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Mogoi NN, Sifuna AW, Okoth PK, Reva O, Malaba R, Negesa R, Nyongesa KP, Osoro KE, Welch M. Staphylococcus aureus associated with surgical site infections in Western Kenya reveals genomic hotspots for pathogen evolution. Access Microbiol 2024; 6:000734.v4. [PMID: 39045253 PMCID: PMC11261728 DOI: 10.1099/acmi.0.000734.v4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 06/03/2024] [Indexed: 07/25/2024] Open
Abstract
Objectives. Staphylococcus aureus is one of the most common pathogens attributed to hospital infections. Although S. aureus infections have been well studied in developed countries, far less is known about the biology of the pathogen in sub-Saharan Africa. Methods. Here, we report on the isolation, antibiotic resistance profiling, whole genome sequencing, and genome comparison of six multi-drug resistant isolates of S. aureus obtained from a referral hospital in Kakamega, Western Kenya. Results. Five of the six isolates contained a 20.7 kb circular plasmid carrying blaZ (associated with resistance to β-lactam antibiotics). These five strains all belonged to the same sequence type, ST152. Despite the similarity of the plasmid in these isolates, whole genome sequencing revealed that the strains differed, depending on whether they were associated with hospital-acquired or community-acquired infections. Conclusion. The intriguing finding is that the hospital-acquired and the community-acquired isolates of S. aureus belonging to the same genotype, ST152, formed two separate sub-clusters in the phylogenetic tree and differed by the repertoire of accessory virulence genes. These data suggest ongoing adaptive evolution and significant genomic plasticity.
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Affiliation(s)
- Nyabera Nicholas Mogoi
- Department of Biological sciences, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Anthony Wawire Sifuna
- Department of Medical Biochemistry, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Patrick Kirsteen Okoth
- Department of Biological sciences, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Oleg Reva
- Department of Biochemistry, Genetics and Microbiology, Centre For Bioinformatics And Computational Biology, University of Pretoria, Pretoria, South Africa
| | - Rose Malaba
- Kakamega County General Teaching and Referral Hospital, Kakamega, Kenya
| | - Ruth Negesa
- Kakamega County General Teaching and Referral Hospital, Kakamega, Kenya
| | - Kuloba Peter Nyongesa
- Department of Medical Microbiology and Parasitology, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Kombo Ezra Osoro
- Department of Medical Biochemistry, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Martin Welch
- Department of Biochemistry, University of Cambridge, Cambridge, UK
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2
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André C, Van Camp AG, Ung L, Gilmore MS, Bispo PJM. Characterization of the resistome and predominant genetic lineages of Gram-positive bacteria causing keratitis. Antimicrob Agents Chemother 2024; 68:e0124723. [PMID: 38289077 PMCID: PMC10916405 DOI: 10.1128/aac.01247-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/03/2023] [Indexed: 02/04/2024] Open
Abstract
Bacterial keratitis is a vision-threatening infection mainly caused by Gram-positive bacteria (GPB). Antimicrobial therapy is commonly empirical using broad-spectrum agents with efficacy increasingly compromised by the emergence of antimicrobial resistance. We used a combination of phenotypic tests and genome sequencing to identify the predominant lineages of GPB causing keratitis and to characterize their antimicrobial resistance patterns. A total of 161 isolates, including Staphylococcus aureus (n = 86), coagulase-negative staphylococci (CoNS; n = 34), Streptococcus spp. (n = 34), and Enterococcus faecalis (n = 7), were included. The population of S. aureus isolates consisted mainly of clonal complex 5 (CC5) (30.2%). Similarly, the population of Staphylococcus epidermidis was homogenous with most of them belonging to CC2 (78.3%). Conversely, the genetic population of Streptococcus pneumoniae was highly diverse. Resistance to first-line antibiotics was common among staphylococci, especially among CC5 S. aureus. Methicillin-resistant S. aureus was commonly resistant to fluoroquinolones and azithromycin (78.6%) and tobramycin (57%). One-third of the CoNS were resistant to fluoroquinolones and 53% to azithromycin. Macrolide resistance was commonly caused by erm genes in S. aureus, mphC and msrA in CoNS, and mefA and msr(D) in streptococci. Aminoglycoside resistance in staphylococci was mainly associated with genes commonly found in mobile genetic elements and that encode for nucleotidyltransferases like ant(4')-Ib and ant(9)-Ia. Fluroquinolone-resistant staphylococci carried from 1 to 4 quinolone resistance-determining region mutations, mainly in the gyrA and parC genes. We found that GPB causing keratitis are associated with strains commonly resistant to first-line topical therapies, especially staphylococcal isolates that are frequently multidrug-resistant and associated with major hospital-adapted epidemic lineages.
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Affiliation(s)
- Camille André
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Infectious Disease Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew G. Van Camp
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Lawson Ung
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Infectious Disease Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael S. Gilmore
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Infectious Disease Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Paulo J. M. Bispo
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Infectious Disease Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
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3
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Jackson JK, Kennedy SJ, Felton EA, Cella E, Lima A, Becker D, Silbert S, Kim K, Azarian T, Shaw LN. Draft genome sequence of a highly proteolytic Staphylococcus aureus USA300 isolate from human urine. Microbiol Resour Announc 2023; 12:e0067923. [PMID: 37933968 PMCID: PMC10720404 DOI: 10.1128/mra.00679-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/29/2023] [Indexed: 11/08/2023] Open
Abstract
The secreted proteases of Staphylococcus aureus have been shown to be critical during infection. Here, we present the draft genome sequence of S. aureus TGH337, a hyper-proteolytic USA300 strain isolated from human urine.
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Affiliation(s)
- Jessica K. Jackson
- Department of Molecular Biosciences, University of South Florida, Tampa, Florida, USA
| | - Sarah J. Kennedy
- Department of Molecular Biosciences, University of South Florida, Tampa, Florida, USA
| | - Emily A. Felton
- Department of Molecular Biosciences, University of South Florida, Tampa, Florida, USA
| | - Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, USA
| | - Amorce Lima
- Esoteric Testing/R&D Laboratory, Tampa General Hospital, Tampa, Florida, USA
| | - Deanna Becker
- Esoteric Testing/R&D Laboratory, Tampa General Hospital, Tampa, Florida, USA
| | - Suzane Silbert
- Esoteric Testing/R&D Laboratory, Tampa General Hospital, Tampa, Florida, USA
| | - Kami Kim
- Division of Infectious Disease and Internal Medicine, University of South Florida, Tampa, Florida, USA
- Center for Global Health Infectious Diseases Research, University of South Florida, Tampa, Florida, USA
- Global Emerging Diseases Institute, Tampa General Hospital, Tampa, Florida, USA
| | - Taj Azarian
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, USA
| | - Lindsey N. Shaw
- Department of Molecular Biosciences, University of South Florida, Tampa, Florida, USA
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4
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Esteves MAC, Viana AS, Viçosa GN, Botelho AMN, Moustafa AM, Mansoldo FRP, Ferreira ALP, Vermelho AB, Ferreira-Carvalho BT, Planet PJ, Figueiredo AMS. RdJ detection tests to identify a unique MRSA clone of ST105-SCC mecII lineage and its variants disseminated in the metropolitan region of Rio de Janeiro. Front Microbiol 2023; 14:1275918. [PMID: 38053559 PMCID: PMC10694290 DOI: 10.3389/fmicb.2023.1275918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
Hospital bloodstream infection (BSI) caused by methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of morbidity and mortality and is frequently related to invasive procedures and medically complex patients. An important feature of MRSA is the clonal structure of its population. Specific MRSA clones may differ in their pathogenic, epidemiological, and antimicrobial resistance profiles. Whole-genome sequencing is currently the most robust and discriminatory technique for tracking hypervirulent/well-adapted MRSA clones. However, it remains an expensive and time-consuming technique that requires specialized personnel. In this work, we describe a pangenome protocol, based on binary matrix (1,0) of open reading frames (ORFs), that can be used to quickly find diagnostic, apomorphic sequence mutations that can serve as biomarkers. We use this technique to create a diagnostic screen for MRSA isolates circulating in the Rio de Janeiro metropolitan area, the RdJ clone, which is prevalent in BSI. The method described here has 100% specificity and sensitivity, eliminating the need to use genomic sequencing for clonal identification. The protocol used is relatively simple and all the steps, formulas and commands used are described in this work, such that this strategy can also be used to identify other MRSA clones and even clones from other bacterial species.
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Affiliation(s)
| | - Alice Slotfeldt Viana
- Departamento de Microbiologia Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gabriela Nogueira Viçosa
- Departamento de Microbiologia Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ahmed M. Moustafa
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Adriana Lucia Pires Ferreira
- Hospital Universitário Clementino Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Dasa Medicina Diagnóstica, Duque de Caxias, Brazil
| | - Alane Beatriz Vermelho
- Departamento de Microbiologia Geral, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paul Joseph Planet
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, United States
| | - Agnes Marie Sá Figueiredo
- Departamento de Microbiologia Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Faculdade de Medicina, Programa de Pós-graduação em Patologia, Universidade Federal Fluminense, Niterói, Brazil
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5
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Alsolami A, ALGhasab NS, Alharbi MSM, Bashir AI, Saleem M, Syed Khaja AS, Aldakheel DF, Rakha E, Alshammari JA, Taha TE, Melibari Z, Alharbi YH, Almutlag AA, Said KB. Community-Acquired Methicillin-Resistant Staphylococcus aureus in Hospitals: Age-Specificity and Potential Zoonotic-Zooanthroponotic Transmission Dynamics. Diagnostics (Basel) 2023; 13:2089. [PMID: 37370983 DOI: 10.3390/diagnostics13122089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) lineages are a devastating clinical and public health issue. Data on local lineage profiles are limited. We report on the frequency of community-acquired and hospital-acquired cases (CA-MRSA, HA-MRSA). We studied 147 isolates from King Khalid tertiary care hospitals (KKH), each from a case in a patient and including 33 patients at the Maternity and Children's Hospital (MCH). Of the 147 isolates, 87 males (59%) and 60 females (41%) were in KKH. The overwhelming majority (80%; n = 119/147) were CA-MRSA in KKH. Intriguingly, despite significant differences between males (70%) and females (53%), lineage-acquisition remained age-specific around 58-60 years in both genders. However, while CA-MRSA dominated early in life (0-20, 70% MCH), it increased with age in KKH adults; 21-50 (28%), >50 (59%) until the overall 80% (n = 144/180). Major specimens included skin-wounds, surgeries (70.3%), blood (13.5%), sputum (8.8%), very rarely urine (4.1%), and nasal (3.4%), albeit most patients showed severe enteritis and necrotizing pneumonia. Antibiograms showed high beta lactam resistances, including amoxicillin-clavulanate (83%), oxacillin (84%), cefoxitin FOX (100%), penicillin and ampicillin (~100%), as well as high resistance (82%) to carbapenem. Fortunately, high susceptibility was seen to non-beta lactams and, to a lesser extent, gentamicin, erythromycin, and fusidic acid; 33%, 34%, and 38%, respectively, in KKH. A similar pattern was seen in MCH except for a low resistance pattern to gentamicin CN, clindamycin CD, erythromycin E, and tobramycin TOB; 34%, 31%, 39%, and 41%, respectively, except for fusidic acid. These findings have significant clinical implications for MRSA patient management strategies. Clinical- and lineage-profiles imply host-selection and zoonotic-zooanthroponotic transmission dynamics. Future molecular typing, sequencing, and characterization of dominant clone(s) is imperative.
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Affiliation(s)
- Ahmed Alsolami
- Department of Internal Medicine, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Naif Saad ALGhasab
- Department of Cardiology, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Mohammed S M Alharbi
- Department of Internal Medicine, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Abdelhafiz I Bashir
- Department of Physiology, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Mohd Saleem
- Department of Pathology, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | | | - Dakheel F Aldakheel
- Medical Coordination Unit, Ha'il General Hospital, Ha'il 55428, Saudi Arabia
| | - Ehab Rakha
- Departments of Microbiology, King Khalid Hospital, Ha'il 55421, Saudi Arabia
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Jabar Aziz Alshammari
- Department of Pathology, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Taha E Taha
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Ziyad Melibari
- Department of Pathology, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Yaseer H Alharbi
- Department of Pathology, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Ali A Almutlag
- Department of Pathology, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Kamaleldin B Said
- Department of Pathology, College of Medicine, University of Ha'il, Ha'il 55476, Saudi Arabia
- Genomics, Bioinformatics and Systems Biology, Carleton University, 1125 Colonel-By Drive, Ottawa, ON K1S 5B6, Canada
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6
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Conte AL, Brunetti F, Marazzato M, Longhi C, Maurizi L, Raponi G, Palamara AT, Grassi S, Conte MP. Atopic dermatitis-derived Staphylococcus aureus strains: what makes them special in the interplay with the host. Front Cell Infect Microbiol 2023; 13:1194254. [PMID: 37389215 PMCID: PMC10303148 DOI: 10.3389/fcimb.2023.1194254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
Background Atopic dermatitis (AD) is a chronic inflammatory skin condition whose pathogenesis involves genetic predisposition, epidermal barrier dysfunction, alterations in the immune responses and microbial dysbiosis. Clinical studies have shown a link between Staphylococcus aureus and the pathogenesis of AD, although the origins and genetic diversity of S. aureus colonizing patients with AD is poorly understood. The aim of the study was to investigate if specific clones might be associated with the disease. Methods WGS analyses were performed on 38 S. aureus strains, deriving from AD patients and healthy carriers. Genotypes (i.e. MLST, spa-, agr- and SCCmec-typing), genomic content (e.g. virulome and resistome), and the pan-genome structure of strains have been investigated. Phenotypic analyses were performed to determine the antibiotic susceptibility, the biofilm production and the invasiveness within the investigated S. aureus population. Results Strains isolated from AD patients revealed a high degree of genetic heterogeneity and a shared set of virulence factors and antimicrobial resistance genes, suggesting that no genotype and genomic content are uniquely associated with AD. The same strains were characterized by a lower variability in terms of gene content, indicating that the inflammatory conditions could exert a selective pressure leading to the optimization of the gene repertoire. Furthermore, genes related to specific mechanisms, like post-translational modification, protein turnover and chaperones as well as intracellular trafficking, secretion and vesicular transport, were significantly more enriched in AD strains. Phenotypic analysis revealed that all of our AD strains were strong or moderate biofilm producers, while less than half showed invasive capabilities. Conclusions We conclude that in AD skin, the functional role played by S. aureus may depend on differential gene expression patterns and/or on post-translational modification mechanisms rather than being associated with peculiar genetic features.
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Affiliation(s)
- Antonietta Lucia Conte
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Francesca Brunetti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Marazzato
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Catia Longhi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Linda Maurizi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Anna Teresa Palamara
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Laboratory Affiliated to Institute Pasteur Italia- Cenci Bolognetti Foundation, Rome, Italy
| | - Sara Grassi
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Pia Conte
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Ibekwe AM, Bhattacharjee AS, Phan D, Ashworth D, Schmidt MP, Murinda SE, Obayiuwana A, Murry MA, Schwartz G, Lundquist T, Ma J, Karathia H, Fanelli B, Hasan NA, Yang CH. Potential reservoirs of antimicrobial resistance in livestock waste and treated wastewater that can be disseminated to agricultural land. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 872:162194. [PMID: 36781130 DOI: 10.1016/j.scitotenv.2023.162194] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Livestock manure, dairy lagoon effluent, and treated wastewater are known reservoirs of antibiotic resistance genes (ARGs), antibiotic-resistant bacteria (ARB), and virulence factor genes (VFGs), and their application to agricultural farmland could be a serious public health threat. However, their dissemination to agricultural lands and impact on important geochemical pathways such as the nitrogen (N) cycle have not been jointly explored. In this study, shotgun metagenomic sequencing and analyses were performed to examine the diversity and composition of microbial communities, ARGs, VFGs, and N cycling genes in different livestock manure/lagoon and treated wastewater collected from concentrated animal feeding operations (CAFOs) and a municipal wastewater treatment plant along the west coast of the United States. Multivariate analysis showed that diversity indices of bacterial taxa from the different microbiomes were not significantly different based on InvSimpson (P = 0.05), but differences in ARG mechanisms were observed between swine manure and other microbiome sources. Comparative resistome profiling showed that ARGs in microbiome samples belonged to four core resistance classes: aminoglycosides (40-55 %), tetracyclines (30-45 %), beta-lactam-resistance (20-35 %), macrolides (18-30 %), and >50 % of the VFGs that the 24 microbiomes harbored were phyletically affiliated with two bacteria, Bacteroidetes fragilis and Enterobacter aerogenes. Network analysis based on Spearman correlation showed co-occurrence patterns between several genes such as transporter-gene and regulator, efflux pump and involved-in-polymyxin- resistance, aminoglycoside, beta-lactam, and macrolide with VFGs and bacterial taxa such as Firmicutes, Candidatus Themoplasmatota, Actinobacteria, and Bacteroidetes. Metabolic reconstruction of metagenome-assembled genome (MAGs) analysis showed that the most prevalent drug resistance mechanisms were associated with carbapenem resistance, multidrug resistance (MDR), and efflux pump. Bacteroidales was the main taxa involved in dissimilatory nitrate reduction (DNRA) in dairy lagoon effluent. This study demonstrates that the dissemination of waste from these sources can increase the spread of ARGs, ARB, and VFGs into agricultural lands, negatively impacting both soil and human health.
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Affiliation(s)
- Abasiofiok M Ibekwe
- US Salinity Laboratory, USDA-ARS, 450 W. Big Springs Rd., Riverside, CA 92507, USA.
| | - Ananda S Bhattacharjee
- US Salinity Laboratory, USDA-ARS, 450 W. Big Springs Rd., Riverside, CA 92507, USA; Department of Environmental Sciences, University of California, Riverside, CA 92507, USA
| | - Duc Phan
- US Salinity Laboratory, USDA-ARS, 450 W. Big Springs Rd., Riverside, CA 92507, USA; Department of Chemical and Environmental Engineering, University of California, Riverside, 92507, CA, USA
| | - Daniel Ashworth
- US Salinity Laboratory, USDA-ARS, 450 W. Big Springs Rd., Riverside, CA 92507, USA
| | - Michael P Schmidt
- US Salinity Laboratory, USDA-ARS, 450 W. Big Springs Rd., Riverside, CA 92507, USA
| | - Shelton E Murinda
- Animal and Veterinary Sciences Department, California State Polytechnic University, Pomona, CA 91768, USA
| | - Amarachukwu Obayiuwana
- Department of Biological Sciences, Augustine University Ilara-Epe, Lagos State 106101, Nigeria
| | - Marcia A Murry
- Biological Sciences Department, California State Polytechnic University, Pomona, CA 91768, USA
| | - Gregory Schwartz
- BioResource and Agricultural Engineering Department, College of Agriculture, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Tryg Lundquist
- Civil and Environmental Engineering Department, College of Engineering, California Polytechnic State University, San Luis Obispo, CA, USA
| | - Jincai Ma
- College of New Energy and Environment, Jilin University, Changchun 130021, PR China
| | | | | | - Nur A Hasan
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD, USA; EzBiome Inc, MD, USA
| | - Ching-Hong Yang
- Department of Biological Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
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8
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Gan C, Langa E, Valenzuela A, Ballestero D, Pino-Otín MR. Synergistic Activity of Thymol with Commercial Antibiotics against Critical and High WHO Priority Pathogenic Bacteria. PLANTS (BASEL, SWITZERLAND) 2023; 12:plants12091868. [PMID: 37176927 PMCID: PMC10180827 DOI: 10.3390/plants12091868] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Abstract
The use of synergistic combinations between natural compounds and commercial antibiotics may be a good strategy to fight against microbial resistance, with fewer side effects on human, animal and environmental, health. The antimicrobial capacity of four compounds of plant origin (thymol and gallic, salicylic and gentisic acids) was analysed against 14 pathogenic bacteria. Thymol showed the best antimicrobial activity, with MICs ranging from 125 µg/mL (for Acinetobacter baumannii, Pasteurella aerogenes, and Salmonella typhimurium) to 250 µg/mL (for Bacillus subtilis, Klebsiella aerogenes, Klebsiella pneumoniae, Serratia marcescens, Staphylococcus aureus, and Streptococcus agalactiae). Combinations of thymol with eight widely used antibiotics were studied to identify combinations with synergistic effects. Thymol showed synergistic activity with chloramphenicol against A. baumannii (critical priority by the WHO), with streptomycin and gentamicin against Staphylococcus aureus (high priority by the WHO), and with streptomycin against Streptococcus agalactiae, decreasing the MICs of these antibiotics by 75% to 87.5%. The kinetics of these synergies indicated that thymol alone at the synergy concentration had almost no effect on the maximum achievable population density and very little effect on the growth rate. However, in combination with antibiotics at the same concentration, it completely inhibited growth, confirming its role in facilitating the action of the antibiotic. The time-kill curves indicated that all the combinations with synergistic effects were mainly bactericidal.
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Affiliation(s)
- Cristina Gan
- Faculty of Health Sciences, Universidad San Jorge, 50830 Villanueva de Gállego, Zaragoza, Spain
| | - Elisa Langa
- Faculty of Health Sciences, Universidad San Jorge, 50830 Villanueva de Gállego, Zaragoza, Spain
| | - Antonio Valenzuela
- Faculty of Health Sciences, Universidad San Jorge, 50830 Villanueva de Gállego, Zaragoza, Spain
| | - Diego Ballestero
- Faculty of Health Sciences, Universidad San Jorge, 50830 Villanueva de Gállego, Zaragoza, Spain
| | - M Rosa Pino-Otín
- Faculty of Health Sciences, Universidad San Jorge, 50830 Villanueva de Gállego, Zaragoza, Spain
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9
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Dyzenhaus S, Sullivan MJ, Alburquerque B, Boff D, van de Guchte A, Chung M, Fulmer Y, Copin R, Ilmain JK, O'Keefe A, Altman DR, Stubbe FX, Podkowik M, Dupper AC, Shopsin B, van Bakel H, Torres VJ. MRSA lineage USA300 isolated from bloodstream infections exhibit altered virulence regulation. Cell Host Microbe 2023; 31:228-242.e8. [PMID: 36681080 PMCID: PMC9911362 DOI: 10.1016/j.chom.2022.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/18/2022] [Accepted: 12/02/2022] [Indexed: 01/22/2023]
Abstract
The epidemic community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) USA300 lineage has recently become a leading cause of hospital-associated bloodstream infections (BSIs). Here, we leveraged this recent introduction into hospitals and the limited genetic variation across USA300 isolates to identify mutations that contribute to its success in a new environment. We found that USA300 BSI isolates exhibit altered virulence regulation. Using comparative genomics to delineate the genes involved in this phenotype, we discovered repeated and independent mutations in the transcriptional regulator sarZ. Mutations in sarZ resulted in increased virulence of USA300 BSI isolates in a murine model of BSI. The sarZ mutations derepressed the expression and production of the surface protein ClfB, which was critical for the pathogenesis of USA300 BSI isolates. Altogether, these findings highlight ongoing evolution of a major MRSA lineage and suggest USA300 strains can optimize their fitness through altered regulation of virulence.
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Affiliation(s)
- Sophie Dyzenhaus
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Mitchell J Sullivan
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bremy Alburquerque
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Daiane Boff
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Adriana van de Guchte
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Marilyn Chung
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Yi Fulmer
- Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Richard Copin
- Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Juliana K Ilmain
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Anna O'Keefe
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Deena R Altman
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - François-Xavier Stubbe
- Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Magdalena Podkowik
- Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Amy C Dupper
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bo Shopsin
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA; Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Harm van Bakel
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Victor J Torres
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA.
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10
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Association of Antibacterial Susceptibility Profile with the Prevalence of Genes Encoding Efflux Proteins in the Bangladeshi Clinical Isolates of Staphylococcus aureus. Antibiotics (Basel) 2023; 12:antibiotics12020305. [PMID: 36830216 PMCID: PMC9952083 DOI: 10.3390/antibiotics12020305] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Expelling antibiotic molecules out of the cell wall through multiple efflux pumps is one of the potential mechanisms of developing resistance against a wide number of antibiotics in Staphylococcus aureus. The aim of this study was to investigate the association between the antibiotic susceptibility profile and the prevalence of different efflux pump genes i.e., norA, norB, norC, mepA, sepA, mdeA, qacA/B, and smr in the clinical isolates of S. aureus. Sixty clinical isolates were collected from a tertiary level hospital in Bangladesh. The disc diffusion method using ten antibiotics of different classes was used to discern the susceptibility profile. polymerase chain reaction (PCR) was employed to observe the resistance patterns and to detect the presence of plasmid and chromosomal encoded genes. Among the clinical isolates, 60% (36 out of 60) of the samples were Methicillin-resistant Staphylococcus aureus (MRSA), whereas 55% (33 out of 60) of the bacterial samples were found to be multi-drug resistant. The bacteria showed higher resistance to vancomycin (73.33%), followed by ciprofloxacin (60%), cefixime (53.33%), azithromycin (43.33%), and amoxicillin (31.67%). The prevalence of the chromosomally-encoded efflux genes norA (91.67%), norB (90%), norC (93.33%), mepA (93.33%), sepA (98.33%), and mdeA (93.33%) were extremely high with a minor portion of them carrying the plasmid-encoded genes qacA/B (20%) and smr (8.33%). Several genetic combinations of efflux pump genes were revealed, among which norA + norB + norC + mepA + sepA + mdeA was the most widely distributed combination among MRSA and MSSA bacteria that conferred resistance against ciprofloxacin and probably vancomycin. Based on the present study, it is evident that the presence of multiple efflux genes potentiated the drug extrusion activity and may play a pivotal role in the development of multidrug resistance in S. aureus.
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11
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Nikolic P, Mudgil P. The Cell Wall, Cell Membrane and Virulence Factors of Staphylococcus aureus and Their Role in Antibiotic Resistance. Microorganisms 2023; 11:microorganisms11020259. [PMID: 36838224 PMCID: PMC9965861 DOI: 10.3390/microorganisms11020259] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Antibiotic resistant strains of bacteria are a serious threat to human health. With increasing antibiotic resistance in common human pathogens, fewer antibiotics remain effective against infectious diseases. Staphylococcus aureus is a pathogenic bacterium of particular concern to human health as it has developed resistance to many of the currently used antibiotics leaving very few remaining as effective treatment. Alternatives to conventional antibiotics are needed for treating resistant bacterial infections. A deeper understanding of the cellular characteristics of resistant bacteria beyond well characterized resistance mechanisms can allow for increased ability to properly treat them and to potentially identify targetable changes. This review looks at antibiotic resistance in S aureus in relation to its cellular components, the cell wall, cell membrane and virulence factors. Methicillin resistant S aureus bacteria are resistant to most antibiotics and some strains have even developed resistance to the last resort antibiotics vancomycin and daptomycin. Modifications in cell wall peptidoglycan and teichoic acids are noted in antibiotic resistant bacteria. Alterations in cell membrane lipids affect susceptibility to antibiotics through surface charge, permeability, fluidity, and stability of the bacterial membrane. Virulence factors such as adhesins, toxins and immunomodulators serve versatile pathogenic functions in S aureus. New antimicrobial strategies can target cell membrane lipids and virulence factors including anti-virulence treatment as an adjuvant to traditional antibiotic therapy.
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12
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Li G, Walker MJ, De Oliveira DMP. Vancomycin Resistance in Enterococcus and Staphylococcus aureus. Microorganisms 2022; 11:microorganisms11010024. [PMID: 36677316 PMCID: PMC9866002 DOI: 10.3390/microorganisms11010024] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Enterococcus faecalis, Enterococcus faecium and Staphylococcus aureus are both common commensals and major opportunistic human pathogens. In recent decades, these bacteria have acquired broad resistance to several major classes of antibiotics, including commonly employed glycopeptides. Exemplified by resistance to vancomycin, glycopeptide resistance is mediated through intrinsic gene mutations, and/or transferrable van resistance gene cassette-carrying mobile genetic elements. Here, this review will discuss the epidemiology of vancomycin-resistant Enterococcus and S. aureus in healthcare, community, and agricultural settings, explore vancomycin resistance in the context of van and non-van mediated resistance development and provide insights into alternative therapeutic approaches aimed at treating drug-resistant Enterococcus and S. aureus infections.
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13
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Bakr ME, Kashef MT, Hosny AEDMS, Ramadan MA. Effect of spdC gene expression on virulence and antibiotic resistance in clinical Staphylococcus aureus isolates. Int Microbiol 2022; 25:649-659. [PMID: 35608714 PMCID: PMC9307553 DOI: 10.1007/s10123-022-00249-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/30/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022]
Abstract
Surface protein display C (SpdC) protein was described as a novel virulence factor of Staphylococcus aureus that affects biofilm formation and pathogenesis and favors resistance to antimicrobials targeting cell wall. We evaluated the possible correlation between spdC gene expression level and virulence as well as antibiotic resistance phenotypes in S. aureus clinical isolates. The antimicrobial susceptibility of S. aureus clinical isolates (n = 100) was determined by the disk diffusion method. Vancomycin susceptibility was determined by the broth microdilution method. The level of the extracellular proteases and delta-hemolysin was evaluated by measuring the proteolysis and hemolysis zone diameters in skim milk and blood agar plates, respectively. Biofilm formation was assayed using the 96-well microtiter plate method. Most of the isolates (81%) were multidrug-resistant and about half of the isolates (49%) were methicillin-resistant S. aureus. Hemolysin, protease, and biofilm production were detectable in 79%, 71%, and 96% of the isolates. No significant correlation was detectable between the level of spdC gene expression and the activity of tested virulence factors or the antimicrobial resistance phenotype. Therefore, the role of SpdC protein as a virulence regulator in S. aureus needs further evaluation together with the determination of the predominant regulators for each virulence factor.
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Affiliation(s)
- Mayada E Bakr
- Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| | - Mona T Kashef
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt.
| | - Alaa El-Dien M S Hosny
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt
| | - Mohammed A Ramadan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt
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14
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An Interplay of Multiple Positive and Negative Factors Governs Methicillin Resistance in Staphylococcus aureus. Microbiol Mol Biol Rev 2022; 86:e0015921. [PMID: 35420454 PMCID: PMC9199415 DOI: 10.1128/mmbr.00159-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The development of resistance to β-lactam antibiotics has made Staphylococcus aureus a clinical burden on a global scale. MRSA (methicillin-resistant S. aureus) is commonly known as a superbug. The ability of MRSA to proliferate in the presence of β-lactams is attributed to the acquisition of mecA, which encodes the alternative penicillin binding protein, PBP2A, which is insensitive to the antibiotics. Most MRSA isolates exhibit low-level β-lactam resistance, whereby additional genetic adjustments are required to develop high-level resistance. Although several genetic factors that potentiate or are required for high-level resistance have been identified, how these interact at the mechanistic level has remained elusive. Here, we discuss the development of resistance and assess the role of the associated components in tailoring physiology to accommodate incoming mecA.
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15
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Recent Developments in Phenotypic and Molecular Diagnostic Methods for Antimicrobial Resistance Detection in Staphylococcus aureus: A Narrative Review. Diagnostics (Basel) 2022; 12:diagnostics12010208. [PMID: 35054375 PMCID: PMC8774325 DOI: 10.3390/diagnostics12010208] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/17/2022] Open
Abstract
Staphylococcus aureus is an opportunistic pathogen responsible for a wide range of infections in humans, such as skin and soft tissue infections, pneumonia, food poisoning or sepsis. Historically, S. aureus was able to rapidly adapt to anti-staphylococcal antibiotics and become resistant to several classes of antibiotics. Today, methicillin-resistant S. aureus (MRSA) is a multidrug-resistant pathogen and is one of the most common bacteria responsible for hospital-acquired infections and outbreaks, in community settings as well. The rapid and accurate diagnosis of antimicrobial resistance in S. aureus is crucial to the early initiation of directed antibiotic therapy and to improve clinical outcomes for patients. In this narrative review, I provide an overview of recent phenotypic and molecular diagnostic methods for antimicrobial resistance detection in S. aureus, with a particular focus on MRSA detection. I consider methods for resistance detection in both clinical samples and isolated S. aureus cultures, along with a brief discussion of the advantages and the challenges of implementing such methods in routine diagnostics.
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16
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Sabat AJ, Pantano D, Akkerboom V, Bathoorn E, Friedrich AW. Pseudomonas aeruginosa and Staphylococcus aureus virulence factors as biomarkers of infection. Biol Chem 2021; 402:1565-1573. [PMID: 34505460 DOI: 10.1515/hsz-2021-0243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/30/2021] [Indexed: 12/13/2022]
Abstract
The gold standard for the diagnosis of bacterial infections in clinical samples is based on culture tests that are time-consuming and labor-intense. For these reasons, an extraordinary effort has been made to identify biomarkers as the tools for sensitive, rapid and accurate identification of pathogenic microorganisms. Moreover, biomarkers have been tested to distinguish colonization from infection, monitor disease progression, determine the clinical status of patients or predict clinical outcomes. This mini-review describes Pseudomonas aeruginosa and Staphylococcus aureus biomarkers, which contribute to pathogenesis and have been used in culture-independent bacterial identification directly from patient samples.
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Affiliation(s)
- Artur J Sabat
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, NL-9713 GZ Groningen, The Netherlands
| | - Daniele Pantano
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, NL-9713 GZ Groningen, The Netherlands
| | - Viktoria Akkerboom
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, NL-9713 GZ Groningen, The Netherlands
| | - Erik Bathoorn
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, NL-9713 GZ Groningen, The Netherlands
| | - Alexander W Friedrich
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, NL-9713 GZ Groningen, The Netherlands
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17
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Abstract
Staphylococcus aureus is a common cause of both superficial and invasive infections of humans and animals. Despite a potent host response and apparently appropriate antibiotic therapy, staphylococcal infections frequently become chronic or recurrent, demonstrating a remarkable ability of S. aureus to withstand the hostile host environment. There is growing evidence that staphylococcal DNA repair makes important contributions to the survival of the pathogen in host tissues, as well as promoting the emergence of mutants that resist host defenses and antibiotics. While much of what we know about DNA repair in S. aureus is inferred from studies with model organisms, the roles of specific repair mechanisms in infection are becoming clear and differences with Bacillus subtilis and Escherichia coli have been identified. Furthermore, there is growing interest in staphylococcal DNA repair as a target for novel therapeutics that sensitize the pathogen to host defenses and antibiotics. In this review, we discuss what is known about staphylococcal DNA repair and its role in infection, examine how repair in S. aureus is similar to, or differs from, repair in well-characterized model organisms, and assess the potential of staphylococcal DNA repair as a novel therapeutic target.
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18
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Genomic Update of Phenotypic Prediction Rule for Methicillin-Resistant Staphylococcus aureus (MRSA) USA300 Discloses Jail Transmission Networks with Increased Resistance. Microbiol Spectr 2021; 9:e0037621. [PMID: 34287060 PMCID: PMC8552710 DOI: 10.1128/spectrum.00376-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of health care-associated (HA) and community-associated (CA) infections. USA300 strains are historically CA-MRSA, while USA100 strains are HA-MRSA. Here, we update an antibiotic prediction rule to distinguish these two genotypes based on antibiotic resistance phenotype using whole-genome sequencing (WGS), a more discriminatory methodology than pulsed-field gel electrophoresis (PFGE). MRSA clinical isolates collected from 2007 to 2017 underwent WGS; associated epidemiologic data were ascertained. In developing the rule, we examined MRSA isolates that included a population with a history of incarceration. Performance characteristics of antibiotic susceptibility for predicting USA300 compared to USA100, as defined by WGS, were examined. Phylogenetic analysis was performed to examine resistant USA300 clades. We identified 275 isolates (221 USA300, 54 USA100). Combination susceptibility to clindamycin or levofloxacin performed the best overall (sensitivity 80.7%, specificity 75.9%) to identify USA300. The average number of antibiotic classes with resistance was higher for USA100 (3 versus 2, P < 0.001). Resistance to ≤2 classes was predictive for USA300 (area under the curve (AUC) 0.84, 95% confidence interval 0.78 to 0.90). Phylogenetic analysis identified a cluster of USA300 strains characterized by increased resistance among incarcerated individuals. Using a combination of clindamycin or levofloxacin susceptibility, or resistance to ≤2 antibiotic classes, was predictive of USA300 as defined by WGS. Increased resistance was observed among individuals with incarceration exposure, suggesting circulation of a more resistant USA300 clade among at-risk community networks. Our phenotypic prediction rule could be used as an epidemiologic tool to describe community and nosocomial shifts in USA300 MRSA and quickly identify emergence of lineages with increased resistance. IMPORTANCE Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of health care-associated (HA) and community-associated (CA) infections, but the epidemiology of these strains (USA100 and USA300, respectively) now overlaps in health care settings. Although sequencing technology has become more available, many health care facilities still lack the capabilities to perform these analyses. In this study, we update a simple prediction rule based on antibiotic resistance phenotype with integration of whole-genome sequencing (WGS) to predict strain type based on antibiotic resistance profiles that can be used in settings without access to molecular strain typing methods. This prediction rule has many potential epidemiologic applications, such as analysis of retrospective data sets, regional monitoring, and ongoing surveillance of CA-MRSA infection trends. We demonstrate application of this rule to identify an emerging USA300 strain with increased antibiotic resistance among incarcerated individuals that deviates from the rule.
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19
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Earls MR, Steinig EJ, Monecke S, Samaniego Castruita JA, Simbeck A, Schneider-Brachert W, Vremerǎ T, Dorneanu OS, Loncaric I, Bes M, Lacoma A, Prat Aymerich C, Wernery U, Armengol-Porta M, Blomfeldt A, Duchene S, Bartels MD, Ehricht R, Coleman DC. Exploring the evolution and epidemiology of European CC1-MRSA-IV: tracking a multidrug-resistant community-associated meticillin-resistant Staphylococcus aureus clone. Microb Genom 2021; 7. [PMID: 34223815 PMCID: PMC8477393 DOI: 10.1099/mgen.0.000601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
This study investigated the evolution and epidemiology of the community-associated and multidrug-resistant Staphylococcus aureus clone European CC1-MRSA-IV. Whole-genome sequences were obtained for 194 European CC1-MRSA-IV isolates (189 of human and 5 of animal origin) from 12 countries, and 10 meticillin-susceptible precursors (from North-Eastern Romania; all of human origin) of the clone. Phylogenetic analysis was performed using a maximum-likelihood approach, a time-measured phylogeny was reconstructed using Bayesian analysis, and in silico microarray genotyping was performed to identify resistance, virulence-associated and SCCmec (staphylococcal cassette chromosome mec) genes. Isolates were typically sequence type 1 (190/204) and spa type t127 (183/204). Bayesian analysis indicated that European CC1-MRSA-IV emerged in approximately 1995 before undergoing rapid expansion in the late 1990s and 2000s, while spreading throughout Europe and into the Middle East. Phylogenetic analysis revealed an unstructured meticillin-resistant S. aureus (MRSA) population, lacking significant geographical or temporal clusters. The MRSA were genotypically multidrug-resistant, consistently encoded seh, and intermittently (34/194) encoded an undisrupted hlb gene with concomitant absence of the lysogenic phage-encoded genes sak and scn. All MRSA also harboured a characteristic ~5350 nt insertion in SCCmec adjacent to orfX. Detailed demographic data from Denmark showed that there, the clone is typically (25/35) found in the community, and often (10/35) among individuals with links to South-Eastern Europe. This study elucidated the evolution and epidemiology of European CC1-MRSA-IV, which emerged from a meticillin-susceptible lineage prevalent in North-Eastern Romania before disseminating rapidly throughout Europe.
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Affiliation(s)
- Megan R Earls
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland
| | - Eike J Steinig
- Australian Institute of Tropical Health and Medicine, Townsville, Queensland, Australia
| | - Stefan Monecke
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,Institute for Medical Microbiology and Hygiene, Medical Faculty "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| | | | - Alexandra Simbeck
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Wulf Schneider-Brachert
- Institute for Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Teodora Vremerǎ
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy "Grigore T Popa", Iaşi, Romania
| | - Olivia S Dorneanu
- Microbiology Unit, Department of Preventive and Interdisciplinary Medicine, University of Medicine and Pharmacy "Grigore T Popa", Iaşi, Romania
| | - Igor Loncaric
- Institute of Microbiology, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Michèle Bes
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Alicia Lacoma
- Microbiology Department, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Cristina Prat Aymerich
- Microbiology Department, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias, Universitat Autònoma de Barcelona, Badalona, Spain.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | | | - Anita Blomfeldt
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
| | - Sebastian Duchene
- Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
| | - Mette D Bartels
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Ralf Ehricht
- Institute of Physical Chemistry, Friedrich-Schiller University, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,InfectoGnostics Research Campus Jena, Jena, Germany
| | - David C Coleman
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Trinity College, University of Dublin, Dublin, Ireland
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20
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Pang S, Daley DA, Sahibzada S, Mowlaboccus S, Stegger M, Coombs GW. Genome-wide association studies reveal candidate genes associated to bacteraemia caused by ST93-IV CA-MRSA. BMC Genomics 2021; 22:418. [PMID: 34090342 PMCID: PMC8180019 DOI: 10.1186/s12864-021-07738-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The global emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has seen the dominance of specific clones in different regions around the world with the PVL-positive ST93-IV as the predominant CA-MRSA clone in Australia. In this study we applied a genome-wide association study (GWAS) approach on a collection of Australian ST93-IV MRSA genomes to screen for genetic traits that might have assisted the ongoing transmission of ST93-IV in Australia. We also compared the genomes of ST93-IV bacteraemia and non-bacteraemia isolates to search for potential virulence genes associated with bacteraemia. RESULTS Based on single nucleotide polymorphism phylogenetics we revealed two distinct ST93-IV clades circulating concurrently in Australia. One of the clades contained isolates primarily isolated in the northern regions of Australia whilst isolates in the second clade were distributed across the country. Analyses of the ST93-IV genome plasticity over a 15-year period (2002-2017) revealed an observed gain in accessory genes amongst the clone's population. GWAS analysis on the bacteraemia isolates identified two gene candidates that have previously been associated to this kind of infection. CONCLUSIONS Although this hypothesis was not tested here, it is possible that the emergence of a ST93-IV clade containing additional virulence genes might be related to the high prevalence of ST93-IV infections amongst the indigenous population living in the northern regions of Australia. More importantly, our data also demonstrated that GWAS can reveal candidate genes for further investigations on the pathogenesis and evolution of MRSA strains within a same lineage.
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Affiliation(s)
- Stanley Pang
- Antimicrobial Resistance and Infectious Diseases (AMRID) Research Laboratory, Murdoch University, Murdoch, Western Australia, Australia.
- Department of Microbiology, PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
| | - Denise A Daley
- Australian Group on Antimicrobial Resistance (AGAR), Fiona Stanley Hospital, Murdoch, Australia
| | - Shafi Sahibzada
- Antimicrobial Resistance and Infectious Diseases (AMRID) Research Laboratory, Murdoch University, Murdoch, Western Australia, Australia
| | - Shakeel Mowlaboccus
- Antimicrobial Resistance and Infectious Diseases (AMRID) Research Laboratory, Murdoch University, Murdoch, Western Australia, Australia
| | - Marc Stegger
- Antimicrobial Resistance and Infectious Diseases (AMRID) Research Laboratory, Murdoch University, Murdoch, Western Australia, Australia
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Geoffrey W Coombs
- Antimicrobial Resistance and Infectious Diseases (AMRID) Research Laboratory, Murdoch University, Murdoch, Western Australia, Australia
- Department of Microbiology, PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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21
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Bueso-Bordils JI, Alemán-López PA, Martín-Algarra R, Duart MJ, Falcó A, Antón-Fos GM. Molecular Topology for the Search of New Anti-MRSA Compounds. Int J Mol Sci 2021; 22:ijms22115823. [PMID: 34072353 PMCID: PMC8199290 DOI: 10.3390/ijms22115823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 01/04/2023] Open
Abstract
The variability of methicillin-resistant Staphylococcus aureus (MRSA), its rapid adaptive response against environmental changes, and its continued acquisition of antibiotic resistance determinants have made it commonplace in hospitals, where it causes the problem of multidrug resistance. In this study, we used molecular topology to develop several discriminant equations capable of classifying compounds according to their anti-MRSA activity. Topological indices were used as structural descriptors and their relationship with anti-MRSA activity was determined by applying linear discriminant analysis (LDA) on a group of quinolones and quinolone-like compounds. Four extra equations were constructed, named DFMRSA1, DFMRSA2, DFMRSA3 and DFMRSA4 (DFMRSA was built in a previous study), all with good statistical parameters, such as Fisher-Snedecor F (>68 in all cases), Wilk's lambda (<0.13 in all cases), and percentage of correct classification (>94% in all cases), which allows a reliable extrapolation prediction of antibacterial activity in any organic compound. The results obtained clearly reveal the high efficiency of combining molecular topology with LDA for the prediction of anti-MRSA activity.
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Affiliation(s)
- Jose I. Bueso-Bordils
- Departamento de Farmacia, Universidad Cardenal Herrera-CEU, CEU Universities C/Ramón y Cajal s/n, 46115 Alfara del Patriarca, Valencia, Spain; (P.A.A.-L.); (R.M.-A.); (M.J.D.); (G.M.A.-F.)
- Correspondence: ; Tel.: +34-96-1369000
| | - Pedro A. Alemán-López
- Departamento de Farmacia, Universidad Cardenal Herrera-CEU, CEU Universities C/Ramón y Cajal s/n, 46115 Alfara del Patriarca, Valencia, Spain; (P.A.A.-L.); (R.M.-A.); (M.J.D.); (G.M.A.-F.)
| | - Rafael Martín-Algarra
- Departamento de Farmacia, Universidad Cardenal Herrera-CEU, CEU Universities C/Ramón y Cajal s/n, 46115 Alfara del Patriarca, Valencia, Spain; (P.A.A.-L.); (R.M.-A.); (M.J.D.); (G.M.A.-F.)
| | - Maria J. Duart
- Departamento de Farmacia, Universidad Cardenal Herrera-CEU, CEU Universities C/Ramón y Cajal s/n, 46115 Alfara del Patriarca, Valencia, Spain; (P.A.A.-L.); (R.M.-A.); (M.J.D.); (G.M.A.-F.)
| | - Antonio Falcó
- ESI International Chair@CEU-UCH, Departamento de Matemáticas, Física y Ciencias Tecnológicas, Universidad Cardenal Herrera-CEU, CEU Universities San Bartolomé 55, 46115 Alfara del Patriarca, Valencia, Spain;
| | - Gerardo M. Antón-Fos
- Departamento de Farmacia, Universidad Cardenal Herrera-CEU, CEU Universities C/Ramón y Cajal s/n, 46115 Alfara del Patriarca, Valencia, Spain; (P.A.A.-L.); (R.M.-A.); (M.J.D.); (G.M.A.-F.)
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Vahdani Y, Faraji N, Haghighat S, Yazdi MH, Mahdavi M. Molecular cloning and immunogenicity evaluation of IsdE protein of methicillin resistant Staphylococcus aureus as vaccine candidates. Microb Pathog 2021; 157:104953. [PMID: 34044042 DOI: 10.1016/j.micpath.2021.104953] [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: 09/26/2020] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Methicillin resistant Staphylococcus aureus is one of the most common causes of nosocomial infections. Current therapeutic approaches are not always effective in treatment of nosocomial infections, thus, there is a global demand for the development of novel therapeutic strategies. Staphylococcus aureus possesses various systems to uptake iron. One of the most important of them is iron regulated surface determinant (Isd) which can be an excellent candidate for immunization. Here, following the preparation of recombinant IsdE protein, 20 μg of r-IsdE prepared in various formulations were subcutaneously injected in different groups of mice. Two booster vaccinations were administered in two-week intervals, then, blood samples were collected two weeks after each injection. ELISA was used for the evaluation of total IgG and its isotypes (IgG1 and IgG2a) as well as quantity of IFN-γ, IL-4, IL-17, IL-2 and TNF-α cytokines on the serum samples. Meanwhile, the immunized mice were intraperitoneally inoculated with 5 × 108 CFU of bacteria then, their mortality rate and bacterial load were assessed. Our results showed that immunization with the r-IsdE in various formulations raised total IgG and isotypes (IgG1 and IgG2a) compared with the control groups. Moreover, r-IsdE formulation with MF59 and Freund adjuvants raised production of IFN-γ, IL-4, IL-17, IL-2 and TNF-α cytokines and provided an acceptable protection against Staphylococcus aureus infections. Results of present study suggest that r-IsdE which can easily be expressed by Escherichia coli BL21 system shows a great potential to develop a protective immunity against infections caused by Methicillin resistant Staphylococcus aureus.
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Affiliation(s)
- Yasaman Vahdani
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Negin Faraji
- Department of Biotechnology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Setareh Haghighat
- Department of Microbiology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mohammad Hossein Yazdi
- Biotechnology Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Immunotherapy Group, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran; Recombinant Vaccine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mehdi Mahdavi
- Immunotherapy Group, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran; Recombinant Vaccine Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Evaluation of antibacterial activity and reversal of the NorA and MepA efflux pump of estragole against Staphylococcus aureus bacteria. Arch Microbiol 2021; 203:3551-3555. [PMID: 33942156 DOI: 10.1007/s00203-021-02347-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 02/03/2023]
Abstract
The antibacterial activity of the monoterpene estragole was evaluated against two strains of bacteria with an efflux pump mechanism, which are Staphylococcus aureus 1199B and S. aureus K2068, which have a NorA and MepA pump, respectively. For that, the methodology proposed by CLSI with modifications was followed, and to evaluate the reversal of the efflux pump, subinhibitory concentrations (MIC/8) of estragole and standard pump inhibitors, CCCP and Chlorpromazine were used and it was verified whether they managed to modulate the action of Norfloxacin, Ciprofloxacin and Ethidium Bromide, an indicator of an efflux pump. It was observed that estragole positively modulated norfloxacin and ethidium bromide against the strain of S. aureus 1199B and that it also managed to reduce the MIC of ethidium bromide against the strain of S. aureus K2068. In the non-clinical acute toxicity tests with estragole, the animals treated with the dose of 625 mg/kg/v.o. showed no clinical signs of toxicity, according to the parameters evaluated. These results are promising, since it places estragole as a possible inhibitor of the efflux pump, thus managing to inhibit this mechanism of action in the strains tested.
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Characterisation of Staphylococcus aureus isolates from bovine mastitis in Ningxia, Western China. J Glob Antimicrob Resist 2021; 25:232-237. [PMID: 33866044 DOI: 10.1016/j.jgar.2021.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The aim of this study was to explore the antimicrobial resistance, virulence genes and molecular characteristics of Staphylococcus aureus from bovine mastitis cases. METHODS A total of 125 non-duplicate S. aureus isolates from bovine mastitis cases in Ningxia, China, were characterised by antimicrobial susceptibility and molecular testing to determine the antimicrobial resistance, virulence genes and molecular characteristics. RESULTS All methicillin-resistant S. aureus (MRSA) isolates were resistant to ampicillin, oxacillin, ceftiofur, erythromycin, gentamicin and clindamycin, with resistance to nine different categories of antibiotics observed amongst the MRSA isolates. Of the methicillin-susceptible S. aureus (MSSA) isolates, 62.1% were resistant to ampicillin and sulfisoxazole. Nine clonal complexes (CCs) and 16 spa types were identified by multilocus sequence typing (MLST) and spa typing. The dominant CCs were CC97 (51.2%) and CC50 (30.4%), while t224 (30.4%), t518 (20.0%) and t359 (16.8%) were the most common spa types. A relatively high proportion (27.2%) of the S. aureus isolates belonged to ST4053, a novel sequence type identified in this study. In addition, two CC30 MSSA isolates and two CC59 MRSA isolates were positive for Panton-Valentine leukocidin, while one CC239 MRSA isolate and three CC5 MSSA isolates were positive for TSST-1. All MRSA isolates carried the immune evasion cluster (IEC) genes, including scn (100%; 9/9) and sak (100%; 9/9), which were classified into type E. CONCLUSION Our study indicates severe antibiotic resistance and complicated molecular characterisation of S. aureus causing bovine mastitis. Additional studies should be conducted to monitor infection and transmission of S. aureus.
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Jones SU, Chua KH, Chew CH, Yeo CC, Abdullah FH, Othman N, Kee BP, Puah SM. spa diversity of methicillin-resistant and -susceptible Staphylococcus aureus in clinical strains from Malaysia: a high prevalence of invasive European spa-type t032. PeerJ 2021; 9:e11195. [PMID: 33889447 PMCID: PMC8038637 DOI: 10.7717/peerj.11195] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 03/09/2021] [Indexed: 12/30/2022] Open
Abstract
Background Staphylococcus aureus is one of the important pathogens causing nosocomial infection. spa typing allows identification of S. aureus clones in hospital isolates and is useful for epidemiological studies and nosocomial infection control. This study aims to investigate the spa types in Malaysian S. aureus isolates obtained from various clinical specimens. Method A total of 89 methicillin-resistant S. aureus (MRSA) [pus (n = 55), blood (n = 27), respiratory (n = 5), eye (n = 2)] isolates and 109 methicillin-susceptible S. aureus (MSSA) [pus (n = 79), blood (n = 24), respiratory (n = 3), eye (n = 2) and urine (n = 1)] isolates were subjected to spa typing with sequences analysed using BioNumerics version 7. Results The spa sequence was successfully amplified from 77.8% of the strains (154/198) and 47 known spa types were detected. The distribution of known spa types in MRSA (36.2%, 17/47) was less diverse than in MSSA (70.2%, 33/47). The most predominant spa types were t032 (50%) in MRSA, and t127 (19%) and t091 (16.7%) in MSSA, respectively. spa type t091 in MSSA was significantly associated with skin and soft tissue infections (p = 0.0199). Conclusion The previously uncommon spa type t032 was detected in the Malaysian MRSA strains, which also corresponded to the most common spa type in Europe and Australia, and has replaced the dominant spa type t037 which was reported in Malaysia in 2010.
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Affiliation(s)
- Sherry Usun Jones
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kek Heng Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ching Hoong Chew
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
| | - Chew Chieng Yeo
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia
| | | | - Norlela Othman
- Department of Pathology, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia
| | - Boon Pin Kee
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Suat Moi Puah
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Bai Z, Chen M, Lin Q, Ye Y, Fan H, Wen K, Zeng J, Huang D, Mo W, Lei Y, Liao Z. Identification of Methicillin-Resistant Staphylococcus Aureus From Methicillin-Sensitive Staphylococcus Aureus and Molecular Characterization in Quanzhou, China. Front Cell Dev Biol 2021; 9:629681. [PMID: 33553185 PMCID: PMC7858276 DOI: 10.3389/fcell.2021.629681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
To distinguish Methicillin-Resistant Staphylococcus aureus (MRSA) from Methicillin-Sensitive Staphylococcus aureus (MSSA) in the protein sequences level, test the susceptibility to antibiotic of all Staphylococcus aureus isolates from Quanzhou hospitals, define the virulence factor and molecular characteristics of the MRSA isolates. MRSA and MSSA Pfam protein sequences were used to extract feature vectors of 188D, n-gram and 400D. Weka software was applied to classify the two Staphylococcus aureus and performance effect was evaluated. Antibiotic susceptibility testing of the 81 Staphylococcus aureus was performed by the Mérieux Microbial Analysis Instrument. The 65 MRSA isolates were characterized by Panton-Valentine leukocidin (PVL), X polymorphic region of Protein A (spa), multilocus sequence typing test (MLST), staphylococcus chromosomal cassette mec (SCCmec) typing. After comparing the results of Weka six classifiers, the highest correctly classified rates were 91.94, 70.16, and 62.90% from 188D, n-gram and 400D, respectively. Antimicrobial susceptibility test of the 81 Staphylococcus aureus: Penicillin-resistant rate was 100%. No resistance to teicoplanin, linezolid, and vancomycin. The resistance rate of the MRSA isolates to clindamycin, erythromycin and tetracycline was higher than that of the MSSAs. Among the 65 MRSA isolates, the positive rate of PVL gene was 47.7% (31/65). Seventeen sequence types (STs) were identified among the 65 isolates, and ST59 was the most prevalent. SCCmec type III and IV were observed at 24.6 and 72.3%, respectively. Two isolates did not be typed. Twenty-one spa types were identified, spa t437 (34/65, 52.3%) was the most predominant type. MRSA major clone type of molecular typing was CC59-ST59-spa t437-IV (28/65, 43.1%). Overall, 188D feature vectors can be applied to successfully distinguish MRSA from MSSA. In Quanzhou, the detection rate of PVL virulence factor was high, suggesting a high pathogenic risk of MRSA infection. The cross-infection of CA-MRSA and HA-MRSA was presented, the molecular characteristics were increasingly blurred, HA-MRSA with typical CA-MRSA molecular characteristics has become an important cause of healthcare-related infections. CC59-ST59-spa t437-IV was the main clone type in Quanzhou, which was rare in other parts of mainland China.
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Affiliation(s)
- Zhimin Bai
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.,Department of Clinical Laboratory, Jinjiang Municipal Hospital, Jinjiang, China
| | - Min Chen
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.,Microbiological Laboratory Sanming Center for Disease Control and Prevention, Sanming, China
| | - Qiaofa Lin
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Ying Ye
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Hongmei Fan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Kaizhen Wen
- Department of Clinical Laboratory, Jinjiang Municipal Hospital, Jinjiang, China
| | - Jianxing Zeng
- Department of Clinical Laboratory, Jinjiang Municipal Hospital, Jinjiang, China
| | - Donghong Huang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Wenfei Mo
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Ying Lei
- Department of Clinical Laboratory, Quanzhou Women's and Children's Hospital, Quanzhou, China
| | - Zhijun Liao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
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Mohamed SA, Samir TM, Helmy OM, Elhosseiny NM, Ali AA, El-Kholy AA, Attia AS. A Novel Surface-Exposed Polypeptide Is Successfully Employed as a Target for Developing a Prototype One-Step Immunochromatographic Strip for Specific and Sensitive Direct Detection of Staphylococcus aureus Causing Neonatal Sepsis. Biomolecules 2020; 10:E1580. [PMID: 33233724 PMCID: PMC7699858 DOI: 10.3390/biom10111580] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022] Open
Abstract
Neonatal sepsis is a life-threatening condition and Staphylococcus aureus is one of its major causes. However, to date, no rapid and sensitive diagnostic tool has been developed for its direct detection. Bioinformatics analyses identified a surface-exposed 112-amino acid polypeptide of the cell wall protein NWMN_1649, a surface protein involved in cell aggregation and biofilm formation, as being a species-specific and highly conserved moiety. The polypeptide was cloned, purified, and used to immunize mice to raise specific immunoglobulins. The purified antibodies were conjugated to gold nano-particles and used to assemble an immunochromatographic strip (ICS). The developed prototype ICS detected as low as 5 µg purified polypeptide and 102 CFU/mL S. aureus within 15 min. The strip showed superior ability to directly detect S. aureus in neonatal sepsis blood specimens without prior sample processing. Moreover, it showed no cross-reaction in specimens infected with two other major causes of neonatal sepsis; coagulase-negative staphylococci and Klebsiella pneumoniae. The selected NWMN_1649-derived polypeptide demonstrates success as a promising biomolecule upon which a prototype ICS has been developed. This ICS provides a rapid, direct, sensitive, and specific option for the detection of S. aureus causing neonatal sepsis. Such a tool is urgently needed especially in resources-limited countries.
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Affiliation(s)
- Sally A. Mohamed
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt; (S.A.M.); (O.M.H.); (N.M.E.)
| | - Tamer M. Samir
- Department of Microbiology and Immunology, College of Pharmaceutical Sciences and Drug Manufacturing, Misr University for Science and Technology, 6th of October City 12566, Egypt;
| | - Omneya M. Helmy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt; (S.A.M.); (O.M.H.); (N.M.E.)
| | - Noha M. Elhosseiny
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt; (S.A.M.); (O.M.H.); (N.M.E.)
| | - Aliaa A. Ali
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo 11562, Egypt;
| | - Amani A. El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt;
| | - Ahmed S. Attia
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt; (S.A.M.); (O.M.H.); (N.M.E.)
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Vlaeminck J, Raafat D, Surmann K, Timbermont L, Normann N, Sellman B, van Wamel WJB, Malhotra-Kumar S. Exploring Virulence Factors and Alternative Therapies against Staphylococcus aureus Pneumonia. Toxins (Basel) 2020; 12:toxins12110721. [PMID: 33218049 PMCID: PMC7698915 DOI: 10.3390/toxins12110721] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 12/13/2022] Open
Abstract
Pneumonia is an acute pulmonary infection associated with high mortality and an immense financial burden on healthcare systems. Staphylococcus aureus is an opportunistic pathogen capable of inducing S. aureus pneumonia (SAP), with some lineages also showing multidrug resistance. Given the high level of antibiotic resistance, much research has been focused on targeting S. aureus virulence factors, including toxins and biofilm-associated proteins, in an attempt to develop effective SAP therapeutics. Despite several promising leads, many hurdles still remain for S. aureus vaccine research. Here, we review the state-of-the-art SAP therapeutics, highlight their pitfalls, and discuss alternative approaches of potential significance and future perspectives.
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Affiliation(s)
- Jelle Vlaeminck
- Laboratory of Medical Microbiology, Vaccine and Infectious Diseases Institute, University of Antwerp, 2610 Antwerp, Belgium; (J.V.); (L.T.)
| | - Dina Raafat
- Department of Immunology, Institute of Immunology and Transfusion Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (D.R.); (N.N.)
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt
| | - Kristin Surmann
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Leen Timbermont
- Laboratory of Medical Microbiology, Vaccine and Infectious Diseases Institute, University of Antwerp, 2610 Antwerp, Belgium; (J.V.); (L.T.)
| | - Nicole Normann
- Department of Immunology, Institute of Immunology and Transfusion Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (D.R.); (N.N.)
| | - Bret Sellman
- Microbiome Discovery, Microbial Sciences, BioPharmaceuticals R & D, AstraZeneca, Gaithersburg, MD 20878, USA;
| | - Willem J. B. van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center Rotterdam, 3015 Rotterdam, The Netherlands;
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine and Infectious Diseases Institute, University of Antwerp, 2610 Antwerp, Belgium; (J.V.); (L.T.)
- Correspondence: ; Tel.: +32-3-265-27-52
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Li QQ, Luo J, Liu XQ, Kwon DY, Kang OH. Eleutheroside K isolated from Acanthopanax henryi (Oliv.) Harms suppresses methicillin resistance of Staphylococcus aureus. Lett Appl Microbiol 2020; 72:669-676. [PMID: 32955753 DOI: 10.1111/lam.13389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/03/2020] [Accepted: 09/10/2020] [Indexed: 01/03/2023]
Abstract
Acanthopanax (A.) henryi (Oliv.) Harms contain many bioactive compounds commonly used in traditional Chinese medicine. The objective of the present study was to investigate the antibacterial activity of the single constituent, Eleutheroside K (ETSK) isolated from the leaves of A. henryi (Oliv.) Harms, against methicillin-resistant Staphylococcus (S.) aureus (MRSA). Broth microdilution assay was used to measure the minimal inhibitory concentration (MIC) and the MIC values of ETSK against eight clinical S. aureus strains were all 50 µg ml-1 . At sub-inhibitory concentrations, a synergistic effect between oxacillin (OXA) and ETSK was confirmed using checkerboard dilution assay and time-kill curve analysis. The bacteriostatic effect became more pronounced when ETSK was used in combination with detergent (Triton X-100) or ATPase inhibitor (N, N'-dicyclohexylcarbodiimide). According to western blot analysis, the down-regulated expression of Penicillin-binding protein 2a (PBP2a) further validated that the bacterial activity was inhibited when treated with ETSK in a dose-dependent manner. Results based on our study verified that ETSK significantly suppressed MRSA infections and emphasized the potential application of ETSK as a novel anti-MRSA natural drug.
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Affiliation(s)
- Q-Q Li
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang Oriental Medicines Research Institute, Wonkwang University, Jeonbuk, Korea
| | - J Luo
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, Hunan, P.R. China
| | - X-Q Liu
- School of Pharmacy, Hunan University of Chinese Medicine, Changsha, Hunan, P.R. China
| | - D-Y Kwon
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang Oriental Medicines Research Institute, Wonkwang University, Jeonbuk, Korea
| | - O-H Kang
- Department of Oriental Pharmacy, College of Pharmacy and Wonkwang Oriental Medicines Research Institute, Wonkwang University, Jeonbuk, Korea
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Changing Epidemiology of Presumptive Community-associated-methicillin-resistant Staphylococcus Aureus in Slovenia in 2014-2015 Compared To 2010. Zdr Varst 2020; 59:236-244. [PMID: 33133280 PMCID: PMC7583430 DOI: 10.2478/sjph-2020-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/16/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction Although the distinction between the Community-Associated-Methicillin-Resistant Staphylococcus aureus (CA-MRSA) and Hospital-Associated-Methicillin-Resistant S. aureus (HA-MRSA) has blurred in recent years, the CA-MRSA is an important group because of its potential to cause fulminant and severe infections. Its importance has further increased with the emergence of Livestock-Associated-Methicillin-Resistant S. aureus (LA-MRSA). Methods In the present study we analysed clonal distributions and virulence factors in presumptive CA-MRSA isolated from January 2014 to December 2015 and compared the results with our previous study from 2010. Phenotypic definition for presumptive CA-MRSA was based on resistance to cefoxitin and oxacillin and susceptibility to at least two of the following four antibiotics: ciprofloxacin, erythromycin, clindamycin and gentamicin. Results In 2014 and 2015 altogether 304 MRSA isolates fulfilled our screening phenotypic definition, 45 isolates were cultivated from clinical specimens and 259 from screening specimens. Sequence types ST398, LA-MRSA and mecC MRSA increased significantly in 2015 compared to 2010 (p-value <0.05) and were spread over Slovenia. Conclusion The clonal distribution of presumptive CA-MRSA has changed within the study period in Slovenia. In 2015 the most frequent clone among clinical and screening specimens was a pig-associated clone, ST398, but the number of confirmed ST398 infections remains low. While previously ST398 and mecC positive MRSA strains were geographically limited, they have spread throughout the country since 2010.
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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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Coexistence of Antibiotic Resistance Genes and Virulence Factors Deciphered by Large-Scale Complete Genome Analysis. mSystems 2020; 5:5/3/e00821-19. [PMID: 32487745 PMCID: PMC8534731 DOI: 10.1128/msystems.00821-19] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Widespread use of antibiotics has enhanced the evolution of highly resilient pathogens and poses a severe risk to human health via coselection of antibiotic resistance genes (ARGs) and virulence factors (VFs). In this study, we rigorously evaluate the abundance relationship and physical linkage between ARGs and VFs by performing a comprehensive analysis of 9,070 bacterial genomes isolated from multiple species and hosts. The coexistence of ARGs and VFs was observed in bacteria across distinct phyla, pathogenicities, and habitats, especially among human-associated pathogens. The coexistence patterns of gene elements in different habitats and pathogenicity groups were similar, presumably due to frequent gene transfer. A shorter intergenic distance between mobile genetic elements and ARGs/VFs was detected in human/animal-associated bacteria, indicating a higher transfer potential. Increased accumulation of exogenous ARGs/VFs in human pathogens highlights the importance of gene acquisition in the evolution of human commensal bacteria. Overall, the findings provide insights into the genic features of combinations of ARG-VF and expand our understanding of ARG-VF coexistence in bacteria.IMPORTANCE Antibiotic resistance has become a serious global health concern. Despite numerous case studies, a comprehensive analysis of ARG and VF coexistence in bacteria is lacking. In this study, we explore the coexistence profiles of ARGs and VFs in diverse categories of bacteria by using a high-resolution bioinformatics approach. We also provide compelling evidence of unique ARG-VF gene pairs coexisting in specific bacterial genomes and reveal the potential risk associated with the coexistence of ARGs and VFs in organisms in both clinical settings and environments.
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Sahibzada S, Pang S, Hernández-Jover M, Jordan D, Abraham S, O'Dea M, Heller J. Prevalence and antimicrobial resistance of MRSA across different pig age groups in an intensive pig production system in Australia. Zoonoses Public Health 2020; 67:576-586. [PMID: 32458580 DOI: 10.1111/zph.12721] [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] [Received: 04/03/2019] [Revised: 11/21/2019] [Accepted: 04/14/2020] [Indexed: 01/22/2023]
Abstract
This observational study aimed to determine MRSA prevalence using strain-specific real-time PCR at the pig level, stratified by age groupings, within a pig enterprise. A total of 658 samples were collected from individual pigs (n = 618) and the piggery environment (n = 40), distributed amongst five different pig age groups. Presumptive MRSA isolates were confirmed by the presence of mecA, and MALDI-TOF was performed for species verification. All isolates were tested against 18 different antimicrobials. MRSA was isolated from 75.2% (95% CI 71.8-78.6) of samples collected from pigs, and 71% of the MRSA isolates from this source were identified as community-associated (CA)-MRSA ST93, while the remainder were livestock-associated (LA)-MRSA ST398. Amongst environmental isolates, 80% (CI 64.3-95.7) were ST93 and the remainder ST398. All MRSA isolates from pigs and the environment were susceptible to ciprofloxacin, gentamicin, linezolid, mupirocin, rifampicin, sulfamethoxazole-trimethoprim, teicoplanin and vancomycin. Phenotypic rates of resistance were penicillin (100%), clindamycin (97.6%), erythromycin (96.3%), ceftiofur (93.7%), chloramphenicol (81.2%), tetracycline (63.1%) and amoxicillin-clavulanate (63.9%). A low prevalence of resistance (9.2%) was observed against neomycin and quinupristin-dalfopristin. The probability of MRSA carriage in dry sows (42.2%) was found to be significantly lower (p < .001) when compared to other age groups: farrowing sows (76.8%, RR1.82), weaners (97.8%, RR 2.32), growers (94.2%, RR 2.23) and finishers (98.3%, RR 2.33). Amongst different production age groups, a significant difference was also found in antimicrobial resistance for amoxicillin-clavulanate, neomycin, chloramphenicol and tetracycline. Using the RT-PCR assay adopted in this study, filtering of highly prevalent ST93 and non-ST93 isolates was performed at high throughput and low cost. In conclusion, this study found that weaner pigs presented a higher risk for CA-MRSA and antimicrobial resistance compared to other age groups. These findings have major implications for how investigations of MRSA outbreaks should be approached under the One-Health context.
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Affiliation(s)
- Shafi Sahibzada
- Antimicrobial Resistance and Infectious Diseases Laboratory, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia.,School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.,Graham Centre for Agricultural Innovation, Wagga Wagga, NSW, Australia
| | - Stanley Pang
- Antimicrobial Resistance and Infectious Diseases Laboratory, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia.,PathWest Laboratory Medicine - WA, Fiona Stanley Hospital, Murdoch, Australia
| | - Marta Hernández-Jover
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.,Graham Centre for Agricultural Innovation, Wagga Wagga, NSW, Australia
| | - David Jordan
- New South Wales Department of Primary Industries, Wollongbar, NSW, Australia
| | - Sam Abraham
- Antimicrobial Resistance and Infectious Diseases Laboratory, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Mark O'Dea
- Antimicrobial Resistance and Infectious Diseases Laboratory, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Jane Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.,Graham Centre for Agricultural Innovation, Wagga Wagga, NSW, Australia
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Ernst CM, Braxton JR, Rodriguez-Osorio CA, Zagieboylo AP, Li L, Pironti A, Manson AL, Nair AV, Benson M, Cummins K, Clatworthy AE, Earl AM, Cosimi LA, Hung DT. Adaptive evolution of virulence and persistence in carbapenem-resistant Klebsiella pneumoniae. Nat Med 2020; 26:705-711. [PMID: 32284589 PMCID: PMC9194776 DOI: 10.1038/s41591-020-0825-4] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/06/2020] [Indexed: 12/13/2022]
Abstract
Among the most urgent public health threats is the worldwide emergence of carbapenem-resistant Enterobacteriaceae1-4, which are resistant to the antibiotic class of 'last resort'. In the United States and Europe, carbapenem-resistant strains of the Klebsiella pneumoniae ST258 (ref. 5) sequence type are dominant, endemic6-8 and associated with high mortality6,9,10. We report the global evolution of pathogenicity in carbapenem-resistant K. pneumoniae, resulting in the repeated convergence of virulence and carbapenem resistance in the United States and Europe, dating back to as early as 2009. We demonstrate that K. pneumoniae can enhance its pathogenicity by adopting two opposing infection programs through easily acquired gain- and loss-of-function mutations. Single-nucleotide polymorphisms in the capsule biosynthesis gene wzc lead to hypercapsule production, which confers phagocytosis resistance, enhanced dissemination and increased mortality in animal models. In contrast, mutations disrupting capsule biosynthesis genes impair capsule production, which enhances epithelial cell invasion, in vitro biofilm formation and persistence in urinary tract infections. These two types of capsule mutants have emerged repeatedly and independently in Europe and the United States, with hypercapsule mutants associated with bloodstream infections and capsule-deficient mutants associated with urinary tract infections. In the latter case, drug-tolerant K. pneumoniae can persist to yield potentially untreatable, persistent infection.
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Affiliation(s)
- Christoph M Ernst
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Julian R Braxton
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Carlos A Rodriguez-Osorio
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Anna P Zagieboylo
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Li Li
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | | | | | - Anil V Nair
- Center for Systems Biology, Program in Membrane Biology, Division of Nephrology, Massachusetts General Hospital, Boston, MA, USA
| | - Maura Benson
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Kaelyn Cummins
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Anne E Clatworthy
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Ashlee M Earl
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Lisa A Cosimi
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Deborah T Hung
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Department of Molecular Biology and Center for Computational and Integrative Biology, Massachusetts General Hospital, Boston, MA, USA.
- Department of Genetics, Harvard Medical School, Boston, MA, USA.
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Synthetic molecular evolution of host cell-compatible, antimicrobial peptides effective against drug-resistant, biofilm-forming bacteria. Proc Natl Acad Sci U S A 2020; 117:8437-8448. [PMID: 32241895 DOI: 10.1073/pnas.1918427117] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Novel classes of antibiotics and new strategies to prevent and treat infections are urgently needed because the rapid rise in drug-resistant bacterial infections in recent decades has been accompanied by a parallel decline in development of new antibiotics. Membrane permeabilizing antimicrobial peptides (AMPs) have long been considered a potentially promising, novel class of antibiotic, especially for wound protection and treatment to prevent the development of serious infections. Yet, despite thousands of known examples, AMPs have only infrequently proceeded as far as clinical trials, especially the chemically simple, linear examples. In part, this is due to impediments that often limit their applications in vivo. These can include low solubility, residual toxicity, susceptibility to proteolysis, and loss of activity due to host cell, tissue, and protein binding. Here we show how synthetic molecular evolution can be used to evolve potentially advantageous antimicrobial peptides that lack these impediments from parent peptides that have at least some of them. As an example of how the antibiotic discovery pipeline can be populated with more promising candidates, we evolved and optimized one family of linear AMPs into a new generation with high solubility, low cytotoxicity, potent broad-spectrum sterilizing activity against a panel of gram-positive and gram-negative ESKAPE pathogens, and antibiofilm activity against gram-positive and gram-negative biofilms. The evolved peptides have these activities in vitro even in the presence of concentrated host cells and also in vivo in the complex, cell- and protein-rich environment of a purulent animal wound model infected with drug-resistant bacteria.
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36
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Malik Z. Photodynamic inactivation of antibiotic‐resistant Gram‐positive bacteria: Challenges and opportunities. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.201900030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Zvi Malik
- Faculty of Life ScienceBar‐Ilan University Ramat‐Gan Israel
- Zefat Academic College Zefat Israel
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37
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Coombs GW, Baines SL, Howden BP, Swenson KM, O’Brien FG. Diversity of bacteriophages encoding Panton-Valentine leukocidin in temporally and geographically related Staphylococcus aureus. PLoS One 2020; 15:e0228676. [PMID: 32040487 PMCID: PMC7010278 DOI: 10.1371/journal.pone.0228676] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 01/21/2020] [Indexed: 01/21/2023] Open
Abstract
Production of the Panton-Valentine leukocidin (PVL) by Staphylococcus aureus is mediated via the genes lukS-PV and lukF-PV which are carried on bacteriophage ϕSa2. PVL is associated with S. aureus strains that cause serious infections and clones of community-associated methicillin-resistant S. aureus (CA-MRSA) that have additionally disseminated widely. In Western Australia (WA) the original CA-MRSA were PVL negative however, between 2005 and 2008, following the introduction of eight international PVL-positive CA-MRSA, PVL-positive WA CA-MRSA were found. There was concern that PVL bacteriophages from the international clones were transferring into the local clones, therefore a comparative study of PVL-carrying ϕSa2 prophage genomes from historic WA PVL-positive S. aureus and representatives of all PVL-positive CA-MRSA isolated in WA between 2005 and 2008 was performed. The prophages were classified into two genera and three PVL bacteriophage groups and had undergone many recombination events during their evolution. Comparative analysis of mosaic regions of selected bacteriophages using the Alignments of bacteriophage genomes (Alpha) aligner revealed novel recombinations and modules. There was heterogeneity in the chromosomal integration sites, the lysogeny regulation regions, the defence and DNA processing modules, the structural and packaging modules and the lukSF-PV genes. One WA CA-MRSA (WA518751) and one international clone (Korean Clone) have probably acquired PVL-carrying ϕSa2 in WA, however these clones did not disseminate in the community. Genetic heterogeneity made it impossible to trace the source of the PVL prophages in the other WA clones. Against this background of PVL prophage diversity, the sequence of one group, the ϕSa2USA/ϕSa2wa-st93 group, was remarkably stable over at least 20 years and associated with the highly virulent USA300 and ST93-IVa CA-MRSA lineages that have disseminated globally.
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Affiliation(s)
- Geoffrey W. Coombs
- Antimicrobial Resistance and Infectious Diseases Research Laboratory, Murdoch University, Murdoch, Western Australia, Australia
- PathWest Laboratory Medicine—WA, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- * E-mail:
| | - Sarah L. Baines
- Doherty Applied Microbial Genomics, Department of Microbiology & Immunology, The University of Melbourne at The Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia
| | - Benjamin P. Howden
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology & Immunology, The University of Melbourne at The Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia
| | - Krister M. Swenson
- LIRMM, CNRS-Univ. Montpellier, Montpellier, France
- IBC Institute de Biologie Computationnelle, Montpellier, France
| | - Frances G. O’Brien
- Curtin Health Innovation Research Institute and the School of Pharmacy & Biomedical Sciences, Curtin University, Western Australia, Australia
- Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, School of Veterinary Sciences and Life Sciences, Murdoch University and Curtin University, School of Pharmacy and Biomedical Sciences, Perth, Western Australia, Australia
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38
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Lai CF, Xiao WB, Yan HC, Yang H, Wang LX, Guan H, Peng QJ, Deng ZR, Chen JW, An LK, Shi L. ZTW-41, a Potent Indolizinoquinoline-5,12-Dione Derivative Against Drug-Resistant Staphylococci and Enterococci Bacteria. Microb Drug Resist 2020; 26:100-109. [PMID: 31441704 DOI: 10.1089/mdr.2019.0008] [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: 10/26/2022] Open
Abstract
ZTW-41, an indolizinoquinoline-5,12-dione derivative, was investigated for antibacterial activity against Gram-positive bacteria, especially methicillin-resistant Staphylococcus aureus (MRSA). In our study, the MIC90s (minimum inhibitory concentrations) of ZTW-41 against MRSA (MRSA, n = 200), methicillin-sensitive S. aureus (MSSA, n = 100), Enterococcus faecalis (E. faecalis, n = 32), and Enterococcus faecium (E. faecium n = 32) were 0.25, 0.25, 0.125, and 8 μg/mL, respectively, whereas the MBC90s (minimum bactericidal concentrations) were 2, 1, 1, and >32 μg/mL, respectively. ZTW-41 maintained its potency at different pH levels (range 5-9) and in starting inoculum size up to 107 CFU/mL. The presence of human serum (25-75%) increased ZTW-41 MICs by two- to eightfold. Time-kill curves showed that ZTW-41 had bactericidal activity against MRSA, MSSA, and E. faecalis strains within 8 hours, and rebound growth occurred after 8 hours except at higher multiples of the MIC (4 × and 8 × ). In the acute toxicity study, no mortality or signs of toxicity was noted in mice after 14 days of observation at doses <50 mg/kg. ZTW-41 exhibited good selectivity indices (SIs) (SI = IC50/MIC90) ranging from 1.12 to 71.76 against clinical isolates, demonstrating excellent therapeutic selectivity in MRSA, MSSA, and E. faecalis strains. Moreover, the in vivo efficacy (effective dose [ED]50 = 6.59 mg/kg) of ZTW-41 was found comparable with vancomycin. Collectively, our favorable results supported ZTW-41 as a promising investigational candidate for treating drug-resistant bacteria infection.
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Affiliation(s)
- Chong-Fa Lai
- Southern Medical University, Guangzhou, China.,General Hospital of Southern Theatre Command, Guangzhou, China
| | - Wei-Bin Xiao
- General Hospital of Southern Theatre Command, Guangzhou, China
| | - Hua-Cheng Yan
- Center for Disease Control and Prevention of Southern Theatre Command, Guangzhou, China
| | - Hui Yang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China
| | - Lu-Xia Wang
- General Hospital of Southern Theatre Command, Guangzhou, China
| | - Hui Guan
- General Hospital of Southern Theatre Command, Guangzhou, China
| | - Qiu-Ju Peng
- Center for Disease Control and Prevention of Southern Theatre Command, Guangzhou, China
| | - Zhi-Rong Deng
- Center for Disease Control and Prevention of Southern Theatre Command, Guangzhou, China
| | - Jian-Wen Chen
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China
| | - Lin-Kun An
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Guangzhou, China
| | - Lei Shi
- Southern Medical University, Guangzhou, China.,General Hospital of Southern Theatre Command, Guangzhou, China
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39
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Pardo L, Machado V, Cuello D, Aguerrebere P, Seija V, Braga V, Varela G. Macrolide-lincosamide-streptogramin B resistance phenotypes and their associated genotypes in Staphylococcus aureus isolates from a tertiary level public hospital of Uruguay. Rev Argent Microbiol 2020; 52:202-210. [PMID: 31928835 DOI: 10.1016/j.ram.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/27/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022] Open
Abstract
This study was undertaken to investigate the resistance phenotypes to macrolide-lincosamide-streptogramin B (MLSB) antibiotics and their associated genotypes in isolates of Staphylococcus aureus. We analyzed one hundred, consecutive, non-duplicate isolates (methicillin-susceptible MSSA, n=53 and methicillin-resistant MRSA, n=47) obtained from various clinical samples between July 2012 to December 2013. The resistance profile to MLSB antibiotics was determined by phenotypic methods and the resistance genes were detected by PCR assays. All of the isolates were subjected to pulsed-field gel electrophoresis (SmaI-PFGE). The overall prevalence of resistance to MLSB antibiotics was 38% and the resistance phenotype distribution was as follows: cMLSB, 22%; iMLSB, 10%; MSB, 5% and L, 1%. We detected ermA, ermC, ermB and mrsA/B genes in these resistant isolates. The single ermA gene was commonly observed mainly in those with a cMLSB R phenotype, whereas the combination ermA and ermC was more commonly observed in isolates with inducible expression. The patterns of SmaI-PFGE suggest a great genetic diversity in both MRSA and MSSA resistant to MLSB antibiotics. The results demonstrate the local presence of S. aureus resistant to MLSB antibiotics and its most frequently described responsible genes. Some of these isolates, especially those with the iMLSB phenotype, may be associated with therapeutic failure. Therefore, efforts should be directed to the correct detection of all MLSB resistant isolates using appropriate laboratory tests. PFGE results reveal a wide spread of resistance genes rather than the circulation of S. aureus clones resistant to MLSB antibiotics.
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Affiliation(s)
- Lorena Pardo
- Bacteriology and Virology Department, Medicine School, Universidad de la República, Montevideo Alfredo Navarro 3051 (south entrance), 11800, Uruguay
| | - Virginia Machado
- Bacteriology and Virology Department, Medicine School, Universidad de la República, Montevideo Alfredo Navarro 3051 (south entrance), 11800, Uruguay
| | - Dianna Cuello
- Bacteriology and Virology Department, Medicine School, Universidad de la República, Montevideo Alfredo Navarro 3051 (south entrance), 11800, Uruguay
| | - Paula Aguerrebere
- Bacteriology and Virology Department, Medicine School, Universidad de la República, Montevideo Alfredo Navarro 3051 (south entrance), 11800, Uruguay
| | - Verónica Seija
- Bacteriology Laboratory, "Hospital Pasteur", Montevideo, Larravide 2458, 11800, Uruguay; Laboratory of Public Health, Alfredo Navarro 3051 (north-entrance), Montevideo, Uruguay
| | - Valeria Braga
- Bacteriology and Virology Department, Medicine School, Universidad de la República, Montevideo Alfredo Navarro 3051 (south entrance), 11800, Uruguay
| | - Gustavo Varela
- Bacteriology and Virology Department, Medicine School, Universidad de la República, Montevideo Alfredo Navarro 3051 (south entrance), 11800, Uruguay.
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40
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Hassan D, Omolo CA, Fasiku VO, Mocktar C, Govender T. Novel chitosan-based pH-responsive lipid-polymer hybrid nanovesicles (OLA-LPHVs) for delivery of vancomycin against methicillin-resistant Staphylococcus aureus infections. Int J Biol Macromol 2020; 147:385-398. [PMID: 31926237 DOI: 10.1016/j.ijbiomac.2020.01.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/18/2019] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
Abstract
The development of novel materials is necessary for adequate delivery of drugs to combat the Methicillin-resistant Staphylococcus aureus (MRSA) burden due to the limitations of conventional methods and challenges associated with antimicrobial resistance. Hence, this study aimed to synthesise a novel oleylamine based zwitterionic lipid (OLA) and explore its potential to formulate chitosan-based pH-responsive lipid-polymer hybrid nanovesicles (VM-OLA-LPHVs1) to deliver VM against MRSA. The OLA was synthesised, and the structure characterised by 1H NMR, 13C NMR, FT-IR and HR-MS. The preliminary biocompatibility of OLA and VM-OLA-LPHVs1 was evaluated on HEK-293, A-549, MCF-7 and HepG-2 cell lines using in vitro cytotoxicity assay. The VM-OLA-LPHVs1 were formulated by ionic gelation method and characterised in order to determine the hydrodynamic diameter (DH), morphology in vitro and in vivo antibacterial efficacy. The result of the in vitro cytotoxicity study revealed cell viability of above 75% in all cell lines when exposed to OLA and VM-OLA-LPHVs1, thus indicating their biosafety. The VM-OLA-LPHVs1 had a DH, polydispersity index (PDI), and EE% of 198.0 ± 14.04 nm, 0.137 ± 0.02, and 45.61 ± 0.54% respectively at physiological pH, with surface-charge (ζ) switching from negative at pH 7.4 to positive at pH 6.0. The VM release from the VM-OLA-LPHVs1 was faster at pH 6.0 compared to physiological pH, with 97% release after 72-h. The VM-OLA-LPHVs1 had a lower minimum inhibitory concentration (MIC) value of 0.59 μg/mL at pH 6.0 compared to 2.39 μg/mL at pH 7.4, against MRSA with 52.9-fold antibacterial enhancement. The flow cytometry study revealed that VM-OLA-LPHVs1 had similar bactericidal efficacy on MRSA compared to bare VM, despite an 8-fold lower VM concentration in the nanovesicles. Additionally, fluorescence microscopy study showed the ability of the VM-OLA-LPHVs1 to eliminate biofilms. The electrical conductivity, and protein/DNA concentration, increased and decreased respectively, as compared to bare VM which indicated greater MRSA membrane damage. The in vivo studies in a BALB/c mouse-infected skin model treated with VM-OLA-LPHVs1 revealed 95-fold lower MRSA burden compared to the group treated with bare VM. These findings suggest that OLA can be used as an effective novel material for complexation with biodegradable polymer chitosan (CHs) to form pH-responsive VM-OLA-LPHVs1 nanovesicles which show greater potential for enhancement and improvement of treatment of bacterial infections.
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Affiliation(s)
- Daniel Hassan
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa
| | - Calvin A Omolo
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa; United States International University-Africa, School of Pharmacy and Health Sciences, Department of Pharmaceutics, P. O. Box 14634-00800, Nairobi, Kenya.
| | - Victoria Oluwaseun Fasiku
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa
| | - Chunderika Mocktar
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa
| | - Thirumala Govender
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa.
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41
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Quorum sensing in food spoilage and natural-based strategies for its inhibition. Food Res Int 2019; 127:108754. [PMID: 31882100 DOI: 10.1016/j.foodres.2019.108754] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/27/2019] [Accepted: 10/13/2019] [Indexed: 10/25/2022]
Abstract
Food can harbor a variety of microorganisms including spoilage and pathogenic bacteria. Many bacterial processes, including production of degrading enzymes, virulence factors, and biofilm formation are known to depend on cell density through a process called quorum sensing (QS), in which cells communicate by synthesizing, detecting and reacting to small diffusible signaling molecules - autoinducers (AI). The disruption of QS could decisively contribute to control the expression of many harmful bacterial phenotypes. Several quorum sensing inhibitors (QSI) have been extensively studied, being many of them of natural origin. This review provides an analysis on the role of QS in food spoilage and biofilm formation within the food industry. QSI from natural sources are also reviewed towards their putative future applications to prolong shelf life of food products and decrease foodborne pathogenicity.
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42
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Che Hamzah AM, Yeo CC, Puah SM, Chua KH, A Rahman NI, Abdullah FH, Othman N, Chew CH. Tigecycline and inducible clindamycin resistance in clinical isolates of methicillin-resistant Staphylococcus aureus from Terengganu, Malaysia. J Med Microbiol 2019; 68:1299-1305. [PMID: 31140965 DOI: 10.1099/jmm.0.000993] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The spread of multidrug-resistant Staphylococcus aureus is a public health concern. The inducible macrolide-lincosamide-streptogrammin B (iMLSB ) phenotype (or inducible clindamycin resistance) is associated with false clindamycin susceptibility in routine laboratory testing and may lead to treatment failure. Tigecycline resistance remains rare in S. aureus worldwide. This study aims to determine the antimicrobial susceptibility profiles of clinical isolates of S. aureus obtained from the main tertiary hospital in Terengganu state, Malaysia, from July 2016 to June 2017. The antimicrobial susceptibilities of 90 methicillin-resistant S. aureus (MRSA) and 109 methicillin-susceptible S. aureus (MSSA) isolates were determined by disc diffusion with the iMLSB phenotype determined by D-test. Multidrug resistance (MDR) and the iMLSB phenotype were more prevalent in MRSA (84.4 and 46.7 %, respectively) compared to MSSA isolates. All five tigecycline-resistant isolates were MRSA. The high incidence of MDR and the iMLSB phenotype and the emergence of tigecycline resistance in the Terengganu S. aureus isolates warrants continuous vigilance.
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Affiliation(s)
- Ainal Mardziah Che Hamzah
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
| | - Chew Chieng Yeo
- Faculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu, Malaysia
| | - Suat Moi Puah
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Kek Heng Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nor Iza A Rahman
- Faculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu, Malaysia
| | - Fatimah Haslina Abdullah
- Department of Pathology, Hospital Sultanah Nur Zahirah, 20400 Kuala Terengganu, Terengganu, Malaysia
| | - Norlela Othman
- Department of Pathology, Hospital Sultanah Nur Zahirah, 20400 Kuala Terengganu, Terengganu, Malaysia
| | - Ching Hoong Chew
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
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Li J, Wang H, Han Y, Zhao Y, Zhou H, Xu J, Li L. Novel peptides screened by phage display peptide library can mimic epitopes of the FnBPA-A protein and induce protective immunity against Staphylococcus aureus in mice. Microbiologyopen 2019; 8:e910. [PMID: 31452334 PMCID: PMC6813446 DOI: 10.1002/mbo3.910] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/20/2019] [Accepted: 06/30/2019] [Indexed: 12/15/2022] Open
Abstract
Fibronectin‐binding protein A (FnBPA) is a key adhesin of Staphylococcus aureus, and the protein binding to fibrinogen and elastin is mediated by its N‐terminal A domain. Thus, FnBPA‐A has been considered a potential vaccine candidate, but the relevant epitopes are not fully understood. Here, purified rabbit anti‐FnBPA‐A antibodies were produced and used to screen for peptides corresponding to or mimicking the epitope of native FnBPA‐A protein by using a phage random 12‐mer peptide library. After four rounds of panning, 25 randomly selected phage clones were detected by phage‐ELISA and competition‐inhibition ELISA. Then, eight anti‐rFnBPA‐A antibody‐binding phage clones were selected for sequencing, and six different 12‐mer peptides were displayed by these phages. Although these displayed peptides shared no more than three consecutive amino acid residues identical to the sequence of FnBPA‐A, they could be recognized by the FnBPA‐A‐specific antibodies in vitro and could induce specific antibodies against FnBPA‐A in vivo, suggesting that these displayed peptides were mimotopes of FnBPA‐A. Finally, the protective efficiencies of these mimotopes were investigated by mouse vaccination and challenge experiments. Compared with that of control group mice, the relative percent survival of mice immunized with phage clones displaying a mimotope was 13.33% (C2 or C15), 0% (C8), 6.67% (C10), 26.67% (C19 or 1:2 mixture of C23 and C19), 53.33% (C23), 33.33% (1:1 mixture of C23 and C19), and 66.67% (2:1 mixture of C23 and C19). Overall, five peptides mimicking FnBPA‐A protein epitopes were obtained, and a partially protective immunity against S. aureus infection could be stimulated by these mimotope peptides in mice.
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Affiliation(s)
- Jin‐Nian Li
- Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control, College of Animal Science and TechnologyAnhui Agricultural UniversityHefeiChina
| | - Hong Wang
- Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control, College of Animal Science and TechnologyAnhui Agricultural UniversityHefeiChina
| | - Yu‐Xi Han
- Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control, College of Animal Science and TechnologyAnhui Agricultural UniversityHefeiChina
| | - Yu‐Ting Zhao
- Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control, College of Animal Science and TechnologyAnhui Agricultural UniversityHefeiChina
| | - Huan‐Huan Zhou
- Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control, College of Animal Science and TechnologyAnhui Agricultural UniversityHefeiChina
| | - Jun Xu
- Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control, College of Animal Science and TechnologyAnhui Agricultural UniversityHefeiChina
| | - Lin Li
- Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control, College of Animal Science and TechnologyAnhui Agricultural UniversityHefeiChina
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Abstract
Staphylococcus aureus has been recognised as one of the important zoonotic pathogens. However, knowledge about the epidemiology and genetic characteristics of S. aureus in rabbits was limited. The aim of this study was to determine the characteristics of 281 S. aureus isolated from dead rabbits of nine rabbit farms in Fujian Province, China. All the isolates were characterised by multi-locus sequencing typing, detection of virulence factors and antimicrobial susceptibility test. The results showed that the 281 isolates were grouped into two sequence types, ST121 (13.52%, 38/281) and ST398 (86.48%, 243/281). Surprisingly, the ST121 strains were only recovered from the lung samples from one of the nine rabbit farms studied. In the 281 isolates, the virulence genes of nuc, hla, hlb, clfA, clfB and fnbpA were positive, whereas the sea, seb, tsst, eta and etb genes were negative. Notably, the 38 ST121 isolates carried the pvl gene. All the 281 isolates were methicillin-susceptible S. aureus, and the isolates were susceptible to most of the used antibiotics, except for streptomycin, kanamycin, azithromycin and penicillin, and the resistance rates of which were 23.84%, 19.57%, 16.01% and 11.03%, respectively. This study first described the epidemiology and characteristics of S. aureus in rabbits in Fujian Province, which will help in tracking the evolution of epidemic strains and preventing the rabbit-human transmission events.
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Utsi L, Pichon B, Arunachalam N, Kerrane A, Batten E, Denton M, Townsend R, Agwuh KN, Hughes GJ, Kearns A. Circulation of a community healthcare-associated multiply-resistant meticillin-resistant Staphylococcus aureus lineage in South Yorkshire identified by whole genome sequencing. J Hosp Infect 2019; 103:454-460. [PMID: 31408690 DOI: 10.1016/j.jhin.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/06/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND A cluster of seven cases of skin and wound infections caused by a multiply resistant meticillin-resistant Staphylococcus aureus (MRSA) were detected in a small-town community in South Yorkshire. Initial microbiological investigations showed that all isolates belonged to a spa type observed rarely in England (t1476). AIM To describe the epidemiology of t1476 MRSA in South Yorkshire. METHODS Retrospective and prospective case ascertainment was promoted through communication with local microbiology laboratories. Public health investigation included a detailed review of clinical notes for a subset of nine cases. Genomic and phylogenetic analysis was undertaken on t1476 MRSA. FINDINGS Thirty-two cases of t1476 MRSA infection or colonization were identified between December 2014 and February 2018. Cases were older adults (aged 50-98 years). Healthcare exposures for a subset of nine cases indicated frequent contact with a team of district nurses, with all but one case receiving treatment on the same day as another case prior to their own diagnosis. No cases were admitted to hospital at the time of specimen collection. Despite detailed investigations, no carriers were detected among district nursing staff. A long-term carrier/super-shedder was not found. Phylogenetic analysis indicated that t1476 MRSA cases from South Yorkshire were monophyletic and distant from both MRSA of the same lineage from elsewhere in the UK (N = 15) and from publicly available sequences from Tanzania. CONCLUSION Genomic and epidemiological analyses indicate community-based transmission of a multiply resistant MRSA clone within South Yorkshire introduced around 2012-2013, prior to the detection of a spatial-temporal cluster associated with a distinct risk group. Surveillance data indicate continued circulation.
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Affiliation(s)
- L Utsi
- Field Service Yorkshire and Humber, National Infection Service, Public Health England, Leeds, UK.
| | - B Pichon
- Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
| | - N Arunachalam
- Public Health England Yorkshire and Humber, Leeds, UK
| | - A Kerrane
- The Rotherham NHS Foundation Trust, Rotherham, UK
| | - E Batten
- NHS Rotherham Clinical Commissioning Group, Rotherham, UK
| | - M Denton
- Field Service Yorkshire and Humber, National Infection Service, Public Health England, Leeds, UK
| | - R Townsend
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - K N Agwuh
- Doncaster & Bassetlaw Teaching Hospitals, Doncaster, UK
| | - G J Hughes
- Field Service Yorkshire and Humber, National Infection Service, Public Health England, Leeds, UK
| | - A Kearns
- Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK
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Yasir M, Dutta D, Willcox MDP. Mode of action of the antimicrobial peptide Mel4 is independent of Staphylococcus aureus cell membrane permeability. PLoS One 2019; 14:e0215703. [PMID: 31356627 PMCID: PMC6663011 DOI: 10.1371/journal.pone.0215703] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/11/2019] [Indexed: 01/30/2023] Open
Abstract
Mel4 is a novel cationic peptide with potent activity against Gram-positive bacteria. The current study examined the anti-staphylococcal mechanism of action of Mel4 and its precursor peptide melimine. The interaction of peptides with lipoteichoic acid (LTA) and with the cytoplasmic membrane using DiSC(3)-5, Sytox green, Syto-9 and PI dyes were studied. Release of ATP and DNA/RNA from cells exposed to the peptides were determined. Bacteriolysis and autolysin-activated cell death were determined by measuring decreases in OD620nm and killing of Micrococcus lysodeikticus cells by cell-free media. Both peptides bound to LTA and rapidly dissipated the membrane potential (within 30 seconds) without affecting bacterial viability. Disturbance of the membrane potential was followed by the release of ATP (50% of total cellular ATP) by melimine and by Mel4 (20%) after 2 minutes exposure (p<0.001). Mel4 resulted in staphylococcal cells taking up PI with 3.9% cells predominantly stained after 150 min exposure, whereas melimine showed 34% staining. Unlike melimine, Mel4 did not release DNA/RNA. Cell-free media from Mel4 treated cells hydrolysed peptidoglycan and produced greater zones of inhibition against M. lysodeikticus lawn than melimine treated samples. These findings suggest that pore formation is unlikely to be involved in Mel4-mediated membrane destabilization for staphylococci, since there was no significant Mel4-induced PI staining and DNA/RNA leakage. It is likely that the S. aureus killing mechanism of Mel4 involves the release of autolysins followed by cell death. Whereas, membrane interaction is the primary bactericidal activity of melimine, which includes membrane depolarization, pore formation, release of cellular contents leading to cell death.
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Affiliation(s)
- Muhammad Yasir
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- * E-mail:
| | - Debarun Dutta
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- Ophthalmic Research Group, School of Health and Life Sciences, Aston University Birmingham, United Kingdom
| | - Mark D. P. Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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Zhang W, Zhuo S, He L, Cheng C, Zhu B, Lu Y, Wu Q, Shang W, Ge W, Shi L. Daphnetin prevents methicillin-resistant Staphylococcus aureus infection by inducing autophagic response. Int Immunopharmacol 2019; 72:195-203. [PMID: 30991161 DOI: 10.1016/j.intimp.2019.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/25/2019] [Accepted: 04/03/2019] [Indexed: 12/19/2022]
Abstract
The bacterial pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) is a potentially fatal disease, featured with extensive infection, inflammation, and airway dysfunction. With the increasing emerging of drug-resistant strains, new therapeutic strategies beyond canonical antibiotic treatment are pressingly needed. Daphnetin (DAPH) is a natural coumarin derivative with anti-inflammation, anti-microorganism and anti-oxidative properties. However, the protective effect of DAPH on S. aureus-caused pneumonia and the mechanism involved are never explored. Here we show that DAPH treatment conferred substantial protection against S. aureus-induced pneumonia, characterized by the reduced inflammatory responses, the augmented bacterial clearance and the alleviated tissue damage. Our study indicates that DAPH significantly enhanced mTOR-dependent autophagic pathway, leading to the boosted microphage bactericidal activity and the suppressed inflammatory responses. Inhibition of autophagic pathway therefore largely abolished DAPH-elicited repression of inflammatory response and macrophage anti-bacterial capability. Together, we herein not only identify a novel, natural agent to combat bacterial pneumonia, but also underscore the significance of autophagic pathway in orchestrating antimicrobial and anti-inflammatory responses, which may have important implication for the treatment of the infectious diseases, particularly that caused by obstinate, antibiotic-resistant pathogens such as MRSA.
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Affiliation(s)
- Wei Zhang
- School of Medicine and Life Science, Nanjing University of Chinese Medicine, Nanjing 210046, China
| | - Shiqin Zhuo
- School of Pharmaceutics, Zhejiang Chinese Medical University, Zhejiang 310053, China
| | - Long He
- School of Medicine and Life Science, Nanjing University of Chinese Medicine, Nanjing 210046, China
| | - Cheng Cheng
- School of Medicine and Life Science, Nanjing University of Chinese Medicine, Nanjing 210046, China
| | - Bo Zhu
- School of Medicine and Life Science, Nanjing University of Chinese Medicine, Nanjing 210046, China
| | - Yin Lu
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Qinan Wu
- Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing 210023, China
| | - Wenbin Shang
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Weihong Ge
- School of Pharmaceutics, Zhejiang Chinese Medical University, Zhejiang 310053, China
| | - Liyun Shi
- School of Medicine and Life Science, Nanjing University of Chinese Medicine, Nanjing 210046, China.
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Peterson JC, Durkee H, Miller D, Maestre-Mesa J, Arboleda A, Aguilar MC, Relhan N, Flynn HW, Amescua G, Parel JM, Alfonso E. Molecular epidemiology and resistance profiles among healthcare- and community-associated Staphylococcus aureus keratitis isolates. Infect Drug Resist 2019; 12:831-843. [PMID: 31043797 PMCID: PMC6469469 DOI: 10.2147/idr.s190245] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To characterize the molecular, epidemiological, and resistance profiles of methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) keratitis isolates. PATIENTS AND METHODS We used a combination of standard microbiological techniques and DNA microarray analysis to characterize the molecular and antibiotic resistance profiles of 75 Staphylococcus aureus keratitis isolates collected over an 11-year period (2006-2016). RESULTS Two major USA clonal complexes (CC), CC5 (n=30, 40%) and CC8 (n=28, 37.3%), accounted for 77.3% of the collected S. aureus isolates. USA100, traditionally healthcare associated (n=18/47, 38.3%), and USA300, traditionally community associated (n=12/47, 25.5%), were the dominant MRSA strains. Four (22.2%) of the USA100 MRSA isolates were recovered from patients with no prior healthcare exposure. Eleven (91.7%) of the USA300 isolates were recovered from patients with documented healthcare risk factors. MSSA isolates were polyclonal (n=13). Ninety-three percent of MSSA infections were of healthcare origin. Thirty-seven of 61 (60.6%) healthcare- and 11 of 14 (78.6%) community-associated strains were resistant to three or more antibiotic classes. Sixty-eight percent (n=51) of isolates harbored three of more resistance determinants (genes). The Panton-Valentine Leucocidin gene was detected in 11 (14.7%) of the study isolates. The majority (72.7%) of the strains were members of the USA300 MRSA clone. CONCLUSION Clonal complexes CC5 and CC8 were the most frequent clones detected among both the MSSA and the MRSA keratitis isolates. USA100 and USA300 clones were the dominant MRSA genotypes. The USA300 MRSA clone has become a leading cause of healthcare-associated keratitis in South Florida. The USA100 MRSA clone has emerged as an increasing cause of community-associated corneal infections in our outpatient population. This shifting epidemiology coupled with the increasing prevalence of multidrug resistance among both MSSA and MRSA keratitis is a cause of concern.
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Affiliation(s)
- Jeffrey C Peterson
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Heather Durkee
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Darlene Miller
- Anne Bates Leach Eye Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA,
- Ocular Microbiology Laboratory, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA,
| | - Jorge Maestre-Mesa
- Anne Bates Leach Eye Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA,
- Ocular Microbiology Laboratory, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA,
| | - Alejandro Arboleda
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mariela C Aguilar
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nidhi Relhan
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Harry W Flynn
- Anne Bates Leach Eye Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA,
| | - Guillermo Amescua
- Anne Bates Leach Eye Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA,
| | - Jean-Marie Parel
- Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
- Anne Bates Leach Eye Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA,
| | - Eduardo Alfonso
- Anne Bates Leach Eye Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA,
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Asanin J, Misic D, Aksentijevic K, Tambur Z, Rakonjac B, Kovacevic I, Spergser J, Loncaric I. Genetic Profiling and Comparison of Human and Animal Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Serbia. Antibiotics (Basel) 2019; 8:E26. [PMID: 30884836 PMCID: PMC6466565 DOI: 10.3390/antibiotics8010026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 03/09/2019] [Accepted: 03/13/2019] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to characterize a collection of methicillin-resistant Staphylococcus aureus (MRSA) isolates of human and animal origin from Serbia. In total, 36 MRSA isolates-30 obtained from humans and six from companion animals-were investigated by PCR for the presence of antibiotic and biocide resistance determinants and virulence genes (PVL-Panton⁻Valentine leukocidin, ETs-exfoliative toxins, TSST-toxic shock syndrome toxin, SEs-staphylococcal enterotoxins, and MSCRAMMs-microbial surface components recognizing adhesive matrix molecules and biofilm). Isolates were analyzed by staphylococcal cassette chromosome mec (SCCmec), spa, and dru typing, as well as by multiple locus variable number of tandem repeat analyses (MLVA), multilocus sequence typing (MLST), and subsequently, eBURST. The majority of human MRSA isolates were resistant to gentamicin, erythromycin, clindamycin, and ciprofloxacin. Different antibiotic resistance genes were detected: aac-aphD, ant(6')-Ia, erm(A), erm(B), erm(C), tet(K), tet(M), fexA, and catpC221. All isolates were susceptible to teicoplanin and linezolid. SCCmec type III was prevalent in human isolates, while SCCmec elements in animals were mostly nontypeable. t037 was the predominant spa type in human and t242 in animal MRSA isolates. The prevalent dru type was dt11c in human and dt10a in animal MRSA isolates. MRSA isolates exhibited 27 different MLVA types. ST239 was predominant in human, while ST5 was prevalent in canine MRSA isolates. PVL was found in two, while tsst-1 was detected in three human isolates. Human-associated clones belonging to ST5, ST45, and ST239 MRSA clones were discovered in companion animals, which suggests anthropozoonotic transmission.
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Affiliation(s)
- Jelena Asanin
- Innovation Center of Faculty of Technology and Metallurgy, University of Belgrade, 11000 Beograd, Serbia.
| | - Dusan Misic
- Faculty of Veterinary Medicine, University of Belgrade, 11000 Beograd, Serbia.
| | | | - Zoran Tambur
- Institute of Hygiene Military Medical Academy, Belgrade, Serbia and Faculty of Stomatology in Pancevo, 11000 Beograd, Serbia.
| | - Bojan Rakonjac
- Institute of Microbiology Military Medical Academy, 11000 Beograd, Serbia.
| | - Ivana Kovacevic
- Institute of Hygiene Military Medical Academy, 11000 Beograd, Serbia.
| | - Joachim Spergser
- Institute of Microbiology, University of Veterinary Medicine, 1210 Wien, Austria.
| | - Igor Loncaric
- Institute of Microbiology, University of Veterinary Medicine, 1210 Wien, Austria.
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Single-institution experience of medical students' bacterial colonization during training. Am J Infect Control 2019; 47:268-270. [PMID: 30616931 DOI: 10.1016/j.ajic.2018.08.025] [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: 07/04/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Medical students are often potential vectors for resistant bacteria to their entourage. We therefore conducted this study to evaluate the variation of medical students' multiple drug resistant bacterial flora throughout their medical training. METHODS We performed a cross-sectional study enrolling medical students of the 2016 academic year from the Saint-Joseph University - Faculty of Medicine, Lebanon. RESULTS The multivariate analysis identified the medical year as the sole factor contributing to the extended spectrum beta-lactamase producing Enterobacteriaceae colonization (OR = 2.33 [1.14-4.77], P = 0.021). DISCUSSION Lack of hygiene knowledge among medical trainees is not uncommon. Hence, the degree of clinical exposure predicts their risk of contamination from critically ill patients. CONCLUSIONS Implementing regular and practical training in line with a behavioral modification program would limit the colonization of medical students with resistant germs.
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