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El Aila NA, Al Laham NA, Naas T. Prevalence of mecA and Panton-Valentine Leukocidin Genes in Staphylococcus aureus Clinical Isolates from Gaza Strip Hospitals. Microorganisms 2023; 11:1155. [PMID: 37317129 DOI: 10.3390/microorganisms11051155] [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: 01/17/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 06/16/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) are spreading worldwide in hospital and community settings, thus posing a serious public health problem. Panton-Valentine Leukocidin (PVL), an important virulence factor of S. aureus, is a marker of community-acquired MRSA. Here we determined the prevalence of pvl genes among S. aureus isolates from different hospitals in the Gaza Strip, Palestine. A total of 285 S. aureus isolates were collected from five different hospitals in the Gaza Strip. All isolates were characterized for their susceptibility patterns to available antimicrobial agents and by using multiplex PCR for the detection of mecA and pvl genes. The overall prevalence of MRSA in Gaza hospitals was 70.2% (range: 76.3% to 65.5%) and that of pvl among S. aureus isolates was 29.8% (range: 32.9% to 26.2%). The pvl gene was equally prevalent among MRSA isolates (30.5%) and MSSA isolates (28.2%). The most effective antibiotics were rifampicin, vancomycin, and clindamycin, with susceptibility rates of 91.2%, 88.7%, and 84.6%, respectively. The highest percentage of strains were observed to be resistant to penicillin and amoxicillin with clavulanic acid-96.1% and 73.6%, respectively. Our results showed a high prevalence of MRSA and pvl-positive isolates in Gaza Strip hospitals, which likely reflects the situation in the community. It is mandatory to implement systematic surveillance of both hospital and community isolates, together with interventions (such as increased hand hygiene, use of hydroalcoholic solutions, and isolation of carriers) to limit their spread.
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Affiliation(s)
- Nabil Abdullah El Aila
- Department of Medical Laboratory Sciences, Faculty of Medical Sciences, Al-Aqsa University Gaza, Gaza P.O. Box 405, Palestine
| | - Nahed Ali Al Laham
- Department of Laboratory Medicine, Faculty of Medical Sciences, Al-Azhar University-Gaza, Gaza P.O. Box 1277, Palestine
| | - Thierry Naas
- Bacteriology-Hygiene Unit, Hôpital Bicêtre, AP-HP Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
- Faculty of Medicine, Team ReSIST, UMR1184, INSERM, CEA, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
- French National Reference Center for Antimicrobial Resistances, Hôpital Bicêtre, AP-HP Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
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Molecular Characteristics and Distribution of Virulence Genes among Staphylococcus aureus Complex Isolates Derived from Vascular Access Infections. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:3196545. [PMCID: PMC9616667 DOI: 10.1155/2022/3196545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
Abstract
Staphylococcus aureus is a major human pathogen that produces various virulence factors which promote the binding of bacteria to tissues and medical devices such as vascular access devices, thereby developing a wide range of invasive infections. Vascular access serves as an entry site for S. aureus and elevates the risk of infection in the hemodialysis population. Nevertheless, the distribution of virulence genes in Staphylococcus spp. associated with vascular access infections (VAIs) has not been studied previously. In this study, we determined the relationship between the molecular characteristics and virulence profiles of S. aureus isolates obtained from VAIs. We collected isolates from patients with VAIs between August 2017 and December 2020 and further analyzed the molecular characteristics, antimicrobial resistance profiles, and virulence gene distribution in the isolates. Overall, 15 sequence types (STs), including a new ST (ST6892) and 19 spa types, were identified among the 56 isolates. Of the 53 S. aureus isolates, ST8, ST239, ST45, and ST59 were the predominant STs, whereas ST2250 was the only ST in 3 S. argenteus isolates. ST45-SCCmecIV-t026 (abbreviated as ST45-IV-t026), ST59-V-t437, and ST8-IV-t008 were the predominant clones that belonged to agr type I. All isolates harbored clfB and eno, whereas all S. aureus isolates harbored clfA. In addition, 10 Panton-Valentine leucocidin-positive isolates belonged to ST8 and ST59, with ST8-IV-t008 and ST59-V-t437 being the predominant clones. In brief, the distribution of virulence genes associated with STs may assist in the spread of molecular types of Staphylococcus spp.
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Yueh CM, Chi H, Chiu NC, Huang FY, Tsung-Ning Huang D, Chang L, Kung YH, Huang CY. Etiology, clinical features, management, and outcomes of skin and soft tissue infections in hospitalized children: A 10-year review. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2022; 55:728-739. [PMID: 35283045 DOI: 10.1016/j.jmii.2022.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/25/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE This study aimed to describe the etiology, clinical features, hospital course, and outcomes of hospitalized children with skin and soft tissue infections (SSTIs) and to test if clinical and laboratory variables at admission could differentiate between community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) and community-acquired methicillin-sensitive S. aureus (CA-MSSA). METHODS We reviewed the clinical, laboratory, treatment, and outcome data for children hospitalized with SSTIs, aged 0-18 years at MacKay Children's Hospital between 2010 and 2019. Multivariable logistic regression was used to identify independent predictors of CA-MRSA and CA-MSSA SSTIs. RESULTS A total of 1631 patients were enrolled. Erysipelas/cellulitis (73.8%) was the most common pediatric SSTI type, followed by acute lymphadenitis (13.6%) and abscess/furuncle/carbuncle (8.6%). Among the 639 culture-positive isolates (purulent SSTIs), 142 (22.2%) were CA-MSSA and 363 (56.8%) were CA-MRSA. The age group 0-1 month (OR, 6.52; 95% CI 1.09-38.92; P = 0.04) and local lymph node reaction (OR, 2.47; 95% CI 1.004-6.08; P = 0.049) were independent factors for differentiating children with CA-MSSA from those with CA-MRSA SSTIs. MRSA isolates in our cohort were highly susceptible to glycopeptides (100%), linezolid (100%), daptomycin (100%), and sulfamethoxazole/trimethoprim (98.6%) but were significantly less susceptible to clindamycin compared with MSSA (34.2% vs. 78.2%, P < 0.001). CONCLUSION S. aureus is the leading pathogen of culture-proven SSTIs in hospitalized children with MRSA accounting for more than half. Determining the optimal empirical antibiotics in CA-SSTIs may rely on the patient's age, disease severity, and local epidemiologic data.
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Affiliation(s)
- Chih-Ming Yueh
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Pediatrics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei, Taiwan
| | - Hsin Chi
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Fu-Yuan Huang
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan
| | - Daniel Tsung-Ning Huang
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan
| | - Lung Chang
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Hsin Kung
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan
| | - Ching-Ying Huang
- Department of Pediatrics, MacKay Children's Hospital and MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan.
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Amin DHM, Guler E, Baddal B. Prevalence of Panton-Valentine leukocidin in methicillin-resistant Staphylococcus aureus clinical isolates at a university hospital in Northern Cyprus: a pilot study. BMC Res Notes 2020; 13:490. [PMID: 33081819 PMCID: PMC7576721 DOI: 10.1186/s13104-020-05339-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/14/2020] [Indexed: 11/17/2022] Open
Abstract
Objective Panton-Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) is a healthcare problem worldwide. There are no reports on the virulence characteristics of MRSA in Northern Cyprus (NC). This study aimed to determine the presence of pvl among MRSA isolates from patients admitted to a university hospital in NC using molecular methods. Fifty S. aureus strains were included in this study. BD Phoenix automated identification system was used for bacterial identification and antibiotic susceptibility testing. Methicillin resistance was confirmed by disc diffusion assay. Presence of nuc and mecA genes was tested by multiplex PCR. Detection of pvl gene was performed by single-target PCR. Results Out of 50 S. aureus isolates identified as MRSA by BD Phoenix system, 3 were susceptible to cefoxitin with disc diffusion assay and were confirmed as methicillin-sensitive S. aureus (MSSA). All isolates (n = 50, 100%) tested positive for the presence nuc gene and 68% (n = 34/50) were mecA positive. pvl was detected in 27.7% (n = 13/47) of the MRSA isolates. Among PVL-positive MRSA isolates, 69.2% (9/13) were inpatients. PVL-MRSA was more common in isolates from deep tracheal aspirate (30.8%, 4/13) and abscess/wound (23.1%, 3/13). This represents the first study of PVL presence among MRSA in hospital setting in NC.
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Affiliation(s)
- Danyar Hameed M Amin
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Cyprus
| | - Emrah Guler
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Cyprus
| | - Buket Baddal
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Cyprus. .,Microbial Pathogenesis Research Group, DESAM Institute, Near East University, 99138, Nicosia, Cyprus.
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Rimoldi SG, Pileri P, Mazzocco MI, Romeri F, Bestetti G, Calvagna N, Tonielli C, Fiori L, Gigantiello A, Pagani C, Magistrelli P, Sartani A, De Silvestri A, Gismondo MR, Cetin I. The Role of Staphylococcus aureus in Mastitis : A Multidisciplinary Working Group Experience. J Hum Lact 2020; 36:503-509. [PMID: 31593644 DOI: 10.1177/0890334419876272] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Breastfeeding women are at risk of developing mastitis during the lactation period. Staphylococcus aureus has emerged as the community-acquired pathogen responsible for virulence (methicillin resistance and Panton-Valentine leukocidin toxin producing). RESEARCH AIM The aim was to compare the microorganisms responsible for mastitis and breast abscesses during breastfeeding. METHODS This observational study was conducted with a sample of women (N = 60) admitted to our hospital between 2016 and 2018. Participants affected by mastitis and breast abscess were studied and cared for by a multidisciplinary working group. A diagnostic breast ultrasound identified the pathology. RESULTS Twenty-six participants (43.3%) were affected by mastitis and 34 (56.7%) by breast abscess. The most common microorganism identified was Staphylococcus aureus (S. aureus; mastitis, n = 13; abscesses, n = 24). Methicillin resistance was identified in 21 (44.7%) S. aureus strains: 17 (80.9%) cases of abscess and four (19.1%) cases of mastitis. The median number of months of breastfeeding was smaller in the methicillin-resistant S. aureus (MRSA) cases (median = 3, range = 1-20 months) than in the methicillin-sensitive S. aureus (MSSA) cases (median = 6.5, range = 3-21 months). The Panton-Valentine leukocidin toxin gene was detected in 12 (25.5%) cases (MRSA, n = 8, 66.7%; MSSA, n = 4, 33.3%). Hospitalization was required more frequently in MRSA (n = 8, 38%; five Panton-Valentine leukocidin positive) than in MSSA cases (n = 5, 19%; one Panton-Valentine leukocidin positive). Four women out of the eight MRSA cases (50%) that were Panton-Valentine leukocidin positive stopped breastfeeding during mammary pathologies, three (37.5%) participants continued breastfeeding until the follow-up recall, and one case was lost at follow-up. CONCLUSION Clinical severity was probably complicated by the presence of the Panton-Valentine leukocidin toxin, which required hospitalization more frequently.
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Affiliation(s)
| | - Paola Pileri
- 472674 ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | | | - Francesca Romeri
- 472674 ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | | | | | - Claudia Tonielli
- 472674 ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Lorenza Fiori
- 472674 ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Anna Gigantiello
- 472674 ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | - Cristina Pagani
- 472674 ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
| | | | | | | | | | - Irene Cetin
- 472674 ASST Fatebenefratelli Sacco-Polo Universitario, Milan, Italy
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Darboe S, Dobreniecki S, Jarju S, Jallow M, Mohammed NI, Wathuo M, Ceesay B, Tweed S, Basu Roy R, Okomo U, Kwambana-Adams B, Antonio M, Bradbury RS, de Silva TI, Forrest K, Roca A, Lawal BJ, Nwakanma D, Secka O. Prevalence of Panton-Valentine Leukocidin (PVL) and Antimicrobial Resistance in Community-Acquired Clinical Staphylococcus aureus in an Urban Gambian Hospital: A 11-Year Period Retrospective Pilot Study. Front Cell Infect Microbiol 2019; 9:170. [PMID: 31192162 PMCID: PMC6540874 DOI: 10.3389/fcimb.2019.00170] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/06/2019] [Indexed: 11/13/2022] Open
Abstract
Background:Staphylococcus aureus is a major human pathogen. Panton-Valentine leukocidin (PVL) is a virulence factor produced by some strains that causes leukocyte lysis and tissue necrosis. PVL-associated S. aureus (PVL-SA) predominantly causes skin and soft-tissue infections (SSTIs) but can also cause invasive infections such as necrotizing pneumonia. It is carried by both community-associated methicillin susceptible S. aureus (CA-MSSA) and methicillin resistant S. aureus (CA-MRSA). This study aims to determine the prevalence of PVL-SA among patients seen at an urban Gambian hospital and associated antibiotic resistance. Methods: Archived clinical S. aureus (70 invasive bacteraemia and 223 non-invasive SSTIs) from 293 patients were retrieved as well as relevant data from clinical records where available. Antibiotic susceptibility was assessed using disc diffusion according to Clinical Laboratory Standards Institute (CLSI) guidelines. Genomic DNA was extracted and the presence of lukF and lukS PVL genes was detected by conventional gel-based PCR. Result: PVL-SA strains accounted for 61.4% (180/293) of S. aureus isolates. PVL prevalence was high in both Gambian bacteraemia and SSTIs S. aureus strains. Antimicrobial resistance was low and included chloramphenicol (4.8%), cefoxitin (2.4%), ciprofloxacin (3.8%), erythromycin (8.9%), gentamicin (5.5%) penicillin (92.5%), tetracycline (41.0%), and sulfamethoxazole-trimethoprim (24.2%). There was no association of PVL with antimicrobial resistance. Conclusion: PVL expression is high among clinical S. aureus strains among Gambian patients. Reporting of PVL-SA clinical infections is necessary to enable the monitoring of the clinical impact of these strains in the population and guide prevention of the spread of virulent PVL-positive CA-MRSA strains. SUMMARY Staphylococcus aureus (S. aureus) is a major human pathogen with several virulence factors. We performed a retrospective analysis to investigate the prevalence of one such virulence factor (PVL) amongst clinical S. aureus samples. We found a high prevalence in our setting but antimicrobial resistance including methicillin resistance was low.
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Affiliation(s)
- Saffiatou Darboe
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | | | - Sheikh Jarju
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Mamadou Jallow
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Nuredin Ibrahim Mohammed
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Miriam Wathuo
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Buntung Ceesay
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Sam Tweed
- The School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Robindra Basu Roy
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Uduak Okomo
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Brenda Kwambana-Adams
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Martin Antonio
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Richard S. Bradbury
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Thushan I. de Silva
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Karen Forrest
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Anna Roca
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Bolarinde Joseph Lawal
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Davis Nwakanma
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
| | - Ousman Secka
- Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia
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Chen YJ, Chen PA, Chen CJ, Huang YC. Molecular characteristics and clinical features of pediatric methicillin-susceptible Staphylococcus aureus infection in a medical center in northern Taiwan. BMC Infect Dis 2019; 19:402. [PMID: 31077140 PMCID: PMC6509804 DOI: 10.1186/s12879-019-4033-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 04/26/2019] [Indexed: 01/03/2023] Open
Abstract
Background There have been no reports regarding clinical features and molecular characteristics of childhood methicillin-susceptible Staphylococcus aureus (MSSA) infections in Taiwan. Methods We prospectively collected clinical S. aureus isolates from patients aged < 18 years in a university-affiliated hospital in 2015. Only the first isolate from each patient was included. Medical records were retrospectively reviewed. Patients were classified as community-associated (CA) or healthcare-associated (HA) by the epidemiologic criteria. All MSSA isolates were molecularly characterized. Results A total of 495 S. aureus isolates were identified, and 178 (36.0%) were MSSA. Among the 131 MSSA-infected patients enrolled, 94 (71.8%) were community-associated and 60 (45.8%) were inpatients. Patients with HA infections was significantly younger than those with CA infections (median, 15 vs. 67.5 months). The most common specimen of MSSA identified was pus or wound (73.3%). Compared to HA-MSSA, CA-MSSA isolates were significantly less frequently from sputum (6.4% vs. 27%, p = 0.001). Nineteen pulsotypes were identified. Four pulsotypes accounted for 60% of the isolates. Isolates of ST15/pulsotype F were more frequently seen in CA than in HA (p = 0.064) while isolates of ST188/pulsotype AX frequently seen in HA (p = 0.049). PVL genes were identified in 11 isolates (8.4%), nine of which were characterized as ST59/pulsotype D, same as the local endemic CA-MRSA clone. Conclusions MSSA accounted for around one-third of childhood S. aureus infections in northern Taiwan. SSTI was the most common manifestation. The molecular characteristics of these clinical MSSA isolates were relatively diverse and had certain significant differences between CA and HA isolates.
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Affiliation(s)
- Yu-Jen Chen
- School of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan
| | - Po-An Chen
- School of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan
| | - Chih-Jung Chen
- School of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan.,Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, No. 5, Fu-Shin Street, Kweishan, 333, Taoyuan, Taiwan
| | - Yhu-Chering Huang
- School of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan. .,Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, No. 5, Fu-Shin Street, Kweishan, 333, Taoyuan, Taiwan.
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Remitting infections due to community-acquired Panton–Valentine leukocidin-producing Staphylococcus aureus in the Milan area. J Infect Public Health 2018; 11:255-259. [DOI: 10.1016/j.jiph.2017.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 07/03/2017] [Accepted: 08/04/2017] [Indexed: 11/18/2022] Open
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Vubil D, Garrine M, Ruffing U, Acácio S, Sigaúque B, Alonso PL, von Müller L, Herrmann M, Mandomando I. Molecular Characterization of Community Acquired Staphylococcus aureus Bacteremia in Young Children in Southern Mozambique, 2001-2009. Front Microbiol 2017; 8:730. [PMID: 28522992 PMCID: PMC5415612 DOI: 10.3389/fmicb.2017.00730] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 04/07/2017] [Indexed: 01/15/2023] Open
Abstract
Background: The emergence of community-acquired Staphylococcus aureus infections is increasingly recognized as life threating problem worldwide. In Manhiça district, southern Mozambique, S. aureus is the leading cause of community-acquired bacteremia in neonates. Methods: Eighty-four S. aureus isolates from children less than 5 years admitted to Manhiça District Hospital from 2001 to 2009 were randomly selected and genetically characterized by DNA microarray and spa typing. Antimicrobial susceptibility was determined by VITEK 2. Results: Thirty-eight different spa types and 14 clonal complexes (CC) were identified. Spa-type t084 (n = 10; 12%) was the most predominant while CC8 (n = 18; 21%) and CC15 (n = 14; 16%) were the most frequent CCs. Mortality tended to be higher among children infected with CC45 (33.3%, 1/3) and CC8 (27.8%, 5/18). The majority of isolates possessed the accessory gene regulator I (45%) and belonged to either capsule type 8 (52%) or 5 (47%). Panton valentine leukocidin (PVL) encoding genes were detected in 30%. Antibiotic resistance was high for penicillin (89%), tetracycline (59%) and Trimethoprim Sulfamethoxazole (36%) while MRSA was uncommon (8%). Conclusions: Although MRSA were uncommon, we found high genetic diversity of methicillin susceptible S. aureus causing bacteremia in Mozambican children, associated with high resistance to the most available antibiotics in this community. Some CCs are likely to be more lethal indicating the need for prompt recognition and appropriate treatment.
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Affiliation(s)
- Delfino Vubil
- Centro de Investigação em Saúde de Manhiça (CISM)Maputo, Mozambique
| | | | - Ulla Ruffing
- Institute of Medical Microbiology and Hygiene, University of SaarlandHomburg, Germany
| | - Sozinho Acácio
- Centro de Investigação em Saúde de Manhiça (CISM)Maputo, Mozambique.,Instituto Nacional de Saúde (INS), Ministério da SaúdeMaputo, Mozambique
| | - Betuel Sigaúque
- Centro de Investigação em Saúde de Manhiça (CISM)Maputo, Mozambique.,Instituto Nacional de Saúde (INS), Ministério da SaúdeMaputo, Mozambique
| | - Pedro L Alonso
- Centro de Investigação em Saúde de Manhiça (CISM)Maputo, Mozambique.,Barcelona Institute of Global HealthBarcelona, Spain
| | - Lutz von Müller
- Institute of Medical Microbiology and Hygiene, University of SaarlandHomburg, Germany
| | - Mathias Herrmann
- Institute of Medical Microbiology and Hygiene, University of SaarlandHomburg, Germany
| | - Inácio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM)Maputo, Mozambique.,Instituto Nacional de Saúde (INS), Ministério da SaúdeMaputo, Mozambique
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Sowash MG, Uhlemann AC. Community-associated methicillin-resistant Staphylococcus aureus case studies. Methods Mol Biol 2014; 1085:25-69. [PMID: 24085688 DOI: 10.1007/978-1-62703-664-1_2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Over the past decade, the emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has changed the landscape of S. aureus infections around the globe. Initially recognized for its ability to cause disease in young and healthy individuals without healthcare exposures as well as for its distinct genotype and phenotype, this original description no longer fully encompasses the diversity of CA-MRSA as it continues to expand its niche. Using four case studies, we highlight a wide range of the clinical presentations and challenges of CA-MRSA. Based on these cases we further explore the globally polygenetic background of CA-MRSA with a special emphasis on generally less characterized populations.
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Affiliation(s)
- Madeleine G Sowash
- Division of Infectious Diseases, Department of Medicine, College of Physicians & Surgeons, Columbia University, New York, NY, USA
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11
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Yu F, Liu Y, Xu Y, Shang Y, Lou D, Qin Z, Parsons C, Zhou W, Huang X, Li Y, Hu L, Wang L. Expression of Panton-Valentine leukocidin mRNA among Staphylococcus aureus isolates associates with specific clinical presentations. PLoS One 2013; 8:e83368. [PMID: 24349495 PMCID: PMC3861483 DOI: 10.1371/journal.pone.0083368] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 11/02/2013] [Indexed: 11/19/2022] Open
Abstract
Panton-Valentine leukocidin (PVL; gene designation lukF/S-PV) is likely an important virulence factor for Staphylococcus aureus (S. aureus), as qualitative expression of the protein correlates with severity for specific clinical presentations, including skin and soft tissue infections (SSTIs). Development of genetic approaches for risk-assessment of patients with S. aureus infections may prove clinically useful, and whether lukF/S-PV gene expression correlates with specific clinical presentations for S. aureus has been largely unexplored. In the present study, we quantified lukS-PV mRNA among 96 S. aureus isolates to determine whether expression levels correlated with specific clinical presentations in adults and children. Expression level of lukS-PV mRNA among isolates from skin and soft tissue infections (SSTIs) was significantly greater than among isolates from blood stream infection (BSIs), and expression level of lukS-PV mRNA among BSI isolates from children was significantly greater than for BSI isolates among adults. Moreover, expression level of lukS-PV mRNA among community-acquired (CA) isolates was significantly greater than for hospital-acquired (HA) isolates. These data justify additional studies to determine the potential clinical utility for lukS-PV mRNA quantification as a predictive tool for severity of S. aureus infection.
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Affiliation(s)
- Fangyou Yu
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou, Medical University, Wenzhou, Zhejiang, China
| | - Ying Liu
- Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuanyuan Xu
- Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yongpeng Shang
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou, Medical University, Wenzhou, Zhejiang, China
| | - Danping Lou
- Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhiqiang Qin
- Departments of Medicine and Microbiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Chris Parsons
- Departments of Medicine and Microbiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Wu Zhou
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou, Medical University, Wenzhou, Zhejiang, China
| | - Xiaoying Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuping Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Longhua Hu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Liangxing Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail:
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12
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Montagnani C, Cocchi P, Bianchi L, Resti M, de Martino M, Galli L. Severe infections caused by Panton-Valentine leukocidin-positive Staphylococcus aureus in infants: report of three cases and review of literature. Acta Paediatr 2013; 102:e284-7. [PMID: 23551699 DOI: 10.1111/apa.12225] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 02/25/2013] [Accepted: 02/28/2013] [Indexed: 12/11/2022]
Abstract
UNLABELLED We report three cases of severe infections in infants caused by Panton-Valentine leukocidin positive Staphylococcus aureus and evolved with a positive outcome. The literature of Panton-Valentine leukocidin positive Staphylococcus aureus infections in infants is reviewed. CONCLUSION Our findings suggest that a prompt identification of Panton-Valentine leukocidin positive Staphylococcus aureus and an appropriate therapy can reduce mortality and long-term sequelae. Further research is needed to specify features of Panton-Valentine leukocidin positive Staphylococcus aureus infections in infants.
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Affiliation(s)
- Carlotta Montagnani
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Priscilla Cocchi
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Leila Bianchi
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Massimo Resti
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Maurizio de Martino
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Luisa Galli
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
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