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Lynch JP, Zhanel GG. Escalation of antimicrobial resistance among MRSA part 1: focus on global spread. Expert Rev Anti Infect Ther 2023; 21:99-113. [PMID: 36470275 DOI: 10.1080/14787210.2023.2154653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Staphylococcus aureus produce numerous virulence factors that influence tissue invasion, cytotoxicity, membrane damage, and intracellular persistence allowing them to be very common human pathogens. S. aureus isolates exhibit considerable diversity though specific genotypes have been associated with antimicrobial resistance (AMR) and toxin gene profiles. MRSA is an important pathogen causing both community-acquired (CA) and healthcare-acquired (HCA) infections. Importantly, over the past several decades, both HCA-MRSA and CA-MRSA have spread all over the globe. Even more concerning is that CA-MRSA clones have disseminated into hospitals and HCA-MRSA have entered the community. Factors that enhance spread of MRSA include: poor antimicrobial stewardship and inadequate infection control. The emergence and spread of multidrug resistant (MDR) MRSA has limited therapeutic options. AREAS COVERED The authors discuss the escalation of MRSA, both HCA-MRSA and CA-MRSA across the globe. A literature search of MRSA was performed via PubMed (up to September 2022), using the key words: antimicrobial resistance; β-lactams; community-associated MRSA; epidemiology; infection; multidrug resistance; Staphylococcus aureus. EXPERT OPINION Over the past several decades, MRSA has spread all over the globe. We encourage the judicious use of antimicrobials in accordance with antimicrobial stewardship programs along with infection control measures to minimize the spread of MRSA.
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Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at Ucla, Los Angeles, CA, USA
| | - George G Zhanel
- Professor-Department of Medical Microbiology and Infectious Diseases, Department of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Lawal OU, Ayobami O, Abouelfetouh A, Mourabit N, Kaba M, Egyir B, Abdulgader SM, Shittu AO. A 6-Year Update on the Diversity of Methicillin-Resistant Staphylococcus aureus Clones in Africa: A Systematic Review. Front Microbiol 2022; 13:860436. [PMID: 35591993 PMCID: PMC9113548 DOI: 10.3389/fmicb.2022.860436] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of hospital-associated (HA) and community-associated (CA) infections globally. The multi-drug resistant nature of this pathogen and its capacity to cause outbreaks in hospital and community settings highlight the need for effective interventions, including its surveillance for prevention and control. This study provides an update on the clonal distribution of MRSA in Africa. Methods A systematic review was conducted by screening for eligible English, French, and Arabic articles from November 2014 to December 2020, using six electronic databases (PubMed, EBSCOhost, Web of Science, Scopus, African Journals Online, and Google Scholar). Data were retrieved and analyzed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (registered at PROSPERO: CRD42021277238). Genotyping data was based primarily on multilocus sequence types (STs) and Staphylococcal Cassette Chromosome mec (SCCmec) types. We utilized the Phyloviz algorithm in the cluster analysis and categorization of the MRSA STs into various clonal complexes (CCs). Results We identified 65 studies and 26 publications from 16 of 54 (30%) African countries that provided sufficient genotyping data. MRSA with diverse staphylococcal protein A (spa) and SCCmec types in CC5 and CC8 were reported across the continent. The ST5-IV [2B] and ST8-IV [2B] were dominant clones in Angola and the Democratic Republic of Congo (DRC), respectively. Also, ST88-IV [2B] was widely distributed across the continent, particularly in three Portuguese-speaking countries (Angola, Cape Verde, and São Tomé and Príncipe). The ST80-IV [2B] was described in Algeria and Egypt, while the HA-ST239/ST241-III [3A] was only identified in Egypt, Ghana, Kenya, and South Africa. ST152-MRSA was documented in the DRC, Kenya, Nigeria, and South Africa. Panton-Valentine leukocidin (PVL)-positive MRSA was observed in several CCs across the continent. The median prevalence of PVL-positive MRSA was 33% (ranged from 0 to 77%; n = 15). Conclusion We observed an increase in the distribution of ST1, ST22, and ST152, but a decline of ST239/241 in Africa. Data on MRSA clones in Africa is still limited. There is a need to strengthen genomic surveillance capacity based on a "One-Health" strategy to prevent and control MRSA in Africa.
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Affiliation(s)
- Opeyemi Uwangbaoje Lawal
- Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa (ITQB-NOVA), Oeiras, Portugal
| | - Olaniyi Ayobami
- Unit for Healthcare-Associated Infections, Surveillance of Antimicrobial Resistance and Consumption, Robert Koch Institute, Berlin, Germany
| | - Alaa Abouelfetouh
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.,Department of Microbiology and Immunology, Faculty of Pharmacy, AlAlamein International University, Alalamein, Egypt
| | - Nadira Mourabit
- Biotechnology, Environmental Technology and Valorisation of Bio-Resources Team, Department of Biology, Faculty of Sciences and Techniques of Al Hoceima, Abdelmalek Essaadi University, Tetouan, Morocco
| | - Mamadou Kaba
- Division of Medical Microbiology, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Beverly Egyir
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Shima M Abdulgader
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
| | - Adebayo Osagie Shittu
- Department of Microbiology, Obafemi Awolowo University, Ile-Ife, Nigeria.,Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
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Othman AA, Hiblu MA, Abbassi MS, Abouzeed YM, Ahmed MO. Nasal colonization and antibiotic resistance patterns of Staphylococcus species isolated from healthy horses in Tripoli, Libya. J Equine Sci 2021; 32:61-65. [PMID: 34220273 PMCID: PMC8240523 DOI: 10.1294/jes.32.61] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/09/2021] [Indexed: 11/06/2022] Open
Abstract
The present study investigated the colonization rates and antimicrobial susceptibility of
Staphylococcus species isolated from the nostrils of healthy horses. A nonselective
laboratory approach was applied, followed by confirmation using a Phoenix automated
microbiological system. Among the 92 horses included in the study, 48.9% (45/92) carried
Staphylococcus species of mostly the coagulase-negative staphylococci (CoNS) type yielding
70 Staphylococcus strains. Of these strains, 37.1% (26/70; 24 CoNS and 2
coagulase-positive staphylococci; CoPS) were identified as methicillin-resistant
staphylococci (MRS) expressing significant resistance to important antimicrobial classes
represented mainly by subspecies of CoNS. This is the first study reporting a high
prevalence of various Staphylococcus species, particularly strains of CoNS expressing
multidrug resistance patterns of public health concern, colonizing healthy horses in
Libya.
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Affiliation(s)
- Aesha A Othman
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, P.O. Box 13362, Libya
| | - Murad A Hiblu
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Tripoli, P.O. Box 13662, Libya
| | - Mohamed Salah Abbassi
- University of Tunis El Manar, Institute of Veterinary Research of Tunisia, Tunis 1006, Tunisia
| | - Yousef M Abouzeed
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, P.O. Box 13362, Libya
| | - Mohamed O Ahmed
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, P.O. Box 13362, Libya
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Elnageh HR, Hiblu MA, Abbassi MS, Abouzeed YM, Ahmed MO. Prevalence and antimicrobial resistance of Staphylococcus species isolated from cats and dogs. Open Vet J 2020; 10:452-456. [PMID: 33614441 PMCID: PMC7830183 DOI: 10.4314/ovj.v10i4.13] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/01/2020] [Indexed: 01/25/2023] Open
Abstract
Background: Methicillin-resistant staphylococci (MRS) are an emerging global problem with serious public health concern. Aims: This study investigated the prevalence and antimicrobial susceptibility of commensal Staphylococcus species isolated from healthy and clinical cats and dogs. Methods: Nasal swab samples were collected from animals and processed using selective and semi-selective mediums. Presumptive isolates were subjected to biochemical testing and analyzed using the Phoenix automated identification and susceptibility testing system. PCRs protocols were used to screen for mecA and pvl genes. Results: In total, 151 pets (103 cats and 48 dogs) were enrolled, of which 14 dogs (29%) and 24 cats (23%) were colonized with various Staphylococcus species mainly originated from healthy animals. A total of 38 staphylococci isolates were collected and distributed between 24 coagulase-negative and 14 coagulase-positive staphylococci. Only 13 staphylococci strains were identified as MRS, out of which only five isolates expressed that the mecA gene exclusively originated from healthy pets. Conclusion: This is the first study reporting the prevalence and colonization status of staphylococci species and MRS strains isolated from cats and dogs in Libya. The study reports important information of medical and clinical importance on antimicrobial and multidrug resistance of different staphylococci strains, particularly the coagulase negative species.
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Affiliation(s)
- Hiam R Elnageh
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
| | - Murad A Hiblu
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
| | - Mohamed Salah Abbassi
- University of Tunis El Manar, Institute of Veterinary Research of Tunisia, Tunis, Tunisia
| | - Yousef M Abouzeed
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
| | - Mohamed O Ahmed
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
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Ahmed MO, Elramalli AK, Baptiste KE, Daw MA, Zorgani A, Brouwer E, Willems RJL, Top J. Whole Genome Sequence Analysis of the First Vancomycin-Resistant Enterococcus faecium Isolates from a Libyan Hospital in Tripoli. Microb Drug Resist 2020; 26:1390-1398. [PMID: 32181678 DOI: 10.1089/mdr.2019.0095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The purpose of the study was to investigate the molecular characteristics and genetic relatedness of the first reported cases of vancomycin-resistant enterococci (VRE) from the Tripoli Medical Center, Libya. In total, 43 VRE isolates were obtained from various clinical sites throughout the years 2013-2014, including 40 vanA-type and 2 vanB-type vancomycin-resistant Enterococcus faecium isolates and 1 vanC1-type Enterococcus gallinarum. Of the 42 E. faecium, 19 isolates were subjected to whole genome sequencing. Core genome multilocus sequence typing (cgMLST) analysis revealed three sequence clusters (SCs) of clonally related isolates, which were linked to different hospital wards. The first two VRE isolates, isolated early 2013 from patients in the medical intensive care unit, were grouped in SC1 (MLST [ST] 78, vanB) and differed in only 3 of 1423 cgMLST alleles. The SC2 (n = 16, special care baby unit, neonatal intensive care unit, pediatric surgery ward, and oncology ward) and SC3 (n = 1, antenatal ward) were all ST80 vanA-VRE, but the single SC3 isolate differed in 233 alleles compared with SC2. Within SC2, isolates differed in 1-23 alleles. Comparison with a larger database of E. faecium strains indicated that all isolates clustered within the previously defined hospital clade A1. A combination of Resfinder and mlplasmid analysis identified the presence of resistance genes on different plasmid predicted genetic elements among different SCs. In conclusion, this study documents the first isolates causing outbreaks with VRE in the Libyan health care system. Further surveillance efforts using molecular typing methods to monitor spread of multidrug-resistant bacteria in the Libyan health care system are urgently needed.
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Affiliation(s)
- Mohamed O Ahmed
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Tripoli, Libya
| | - Asma K Elramalli
- Department of Microbiology, Tripoli Medical Center, Tripoli, Libya
| | - Keith E Baptiste
- Department of Veterinary Medicine, Danish Medicines Agency, Copenhagen, Denmark
| | - Mohamed A Daw
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Abdulaziz Zorgani
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Ellen Brouwer
- Department of Medical Microbiology, UMCU, Utrecht, The Netherlands
| | - Rob J L Willems
- Department of Medical Microbiology, UMCU, Utrecht, The Netherlands
| | - Janetta Top
- Department of Medical Microbiology, UMCU, Utrecht, The Netherlands
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Mairi A, Touati A, Lavigne JP. Methicillin-Resistant Staphylococcus aureus ST80 Clone: A Systematic Review. Toxins (Basel) 2020; 12:toxins12020119. [PMID: 32075074 PMCID: PMC7076798 DOI: 10.3390/toxins12020119] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/05/2020] [Accepted: 02/11/2020] [Indexed: 01/09/2023] Open
Abstract
This review assessed the molecular characterization of the methicillin-resistant Staphylococcus aureus (MRSA)-ST80 clone with an emphasis on its proportion of total MRSA strains isolated, PVL production, spa-typing, antibiotic resistance, and virulence. A systematic review of the literature was conducted on MRSA-ST80 clone published between 1 January 2000 and 31 August 2019. Citations were chosen for a review of the full text if we found evidence that MRSA-ST80 clone was reported in the study. For each isolate, the country of isolation, the sampling period, the source of isolation (the type of infection, nasal swabs, or extra-human), the total number of MRSA strains isolated, number of MRSA-ST80 strains, antibiotic resistance patterns, PVL production, virulence genes, and spa type were recorded. The data from 103 articles were abstracted into an Excel database. Analysis of the data showed that the overall proportion of MRSA-ST80 has been decreasing in many countries in recent years. The majority of MRSA-ST80 were PVL positive with spa-type t044. Only six reports of MRSA-ST80 in extra-human niches were found. This review summarizes the rise of MRSA-ST80 and the evidence that suggests that it could be in decline in many countries.
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Affiliation(s)
- Assia Mairi
- Laboratoire d’Ecologie Microbienne, FSNV, Université de Bejaia, Bejaia 06000, Algeria; (A.M.); (A.T.)
| | - Abdelaziz Touati
- Laboratoire d’Ecologie Microbienne, FSNV, Université de Bejaia, Bejaia 06000, Algeria; (A.M.); (A.T.)
| | - Jean-Philippe Lavigne
- VBMI, INSERM U1047, Université de Montpellier, Service de Microbiologie et Hygiène Hospitalière, CHU Nîmes, 30029 Nîmes, France
- Correspondence: ; Tel.: +33-4666-832-02
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Dan M, Yehui W, Qingling M, Jun Q, Xingxing Z, Shuai M, Kuojun C, Jinsheng Z, Zibing C, Zaichao Z, Xuepeng C. Antimicrobial resistance, virulence gene profile and molecular typing of Staphylococcus aureus isolates from dairy cows in Xinjiang Province, northwest China. J Glob Antimicrob Resist 2019; 16:98-104. [DOI: 10.1016/j.jgar.2018.08.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 02/07/2023] Open
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Asadollahi P, Farahani NN, Mirzaii M, Khoramrooz SS, van Belkum A, Asadollahi K, Dadashi M, Darban-Sarokhalil D. Distribution of the Most Prevalent Spa Types among Clinical Isolates of Methicillin-Resistant and -Susceptible Staphylococcus aureus around the World: A Review. Front Microbiol 2018; 9:163. [PMID: 29487578 PMCID: PMC5816571 DOI: 10.3389/fmicb.2018.00163] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/24/2018] [Indexed: 12/25/2022] Open
Abstract
Background:Staphylococcus aureus, a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies. Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were “Staphylococcus aureus, spa typing.” Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95% of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence. Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution.
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Affiliation(s)
- Parisa Asadollahi
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narges Nodeh Farahani
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mirzaii
- Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyed Sajjad Khoramrooz
- Department of Microbiology, Faculty of Medicine, Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Alex van Belkum
- Data Analytics Unit, bioMérieux 3, La Balme Les Grottes, France
| | - Khairollah Asadollahi
- Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.,Faculty of Medicine, Biotechnology and Medicinal Plants Researches Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Masoud Dadashi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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