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Kim SG, Kwon J, Giri SS, Yun S, Kim HJ, Kim SW, Kang JW, Lee SB, Jung WJ, Park SC. Strategy for mass production of lytic Staphylococcus aureus bacteriophage pSa-3: contribution of multiplicity of infection and response surface methodology. Microb Cell Fact 2021; 20:56. [PMID: 33653327 PMCID: PMC7923500 DOI: 10.1186/s12934-021-01549-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/18/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Antibiotic-resistant bacteria have emerged as a serious problem; bacteriophages have, therefore, been proposed as a therapeutic alternative to antibiotics. Several authorities, such as pharmacopeia, FDA, have confirmed their safety, and some bacteriophages are commercially available worldwide. The demand for bacteriophages is expected to increase exponentially in the future; hence, there is an urgent need to mass-produce bacteriophages economically. Unlike the replication of non-lytic bacteriophages, lytic bacteriophages are replicated by lysing host bacteria, which leads to the termination of phage production; hence, strategies that can prolong the lysis of host bacteria in bacteria-bacteriophage co-cultures, are required. RESULTS In the current study, we manipulated the inoculum concentrations of Staphylococcus aureus and phage pSa-3 (multiplicity of infection, MOI), and their energy sources to delay the bactericidal effect while optimizing phage production. We examined an increasing range of bacterial inoculum concentration (2 × 108 to 2 × 109 CFU/mL) to decrease the lag phase, in combination with a decreasing range of phage inoculum (from MOI 0.01 to 0.00000001) to delay the lysis of the host. Bacterial concentration of 2 × 108 CFU/mL and phage MOI of 0.0001 showed the maximum final phage production rate (1.68 × 1010 plaque forming unit (PFU)/mL). With this combination of phage-bacteria inoculum, we selected glycerol, glycine, and calcium as carbon, nitrogen, and divalent ion sources, respectively, for phage production. After optimization using response surface methodology, the final concentration of the lytic Staphylococcus phage was 8.63 × 1010 ± 9.71 × 109 PFU/mL (5.13-fold increase). CONCLUSIONS Therefore, Staphylococcus phage pSa-3 production can be maximized by increasing the bacterial inoculum and reducing the seeding phage MOI, and this combinatorial strategy could decrease the phage production time. Further, we suggest that response surface methodology has the potential for optimizing the mass production of lytic bacteriophages.
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Affiliation(s)
- Sang Guen Kim
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Jun Kwon
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Sib Sankar Giri
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Saekil Yun
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Hyoun Joong Kim
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Sang Wha Kim
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Jung Woo Kang
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Sung Bin Lee
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Won Joon Jung
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea
| | - Se Chang Park
- Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea.
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The learning hospital: From theory to practice in a hospital infection prevention program. Infect Control Hosp Epidemiol 2020; 41:86-97. [DOI: 10.1017/ice.2019.318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AbstractThe learning hospital is distinguished by ceaseless evolution of erudition, enhancement, and implementation of clinical best practices. We describe a model for the learning hospital within the framework of a hospital infection prevention program and argue that a critical assessment of safety practices is possible without significant grant funding. We reviewed 121 peer-reviewed manuscripts published by the VCU Hospital Infection Prevention Program over 16 years. Publications included quasi-experimental studies, observational studies, surveys, interrupted time series analyses, and editorials. We summarized the articles based on their infection prevention focus, and we provide a brief summary of the findings. We also summarized the involvement of nonfaculty learners in these manuscripts as well as the contributions of grant funding. Despite the absence of significant grant funding, infection prevention programs can critically assess safety strategies under the learning hospital framework by leveraging a diverse collaboration of motivated nonfaculty learners. This model is a valuable adjunct to traditional grant-funded efforts in infection prevention science and is part of a successful horizontal infection control program.
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Sianglum W, Saeloh D, Tongtawe P, Wootipoom N, Indrawattana N, Voravuthikunchai SP. Early Effects of Rhodomyrtone on Membrane Integrity in Methicillin-Resistant Staphylococcus aureus. Microb Drug Resist 2017; 24:882-889. [PMID: 29215320 DOI: 10.1089/mdr.2016.0294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Strong evidence of high potency of rhodomyrtone as a promising antibacterial agent against pathogenic gram-positive bacteria has been clearly demonstrated in our previous work. The aim of this study was to provide insight into early action of rhodomyrtone, an acylphloroglucinol, on membrane damage in multidrug-resistant methicillin-resistant Staphylococcus aureus (MRSA). Early effects of rhodomyrtone on the bacterial membrane integrity were detected in a time-course study. Flow cytometry revealed a reduction in green fluorescent emission and increase in uptake of propidium iodide in rhodomyrtone-treated bacterial cells in a concentration- and time-dependent manner. Disruption of cytoplasmic membrane was further monitored by measuring cellular adenosine triphosphate (ATP) and potassium ion (K+). Leakage of both ATP and K+ and significant decrease in intracellular ATP in MRSA were observed following treatment. Pronounced changes in the bacterial ultrastructure and morphology were confirmed by transmission electron microscopy and scanning electron microscopy. Bacterial cell disruption, holes in cell surface, and bulge formations were noted in rhodomyrtone-treated cells. In this study, we provided relevant data to clarify that rhodomyrtone is a bacterial cell membrane-damaging agent. A possible early effect of this novel compound involves bacterial membrane disruption.
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Affiliation(s)
- Wipawadee Sianglum
- 1 Department of Microbiology and Excellence Research Laboratory on Natural Products, Faculty of Science and Natural Product Research Center of Excellence, Prince of Songkla University , Hat Yai, Thailand
| | - Dennapa Saeloh
- 2 Faculty of Medical Technology, Prince of Songkla University , Hat Yai, Thailand
| | - Pongsri Tongtawe
- 3 Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University , Pathumtanee, Thailand
| | - Natthakul Wootipoom
- 4 Immunology and Virology Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University , Hat Yai, Thailand
| | - Nitaya Indrawattana
- 5 Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University , Bangkok, Thailand
| | - Supayang Piyawan Voravuthikunchai
- 1 Department of Microbiology and Excellence Research Laboratory on Natural Products, Faculty of Science and Natural Product Research Center of Excellence, Prince of Songkla University , Hat Yai, Thailand
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Chung DR, Huh K. Novel pandemic influenza A (H1N1) and community-associated methicillin-resistant Staphylococcus aureus pneumonia. Expert Rev Anti Infect Ther 2016; 13:197-207. [PMID: 25578884 DOI: 10.1586/14787210.2015.999668] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Postinfluenza bacterial pneumonia is a leading cause of influenza-associated death, and Staphylococcus aureus and Streptococcus pneumoniae have been important pathogens that have caused pneumonia since the influenza pandemic in 1919. Emergence of novel influenza A (H1N1) pdm09 and the concomitant global spread of community-associated methicillin-resistant S. aureus (CA-MRSA) have led to increasing prevalence of CA-MRSA pneumonia following influenza infection. Such an epidemiologic change poses a therapeutic challenge due to a high risk of inappropriate empiric antimicrobial therapy and poor clinical outcomes. Early diagnosis and initiation of appropriate antimicrobial therapy for post-influenza bacterial pneumonia have become even more important in the era of CA-MRSA. Therefore, novel molecular diagnostic techniques should be applied to more readily diagnose MRSA pneumonia.
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Affiliation(s)
- Doo Ryeon Chung
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, Seoul 135-710, Republic of Korea
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Zarfeshany A, Asgary S, Javanmard SH. Potent health effects of pomegranate. Adv Biomed Res 2014; 3:100. [PMID: 24800189 PMCID: PMC4007340 DOI: 10.4103/2277-9175.129371] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 11/13/2012] [Indexed: 01/25/2023] Open
Abstract
Accumulating data clearly claimed that Punica granatum L. (pomegranate) has several health benefits. Pomegranates can help prevent or treat various disease risk factors including high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammatory activities. It is demonstrated that certain components of pomegranate such as polyphenols have potential antioxidant, anti-inflammatory, and anticarcinogenic effects. The antioxidant potential of pomegranate juice is more than that of red wine and green tea, which is induced through ellagitannins and hydrosable tannins. Pomegranate juice can reduce macrophage oxidative stress, free radicals, and lipid peroxidation. Moreover, pomegranate fruit extract prevents cell growth and induces apoptosis, which can lead to its anticarcinogenic effects. In addition, promoter inhibition of some inflammatory markers and their production are blocked via ellagitannins. In this article, we highlight different studies on the therapeutic effects of pomegranate and their suggested mechanisms of actions.
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Affiliation(s)
- Aida Zarfeshany
- Physiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran
| | - Sedigheh Asgary
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran
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Priya S, Nithya R, Berchmans S. S-nitrosothiol tethered polymer hexagons: synthesis, characterisation and antibacterial effect. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:1-10. [PMID: 23996380 DOI: 10.1007/s10856-013-5032-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 08/12/2013] [Indexed: 06/02/2023]
Abstract
In this work, we portray a new controlled nitric oxide (NO) delivery platform by grafting S-nitrosothiol derived from cysteine into the polymeric backbone of poly(vinyl methyl ether-co-maleic anhydride). Nitrosothiols (RSNO's) are linked to the polymeric backbone through solvent displacement method. By adjusting solvent polarity, materials of different shapes and sizes varying between μm and nm are prepared. More often our method of preparation resulted in hexagonally shaped polymeric materials. The structure and RSNO conjugation analysis was investigated using scanning electron microscopy (SEM), FT-IR, UV-Vis spectroscopy and thermogravimetric analysis (TGA). Bactericidal efficacy of nitric oxide releasing polymer hexagons, a novel antibacterial agent is demonstrated against Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. Confocal microscopic studies revealed the enhanced bactericidal effect of polymer hexagons via membrane destruction. Results suggest that this biocompatible NO releasing RSNO conjugated polymer hexagons could be potentially useful for antimicrobial applications.
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Affiliation(s)
- S Priya
- Electrodics and Electrocatalysis Division, Central Electrochemical Research Institute, Karaikudi, 630006, Tamil Nadu, India,
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Abstract
Critically ill patients in intensive care units are subject to many complications associated with therapy. Many of these complications are health care-associated infections and are related to indwelling devices, including ventilator-associated pneumonia, central line-associated bloodstream infection, catheter-associated urinary tract infection; surgical site infection, venous thromboembolism, deep venous thrombosis, and pulmonary embolus are other common complications. All efforts should be undertaken to prevent these complications in surgical critical care, and national efforts are under way for each of these complications. In this article, epidemiology, risk factors, diagnosis, treatment, and prevention of these complications in critically ill patients are discussed.
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Affiliation(s)
- Kathleen B To
- Division of Acute Care Surgery [Trauma, Burns, Surgical Critical Care, Emergency Surgery], Department of Surgery, University of Michigan Health System, Ann Arbor, MI 48109-5033, USA
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Sianglum W, Srimanote P, Taylor PW, Rosado H, Voravuthikunchai SP. Transcriptome analysis of responses to rhodomyrtone in methicillin-resistant Staphylococcus aureus. PLoS One 2012; 7:e45744. [PMID: 23029218 PMCID: PMC3459976 DOI: 10.1371/journal.pone.0045744] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 08/24/2012] [Indexed: 11/18/2022] Open
Abstract
Rhodomyrtone, purified from Rhodomyrtus tomentosa (Aiton) Hassk, exhibits a high degree of potency against methicillin-resistant Staphylococcus aureus (MRSA). We recently demonstrated that exposure of MRSA to a subinhibitory concentration (0.174 µg/ml) of rhodomyrtone resulted in the alteration of expression of several functional classes of bacterial proteins. To provide further insight into the antibacterial mode of action of this compound, we determined the impact of exposure to rhodomyrtone on the gene transcriptional profile of MRSA using microarray analysis. Exposure of MRSA to subinhibitory concentrations (0.5MIC; 0.5 µg/ml) of rhodomyrtone revealed significant modulation of gene expression, with induction of 64 genes and repression of 35 genes. Prominent changes in response to exposure to rhodomyrtone involved genes encoding proteins essential to metabolic pathways and processes such as amino acid metabolism, membrane function, ATP-binding cassette (ABC) transportation and lipoprotein and nucleotide metabolism. Genes involved in the synthesis of the aspartate family of amino acids, in particular proteins encoded by the dap operon were prominent. The diaminopimelate (DAP) biosynthetic pathway is the precursor of lysine synthesis and is essential for peptidoglycan biosynthesis. However, phenotypic analysis of the peptidoglycan amino acid content of rhodomyrtone-treated MRSA did not differ significantly from that extracted from control cells. Genes involved in the biosynthesis of amino acids and peptidoglycan, and a high affinity ATP-driven K ((+)) transport system, were investigated by quantitative reverse transcription-PCR (qRT-PCR) using EMRSA-16 1, 4, or 18 h after exposure to rhodomyrtone and in general the data concurred with that obtained by microarray, highlighting the relevance of the DAP biosynthetic pathway to the mode of action of rhodomyrtone.
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Affiliation(s)
- Wipawadee Sianglum
- Department of Microbiology and Natural Products Research Center, Faculty of Science, Prince of Songkla University, Songkla, Thailand
| | - Potjanee Srimanote
- Graduate Study, Faculty of Allied Health Sciences, Thammasat University, Pathumtanee, Thailand
| | - Peter W. Taylor
- School of Pharmacy, University College London, London, United Kingdom
| | - Helena Rosado
- School of Pharmacy, University College London, London, United Kingdom
| | - Supayang P. Voravuthikunchai
- Department of Microbiology and Natural Products Research Center, Faculty of Science, Prince of Songkla University, Songkla, Thailand
- * E-mail:
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Bos ME, Graveland H, Portengen L, Wagenaar JA, Heederik DJ. Livestock-associated MRSA prevalence in veal calf production is associated with farm hygiene, use of antimicrobials, and age of the calves. Prev Vet Med 2012; 105:155-9. [DOI: 10.1016/j.prevetmed.2012.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 12/01/2011] [Accepted: 01/09/2012] [Indexed: 11/26/2022]
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Sachdev G, Napolitano LM. Postoperative pulmonary complications: pneumonia and acute respiratory failure. Surg Clin North Am 2012; 92:321-44, ix. [PMID: 22414416 DOI: 10.1016/j.suc.2012.01.013] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Postoperative pulmonary complications (atelectasis, pneumonia, pulmonary edema, acute respiratory failure) are common, particularly after abdominal and thoracic surgery, pneumonia and atelectasis being the most common. Postoperative pneumonia is associated with increased morbidity, length of hospital stay, and costs. Few institutions have pneumonia prevention programs for surgical patients, and these should be strongly considered. Acute respiratory failure is a life-threatening pulmonary complication that requires institution of mechanical ventilation and admission to the intensive care unit, and is associated with increased risk for ventilator-associated pneumonia. This article discusses epidemiology, risk factors, diagnosis, treatment, and prevention of these pulmonary complications in surgical patients.
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Affiliation(s)
- Gaurav Sachdev
- Division of Acute Care Surgery (Trauma, Burns, Critical Care, Emergency Surgery), Department of Surgery, University of Michigan, Ann Arbor, MI 48109-0033, USA
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Rapid identification of community-associated methicillin-resistant Staphylococcus aureus by Fourier transform infrared spectroscopy. Diagn Microbiol Infect Dis 2011; 70:157-66. [PMID: 21596219 DOI: 10.1016/j.diagmicrobio.2010.12.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 12/16/2010] [Accepted: 12/17/2010] [Indexed: 11/21/2022]
Abstract
The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) carrying Panton-Valentine leukocidin is a worldwide problem. Their identification is based currently on costly and complicated molecular methods. This article describes a simple method for differentiating CA-MRSA from hospital-associated (HA) epidemic MRSA pulsed-field gel electrophoresis types using Fourier transform infrared (FTIR) spectroscopy. The 47 CA-MRSA isolates included 3 Southwest Pacific (resembling USA1100), 24 CMRSA7 (resembling USA400/MW2), 19 CMRSA10 (resembling USA300), and 1 European ST80, while HA-MRSA were represented by 27, 16, 11, 15, 7, and 8 Canadian epidemic isolates CMRSA1 through CMRSA6 respectively, plus 25 nontyped Canadian HA-MRSA. Principal component analysis (PCA), self-organized maps (SOMs), and the K-nearest neighbor (KNN) method were used to cluster the isolates based on chemometric analysis of FTIR spectra of dried films of stationary-phase cells grown on Que-Bact® Universal Medium No. 2 (Quelab Laboratories, Montreal, QC, Canada). First-derivative normalized data from a single narrow spectral region (1361-1236 cm(-1), suggesting differences in protein amide III and nucleic acid phosphodiester contents) allowed 98% correct classification by KNN, 93% by SOMs, and 92% by PCA. FTIR spectroscopic analysis of cells grown on Que-Bact® Universal Medium No. 2 offers a rapid and simple alternative to molecular methods for routine identification of CA-MRSA epidemic isolates.
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Beta-lactams interfering with PBP1 induce Panton-Valentine leukocidin expression by triggering sarA and rot global regulators of Staphylococcus aureus. Antimicrob Agents Chemother 2011; 55:3261-71. [PMID: 21502633 DOI: 10.1128/aac.01401-10] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Previous articles reported that beta-lactam antibiotics increase the expression of Staphylococcus aureus Panton-Valentine leukocidin (PVL) by activating its transcription. We investigated the mechanisms underlying the inductor effect of beta-lactams on PVL expression by determining targets and regulatory pathways possibly implicated in this process. We measured PVL production in the presence of oxacillin (nonselective), imipenem (penicillin-binding protein 1 [PBP1] selective), cefotaxime (PBP2 selective), cefaclore (PBP3 selective), and cefoxitin (PBP4 selective). In vitro, we observed increased PVL production consistent with luk-PV mRNA levels that were 20 to 25 times higher for community-acquired methicillin-resistant S. aureus (CA-MRSA) cultures treated with PBP1-binding oxacillin and imipenem than for cultures treated with other beta-lactams or no antibiotic at all. This effect was also observed in vivo, with increased PVL mRNA levels in lung tissues from CA-MRSA-infected mice treated with imipenem but not cefoxitin. To confirm the involvement of PBP1 inhibition in this pathway, PBP1 depletion by use of an inducible pbp1 antisense RNA showed a dose-dependent relationship between the level of pbp1 antisense RNA and the luk-PV mRNA level. Upon imipenem treatment of exponential-phase cultures, we observed an increased sarA mRNA level after 30 min of incubation followed by a decreased rot mRNA level after 1 to 4 h of incubation. Unlike the agr and saeRS positive regulators, which were nonessential for PVL induction by beta-lactams, the sarA (positive) and rot (negative) PVL regulators were necessary for PVL induction by imipenem. Our results suggest that antibiotics binding to PBP1 increase PVL expression by modulating sarA and rot, which are essential mediators of the inductor effect of beta-lactams on PVL expression.
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Li HT, Zhang TT, Huang J, Zhou YQ, Zhu JX, Wu BQ. Factors associated with the outcome of life-threatening necrotizing pneumonia due to community-acquired Staphylococcus aureus in adult and adolescent patients. Respiration 2010; 81:448-60. [PMID: 21051855 DOI: 10.1159/000319557] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 07/07/2010] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Although community-acquired Staphylococcus aureus pneumonia with highly virulent Panton-Valentine leukocidin (PVL)-positive strains, a severe disease with significant lethality, is rare, especially in adult and adolescent patients, recent reports highlight that these infections are on the rise. OBJECTIVES To describe the demographic and clinical features of reported cases of life-threatening community-acquired S. aureus pneumonia with usually PVL-positive strains in adult and adolescent patients, to evaluate the variables related to death, and to select a more appropriate antimicrobial treatment for this potentially deadly disease. METHODS We summarized all of the 92 reported cases and our case. The effect of 5 variables on mortality was measured using logistic regression. RESULTS S. aureus community-acquired pneumonia (CAP) with usually PVL-positive strains is a severe disease with significant lethality, i.e. 42.9%; a short duration of the time from the onset of symptoms to death, i.e. 5.5 ± 10.1 days, and prolonged hospital admissions, i.e. 33.2 ± 29.5 days. Seventy-three cases have been tested for the gene for PVL, and 71 strains have been found to carry the PVL gene. Logistic regression analysis showed that leucopenia (p = 0.002), influenza-like symptoms or laboratory-confirmed influenza (p = 0.011), and hemoptysis (p = 0.024) were the factors associated with death. Antibiotic therapies inhibiting toxin production were associated with an improved outcome in these cases (p = 0.007). CONCLUSIONS Physicians should pay special attention to those patients who acquired severe CAP during influenza season and have flu-like symptoms, hemoptysis, and leucopenia, and they should consider S. aureus more frequently among the possible pathogens of severe CAP. Empiric therapy for severe CAP with this distinct clinical picture should include coverage for S. aureus. Targeted treatment with antimicrobials inhibiting toxin production appears to be a more appropriate selection.
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Affiliation(s)
- Hong-Tao Li
- Department of Respiratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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14
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Efficacy of Polyvalent Bacteriophage P-27/HP to Control Multidrug Resistant Staphylococcus aureus Associated with Human Infections. Curr Microbiol 2010; 62:255-60. [DOI: 10.1007/s00284-010-9699-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 06/08/2010] [Indexed: 10/19/2022]
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Napolitano LM. Perspectives in surgical infections: what does the future hold? Surg Infect (Larchmt) 2010; 11:111-23. [PMID: 20374004 DOI: 10.1089/sur.2010.9932] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Lena M Napolitano
- Division of Acute Care Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan 48109-0033, USA.
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Halpenny GM, Gandhi KR, Mascharak PK. Eradication of Pathogenic Bacteria by Remote Delivery of Nitric Oxide via Light-Triggering of Nitrosyl-Containing Materials. ACS Med Chem Lett 2010; 1:180-183. [PMID: 20802849 DOI: 10.1021/ml1000646] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Although nitric oxide (NO) delivery systems have been fabricated with sol-gel-based materials, remote control of such systems with light has not been achieved. In this work, a fiber optic-based NO delivery system is described in which the photoactive metal-nitrosyl, [Mn(PaPy(3))(NO)]ClO(4) (1), has been employed in a sol-gel material. The material (1*FO) contains the manganese-nitrosyl which releases NO upon illumination with visible light. The NO-releasing capacity of 1*FO has been measured with an NO-sensitive electrode and the spatial diffusion of NO in solution has been visualized using the Griess reaction. The utility of 1*FO has been demonstrated in effective reduction of bacterial loads of Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus (MRSA). The results suggest that a device that releases NO via illumination by optical fiber may have clinical applications in combating infections with both Gram-positive, Gram-negative and to some degree antibiotic resistant bacteria.
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Affiliation(s)
- Genevieve M. Halpenny
- Department of Chemistry and Biochemistry, University of California at Santa Cruz, 1156 High Street, Santa Cruz, California 95064
| | - Kavita R. Gandhi
- Department of Chemistry and Biochemistry, University of California at Santa Cruz, 1156 High Street, Santa Cruz, California 95064
| | - Pradip K. Mascharak
- Department of Chemistry and Biochemistry, University of California at Santa Cruz, 1156 High Street, Santa Cruz, California 95064
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Nitric oxide-donating materials and their potential in pharmacological applications for site-specific nitric oxide delivery. Future Med Chem 2009; 1:1497-507. [DOI: 10.4155/fmc.09.111] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The discovery of various regulatory, protective and deleterious effects of nitric oxide (NO) has prompted intense research activity in the design and synthesis of NO-donating drugs and materials that can be used to modulate the effective concentrations of NO at biological targets. To date, various NO-donating compounds have been incorporated or immobilized in biocompatible polymer matrices and such materials have been used as patches, wound dressings, coatings on blood-contacting medical devices and time-release NO drugs. Recently, attention has been drawn toward light-sensitive NO donors, such as S-nitrosothiols and metal nitrosyls, which can deliver NO at selected targets under the total control of light. The pharmacological potential of such NO-donating materials including those with immobilized photoactive NO donors are reviewed in this article.
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Halpenny GM, Steinhardt RC, Okialda KA, Mascharak PK. Characterization of pHEMA-based hydrogels that exhibit light-induced bactericidal effect via release of NO. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2009; 20:2353-60. [PMID: 19554428 PMCID: PMC2778696 DOI: 10.1007/s10856-009-3795-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 06/01/2009] [Indexed: 05/17/2023]
Abstract
A light-activated NO donor, [Mn(PaPy(3))(NO)]ClO(4) (1a), has been incorporated into HEMA-based polymer hydrogel and the nitrosyl-polymer conjugate materials 1a(x) · HG and 1a(x) · HG(MB) have been characterized. The NO releasing properties and antibacterial capabilities of these materials in conjunction with growth attenuators such as hydrogen peroxide and methylene blue (MB) are reported. Since the nitrosyl releases NO only upon exposure to light, materials like 1a(x) · HG(MB) could be used as wound dressings that deliver NO under controlled conditions.
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Affiliation(s)
- Genevieve M. Halpenny
- Department of Chemistry and Biochemistry, University of California at Santa Cruz, 1156 High Street, Santa Cruz, CA 95064 USA
| | - Rachel C. Steinhardt
- Department of Chemistry and Biochemistry, University of California at Santa Cruz, 1156 High Street, Santa Cruz, CA 95064 USA
| | - Krystle A. Okialda
- Department of Chemistry and Biochemistry, University of California at Santa Cruz, 1156 High Street, Santa Cruz, CA 95064 USA
| | - Pradip K. Mascharak
- Department of Chemistry and Biochemistry, University of California at Santa Cruz, 1156 High Street, Santa Cruz, CA 95064 USA
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19
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Anti-microbial activities of pomegranate rind extracts: enhancement by cupric sulphate against clinical isolates of S. aureus, MRSA and PVL positive CA-MSSA. Altern Ther Health Med 2009; 9:23. [PMID: 19635137 PMCID: PMC2724405 DOI: 10.1186/1472-6882-9-23] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 07/27/2009] [Indexed: 11/13/2022]
Abstract
Background Recently, natural products have been evaluated as sources of antimicrobial agents with efficacies against a variety of micro-organisms. Methods This report describes the antimicrobial activities of pomegranate rind extract (PRE) singularly and in combination with cupric sulphate against methicillin-sensitive and -resistant Staphylococcus aureus (MSSA, MRSA respectively), and Panton-Valentine Leukocidin positive community acquired MSSA (PVL positive CA-MSSA). Results PRE alone showed limited efficacy against MRSA and MSSA strains. Exposure to copper (II) ions alone for 2 hours resulted in moderate activity of between 102 to 103 log10 cfu mL-1 reduction in growth. This was enhanced by the addition of PRE to 104 log10 cfu mL-1 reduction in growth being observed in 80% of the isolates. However, the PVL positive CA-MSSA strains were more sensitive to copper (II) ions which exhibited moderate activities of between 103 log10 cfu mL-1 reduction in growth for 60% of the isolates. Conclusion PRE, in combination with Cu(II) ions, was seen to exhibit moderate antimicrobial effects against clinical isolates of MSSA, MRSA and PVL positive CA-MSSA isolates. The results of this study indicate that further investigation into the active ingredients of natural products, their mode of action and potential synergism with other antimicrobial agents is warranted. This is the first report of the efficacy of pomegranate against clinical PVL positive CA-MSSA isolates.
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20
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Hidron AI, Low CE, Honig EG, Blumberg HM. Emergence of community-acquired meticillin-resistant Staphylococcus aureus strain USA300 as a cause of necrotising community-onset pneumonia. THE LANCET. INFECTIOUS DISEASES 2009; 9:384-92. [DOI: 10.1016/s1473-3099(09)70133-1] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Wenzel RP, Bearman G, Edmond MB. Screening for MRSA: a flawed hospital infection control intervention. Infect Control Hosp Epidemiol 2009; 29:1012-8. [PMID: 18937571 DOI: 10.1086/593120] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Focusing hospital resources on a single antibiotic-resistant pathogen as a sole approach to infection control is inherently flawed. We applied attributable mortality principles to a basic model of bloodstream infections to outline the argument. Screening for methicillin-resistant Staphylococcus aureus alone made sense in the 1980s, but the ongoing emergence of vancomycin-resistant enterococci and antibiotic-resistant strains of gram-negative rods and Candida species, as well as the recognition of the value of team-based infection control programs, support a population-based approach.
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Affiliation(s)
- Richard P Wenzel
- Department of Internal Medicine, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, Virginia, USA
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22
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Missed epidural brain abscess after furunculosis. Am J Emerg Med 2008; 26:522.e3-4. [DOI: 10.1016/j.ajem.2007.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Accepted: 09/21/2007] [Indexed: 11/30/2022] Open
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23
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24
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O’hara C, Geddes A. Int J Antimicrob Agents 2008; 31:1-2. [DOI: 10.1016/j.ijantimicag.2007.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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25
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Multiplex PCR for rapid detection of Staphylococcus aureus isolates suspected to represent community-acquired strains. J Clin Microbiol 2007; 46:582-7. [PMID: 18032620 DOI: 10.1128/jcm.01600-07] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The continuous spread of community-acquired methicillin-resistant Staphylococcus aureus (caMRSA) and the introduction of these highly virulent isolates into hospitals represent increasing threats. The timely recognition of caMRSA strains is crucial for infection control purposes. Thus, we developed a PCR-based assay for the easy and rapid determination of those caMRSA clones that currently are the most prevalent in Germany and Central Europe. This assay was able to correctly identify the majority of the isolates as caMRSA of sequence type 80 (ST80), clonal complex 1 (USA400), and ST8 (USA300). In combination with spa typing-BURP (based upon repeat pattern) analysis and resistance typing, it provides a means for the extensive characterization of suspicious isolates. Thus, this assay represents a reliable tool for monitoring the emergence and spread of different caMRSA clones. The resulting information, in combination with careful interpretation of the epidemiological records, might help to prevent the further spread of those highly virulent caMRSA clones.
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26
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The SarA protein family of Staphylococcus aureus. Int J Biochem Cell Biol 2007; 40:355-61. [PMID: 18083623 DOI: 10.1016/j.biocel.2007.10.032] [Citation(s) in RCA: 150] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Revised: 10/20/2007] [Accepted: 10/29/2007] [Indexed: 12/20/2022]
Abstract
Staphylococcus aureus is widely appreciated as an opportunistic pathogen, primarily in hospital-related infections. However, recent reports indicate that S. aureus infections can now occur in other wise healthy individuals in the community setting. The success of this organism can be attributed to the large array of regulatory proteins, including the SarA protein family, used to respond to changing microenvironments. Sequence alignment and structural data reveal that the SarA protein family can be divided into three subfamilies: (1) single domain proteins; (2) double domain proteins; (3) MarR homologs. Structural studies have also demonstrated that SarA, SarR, SarS, MgrA and thus possibly all members of this protein family are winged helix proteins with minor variations. Mutagenesis studies of SarA disclose that the winged helix motifs are important for DNA binding and function. Recent progress concerning the functions and plausible mechanisms of regulation of SarA and its homologs are discussed.
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27
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Wenzel RP. Health Care–Associated Infections: Major Issues in the Early Years of the 21st Century. Clin Infect Dis 2007; 45 Suppl 1:S85-8. [PMID: 17582577 DOI: 10.1086/518136] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Health care-associated bloodstream infections are associated with an attributable mortality that makes them equivalent to the eighth leading cause of death in the United States. Increasing levels of antibiotic resistance and the problems associated with biofilms surrounding prostheses and vascular catheters pose special challenges. These issues and potential solutions are addressed in the present article.
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Affiliation(s)
- Richard P Wenzel
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA.
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