road, Nanshan district, Shenzhen, 518052, China.
| | - Qi-Wen Deng
- Department of Infectious Diseases and Shenzhen Key Lab for Endogenous infection, The Affiliated Shenzhen Nanshan Hospital, Guangdong Medical University, No 89, Taoyuan Road, Nanshan district, Shenzhen, 518052, China.
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246
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Costa SS, Palma C, Kadlec K, Fessler AT, Viveiros M, Melo-Cristino J, Schwarz S, Couto I. Plasmid-Borne Antimicrobial Resistance of Staphylococcus aureus Isolated in a Hospital in Lisbon, Portugal. Microb Drug Resist 2016; 22:617-626. [PMID: 27309487 DOI: 10.1089/mdr.2015.0352] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Plasmids play a key role in the genetic plasticity and survival of Staphylococcus aureus in challenging environments. Although many S. aureus plasmids have been described, still few studies portray the plasmid content of a given S. aureus population. The aim of this work was to characterize the plasmids carried by a collection of 53 S. aureus isolates collected in a large hospital in Lisbon, Portugal, and investigate their role in conferring resistance to several antimicrobial agents. Plasmids were present in 44 out of the 53 isolates and were grouped into eleven AccI restriction profiles. Plasmid curing of representative strains and comparison of antimicrobial susceptibility profiles between pairs of isogenic strains proved to be a valuable guidance tool in the identification of plasmid-located resistance genes. The plasmids harbored several resistance genes, namely blaZ (resistance to β-lactams), erm(C) (resistance to macrolides, lincosamides, and streptogramin B), cadA (resistance to cadmium and zinc), cadD (resistance to cadmium), and qacA and smr (resistance to biocides and dyes). This study demonstrates the impact of plasmids on the resistance properties of S. aureus, highlighting their role in the dissemination of antibiotic, heavy metal, and biocide resistance genes, and survival of this major pathogen in the hospital environment.
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Affiliation(s)
- Sofia Santos Costa
- 1 Global Health and Tropical Medicine, GHTM, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa , UNL, Lisbon, Portugal
| | - Cláudia Palma
- 1 Global Health and Tropical Medicine, GHTM, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa , UNL, Lisbon, Portugal
| | - Kristina Kadlec
- 2 Institute of Farm Animal Genetics , Friedrich-Loeffler-Institut (FLI), Neustadt-Mariensee, Germany
| | - Andrea T Fessler
- 2 Institute of Farm Animal Genetics , Friedrich-Loeffler-Institut (FLI), Neustadt-Mariensee, Germany
| | - Miguel Viveiros
- 1 Global Health and Tropical Medicine, GHTM, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa , UNL, Lisbon, Portugal
| | - José Melo-Cristino
- 3 Centro Hospitalar Lisboa Norte E.P.E., Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Stefan Schwarz
- 2 Institute of Farm Animal Genetics , Friedrich-Loeffler-Institut (FLI), Neustadt-Mariensee, Germany
| | - Isabel Couto
- 1 Global Health and Tropical Medicine, GHTM, Unidade de Microbiologia Médica, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa , UNL, Lisbon, Portugal
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247
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Liu SH, Chen KF, Chen CJ, Lin YH, Huang YC. Intermittent nasal carriage with Staphylococcus aureus within a menstrual cycle: Results from a prospective cohort of healthy carriers. Medicine (Baltimore) 2016; 95:e4040. [PMID: 27368032 PMCID: PMC4937946 DOI: 10.1097/md.0000000000004040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Female sex hormones have been related to nasal Staphylococcus aureus carriage in healthy individuals; however, whether nasal staphylococcal carriage varies by menstrual cycle phase remains unknown.We sampled anterior nares of female healthcare workers twice per week for 6 consecutive menstrual cycles. We used mixed-effects Poisson regression models to determine whether intermittent carriage was associated with cycle phases in a given individual. We also performed recurrent event survival analysis to identify host factors linked to incident carriage status.Overall, we collected 754 nasal swabs over 89 consecutive person-cycles from 14 intermittent carriers. In 84 ovulation-defined menstrual cycles (715 swabs), the period prevalence of staphylococcal carriage was 58.7%, 63.1%, and 64.9% in the follicular, periovulatory, and luteal phases, respectively; these differences were not statistically significant after multivariable adjustment and correction for within-person correlation (adjusted relative risk [RR]-periovulatory 0.92, P: 0.30; luteal 1.00, P: 0.98).Using survival analysis, we identified several host factors that were associated with incident loss, gain of colonization, or both. For example, as compared to women aged 20 to 30 years, those aged 30 to 40 years were less likely to losing carriage (hazard ratio [HR]: 0.26, 95% confidence interval [CI]: 0.09, 0.80) but were as likely to regaining carriage (HR: 0.53, 95% CI: 0.21, 1.34). In comparison, being underweight (body mass index [BMI] <18.5) was significantly associated with a higher risk for regaining (HR: 1.95, 95% CI: 1.34, 1.51) and losing (HR: 1.57, 95% CI: 1.16, 2.12) colonization, indicating the alternating tendency for status changes. Personal hygiene behaviors, such as nostril cleansing habit and methods, differentially affected carriers' risk for losing or regaining staphylococcal colonization.Using an intensive sampling scheme, we found that nasal staphylococcal carriage could vary substantially over time in healthy carriers. Yet, such dynamic intraperson changes in carriage status did not depend on menstrual cycle phases but were associated with host age, BMI, and personal hygiene behavior.
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Affiliation(s)
- Su-Hsun Liu
- College of Medicine, Chang Gung University
- Department of Family Medicine, Chang Gung Memorial Hospital
| | - Kuan-Fu Chen
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Jung Chen
- College of Medicine, Chang Gung University
- Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan
| | | | - Yhu-Chering Huang
- College of Medicine, Chang Gung University
- Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan
- Correspondence: Yhu-Chering Huang, Department of Pediatrics, Chang Gung Memorial Hospital, 5 Fuhsin Street, Gueishan District, Taoyuan 333, Taiwan (e-mail: )
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248
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Kraushaar B, Ballhausen B, Leeser D, Tenhagen BA, Käsbohrer A, Fetsch A. Antimicrobial resistances and virulence markers in Methicillin-resistant Staphylococcus aureus from broiler and turkey: A molecular view from farm to fork. Vet Microbiol 2016; 200:25-32. [PMID: 27318609 DOI: 10.1016/j.vetmic.2016.05.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/27/2016] [Accepted: 05/30/2016] [Indexed: 11/16/2022]
Abstract
Little is known about the characteristics of MRSA occurring along the broiler and turkey production chains. The aim of this study was to characterise and compare MRSA of turkey and broiler origin sampled on different production levels using a DNA microarray and antimicrobial susceptibility testing. Main differences could be observed in the prevalence of the resistance genes erm(C), aacA-aphD and tet(K) and the number of non-wild type strains with minimum inhibitory concentration values (MICs) above the epidemiological cut-off values (ECOFFs) for gentamicin and kanamycin. Overall, MRSA with non-wild type phenotype for the macrolide-lincosamide-streptogramin group, tetracycline, and trimethoprim were found in more than 70% of poultry isolates. Non-wild type isolates carrying the qacC gene conferring resistance to quaternary ammonium compound disinfectants were found at all production stages in similar frequencies. Regarding the presence of enterotoxin genes in poultry-derived MRSA the enterotoxin gene cluster (egc) was only found in Non-CC (clonal complex) 398 strains. Three CC398 strains harboured the genes sed (from turkey at slaughter and broiler meat) and sea-N315 (from a chicken carcass). One Non-CC398 strain isolated from turkey meat was found positive for the seb gene and also enterotoxin production. Similarity analysis based on selected resistance and virulence markers revealed a high clonality among Non-CC398 isolates. Isolates of the same clonal complex clustered together according to their common virulence and resistance profiles. Strains of CC9 were grouped in two subclusters due to different resistance genes. Our results underline, that there are other poultry associated clones of MRSA (mainly CC9 and CC5) besides the predominant CC398 which are similar in both poultry species.
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Affiliation(s)
- Britta Kraushaar
- Federal Institute for Risk Assessment, Department Biological Safety, Berlin, Germany
| | - Britta Ballhausen
- Federal Institute for Risk Assessment, Department Biological Safety, Berlin, Germany
| | - Daniel Leeser
- Federal Institute for Risk Assessment, Department Biological Safety, Berlin, Germany
| | - Bernd-Alois Tenhagen
- Federal Institute for Risk Assessment, Department Biological Safety, Berlin, Germany
| | - Annemarie Käsbohrer
- Federal Institute for Risk Assessment, Department Biological Safety, Berlin, Germany
| | - Alexandra Fetsch
- Federal Institute for Risk Assessment, Department Biological Safety, Berlin, Germany.
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249
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Knox J, Sullivan SB, Urena J, Miller M, Vavagiakis P, Shi Q, Uhlemann AC, Lowy FD. Association of Environmental Contamination in the Home With the Risk for Recurrent Community-Associated, Methicillin-Resistant Staphylococcus aureus Infection. JAMA Intern Med 2016; 176:807-15. [PMID: 27159126 PMCID: PMC4981655 DOI: 10.1001/jamainternmed.2016.1500] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE The role of environmental contamination in recurrent Staphylococcus aureus infections within households and its potential effect on intervention strategies has been debated recently. OBJECTIVE To assess whether household environmental contamination increases the risk for recurrent infection among individuals with a community-associated methicillin-resistant S aureus (MRSA) infection. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted from November 1, 2011, to June 30, 2014, in the Columbia University Medical Center catchment area. All patients within 72 hours of presentation with skin or soft-tissue infections and blood, urine, or sputum cultures positive for MRSA were identified. Two hundred sixty-two patients met study inclusion criteria; 83 of these (31.7%) agreed to participate (index patients) with 214 household members. Participants were followed up for 6 months, and 62 of the 83 households (74.7%) completed follow-up. Participants and researchers were blinded to exposure status throughout the study. Follow-up was completed on June 30, 2014, and data were assessed from July 1, 2014, to February 19, 2016. EXPOSURE Concordant environmental contamination, defined as having an isolate with the identical staphylococcal protein A and staphylococcal chromosomal cassette mec type or antibiogram type as the index patient's clinical isolate, present on 1 or more environmental surfaces at the time of a home visit to the index patient after infection. MAIN OUTCOMES AND MEASURES Index recurrent infection, defined as any self-reported infection among the index patients during follow-up. RESULTS One patient did not complete any follow-up. Of the remaining 82 index patients, 53 (64.6%) were female and 59 (72.0%) were Hispanic. The mean age was 30 (SD, 20; range, 1-79) years. Forty-nine of 61 MRSA infections where the clinical isolate could be obtained (80.3%) were due to the epidemic strain USA300. Among the 82 households in which a patient had an index MRSA infection, the clinical isolate was present in the environment in 20 (24.4%) and not found in 62 (75.6%). Thirty-five patients (42.7%) reported a recurrent infection during follow-up, of whom 15 (42.9%) required hospitalization. Thirteen recurrent infections were from the 20 households (65.0%) with and 22 were from the 62 households (35.5%) without environmental contamination (P = .04). Environmental contamination increased the rate of index recurrent infection (incident rate ratio, 2.05; 95% CI, 1.03-4.10; P = .04). CONCLUSIONS AND RELEVANCE Household environmental contamination was associated with an increased rate of recurrent infection. Environmental decontamination should be considered as a strategy to prevent future MRSA infections, particularly among households where an infection has occurred.
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Affiliation(s)
- Justin Knox
- Division of Infectious Diseases, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Sean B Sullivan
- Division of Infectious Diseases, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Julia Urena
- Division of Infectious Diseases, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Maureen Miller
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | | | - Qiuhu Shi
- Department of Epidemiology and Community Health, School of Health Sciences and Practice, New York Medical College, New York, New York
| | - Anne-Catrin Uhlemann
- Division of Infectious Diseases, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Franklin D Lowy
- Division of Infectious Diseases, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York5Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, New York
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250
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Shin E, Hong H, Park J, Oh Y, Jung J, Lee Y. Characterization of Staphylococcus aureus faecal isolates associated with food-borne disease in Korea. J Appl Microbiol 2016; 121:277-86. [PMID: 26991816 DOI: 10.1111/jam.13133] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/17/2016] [Accepted: 02/26/2016] [Indexed: 11/30/2022]
Abstract
AIMS To characterize Staphylococcus aureus faecal isolates from people suspected to be infected with food poisoning by using antimicrobial susceptibility testing and molecular techniques. METHODS AND RESULTS A total of 340 Staph. aureus isolates from 6226 people suspected to be infected with food poisoning were identified and characterized by biochemical methods, antimicrobial susceptibility testing and PCR. Samples were obtained from January 2006 to December 2008 from the National Notifiable Diseases Surveillance System at the Research Institute of Public Health and Environment in Seoul Metropolitan, Korea. All strains carried at least one of the eight staphylococcal enterotoxin (se) genes tested and a total of 27 se profiles were produced; the most frequent se profile was seg-sei and the next was sea. Among the total isolates, 36 methicillin-resistant Staphylococcus aureus (MRSAs) isolates were further analysed by multilocus sequence typing (MLST), Staphylococcal cassette chromosome mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE) and PCR detection for pvl. ST72-SCCmec type IV was the most predominant clone (27 isolates, 75%) followed by ST1-SCCmec type IV (five isolates, 13·8%), ST20-SCCmec type IV (one isolate, 2·8%), ST493-SCCmec type IV (one isolate, 2·8%), ST903-SCCmec type IV (one isolate, 2·8%) and ST5-SCCmec type II (one isolate, 2·8%). By PFGE typing, MRSAs isolated during the same period were grouped together although they were isolated from different regions. None of MRSAs had PVL gene and nine MRSAs were multidrug resistant. CONCLUSIONS Analysis of MRSAs by MLST, SCCmec typing, PFGE and pvl detection showed that the majority of strain associated with food-borne diseases belonged to a Korean community-acquired (CA) MRSA clone with ST72-SCCmec type IV-PVL negative-SEG/SEI and its variations while one strain was hospital-acquired (HA) MRSA. SIGNIFICANCE AND IMPACT OF THE STUDY CA-MRSA clone which possessed ST72-SCCmec type IV-PVL negative-SEG/SEI was spread most commonly among MRSAs that were associated with food-borne diseases. This is the first report of ST903 strain in Korea.
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Affiliation(s)
- E Shin
- Culture Collection of Antimicrobial Resistant Microbes, Department of Horticulture, Biotechnology, and Landscape Architecture, Seoul Women's University, Seoul, Korea
| | - H Hong
- Culture Collection of Antimicrobial Resistant Microbes, Department of Horticulture, Biotechnology, and Landscape Architecture, Seoul Women's University, Seoul, Korea
| | - J Park
- Culture Collection of Antimicrobial Resistant Microbes, Department of Horticulture, Biotechnology, and Landscape Architecture, Seoul Women's University, Seoul, Korea
| | - Y Oh
- Epidemiology Team, Biomedical Research Division, Research Institute of Public Health & Environment, Seoul Metropolitan Government, Gwachon, Korea
| | - J Jung
- Epidemiology Team, Biomedical Research Division, Research Institute of Public Health & Environment, Seoul Metropolitan Government, Gwachon, Korea
| | - Y Lee
- Culture Collection of Antimicrobial Resistant Microbes, Department of Horticulture, Biotechnology, and Landscape Architecture, Seoul Women's University, Seoul, Korea
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