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Kami W, Baba M, Chinen T, Fujita J, Yamaguchi T. A case of refractory disseminated subcutaneous abscess with intrahousehold transmission by a USA300-LV-like strain of PVL-positive community-acquired MRSA clone. J Infect Chemother 2024:S1341-321X(24)00086-2. [PMID: 38508338 DOI: 10.1016/j.jiac.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/08/2024] [Accepted: 03/17/2024] [Indexed: 03/22/2024]
Abstract
A 44-year-old man with hypertension and dyslipidemia presented with pain in the buttocks. The patient was diagnosed with perianal ischiorectal fossa abscesses and cellulitis. He was subsequently diagnosed with a perineal subcutaneous abscess after a week, a right lower leg impetigo after a month, right periorchitis, a scrotal abscess, and Fournier's gangrene after two months. The patient was treated with various antimicrobials and underwent incisional drainage. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in all draining specimens. Her daughter and son, who lived with the patient, presented with subcutaneous abscesses caused by MRSA. Suspecting repeated infections and household infections by virulent types of MRSA, such as PVL-positive strains, we performed genetic analyses of his and his son's strains. The results showed that the genotype and toxin gene profiles [ST8/t008/SCCmec type IVc/Panton-Valentine leucocidin (PVL) (+)/arginine catabolic mobile element (ACME) (-)] of both strains matched. single nucleotide polymorphism (SNP) analysis confirmed genetic homology between the two, concluding that home transmission by the same clone had occurred. In addition, the strain in this case differed from USA300 [ST8/t008/SCCmec type IVa/PVL (+) ACME (+)], which is a PVL-positive MRSA worldwide, including Japan, and its genetic profile matches that of USA300-LV, which is detected mainly in South America. Furthermore, SNP analysis showed that this strain is similar to USA300-LV/J (derived from USA300-LV) detected on Ishigaki Island, Okinawa Prefecture, Japan. This is the first report of refractory infections and household transmission of USA300-LV/J. Therefore, it is necessary to closely monitor both the USA300 and the USA300-LV.
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Affiliation(s)
- Wakaki Kami
- Department of Respiratory Medicine, Ohama Dai-ichi Hospital, Okinawa, Japan; Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara Nishihara, Okinawa, 903-0215, Japan.
| | - Motoo Baba
- Department of Respiratory Medicine, Ohama Dai-ichi Hospital, Okinawa, Japan
| | - Tetsu Chinen
- Department of Respiratory Medicine, Ohama Dai-ichi Hospital, Okinawa, Japan
| | - Jiro Fujita
- Department of Respiratory Medicine, Ohama Dai-ichi Hospital, Okinawa, Japan
| | - Tetsuo Yamaguchi
- Department of Microbiology and Infectious Diseases, Faculty of Medicine, Toho University School of Medicine, Tokyo, Japan
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Ožegić O, Bedenić B, Sternak SL, Sviben M, Talapko J, Pažur I, Škrlec I, Segedi I, Meštrović T. Antimicrobial Resistance and Sports: The Scope of the Problem, Implications for Athletes' Health and Avenues for Collaborative Public Health Action. Antibiotics (Basel) 2024; 13:232. [PMID: 38534667 DOI: 10.3390/antibiotics13030232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Antimicrobial resistance (AMR) poses a global threat, leading to increased mortality and necessitating urgent action-however, its impact on athletes and the world of sports has hitherto been neglected. Sports environments (including athletic and aquatic) exhibit high levels of microbial contamination, potentially contributing to the spread of resistant microorganisms during physical activities. Moreover, the literature suggests that travel for sports events may lead to changes in athletes' gut microbiomes and potentially impact their antibiotic resistance profiles, raising questions about the broader implications for individual and public/global health. The prevalence of Staphylococcus aureus (S. aureus) among athletes (particularly those engaged in contact or collision sports) ranges between 22.4% and 68.6%, with MRSA strains being isolated in up to 34.9% of tested individuals. Factors such as training frequency, equipment sharing, delayed post-training showers, and a history of certain medical conditions are linked to higher colonization rates. Moreover, MRSA outbreaks have been documented in sports teams previously, highlighting the importance of implementing preventive measures and hygiene protocols in athletic settings. In light of the growing threat of AMR, there is a critical need for evidence-based treatment guidelines tailored to athletes' unique physiological demands to ensure responsible antibiotic use and mitigate potential health risks. While various initiatives-such as incorporating AMR awareness into major sporting events-aim to leverage the broad audience of sports to communicate the importance of addressing AMR, proactive measures (including improved AMR surveillance during large sporting events) will be indispensable for enhancing preparedness and safeguarding both athletes' and the general public's health. This narrative review thoroughly assesses the existing literature on AMR and antibiotic usage in the context of sports, aiming to illuminate areas where information may be lacking and underscoring the significance of promoting global awareness about AMR through sports.
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Affiliation(s)
- Ognjen Ožegić
- Department of Anaesthesiology, Intensive Medicine and Pain Management, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Branka Bedenić
- Medical Microbiology Department, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- BIMIS-Biomedical Research Center Šalata, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Sunčanica Ljubin Sternak
- Medical Microbiology Department, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Clinical Microbiology Department, Teaching Institute of Public Health "Dr Andrija Štampar", 10000 Zagreb, Croatia
| | - Mario Sviben
- Medical Microbiology Department, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Parasitology Department, Microbiology Service, Croatian National Institute of Public Health, 10000 Zagreb, Croatia
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Iva Pažur
- Department of Anaesthesiology, Intensive Medicine and Pain Management, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia
| | - Ivana Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Ivan Segedi
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Tomislav Meštrović
- University Centre Varaždin, University North, 42000 Varaždin, Croatia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
- Department for Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA 98195, USA
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Shinohara K, Uehara Y, Teruya K, Sasaki T, Baba T, Nakaminami H, Kananizadeh P, Morimoto Y, Kikuchi Y, Oka S. Emergence of community-associated methicillin-resistant Staphylococcus aureus ΨUSA300 among Japanese people with HIV, resulted from stepwise mutations in 2010s. Sci Rep 2023; 13:8322. [PMID: 37221358 DOI: 10.1038/s41598-023-35171-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/14/2023] [Indexed: 05/25/2023] Open
Abstract
Although infection with the methicillin-resistant Staphylococcus aureus (MRSA) clone USA300 is extremely rare in Japan, the uniquely evolved clone ΨUSA300 has been reported in Japan. An outbreak of a distinct USA300 clone was recently reported in an HIV/AIDS referral hospital in Tokyo. The present study investigated the evolutionary origin and genetic diversity of USA300-related clones causing regional outbreaks among people living with HIV (PLWHIV) in Tokyo. MRSA isolates collected from PLWHIV in an HIV/AIDS referral center in Tokyo were subjected to whole-genome sequencing and their genetic features were compared with those of previously described USA300 MRSA genomes. Of the 28 MRSAs isolated in 2016-2019, 23 (82.1%) were identified as USA300, with 22 (95.6%) of the latter identified as ΨUSA300. Although the genomic structure of ΨUSA300 was identical to the structures of reference USA300 strains, one clade (cluster A) was found to have acquired 29 previously identified lineage-specific mutations in a stepwise manner. The estimated divergence dates of ΨUSA300 and Cluster A were 2009 and 2012, respectively. These findings suggested that the ΨUSA300 clone had spread among PLWHIVs in Tokyo in the early 2010s, with stepwise acquisition of lineage-specific nonsynonymous mutations.
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Affiliation(s)
- Koh Shinohara
- AIDS Clinical Center, The National Center for Global Health and Medicine, Tokyo, Japan
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Uehara
- Department of Microbiology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
- Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
| | - Katsuji Teruya
- AIDS Clinical Center, The National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Sasaki
- Animal Research Center, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tadashi Baba
- Graduate School of Nursing, Seisen Jogakuin College, Nagano, Japan
| | - Hidemasa Nakaminami
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Pegah Kananizadeh
- Department of Microbiology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yuh Morimoto
- Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Yoshimi Kikuchi
- AIDS Clinical Center, The National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, The National Center for Global Health and Medicine, Tokyo, Japan
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Gleich S, Kiefer-Trendelenburg T, Schlatterer K, Napp M, Monecke S, Arnold A, Goering R, Strommenger B, Werner G, Daeschlein G. Community-associated Methicillin-Resistant Staphylococcus aureus (ca-MRSA) as a Pandemic Pathogen: Risk Factors and Implications for Healthcare. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1707-7083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Abstract
Background A diversity of risk factors for ca-MRSA manifestations has been described so far. Up to date toxic contact dermatitis induced by plants has not been identified as one.
Patients and Methods After intense skin contact with poison ivy in the US a 24-year-old Afro-American showed pronounced bullous contact dermatitis on the back of the neck and subsequently massive ca-MRSA furunculitis with proof of Panton-Valentin-leukocidin (PVL). After travelling to Germany, his German girlfriend developed a subacute ca-MRSA, PVL-positive superinfection of a mosquito bite at her lower leg. Both infections required surgical intervention.
Results While the male patient displayed contact dermatitis by poison ivy, the female patient demonstrated two risk factors for ca-MRSA: contact with a ca-MRSA positive person and a predisposing skin lesion. Both cases underpin the role of ca-MRSA transmission and the potential severeness of wound infections in young and immunocompetent persons, just to be resolved by invasive intervention.
Conclusions Marked and recalcitrant skin or soft tissue infections in otherwise healthy young patients require instant microbiological analysis and surgical intervention flanked by adequate antibiotic therapy. Contact dermatitis induced by plant toxins should be taken into consideration as possible risk factor for the acquisition of ca-MRSA.
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Affiliation(s)
- Sabine Gleich
- Referat für Gesundheit und Umwelt, Department of Hygiene and Environmental Medicine, München, Germany
| | - Thomas Kiefer-Trendelenburg
- Department of Hematology-Oncology, Rehabilitationszentrum für Innere Medizin, Klinik am See, Rüdersdorf, Germany
| | - Kathrin Schlatterer
- Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
- Institute of Laboratory Medicine, Sankt Gertrauden Krankenhaus, Berlin, Germany
| | - Matthias Napp
- Department of Surgery, Universität Greifswald, Greifswald, Germany
| | - Stefan Monecke
- Institute for Medical Microbiology and Hygiene, Technical University of Dresden, Dresden, Germany
| | - Andreas Arnold
- Department of Dermatology, Universität Greifswald, Greifswald, Germany
| | - Richard Goering
- Department of Medical Microbiology and Immunology, Creighton University Medical Center, School of Medicine, Omaha, USA
| | - Birgit Strommenger
- National Reference Laboratory of Staphylococci, Robert-Koch-Institute, Wernigerode, Germany
| | - Guido Werner
- National Reference Laboratory of Staphylococci, Robert-Koch-Institute, Wernigerode, Germany
| | - Georg Daeschlein
- Section Dermatological Infectiology, Department of Dermatology, Städtisches Klinikum Dessau, Brandenburg Medical School, Dessau, Germany
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Hirose M, Aung MS, Fukuda A, Yahata S, Fujita Y, Saitoh M, Hirose Y, Urushibara N, Kobayashi N. Antimicrobial Resistance and Molecular Epidemiological Characteristics of Methicillin-Resistant and Susceptible Staphylococcal Isolates from Oral Cavity of Dental Patients and Staff in Northern Japan. Antibiotics (Basel) 2021; 10:antibiotics10111316. [PMID: 34827254 PMCID: PMC8615198 DOI: 10.3390/antibiotics10111316] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022] Open
Abstract
The acquisition of drug resistance and virulence by staphylococcal species colonizing humans is a growing public health concern. The present study was conducted to investigate the prevalence, antimicrobial resistance and genetic characteristics of Staphylococcus isolates from the oral cavity and skin (hand) of systemically healthy subjects with dental disease and dental staff in northern Japan. Among a total of 133 subjects (91 patients and 42 staff), 87 coagulase-positive Staphylococcus (83 S. aureus/4 S. argenteus) and 162 coagulase-negative Staphylococcus (CoNS) isolates were recovered from 59 (44.4%) and 95 (71.4%) subjects, respectively. Three oral isolates were methicillin-resistant S. aureus (MRSA) (3.6%, 3/83) that were genotyped as ST8-SCCmec-IVl, ST4775(CC1)-SCCmec-IVa and ST6562(CC8)-SCCmec-IVa. Remarkably, the ST6562 isolate harbored PVL genes on ΦSa2usa and type I ACME (arginine catabolic mobile element). Four methicillin-susceptible isolates were identified as S. argenteus belonging to ST1223 and ST2250, which harbored enterotoxin genes egc-2 and sey, respectively. Among the fourteen CoNS species identified, methicillin-resistant (MR) isolates were detected in five species (11 isolates, 13.3% of CoNS), with S. saprophyticus and S. haemolyticus being the most common. ACME was prevalent in only S. epidermidis and S. capitis. These findings indicated the potential distribution of USA300 clone-like MRSA, toxigenic S. argenteus and MR-CoNS in the oral cavity of dental patients.
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Affiliation(s)
- Mina Hirose
- Division of Pediatric Dentistry, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu 061-0293, Japan; (M.H.); (A.F.); (S.Y.); (Y.F.); (M.S.)
| | - Meiji Soe Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (N.U.); (N.K.)
- Correspondence: ; Tel.: +81-11-611-2111
| | - Atsushi Fukuda
- Division of Pediatric Dentistry, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu 061-0293, Japan; (M.H.); (A.F.); (S.Y.); (Y.F.); (M.S.)
| | - Shoko Yahata
- Division of Pediatric Dentistry, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu 061-0293, Japan; (M.H.); (A.F.); (S.Y.); (Y.F.); (M.S.)
| | - Yusuke Fujita
- Division of Pediatric Dentistry, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu 061-0293, Japan; (M.H.); (A.F.); (S.Y.); (Y.F.); (M.S.)
| | - Masato Saitoh
- Division of Pediatric Dentistry, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu 061-0293, Japan; (M.H.); (A.F.); (S.Y.); (Y.F.); (M.S.)
| | - Yukito Hirose
- Division of Fixed Prosthodontics and Oral Implantology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu 061-0293, Japan;
| | - Noriko Urushibara
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (N.U.); (N.K.)
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; (N.U.); (N.K.)
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Noguchi N. [Antimicrobial Resistance and Infection Control for Gram-positive Bacteria]. YAKUGAKU ZASSHI 2021; 141:235-244. [PMID: 33518644 DOI: 10.1248/yakushi.20-00225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Antimicrobial resistance (AMR) is a serious problem worldwide. We searched for the AMR determinants of various bacteria isolated from clinical settings and studied their resistance mechanisms and molecular epidemiology. This review focuses on the AMR of Staphylococcus aureus, a major gram-positive pathogen, which has the ability to acquire resistance to antimicrobials. The resistance factors of S. aureus are frequently found on mobile elements, including plasmids and transposons. We determined the complete DNA sequence of the tetracycline-resistance plasmid and found that the inducible expression of tetK in S. aureus was regulated by a post-transcriptional attenuation mechanism. Furthermore, outbreaks of methicillin-resistant S. aureus (MRSA) in hospitals and communities have led us to study infection controls, including the antiseptic susceptibility evaluation and molecular epidemiology of MRSA. Various antiseptic resistance determinants, such as qacA/B and smr, were identified on plasmids and characterized. We demonstrated that the plasmid-mediated efflux pump QacB variant QacIII confers fluoroquinolone efflux ability to S. aureus. Studies on MRSA epidemiology had shown that community-acquired MRSA (CA-MRSA) was disseminated into hospitals and that an increased use of alcohol-based rubs could reduce the incidence of MRSA infections in such institutions. Additionally, the study of CA-MRSA collected from communities and hospitals showed an increase in Panton-Valentine leucocidin (PVL)-positive CA-MRSA, causing severe skin and soft tissue infections. Moreover, various PVL-positive CA-MRSA clones have disseminated in Japan, whereas the USA300 LV/J clone evolved in that country. Our study provides important information regarding MRSA infection control.
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Affiliation(s)
- Norihisa Noguchi
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences
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