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Laurence Yehouenou C, Bogaerts B, Vanneste K, De Keersmaecker SCJ, Roosens NHC, Kpangon AA, Affolabi D, Simon A, Dossou FM, Dalleur O. Whole-Genome Sequencing-Based Screening of MRSA in Patients and Healthcare Workers in Public Hospitals in Benin. Microorganisms 2023; 11:1954. [PMID: 37630513 PMCID: PMC10459514 DOI: 10.3390/microorganisms11081954] [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: 06/27/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 08/27/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) constitutes a serious public health concern, with a considerable impact on patients' health, and substantial healthcare costs. In this study, patients and healthcare workers (HCWs) from six public hospitals in Benin were screened for MRSA. Strains were identified as MRSA using conventional microbiological methods in Benin, and confirmed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in Belgium. Whole-genome sequencing (WGS) was used on the confirmed MRSA isolates, to characterize their genomic content and study their relatedness. Amongst the 305 isolates (304 wound swabs and 61 nasal swabs) that were collected from patients and HCWs, we detected 32 and 15 cases of MRSA, respectively. From this collection, 27 high-quality WGS datasets were obtained, which carried numerous genes and mutations associated with antimicrobial resistance. The mecA gene was detected in all the sequenced isolates. These isolates were assigned to five sequence types (STs), with ST8 (55.56%, n = 15/27), ST152 (18.52%, n = 5/27), and ST121 (18.52%, n = 5/27) being the most common. These 27 isolates carried multiple virulence genes, including the genes encoding the Panton-Valentine leukocidin toxin (48.15%, n = 13/27), and the tst gene (29.63%, n = 8/27), associated with toxic shock syndrome. This study highlights the need to implement a multimodal strategy for reducing the risk of the cross-transmission of MRSA in hospitals.
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Affiliation(s)
- Carine Laurence Yehouenou
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain UCLouvain, Avenue Mounier 73, 1200 Brussels, Belgium;
- Laboratoire de Référence des Mycobactéries (LRM), Cotonou BP 817, Benin;
- Faculté des Sciences de la Santé (FSS), Université d’Abomey Calavi (UAC), Cotonou 01 BP 188, Benin
| | - Bert Bogaerts
- Transversal Activities in Applied Genomics, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; (B.B.); (K.V.); (S.C.J.D.K.); (N.H.C.R.)
| | - Kevin Vanneste
- Transversal Activities in Applied Genomics, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; (B.B.); (K.V.); (S.C.J.D.K.); (N.H.C.R.)
| | - Sigrid C. J. De Keersmaecker
- Transversal Activities in Applied Genomics, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; (B.B.); (K.V.); (S.C.J.D.K.); (N.H.C.R.)
| | - Nancy H. C. Roosens
- Transversal Activities in Applied Genomics, Sciensano, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; (B.B.); (K.V.); (S.C.J.D.K.); (N.H.C.R.)
| | - Arsène A. Kpangon
- Ecole Nationale des Techniciens Supérieurs en Santé Publique et Surveillance Épidémiologique, Université de Parakou, Parakou, Benin;
| | - Dissou Affolabi
- Laboratoire de Référence des Mycobactéries (LRM), Cotonou BP 817, Benin;
- Faculté des Sciences de la Santé (FSS), Université d’Abomey Calavi (UAC), Cotonou 01 BP 188, Benin
- Centre National Hospitalier et Universitaire Hubert Koutoukou Maga (CNHU-HKM), Cotonou BP 386, Benin
| | - Anne Simon
- Centres Hospitaliers Jolimont, Prévention et Contrôle des Infections, Groupe Jolimont Asbl, Rue Ferrer 159, 7100 Haine-Saint-Paul, Belgium;
| | - Francis Moise Dossou
- Department of Surgery and Surgical Specialties, Faculty of Health Sciences, Campus Universitaire, Champs de Foire, Cotonou 01 BP 118, Benin;
| | - Olivia Dalleur
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain UCLouvain, Avenue Mounier 73, 1200 Brussels, Belgium;
- Pharmacy, Clinique Universitaire Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
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Abo-Amer AE, Gad El-Rab SMF, Halawani EM, Niaz AM, Bamaga MS. Prevalence and Molecular Characterization of Methicillin-Resistant Staphylococcus aureus from Nasal Specimens: Overcoming MRSA with Silver Nanoparticles and Their Applications. J Microbiol Biotechnol 2022; 32:1537-1546. [PMID: 36379700 PMCID: PMC9843750 DOI: 10.4014/jmb.2208.08004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/10/2022] [Accepted: 10/25/2022] [Indexed: 11/17/2022]
Abstract
Staphylococcus aureus is a cause of high mortality in humans and therefore it is necessary to prevent its transmission and reduce infections. Our goals in this research were to investigate the frequency of methicillin-resistant S. aureus (MRSA) in Taif, Saudi Arabia, and assess the relationship between the phenotypic antimicrobial sensitivity patterns and the genes responsible for resistance. In addition, we examined the antimicrobial efficiency and application of silver nanoparticles (AgNPs) against MRSA isolates. Seventy-two nasal swabs were taken from patients; MRSA was cultivated on Mannitol Salt Agar supplemented with methicillin, and 16S rRNA sequencing was conducted in addition to morphological and biochemical identification. Specific resistance genes such as ermAC, aacA-aphD, tetKM, vatABC and mecA were PCR-amplified and resistance plasmids were also investigated. The MRSA incidence was ~49 % among the 72 S. aureus isolates and all MRSA strains were resistant to oxacillin, penicillin, and cefoxitin. However, vancomycin, linezolid, teicoplanin, mupirocin, and rifampicin were effective against 100% of MRSA strains. About 61% of MRSA strains exhibited multidrug resistance and were resistant to 3-12 antimicrobial medications (MDR). Methicillin resistance gene mecA was presented in all MDR-MRSA strains. Most MDR-MRSA contained a plasmid of > 10 kb. To overcome bacterial resistance, AgNPs were applied and displayed high antimicrobial activity and synergistic effect with penicillin. Our findings may help establish programs to control bacterial spread in communities as AgNPs appeared to exert a synergistic effect with penicillin to control bacterial resistance.
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Affiliation(s)
- Aly E. Abo-Amer
- Department of Botany and Microbiology, Faculty of Science, Sohag University, Sohag 82524, Egypt
| | - Sanaa M. F. Gad El-Rab
- Department of Botany and Microbiology, Faculty of Science, Assuit University, Assiut 71516, Egypt,Corresponding author Phone: +201025475454 E-mail:
| | - Eman M. Halawani
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Ameen M. Niaz
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Mohammed S. Bamaga
- Department of Molecular Pathology, Al-Hada Armed Forces Hospital, P.O. Box 1347, HHRC 479, Taif, Saudi Arabia
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Hajikhani B, Goudarzi M, Kakavandi S, Amini S, Zamani S, van Belkum A, Goudarzi H, Dadashi M. The global prevalence of fusidic acid resistance in clinical isolates of Staphylococcus aureus: a systematic review and meta-analysis. Antimicrob Resist Infect Control 2021; 10:75. [PMID: 33933162 PMCID: PMC8088720 DOI: 10.1186/s13756-021-00943-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/23/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIM Staphylococcus aureus (S. aureus) is one of the most common pathogens causing nosocomial and community-acquired infections with high morbidity and mortality rates. Fusidic acid has been increasingly used for the treatment of infections due to methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA). The present study aimed to determine the precise prevalence of fusidic acid resistant MRSA (FRMRSA), fusidic acid resistant MSSA (FRMSSA), and total fusidic acid resistant S. aureus (FRSA) on a global scale. METHODS Several international databases including Medline, Embase, and the Web of Sciences were searched (2000-2020) to discern studies addressing the prevalence of FRSA, FRMRSA, and FRMSSA. STATA (version14) software was used to interpret the data. RESULTS Of the 1446 records identified from the databases, 215 studies fulfilled the eligibility criteria for the detection of FRSA (208 studies), FRMRSA (143 studies), and FRMSSA (71 studies). The analyses manifested that the global prevalence of FRSA, FRMRSA, and FRMSSA was 0.5%, 2.6% and 6.7%, respectively. CONCLUSION This meta-analysis describes an increasing incidence of FRSA, FRMSSA, and FRMRSA. These results indicate the need for prudent prescription of fusidic acid to stop or diminish the incidence of fusidic acid resistance as well as the development of strategies for monitoring the efficacy of fusidic acid use.
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Affiliation(s)
- Bahareh Hajikhani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sareh Kakavandi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sana Amini
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Zamani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alex van Belkum
- Data Analytics Unit, bioMérieux 3, Route de Port Michaud, La Balme Les Grottes, France
| | - Hossein Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Dadashi
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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Entry of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus into the hospital: prevalence and population structure in Heidelberg, Germany 2015-2018. Sci Rep 2020; 10:13243. [PMID: 32764618 PMCID: PMC7413528 DOI: 10.1038/s41598-020-70112-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/22/2020] [Indexed: 12/21/2022] Open
Abstract
Staphylococcus aureus is one of the major pathogens causing community—and healthcare-acquired infections. The presence of the virulence factor Panton–Valentine leukocidin (PVL) is associated with recurrent infection and clinical severity and generally regarded as a feature of community associated-methicillin-resistant Staphylococcus aureus (MRSA). To date, the focus of PVL-positive MRSA in hospitalized patients has been on outbreaks. We aimed to investigate whether PVL-positive MRSA has penetrated the community-hospital barrier by determining the prevalence of PVL in MRSA of hospitalized patients. MRSA strains isolated from patients hospitalized > 48 h in Heidelberg University Hospital between 2015 and 2018 Isolates were analysed for the presence of PVL and subjected to spa-typing. PVL-positive MRSA were then characterized by whole genome sequencing. We analysed 740 MRSA isolates in the study period and identified 6.2% (n = 46) PVL-positivity. 32.6% of PVL-positive MRSA met the criteria for nosocomial acquisition. The most frequent clones among the PVL-positive strains were ST80-t044 (21.7%, n = 10/46) and ST8-t008 (19.5%, n = 9/46). WGS identified three possible transmission clusters involving seven patients. In conclusion, we found successful epidemic PVL-positive MRSA clones entering the hospital and causing nosocomial infections. Preventive measures and constant surveillance should be maintained to prevent transmissions and clonal outbreaks.
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Carruthers NJ, Stemmer PM, Media J, Swartz K, Wang X, Aube N, Hamann MT, Valeriote F, Shaw J. The anti-MRSA compound 3-O-alpha-L-(2″,3″-di-p-coumaroyl)rhamnoside (KCR) inhibits protein synthesis in Staphylococcus aureus. J Proteomics 2019; 210:103539. [PMID: 31629958 DOI: 10.1016/j.jprot.2019.103539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/05/2019] [Accepted: 09/27/2019] [Indexed: 11/16/2022]
Abstract
Methicillin-resistant S aureus (MRSA) contributes to patient mortality and extended hospital stays. 3-O-alpha-L-(2″,3″-di-p-coumaroyl)rhamnoside (KCR) is a natural product antibiotic that is effective against MRSA but has no known mechanism of action (MOA). We used proteomics to identify the MOA for KCR. Methicillin sensitive S aureus and a mixture of four KCR stereoisomers were tested. A time-kill assay was used to choose a 4 h treatment using KCR at 5× its MIC for proteomic analysis. S aureus was treated in triplicate with KCR, oxacillin or vehicle and quantitative proteomic analysis was carried out using isobaric tags and mass spectrometry. 1190 proteins were identified and 552 were affected by KCR (q < 0.01). Ontology analysis identified 6 distinct translation-related categories that were affected by KCR (PIANO, 10% false-discovery rate) including structural constituent of ribosome, translation, rRNA binding, tRNA binding, tRNA processing and aminoacyl-tRNA ligase activity. Median fold changes (KCR vs Control) for small and large ribosomal components were 1.46 and 1.43 respectively. KCR inhibited the production of luciferase protein in an in vitro assay (IC50 39.6 μg/ml). Upregulation of translation-related proteins in response to KCR indicates that KCR acts to disrupt S aureus protein synthesis. This was confirmed with an in vitro transcription/translation assay. SIGNIFICANCE: Methicillin-resistant S aureus (MRSA) contributes to patient mortality and extended hospital stays. 3-O-alpha-L-(2″,3″-di-p-coumaroyl)rhamnoside (KCR) is a natural product antibiotic that is effective against MRSA but has no known mechanism of action (MOA). Using proteomic analysis we determined that KCR acts by inhibiting protein synthesis. KCR is an exciting novel antibiotic and this work represents an important step in its development towards clinical use.
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Affiliation(s)
- Nicholas J Carruthers
- Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48201, USA; Wayne State University, Institute of Environmental Health Sciences, 2309 Scott Hall, 540 E Canfield Ave, Detroit, MI 48202, United States of America.
| | - Paul M Stemmer
- Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48201, USA.
| | - Joe Media
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48201, USA.
| | - Ken Swartz
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48201, USA.
| | - Xiaojuan Wang
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Nicholas Aube
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Mark T Hamann
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Frederick Valeriote
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48201, USA.
| | - Jiajiu Shaw
- Henry Ford Health System, Detroit, MI, USA; 21st Century Therapeutics, Detroit, MI 48201, USA
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Bassetti M, Carnelutti A, Castaldo N, Peghin M. Important new therapies for methicillin-resistant Staphylococcus aureus. Expert Opin Pharmacother 2019; 20:2317-2334. [PMID: 31622115 DOI: 10.1080/14656566.2019.1675637] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) infections represent a leading cause of infection-related morbidity and mortality worldwide. There has been a welcome increase in the number of agents available for the treatment of MRSA infection over the last decade and several clinical trials are currently investigating the role of new experimental strategies.Areas covered: The purpose of this manuscript is to review the efficacy and safety of recently approved anti-MRSA molecules as well as some newer agents currently under investigation with a specific focus on the potential role of these drugs in everyday clinical practice.Expert opinion: Many new drugs with an activity against MRSA have been recently approved or are in an advanced stage of development. All these compounds represent promising options to enhance our antibiotic armamentarium. However, data regarding the use of these new compounds in real-life terms are limited and their best placement in therapy and in terms of optimization of medical resources and balance of cost-effectiveness requires further investigation.
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Affiliation(s)
- Matteo Bassetti
- Department of Health Sciences, Infectious Disease Clinic, University of Genoa and Hospital Policlinico San Martino-IRCCS, Genoa, Italy
| | - Alessia Carnelutti
- Department of Medicine, Infectious Disease Clinic, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Nadia Castaldo
- Department of Medicine, Infectious Disease Clinic, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Maddalena Peghin
- Department of Medicine, Infectious Disease Clinic, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
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Hellmich L, Fabri M. [25-year-old male with erythematous, encrusted, painful nodules in the beard area : Preparation for the specialist examination: part 49]. Hautarzt 2019; 70:85-88. [PMID: 30976859 DOI: 10.1007/s00105-019-4367-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Luisa Hellmich
- Klinik und Poliklinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Mario Fabri
- Klinik und Poliklinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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Shaw J, Swartz K, Valeriote F, Media J, Chen B, Hamann MT, Wang X. Identification of the Metabolites of a Novel Anti-MRSA Compound, Kaempferol-3- O-Alpha-L-(2″,3″-di- p-coumaroyl)rhamnoside (KCR), Extracted from American Sycamore. Nat Prod Commun 2018. [DOI: 10.1177/1934578x1801300321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fractionation of an extract from American sycamore leaves produced the small molecule, kaempferol-3- O-alpha-L-(2″,3″-di- p-coumaroyl)rhamnoside (KCR), which exists in four stereoisomeric forms ( EE, EZ, ZE, and ZZ) at the olefin in the p-coumaroyl; all four isomers exhibit potent anti-MRSA activity in vitro. As part of the preclinical development of KCR, we set out to investigate the metabolites of KCR in mouse plasma as a prelude of ADME studies and therapeutic assessment. When KCR was added to mouse plasma at 37 °C, two new HPLC peaks appeared with increasing intensity as the incubation time increased; their retention times were shorter than that of KCR indicating that KCR was metabolized to produce two compounds that were more polar. HPLC results indicated that the two metabolites mainly came from the ZE and EE isomers and that the ZZ isomer was the most stable. Based on their respective HPLC retention times and UV spectra, these two metabolites were tentatively identified as p-coumaric acid and afzelin; both of which are more polar than KCR. The molecular weights of both metabolites were then confirmed by a Waters Acquity UPLC system with a QDa mass detector. UPLC chromatograms and molecular ions of metabolites 1 and 2 match well with those of reference materials, p-coumaric acid and afzelin, thus confirming the identities of the two major metabolites of KCR. In summary, KCR was metabolized in mouse plasma and two major metabolites ( p-coumaric acid and afzelin) were identified; the metabolites were mainly converted from the ZE and EE isomers.
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Affiliation(s)
- Jiajiu Shaw
- 21st Century Therapeutics, 440 Burroughs St., Suite 447, Detroit, Michigan 48202, USA
- Henry Ford Health System, Department of Internal Medicine, 440 Burroughs St., Rm 415, Detroit, Michigan 48202, USA
| | - Kenneth Swartz
- 21st Century Therapeutics, 440 Burroughs St., Suite 447, Detroit, Michigan 48202, USA
| | - Frederick Valeriote
- Henry Ford Health System, Department of Internal Medicine, 440 Burroughs St., Rm 415, Detroit, Michigan 48202, USA
| | - Joseph Media
- Henry Ford Health System, Department of Internal Medicine, 440 Burroughs St., Rm 415, Detroit, Michigan 48202, USA
| | - Ben Chen
- 21st Century Therapeutics, 440 Burroughs St., Suite 447, Detroit, Michigan 48202, USA
| | - Mark T. Hamann
- Oxford Laboratories, 213 Timber Lane, Oxford, MS 38655, USA
| | - Xiaojuan Wang
- Medical University of South Carolina, Drug Discovery Building, 70 President Street, MSC 139, Charleston, SC 29425, USA
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Asadollahi P, Farahani NN, Mirzaii M, Khoramrooz SS, van Belkum A, Asadollahi K, Dadashi M, Darban-Sarokhalil D. Distribution of the Most Prevalent Spa Types among Clinical Isolates of Methicillin-Resistant and -Susceptible Staphylococcus aureus around the World: A Review. Front Microbiol 2018; 9:163. [PMID: 29487578 PMCID: PMC5816571 DOI: 10.3389/fmicb.2018.00163] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/24/2018] [Indexed: 12/25/2022] Open
Abstract
Background:Staphylococcus aureus, a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies. Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were “Staphylococcus aureus, spa typing.” Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95% of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence. Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution.
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Affiliation(s)
- Parisa Asadollahi
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narges Nodeh Farahani
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mirzaii
- Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyed Sajjad Khoramrooz
- Department of Microbiology, Faculty of Medicine, Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Alex van Belkum
- Data Analytics Unit, bioMérieux 3, La Balme Les Grottes, France
| | - Khairollah Asadollahi
- Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.,Faculty of Medicine, Biotechnology and Medicinal Plants Researches Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Masoud Dadashi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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10
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Amissah NA, Buultjens AH, Ablordey A, van Dam L, Opoku-Ware A, Baines SL, Bulach D, Tetteh CS, Prah I, van der Werf TS, Friedrich AW, Seemann T, van Dijl JM, Stienstra Y, Stinear TP, Rossen JW. Methicillin Resistant Staphylococcus aureus Transmission in a Ghanaian Burn Unit: The Importance of Active Surveillance in Resource-Limited Settings. Front Microbiol 2017; 8:1906. [PMID: 29056927 PMCID: PMC5635451 DOI: 10.3389/fmicb.2017.01906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/19/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives:Staphylococcus aureus infections in burn patients can lead to serious complications and death. The frequency of S. aureus infection is high in low- and middle-income countries presumably due to limited resources, misuse of antibiotics and poor infection control. The objective of the present study was to apply population genomics to precisely define, for the first time, the transmission of antibiotic resistant S. aureus in a resource-limited setting in sub-Saharan Africa. Methods:Staphylococcus aureus surveillance was performed amongst burn patients and healthcare workers during a 7-months survey within the burn unit of the Korle Bu Teaching Hospital in Ghana. Results: Sixty-six S. aureus isolates (59 colonizing and 7 clinical) were obtained from 31 patients and 10 healthcare workers. Twenty-one of these isolates were ST250-IV methicillin-resistant S. aureus (MRSA). Notably, 25 (81%) of the 31 patients carried or were infected with S. aureus within 24 h of admission. Genome comparisons revealed six distinct S. aureus clones circulating in the burn unit, and demonstrated multiple transmission events between patients and healthcare workers. Further, the collected S. aureus isolates exhibited a wide range of genotypic resistances to antibiotics, including trimethoprim (21%), aminoglycosides (33%), oxacillin (33%), chloramphenicol (50%), tetracycline (59%) and fluoroquinolones (100%). Conclusion: Population genomics uncovered multiple transmission events of S. aureus, especially MRSA, within the investigated burn unit. Our findings highlight lapses in infection control and prevention, and underscore the great importance of active surveillance to protect burn victims against multi-drug resistant pathogens in resource-limited settings.
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Affiliation(s)
- Nana Ama Amissah
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Andrew H Buultjens
- Department of Microbiology and Immunology, The Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony Ablordey
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Lieke van Dam
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ampomah Opoku-Ware
- Burns Unit, Reconstructive Plastic Surgery and Burns Unit, Korle Bu Teaching Hospital, Accra, Ghana
| | - Sarah L Baines
- Department of Microbiology and Immunology, The Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Dieter Bulach
- Department of Microbiology and Immunology, The Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Caitlin S Tetteh
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Isaac Prah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Tjip S van der Werf
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Alexander W Friedrich
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Torsten Seemann
- Victorian Bioinformatics Consortium, Monash University, Clayton, VIC, Australia
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ymkje Stienstra
- Department of Internal Medicine/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Timothy P Stinear
- Department of Microbiology and Immunology, The Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - John W Rossen
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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11
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Ouedraogo AS, Dunyach-Remy C, Kissou A, Sanou S, Poda A, Kyelem CG, Solassol J, Bañuls AL, Van De Perre P, Ouédraogo R, Jean-Pierre H, Lavigne JP, Godreuil S. High Nasal Carriage Rate of Staphylococcus aureus Containing Panton-Valentine leukocidin- and EDIN-Encoding Genes in Community and Hospital Settings in Burkina Faso. Front Microbiol 2016; 7:1406. [PMID: 27679613 PMCID: PMC5020597 DOI: 10.3389/fmicb.2016.01406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 08/24/2016] [Indexed: 12/13/2022] Open
Abstract
The objectives of the present study were to investigate the rate of S.aureus nasal carriage and molecular characteristics in hospital and community settings in Bobo Dioulasso, Burkina Faso. Nasal samples (n = 219) were collected from 116 healthy volunteers and 103 hospitalized patients in July and August 2014. Samples were first screened using CHROMagar Staph aureus chromogenic agar plates, and S. aureus strains were identified by mass spectrometry. Antibiotic susceptibility was tested using the disk diffusion method on Müller-Hinton agar. All S. aureus isolates were genotyped using DNA microarray. Overall, the rate of S. aureus nasal carriage was 32.9% (72/219) with 29% in healthy volunteers and 37% in hospital patients. Among the S. aureus isolates, only four methicillin-resistant S. aureus (MRSA) strains were identified and all in hospital patients (3.9%). The 72 S. aureus isolates from nasal samples belonged to 16 different clonal complexes, particularly to CC 152-MSSA (22 clones) and CC1-MSSA (nine clones). Two clones were significantly associated with community settings: CC1-MSSA and CC45-MSSA. The MRSA strains belonged to the ST88-MRSA-IV or the CC8-MRSA-V complex. A very high prevalence of toxinogenic strains 52.2% (36/69), containing Panton-Valentine leucocidin- and EDIN-encoding genes, was identified among the S. aureus isolates in community and hospital settings. This study provides the first characterization of S. aureus clones and their genetic characteristics in Burkina Faso. Altogether, it highlights the low prevalence of antimicrobial resistance, high diversity of methicillin-sensitive S. aureus clones and high frequency of toxinogenic S. aureus strains.
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Affiliation(s)
- Abdoul-Salam Ouedraogo
- Centre Hospitalier Universitaire Souro SanouBobo Dioulasso, Burkina Faso; Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de MontpellierMontpellier, France; Université de MontpellierMontpellier, France; Institut National de la Santé et de la Recherche Médicale U1058, Infection by HIV and by Agents with Mucocutaneous Tropism: From Pathogenesis to PreventionMontpellier, France
| | - Catherine Dunyach-Remy
- Institut National de la Santé et de la Recherche Médicale U1047, Université de MontpellierNîmes, France; Service de Microbiologie, Centre Hospitalier Universitaire CaremeauNîmes, France
| | - Aimée Kissou
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Soufiane Sanou
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Armel Poda
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Carole G Kyelem
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Jérôme Solassol
- Department of Biopathology, Centre Hospitalier Universitaire MontpellierMontpellier, France; Department of Clinical Oncoproteomics, Montpellier Cancer InstituteMontpellier, France
| | - Anne-Laure Bañuls
- UMR MIVEGEC (IRD 224 - Centre National de la Recherche Scientifique 5290 - Université de Montpellier) Montpellier, France
| | - Philippe Van De Perre
- Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de MontpellierMontpellier, France; Université de MontpellierMontpellier, France; Institut National de la Santé et de la Recherche Médicale U1058, Infection by HIV and by Agents with Mucocutaneous Tropism: From Pathogenesis to PreventionMontpellier, France
| | - Rasmata Ouédraogo
- Centre Hospitalier Universitaire Souro Sanou Bobo Dioulasso, Burkina Faso
| | - Hélène Jean-Pierre
- Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de Montpellier Montpellier, France
| | - Jean-Philippe Lavigne
- Institut National de la Santé et de la Recherche Médicale U1047, Université de MontpellierNîmes, France; Service de Microbiologie, Centre Hospitalier Universitaire CaremeauNîmes, France
| | - Sylvain Godreuil
- Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de MontpellierMontpellier, France; Université de MontpellierMontpellier, France; Institut National de la Santé et de la Recherche Médicale U1058, Infection by HIV and by Agents with Mucocutaneous Tropism: From Pathogenesis to PreventionMontpellier, France
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12
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Antibiotic resistance patterns of Staphylococcus aureus: A multi center study from India. Microb Pathog 2016; 98:167-70. [DOI: 10.1016/j.micpath.2016.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 07/10/2016] [Accepted: 07/13/2016] [Indexed: 11/21/2022]
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13
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Liu PF, Cheng JS, Sy CL, Huang WC, Yang HC, Gallo RL, Huang CM, Shu CW. IsaB Inhibits Autophagic Flux to Promote Host Transmission of Methicillin-Resistant Staphylococcus aureus. J Invest Dermatol 2015; 135:2714-2722. [PMID: 26134948 PMCID: PMC4641007 DOI: 10.1038/jid.2015.254] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 06/17/2015] [Indexed: 12/19/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major nosocomial pathogen that is widespread in both health-care facilities and in the community at large, as a result of direct host-to-host transmission. Several virulence factors are associated with pathogen transmission to naive hosts. Immunodominant surface antigen B (IsaB) is a virulence factor that helps Staphylococcus aureus to evade the host defense system. However, the mechanism of IsaB on host transmissibility remains unclear. We found that IsaB expression was elevated in transmissible MRSA. Wild-type isaB strains inhibited autophagic flux to promote bacterial survival and elicit inflammation in THP-1 cells and mouse skin. MRSA isolates with increased IsaB expression showed decreased autophagic flux, and the MRSA isolate with the lowest IsaB expression showed increased autophagic flux. In addition, recombinant IsaB rescued the virulence of the isaB deletion strain and increased the group A streptococcus (GAS) virulence in vivo. Together, these results reveal that IsaB diminishes autophagic flux, thereby allowing MRSA to evade host degradation. These findings suggest that IsaB is a suitable target for preventing or treating MRSA infection.
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Affiliation(s)
- Pei-Feng Liu
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Medicine, Division of Dermatology, University of California, San Diego, USA
| | - Jin-Shiung Cheng
- Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Cheng-Len Sy
- Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wei-Chun Huang
- Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung City
- School of Medicine, National Yang-Ming University, Taipei City
| | - Hsiu-Chen Yang
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Richard L. Gallo
- Department of Medicine, Division of Dermatology, University of California, San Diego, USA
- VA San Diego Healthcare Center, San Diego, USA
| | - Chun-Ming Huang
- Department of Medicine, Division of Dermatology, University of California, San Diego, USA
| | - Chih-Wen Shu
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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14
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Zhang Y, Valeriote F, Swartz K, Chen B, Hamann MT, Rodenburg DL, McChesney JD, Shaw J. HPLC Plasma Assay of a Novel Anti-MRSA Compound, Kaempferol-3- O-Alpha-L-(2″,3″-di- p-coumaroyl)rhamnoside, from Sycamore Leaves. Nat Prod Commun 2015. [DOI: 10.1177/1934578x1501000818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a serious pathogen that is resistant to current antibiotic therapy. Thus, there is an urgent need for novel antimicrobial agents that can effectively combat these new strains of drug-resistant “superbugs”. Recently, fractionation of an extract from Platanus occidentalis (American sycamore) leaves produced an active kaempferol molecule, 3- O-alpha-L-(2″,3″-di- p-coumaroyl)rhamnoside (KCR), in four isomeric forms; all four isomers exhibit potent anti-MRSA activity. In order to further the preclinical development of KCR as a new antibiotic class, we developed and validated a simple analytical method for assaying KCR plasma concentration. Because KCR will be developed as a new drug, although comprising four stereoisomers, the analytical method was devised to assay the total amount of all four isomers. In the present work, both a plasma processing procedure and an HPLC method have been developed and validated. Mouse plasma containing KCR was first treated with ethanol and then centrifuged. The supernatant was dried, suspended in ethanol, centrifuged, and the supernatant was injected into an HPLC system comprising a Waters C18, a mobile phase composing methanol, acetonitrile, and trifluoroacetic acid and monitored at 313 nm. The method was validated by parameters including a good linear correlation, a limit of quantification of 0.27 μg/mL, and high accuracy. In summary, this method allows a rapid analysis of KCR in the plasma samples for pharmacokinetics studies.
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Affiliation(s)
- Yiguan Zhang
- Henry Ford Health System, 440 Burroughs St, Detroit, MI 48202, USA
| | | | - Kenneth Swartz
- Henry Ford Health System, 440 Burroughs St, Detroit, MI 48202, USA
| | - Ben Chen
- 21st Century Therapeutics, 1366 Hilton Rd, Ferndale, MI 48220, USA
| | - Mark T. Hamann
- Oxford Pharmaceutical Development, Oxford, MS 38655, USA
| | | | | | - Jiajiu Shaw
- Henry Ford Health System, 440 Burroughs St, Detroit, MI 48202, USA
- 21st Century Therapeutics, 1366 Hilton Rd, Ferndale, MI 48220, USA
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15
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Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014. [DOI: 10.1007/s00103-014-1980-x] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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16
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Chronisch rezidivierende Infektionen der Haut und Weichgewebe durch Staphylococcus aureus. Hautarzt 2014; 65:15-25. [DOI: 10.1007/s00105-013-2636-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Champer J, Patel J, Fernando N, Salehi E, Wong V, Kim J. Chitosan against cutaneous pathogens. AMB Express 2013; 3:37. [PMID: 23829873 PMCID: PMC3720194 DOI: 10.1186/2191-0855-3-37] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/02/2013] [Indexed: 11/10/2022] Open
Abstract
Propionibacterium acnes and Staphylococcus aureus are cutaneous pathogens that have become increasingly resistant to antibiotics. We sought to determine if chitosan, a polymer of deacetylated chitin, could be used as a potential treatment against these bacteria. We found that higher molecular weight chitosan had superior antimicrobial properties compared to lower molecular weights, and that this activity occurred in a pH dependent manner. Electron and fluorescence microscopy revealed that chitosan forms aggregates and binds to the surface of bacteria, causing shrinkage of the bacterial membrane from the cell wall. Of special relevance, clinical isolates of P. acnes were vulnerable to chitosan, which could be combined with benzoyl peroxide for additive antibacterial effect. Chitosan also demonstrated significantly less cytotoxicity to monocytes than benzoyl peroxide. Overall, chitosan demonstrates many promising qualities for treatment of cutaneous pathogens.
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Affiliation(s)
- Jackson Champer
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Division of Immunology, Beckman Research Institute, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Julie Patel
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Nathalie Fernando
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Elaheh Salehi
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Victoria Wong
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Jenny Kim
- Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Department of Dermatology, Greater Los Angeles Healthcare System Veterans Affairs, Los Angeles, CA 90073, USA
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18
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Escosa-García L, Ramilo O, Mejías A. Daptomicina a dosis altas en infección diseminada por Staphylococcus aureus resistente a meticilina. An Pediatr (Barc) 2013; 78:185-8. [DOI: 10.1016/j.anpedi.2012.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 07/05/2012] [Accepted: 07/06/2012] [Indexed: 11/30/2022] Open
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19
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Del Giudice P, Tattevin P, Étienne J. Infections à Staphylococcus aureus résistants à la méticilline communautaires. Presse Med 2012; 41:713-20. [DOI: 10.1016/j.lpm.2011.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Accepted: 10/17/2011] [Indexed: 10/14/2022] Open
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20
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Staphylococcus aureus résistant à la méticilline en réanimation. MEDECINE INTENSIVE REANIMATION 2012. [DOI: 10.1007/s13546-012-0497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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Casado-Verrier B, Gómez-Fernández C, Paño-Pardo JR, Gómez-Gil R, Mingorance-Cruz J, Moreno-Alonso de Celada R, Herranz-Pinto P. Prevalencia de infecciones de piel y tejidos blandos producidas por Staphylococcus aureus resistente a Meticilina Comunitario en Madrid. Enferm Infecc Microbiol Clin 2012; 30:300-6. [DOI: 10.1016/j.eimc.2011.11.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 11/21/2011] [Accepted: 11/21/2011] [Indexed: 11/29/2022]
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22
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Nanoscalic silver possesses broad-spectrum antimicrobial activities and exhibits fewer toxicological side effects than silver sulfadiazine. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2012; 8:478-88. [DOI: 10.1016/j.nano.2011.07.005] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 05/21/2011] [Accepted: 07/21/2011] [Indexed: 11/19/2022]
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High genetic diversity among community-associated Staphylococcus aureus in Europe: results from a multicenter study. PLoS One 2012; 7:e34768. [PMID: 22558099 PMCID: PMC3338755 DOI: 10.1371/journal.pone.0034768] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 03/05/2012] [Indexed: 01/22/2023] Open
Abstract
Background Several studies have addressed the epidemiology of community-associated
Staphylococcus aureus (CA-SA) in Europe; nonetheless, a
comprehensive perspective remains unclear. In this study, we aimed to
describe the population structure of CA-SA and to shed light on the origin
of methicillin-resistant S. aureus (MRSA) in this
continent. Methods and Findings A total of 568 colonization and infection isolates, comprising both MRSA and
methicillin-susceptible S. aureus (MSSA), were recovered in
16 European countries, from community and community-onset infections. The
genetic background of isolates was characterized by molecular typing
techniques (spa typing, pulsed-field gel electrophoresis
and multilocus sequence typing) and the presence of PVL and ACME was tested
by PCR. MRSA were further characterized by SCCmec typing.
We found that 59% of all isolates were associated with
community-associated clones. Most MRSA were related with USA300 (ST8-IVa and
variants) (40%), followed by the European clone (ST80-IVc and
derivatives) (28%) and the Taiwan clone (ST59-IVa and related clonal
types) (15%). A total of 83% of MRSA carried Panton-Valentine
leukocidin (PVL) and 14% carried the arginine catabolic mobile
element (ACME). Surprisingly, we found a high genetic diversity among MRSA
clonal types (ST-SCCmec), Simpson’s index of
diversity = 0.852 (0.788–0.916). Specifically,
about half of the isolates carried novel associations between genetic
background and SCCmec. Analysis by BURP showed that some
CA-MSSA and CA-MRSA isolates were highly related, suggesting a probable
local acquisition/loss of SCCmec. Conclusions Our results imply that CA-MRSA origin, epidemiology and population structure
in Europe is very dissimilar from that of USA.
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24
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Schweickert B, Noll I, Feig M, Claus H, Krause G, Velasco E, Eckmanns T. MRSA-surveillance in Germany: data from the Antibiotic Resistance Surveillance System (ARS) and the mandatory surveillance of MRSA in blood. Eur J Clin Microbiol Infect Dis 2011; 31:1855-65. [DOI: 10.1007/s10096-011-1511-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 12/02/2011] [Indexed: 11/28/2022]
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Meyer V, Kerk N, Mellmann A, Friedrich A, Luger TA, Goerge T. MRSA eradication in dermatologic outpatients - theory and practice. J Dtsch Dermatol Ges 2011; 10:186-96. [PMID: 22212172 DOI: 10.1111/j.1610-0387.2011.07861.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The dissemination of methicillin resistant staphylococcus aureus (MRSA) is an increasing challenge in medical care. Apart from hospital acquired MRSA, there has also been an increase in community acquired and livestock associated MRSA. While the risks of MRSA (e. g. wound infections) and consequences (e. g. rejection of patients) are well known, there are little data on the effectiveness of eradication procedures. PATIENTS AND METHODS 32 patients with proven MRSA colonization were monitored during eradication for the following aspects: (1) localization of MRSA (swabs from hairline, anterior nares, throat, axillae, groins, perineum, and wounds, if present), (2) presence of eradication-impairing factors, (3) length of time needed for eradication, (4) cost of eradication, (5) molecular fingerprint and risk assessment (spa-types). RESULTS We describe the successful eradication of MRSA in all 32 patients. Most positive nasal swabs were obtained from the anterior nares and the throat and only rarely from the hairline or axillae. The greater the number of positive swabs, the more time was needed for eradication. In most patients (37.5%), eradication with topical antiseptics was successful. The average time for eradication was 12.97 (± 7.6) days. Twelve patients required systemic antibiotic therapy. Treatment costs associated with the use of systemic antibiotics were significantly higher. The most frequent spa types were t032 and t003. CONCLUSIONS We report successful MRSA eradication in outpatients. Systemic antibiotics are unnecessary in the majority of patients. A combined anti-MRSA strategy for inpatients and outpatients is recommended.
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Affiliation(s)
- Volker Meyer
- Clinic and Polyclinic for Skin Diseases, Münster University Hospital, Germany
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26
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Köck R, Mellmann A, Schaumburg F, Friedrich AW, Kipp F, Becker K. The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Germany. DEUTSCHES ARZTEBLATT INTERNATIONAL 2011; 108:761-7. [PMID: 22163252 DOI: 10.3238/arztebl.2011.0761] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 04/14/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND For decades, methicillin-resistant Staphylococcus aureus (MRSA) has been a major cause of infection in hospitals and nursing homes (health care-associated MRSA, HA-MRSA). Beginning in the late 1990s, many countries have also experienced a rising incidence of MRSA infection outside of the health care setting (community-associated MRSA, CA-MRSA). Moreover, animal reservoirs are increasingly considered to represent an important source of human MRSA acquisition. In this review article the authors describe the current epidemiological situation of MRSA in Germany. METHODS This review is based on pertinent articles published up to 2010 that were retrieved by a selective PubMed search, as well as on publications issued by national reference institutions up to 2010. RESULTS There are about 132 000 cases of MRSA in German hospitals each year. MRSA is found in about 18% to 20% of all inpatient-derived culture specimens that are positive for S. aureus. CA-MRSA is not yet endemic in Germany; important risk factors for its acquisition include travel to high-prevalence areas and household contact with persons that harbor a CA-MRSA infection. Agricultural livestock is the main animal reservoir for MRSA, which is often zoonotically transmitted from animals to human beings by direct contact. However, both CA-MRSA and MRSA from animal reservoirs can be imported into hospitals and cause nosocomial infections. CONCLUSION Hospitals and nursing homes were once the main reservoirs of MRSA, but new ones have now emerged outside of the healthcare setting. Efforts to prevent MRSA and limit its spread must rise to this new challenge.
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Affiliation(s)
- Robin Köck
- Institut für Hygiene, Universitätsklinikum Münster, Germany.
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27
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Panton-valentine leukocidin-positive and toxic shock syndrome toxin 1-positive methicillin-resistant Staphylococcus aureus: a French multicenter prospective study in 2008. Antimicrob Agents Chemother 2011; 55:1734-9. [PMID: 21220529 DOI: 10.1128/aac.01221-10] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The epidemiology of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) differs from country to country. We assess the features of the ST80 European clone, which is the most prevalent PVL-positive CA-MRSA clone in Europe, and the TSST-1 ST5 clone that was recently described in France. In 2008, all MRSA strains susceptible to fluoroquinolones and gentamicin and resistant to fusidic acid that were isolated in 104 French laboratories were characterized using agr alleles, spa typing, and the staphylococcal cassette chromosome mec element and PCR profiling of 21 toxin genes. Three phenotypes were defined: (i) kanamycin resistant, associated with the ST80 clone; (ii) kanamycin and tobramycin resistant, associated with the ST5 clone; and (iii) aminoglycoside susceptible, which was less frequently associated with the ST5 clone. Among the 7,253 MRSA strains isolated, 91 (1.3%) were ST80 CA-MRSA (89 phenotype 1) and 190 (2.6%) were ST5 CA-MRSA (146 phenotype 2, 42 phenotype 3). Compared to the latter, ST80 CA-MRSAs were more likely to be community acquired (80% versus 46%) and found in young patients (median age, 26.0 years versus 49.5 years) with deep cutaneous infections (48% versus 6%). They were less likely to be tetracycline susceptible (22% versus 85%) and to be isolated from respiratory infections (6% versus 27%). The TSST-1 ST5 clone has rapidly emerged in France and has become even more prevalent than the ST80 European clone, whose prevalence has remained stable. The epidemiological and clinical patterns of the two clones differ drastically. Given the low prevalence of both among all staphylococcal infections, no modification of antibiotic recommendations is required yet.
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28
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Yeung M, Balma-Mena A, Shear N, Simor A, Pope E, Walsh S, McGavin MJ. Identification of major clonal complexes and toxin producing strains among Staphylococcus aureus associated with atopic dermatitis. Microbes Infect 2010; 13:189-97. [PMID: 21093604 DOI: 10.1016/j.micinf.2010.10.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 10/20/2010] [Accepted: 10/21/2010] [Indexed: 11/17/2022]
Abstract
Staphylococcus aureus promotes the onset and severity of atopic dermatitis (AD), which is exacerbated by superantigen toxins SEB and SEC. The genetic identity of these isolates, and their relationship to common hospital- or community-associated methicillin resistant S. aureus (HA-MRSA and CA-MRSA) has not been defined. We conducted spa typing, partial multi-locus sequence typing (MLST), and toxin profiling (seb, sec, lukS-PV) of S. aureus from 119 pediatric and 40 adult AD patients. MLST clonal complexes CC45, CC5, CC15, CC1, CC8 and CC30 accounted for 79% of isolates, representing the same major groups reported for nosocomial S. aureus in hospital intensive care units. The highest disease severity was associated with CC1, which was significantly greater relative to CC15 (p = 0.017) or CC30 (p = 0.040), but with no significant difference relative to CC45, CC5 or CC8. Although there were two few lukS-PV, seb or sec isolates to infer a role in disease severity, CC45 was identified as a source of SEC producing strains, and lukS-PVL was associated with a small number of CC5 pediatric isolates. CC1 harbored the only CA-MRSA that was identified, and was a source of isolates that expressed both seb and sec, and closely resembled the USA400 strain of CA-MRSA.
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Affiliation(s)
- Melinda Yeung
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario M5S1A8, Canada
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Malachowa N, DeLeo FR. Mobile genetic elements of Staphylococcus aureus. Cell Mol Life Sci 2010; 67:3057-71. [PMID: 20668911 PMCID: PMC2929429 DOI: 10.1007/s00018-010-0389-4] [Citation(s) in RCA: 328] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 04/06/2010] [Accepted: 04/26/2010] [Indexed: 01/30/2023]
Abstract
Bacteria such as Staphylococcus aureus are successful as commensal organisms or pathogens in part because they adapt rapidly to selective pressures imparted by the human host. Mobile genetic elements (MGEs) play a central role in this adaptation process and are a means to transfer genetic information (DNA) among and within bacterial species. Importantly, MGEs encode putative virulence factors and molecules that confer resistance to antibiotics, including the gene that confers resistance to beta-lactam antibiotics in methicillin-resistant S. aureus (MRSA). Inasmuch as MRSA infections are a significant problem worldwide and continue to emerge in epidemic waves, there has been significant effort to improve diagnostic assays and to develop new antimicrobial agents for treatment of disease. Our understanding of S. aureus MGEs and the molecules they encode has played an important role toward these ends and has provided detailed insight into the evolution of antimicrobial resistance mechanisms and virulence.
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Affiliation(s)
- Natalia Malachowa
- Laboratory of Human Bacterial Pathogenesis, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 903 South 4th Street, Hamilton, MT 59840 USA
| | - Frank R. DeLeo
- Laboratory of Human Bacterial Pathogenesis, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 903 South 4th Street, Hamilton, MT 59840 USA
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Bertrand X. Methicillin-resistantStaphylococcus aureus: an ever emerging threat. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/thy.10.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Reich-Schupke S, Geis G, Reising M, Altmeyer P, Stücker M. MRSA in dermatology - Prospective epidemiological study in employees and patients of a dermatological department of a university hospital. J Dtsch Dermatol Ges 2010; 8:607-13. [PMID: 20184668 DOI: 10.1111/j.1610-0387.2010.07381.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND In recent years, the prevalence of MRSA has increased worldwide. There is a lack of systematic epidemiological studies evaluating the prevalence of MRSA in dermatology in Germany. OBJECTIVE What is the prevalence of MRSA in the employees and hospitalized patients in a dermatological department? What dermatological diagnoses have the highest risk for MRSA? PATIENTS AND METHODS Nasal swabs taken twice (at admission and discharge) from all consenting hospitalized patients and once from all consenting employees were analyzed for MRSA. RESULTS Analysis von 798 swabs (715 patients, 83 employees). Detection of MRSA in 31 swabs (MRSA rates: all = 4.3 %, patients = 3.7 %, employees = 4.8 %). Patients with a chronic leg ulcer had a significantly increased risk for MRSA (p = 0.03). Increased MRSA rates without statistical significance were found for men, patients with at least one hospitalization during the last 12 weeks and a hospitalization of at least 5 days. None of the patients with psoriasis had MRSA. CONCLUSIONS In comparison to international studies, the prevalence of MRSA in the current study is in the lower third. In dermatology, patients with a chronic leg ulcer have an increased risk for MRSA and should be screened at admission. A general screening for MRSA seems to be not reasonable in view of the low MRSA rates in the investigated department.
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Bornstein E, Hermans W, Gridley S, Manni J. Near-infrared photoinactivation of bacteria and fungi at physiologic temperatures. Photochem Photobiol 2010; 85:1364-74. [PMID: 19709379 DOI: 10.1111/j.1751-1097.2009.00615.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We examined a laser system (870 and 930 nm), employing wavelengths that have exhibited cellular photodamage properties in optical traps. In vitro, with 1.5 cm diameter flat-top projections (power density of 5.66 W cm(-2)), at physiologic temperatures, we achieved photoinactivation of Staphylococcus aureus, Escherichia coli, Candida albicans and Trichophyton rubrum. Using nonlethal dosimetry, we measured a decrease in trans-membrane potentials (DeltaPsimt and DeltaPsip) and an increase in reactive oxygen species (ROS) generation in methicillin-resistant S. aureus (MRSA), C. albicans and human embryonic kidney cells. We postulate that these multiplexed wavelengths cause an optically mediated mechano-transduction of cellular redox pathways, decreasing DeltaPsi and increasing ROS. The cellular energetics of prokaryotic and fungal pathogens, along with mammalian cells, are affected in a similar manner when treated with these multiplexed wavelengths at the power densities employed. Following live porcine thermal tolerance skin experiments, we then performed human pilot studies, examining photodamage to MRSA in the nose and fungi in onychomycosis. No observable damage to the nares or the nail matrix was observed, yet photodamage to the pathogens was achieved at physiologic temperatures. The selective aspect of this near-infrared photodamage presents the possibility for its future utilization in human cutaneous antimicrobial therapy.
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Witte W. Community-acquired methicillin-resistant Staphylococcus aureus: what do we need to know? Clin Microbiol Infect 2009; 15 Suppl 7:17-25. [DOI: 10.1111/j.1469-0691.2009.03097.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ben Nejma M, Mastouri M, Bel Hadj Jrad B, Makhlouf M, Nour M. Community-acquired methicillin resistantStaphylococcus aureus isolated in dermatology department. ANN MICROBIOL 2009. [DOI: 10.1007/bf03179229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ibrahim MA, Mansoor AA, Gross A, Ashfaq MK, Jacob M, Khan SI, Hamann MT. Methicillin-resistant Staphylococcus aureus (MRSA)-active metabolites from Platanus occidentalis (American Sycamore). JOURNAL OF NATURAL PRODUCTS 2009; 72:2141-4. [PMID: 19904995 PMCID: PMC4883668 DOI: 10.1021/np900499q] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
One known and three new potent, selective, and nontoxic anti-MRSA metabolites, kaempferol 3-O-alpha-l-(2'',3''-di-E-p-coumaroyl)rhamnoside (1) (IC(50) 2.0 microg/mL), kaempferol 3-O-alpha-l-(2''-E-p-coumaroyl-3''-Z-p-coumaroyl)rhamnoside (2) (IC(50) 0.8 microg/mL), kaempferol 3-O-alpha-l-(2''-Z-p-coumaroyl-3''-E-p-coumaroyl)rhamnoside (3) (IC(50) 0.7 microg/mL), and kaempferol 3-O-alpha-l-(2'',3''-di-Z-p-coumaroyl)rhamnoside (4) (IC(50) 0.4 microg/mL), were isolated from the leaves of the common American sycamore, Platanus occidentalis. Compounds 2-4 are new. Due to the unusual selectivity, potency, and safety of the pure compounds and the semipure glycoside mixture against MRSA, it is clear that this represents a viable class of inhibitors to prevent growth of MRSA on surfaces and systemically.
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Affiliation(s)
- Mohamed A. Ibrahim
- Department of Pharmacognosy, The University of Mississippi, University, Mississippi 38677
| | - Arsala A. Mansoor
- Department of Pharmacognosy, The University of Mississippi, University, Mississippi 38677
| | - Amanda Gross
- Department of Pharmacognosy, The University of Mississippi, University, Mississippi 38677
| | - M. Khalid Ashfaq
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, Mississippi 38677
| | - Melissa Jacob
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, Mississippi 38677
| | - Shabana I. Khan
- Department of Pharmacognosy, The University of Mississippi, University, Mississippi 38677
- National Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, Mississippi 38677
| | - Mark T. Hamann
- Department of Pharmacognosy, The University of Mississippi, University, Mississippi 38677
- Departments of Pharmacology, Chemistry, and Biochemistry, The University of Mississippi, University, Mississippi 38677
- Triton Biopharma LLC, 213 Timber Lane Oxford, Mississippi 38655
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Gbaguidi-Haore H, Thouverez M, Couetdic G, Cholley P, Talon D, Bertrand X. Usefulness of antimicrobial resistance pattern for detecting PVL- or TSST-1-producing meticillin-resistant Staphylococcus aureus in a French university hospital. J Med Microbiol 2009; 58:1337-1340. [PMID: 19556369 DOI: 10.1099/jmm.0.010116-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Several recent reports have suggested that community-associated meticillin-resistant Staphylococcus aureus (MRSA) clones, particularly those harbouring genes for Panton-Valentine leukocidin (PVL) or toxic shock syndrome toxin 1 (TSST-1), are increasingly responsible for infections in hospitals. Here, a retrospective study was carried out to investigate whether antimicrobial resistance patterns could be used to detect these pathogens in a French university hospital. Isolates were characterized by antimicrobial susceptibility testing, PCR profiling (PVL genes and tst), PFGE typing and multilocus sequence typing. Demographic and clinical data were collected from all patients. For PVL-positive MRSA, the typical antimicrobial resistance pattern (susceptible to fluoroquinolones, non-susceptible to fusidic acid, kanamycin resistant and susceptible to gentamicin and tobramycin) had a sensitivity of 77.8 % and a positive predictive value (PPV) of 100 %. For tst-positive MRSA, the antimicrobial resistance pattern (susceptible to fluoroquinolones and non-susceptible to fusidic acid) had a sensitivity of 100 % and a PPV of 72.4 %. These results suggest that phenotypic rules based on antimicrobial resistance patterns are potentially useful for the detection of PVL- and tst-positive MRSA isolates.
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Affiliation(s)
- Houssein Gbaguidi-Haore
- UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.,Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
| | - Michelle Thouverez
- UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.,Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
| | - Gérard Couetdic
- Service de Bactériologie, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
| | - Pascal Cholley
- UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.,Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
| | - Daniel Talon
- UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.,Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
| | - Xavier Bertrand
- UMR CNRS 6249 Chrono-Environnement, Université de Franche-Comté, Besançon, France.,Service d'Hygiène Hospitalière et d'Épidémiologie Moléculaire, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
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Hofmann H, Schnopp C. Kinderdermatologie. Hautarzt 2009; 60:183-4, 186-8, 190-3. [DOI: 10.1007/s00105-008-1659-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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38
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Keegan BR, Romagosa Y, Kirsner RS. MRSA in Dermatology. J Invest Dermatol 2008. [DOI: 10.1038/jid.2008.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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