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Molecular Mechanisms of Drug Resistance in Staphylococcus aureus. Int J Mol Sci 2022; 23:ijms23158088. [PMID: 35897667 PMCID: PMC9332259 DOI: 10.3390/ijms23158088] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 12/03/2022] Open
Abstract
This paper discusses the mechanisms of S. aureus drug resistance including: (1) introduction. (2) resistance to beta-lactam antibiotics, with particular emphasis on the mec genes found in the Staphylococcaceae family, the structure and occurrence of SCCmec cassettes, as well as differences in the presence of some virulence genes and its expression in major epidemiological types and clones of HA-MRSA, CA-MRSA, and LA-MRSA strains. Other mechanisms of resistance to beta-lactam antibiotics will also be discussed, such as mutations in the gdpP gene, BORSA or MODSA phenotypes, as well as resistance to ceftobiprole and ceftaroline. (3) Resistance to glycopeptides (VRSA, VISA, hVISA strains, vancomycin tolerance). (4) Resistance to oxazolidinones (mutational and enzymatic resistance to linezolid). (5) Resistance to MLS-B (macrolides, lincosamides, ketolides, and streptogramin B). (6) Aminoglycosides and spectinomicin, including resistance genes, their regulation and localization (plasmids, transposons, class I integrons, SCCmec), and types and spectrum of enzymes that inactivate aminoglycosides. (7). Fluoroquinolones (8) Tetracyclines, including the mechanisms of active protection of the drug target site and active efflux of the drug from the bacterial cell. (9) Mupirocin. (10) Fusidic acid. (11) Daptomycin. (12) Resistance to other antibiotics and chemioterapeutics (e.g., streptogramins A, quinupristin/dalfopristin, chloramphenicol, rifampicin, fosfomycin, trimethoprim) (13) Molecular epidemiology of MRSA.
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Katkowska M, Garbacz K, Kopala W, Schubert J, Bania J. Genetic diversity and antimicrobial resistance of Staphylococcus aureus from recurrent tonsillitis in children. APMIS 2019; 128:211-219. [PMID: 31692060 DOI: 10.1111/apm.13007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022]
Abstract
The aim of this study was to analyze the prevalence of Staphylococcus aureus in the tonsils of children subjected tonsillectomy due to recurrent tonsilitis and to determine the spa types of the pathogens, carriage of virulence genes and antimicrobial resistance profiles. The study included 73 tonsillectomized children. Bacteria, including S. aureus were isolated from tonsillar surface prior to tonsillectomy, recovered from tonsillar core at the time of the surgery, and from posterior pharynx 2-4 weeks after the procedure. Staphylococcus aureus isolates were compared by spa typing, tested for antimicrobial susceptibility and for the presence of superantigenic toxin genes (sea-seu, eta, etb, tst, lukS/lukF-PV) by multiplex polymerase chain reaction. Seventy-three patients (mean 7.1 ± 4.1 years, 61.6% male) were assessed. The most commonly isolated bacteria were S. aureus. The largest proportion of staphylococcal isolates originated from tonsillar core (63%), followed by tonsillar surface (45.1%) and posterior pharynx in tonsillectomized children (18.2%, p = 0.007). Five (6.3%) isolates were identified as MRSA (mecA-positive). Up to 67.5% of the isolates synthesized penicillinases (blaZ-positive isolates), and 8.8% displayed MLSB resistance. The superantigenic toxin genes were detected in more than half of examined isolates (56.3%). spa types t091, t084, and t002, and clonal complexes (CCs) CC7, CC45, and CC30 turned out to be most common. Staphylococcus aureus associated with RT in children showed pathogenicity potential and considerable genetic diversity, and no clones were found to be specific for this condition although further studies are needed.
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Affiliation(s)
- Marta Katkowska
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Garbacz
- Department of Oral Microbiology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Wacław Kopala
- Voivodeship Specialist Children's Hospital, Olsztyn, Poland
| | - Justyna Schubert
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Jacek Bania
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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Srivastava P, Sivashanmugam K. Combinatorial Drug Therapy for Controlling Pseudomonas aeruginosa and Its Association With Chronic Condition of Diabetic Foot Ulcer. INT J LOW EXTR WOUND 2019; 19:7-20. [DOI: 10.1177/1534734619873785] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus, major observations of DFU cases have reported on amputation of foot region, and microbial bioburden during DFU is a major cause that affects healing of the wound regions. Pathogenic microbes are routinely isolated from these wound regions, especially Staphylococcus, Pseudomonas, Klebsiella, and Escherichia coli have been reported, whereas higher prevalence of Pseudomonas species during chronic condition in the deeper part of the wound, when left untreated, leads to gangrene. Multiple drug-resistant Pseudomonas strains are a new threat because of their biofilm-forming ability, making it more potent and incurable. Acyl homoserine lactones (AHL) are a group of signaling molecules that can regulate biofilm growth, and Las and Rhl operon generally work in tandem to initiate biofilm formation by Pseudomonas species. These signaling molecules also initiate virulence factors that correlates upregulation of inflammatory responses, and AHL can be a therapeutic target in order to prevent the efficacy of multiple drug-resistant strains that form biofilm and also can be an alternative solution against control of multiple drug-resistant strains.
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Stacey HJ, Clements CS, Welburn SC, Jones JD. The prevalence of methicillin-resistant Staphylococcus aureus among diabetic patients: a meta-analysis. Acta Diabetol 2019; 56:907-921. [PMID: 30955124 PMCID: PMC6597605 DOI: 10.1007/s00592-019-01301-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/11/2019] [Indexed: 12/19/2022]
Abstract
AIMS Diabetic patients have multiple risk factors for colonisation with methicillin-resistant Staphylococcus aureus (MRSA), a nosocomial pathogen associated with significant morbidity and mortality. This meta-analysis was conducted to estimate the prevalence of MRSA among diabetic patients. METHODS The MEDLINE, Embase, BIOSIS, and Web of Science databases were searched for studies published up to May 2018 that reported primary data on the prevalence of MRSA in 10 or more diabetic patients. Two authors independently assessed study eligibility and extracted the data. The main outcomes were the pooled prevalence rates of MRSA colonisation and infection among diabetic populations. RESULTS Eligible data sets were divided into three groups containing data about the prevalence of MRSA colonisation or in diabetic foot or other infections. From 23 data sets, the prevalence of MRSA colonisation among 11577 diabetics was 9.20% (95% CI, 6.26-12.63%). Comparison of data from 14 studies that examined diabetic and non-diabetic patients found that diabetics had a 4.75% greater colonisation rate (P < 0.0001). From 41 data sets, the prevalence of MRSA in 10994 diabetic foot infection patients was 16.78% (95% CI, 13.21-20.68%). Among 2147 non-foot skin and soft-tissue infections, the MRSA prevalence rate was 18.03% (95% CI, 6.64-33.41). CONCLUSIONS The prevalence of MRSA colonisation among diabetic patients is often higher than among non-diabetics; this may make targeted screening attractive. In the UK, many diabetic patients may already be covered by the current screening policies. The prevalence and impact of MRSA among diabetic healthcare workers requires further research. The high prevalence of MRSA among diabetic foot infections may have implications for antimicrobial resistance, and should encourage strategies aimed at infection prevention or alternative therapies.
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Affiliation(s)
- Helen J Stacey
- Edinburgh Medical School, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, EH16 4SB, Edinburgh, UK
| | - Caitlin S Clements
- Division of Infection and Pathway Medicine, Edinburgh Medical School, Biomedical Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, EH16 4SB, Edinburgh, UK
| | - Susan C Welburn
- Division of Infection and Pathway Medicine, Edinburgh Medical School, Biomedical Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, EH16 4SB, Edinburgh, UK
- International Campus, ZJU-UoE Institute, Zhejiang University School of Medicine, Zhejiang University, 718 East Haizhou Road, 314400, Haining, Zhejiang, People's Republic of China
| | - Joshua D Jones
- Division of Infection and Pathway Medicine, Edinburgh Medical School, Biomedical Sciences, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, EH16 4SB, Edinburgh, UK.
- International Campus, ZJU-UoE Institute, Zhejiang University School of Medicine, Zhejiang University, 718 East Haizhou Road, 314400, Haining, Zhejiang, People's Republic of China.
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He H, Xia DL, Chen YP, Li XD, Chen C, Wang YF, Shen L, Hu YL, Gu HY. Evaluation of a two-stage antibacterial hydrogel dressing for healing in an infected diabetic wound. J Biomed Mater Res B Appl Biomater 2016; 105:1808-1817. [DOI: 10.1002/jbm.b.33543] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 09/10/2015] [Accepted: 09/17/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Hong He
- Affiliated Hospital of Nantong University; Nantong Jiangsu 226019 China
- Nantong Tongda Chemicals Safety Evaluation Center Co. Ltd.; Nantong Jiangsu 226019 China
| | - Dong-Lin Xia
- School of Public Health; Nantong University; Nantong Jiangsu 226019 China
- Institute of Analytical Chemistry for Life Science, Nantong University; Nantong Jiangsu 226019 China
| | - Yan-Pei Chen
- Nantong Tongda Chemicals Safety Evaluation Center Co. Ltd.; Nantong Jiangsu 226019 China
- School of Public Health; Nantong University; Nantong Jiangsu 226019 China
| | - Xiao-Dong Li
- Nantong Tongda Chemicals Safety Evaluation Center Co. Ltd.; Nantong Jiangsu 226019 China
- School of Public Health; Nantong University; Nantong Jiangsu 226019 China
| | - Chao Chen
- School of Public Health; Nantong University; Nantong Jiangsu 226019 China
- Institute of Analytical Chemistry for Life Science, Nantong University; Nantong Jiangsu 226019 China
| | - Yu-Fei Wang
- Nantong Tongda Chemicals Safety Evaluation Center Co. Ltd.; Nantong Jiangsu 226019 China
- Institute of Analytical Chemistry for Life Science, Nantong University; Nantong Jiangsu 226019 China
| | - Lingling Shen
- School of Public Health; Nantong University; Nantong Jiangsu 226019 China
| | - Yu-Lin Hu
- Nantong Tongda Chemicals Safety Evaluation Center Co. Ltd.; Nantong Jiangsu 226019 China
| | - Hai-Ying Gu
- Nantong Tongda Chemicals Safety Evaluation Center Co. Ltd.; Nantong Jiangsu 226019 China
- School of Public Health; Nantong University; Nantong Jiangsu 226019 China
- Institute of Analytical Chemistry for Life Science, Nantong University; Nantong Jiangsu 226019 China
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Ortego L, Gonzalo-Asensio J, Laguna A, Villacampa MD, Gimeno MC. (Aminophosphane)gold(I) and silver(I) complexes as antibacterial agents. J Inorg Biochem 2015; 146:19-27. [DOI: 10.1016/j.jinorgbio.2015.01.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 12/20/2022]
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Sunagar R, Patil SA, Chandrakanth RK. Bacteriophage therapy for Staphylococcus aureus bacteremia in streptozotocin-induced diabetic mice. Res Microbiol 2010; 161:854-60. [PMID: 20868746 DOI: 10.1016/j.resmic.2010.09.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Accepted: 08/04/2010] [Indexed: 01/21/2023]
Abstract
The protective effect of bacteriophage was assessed against experimental Staphylococcus aureus lethal bacteremia in streptozotocin (STZ) induced-diabetic and non-diabetic mice. Intraperitoneal administrations of S. aureus (RCS21) of 2 × 10⁸ CFU caused lethal bacteremia in both diabetic and non-diabetic mice. A single administration of a newly isolated lytic phage strain (GRCS) significantly protected diabetic and non-diabetic mice from lethal bacteremia (survival rate 90% and 100% for diabetic and non-diabetic bacteremic groups versus 0% for saline-treated groups). Comparison of phage therapy to oxacillin treatment showed a significant decrease in RCS21 of 5 and 3 log units in diabetic and non-diabetic bacteremic mice, respectively. The same protection efficiency of phage GRCS was attained even when the treatment was delayed up to 4 h in both diabetic and non-diabetic bacteremic mice. Inoculation of mice with a high dose (10¹⁰ PFU) of phage GRCS alone produced no adverse effects attributable to the phage per se. These results suggest that phages could constitute valuable prophylaxis against S. aureus infections, especially in immunocompromised patients.
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Affiliation(s)
- Raju Sunagar
- Department of Biotechnology, Gulbarga University, Gulbarga-585 106, Karnataka, India.
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