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Farazandehnia N, Sotoudegan F, Sepahy AA, Fazeli MR. Antibacterial and antioxidant properties of sumac extract on methicillin-resistant Staphylococcus aureus. AMB Express 2024; 14:111. [PMID: 39361209 PMCID: PMC11450108 DOI: 10.1186/s13568-024-01759-4] [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: 02/23/2024] [Accepted: 08/27/2024] [Indexed: 10/06/2024] Open
Abstract
The research aimed to evaluate the antioxidative and antibacterial characteristics of aqueous sumac extract on methicillin-resistant Staphylococcus aureus through in-vitro and in-vivo study. Sumac extract has been obtained through the soaking method, and its antioxidant properties were gauged using the DPPH free radical scavenging method. The minimum inhibitory concentration (MIC) of sumac extract was determined on S. aureus obtained from hospitalized patients, as well as an assessment of biofilm-formation and the release of bacterial intracellular compounds. in vivo experimentation involved injecting bacteria (108 cfu/ml) into mice, which subsequently manifested indicators of symptoms of infection, and the number of bacteria within their bloodstream was quantified. The Sumac extract demonstrated strong antioxidant properties at concentrations of 1000 mg/ml. Furthermore, the agar tests for the gram staining, mannitol, coagulase, and DNase revealed that 190 cultured bacteria samples were identified as Staphylococcus aureus. These bacteria were resistant to clindamycin, ciprofloxacin, and methicillin antibiotics, but sensitive to erythromycin and penicillin antibiotics. Additionally, the bacteria displayed significant methicillin resistance and formed a strong biofilm (65.78%). The sumac extract showed a MIC range of 125-1000 µg/ml against Staphylococcus aureus. Treatment with concentrations above the MIC was found to prevent the formation of biofilm and increase the release of bacterial intracellular compounds. Sumac extract led to a decrease in bacterial count in the blood of mice and reduced signs of infection. Sumac extract demonstrated powerful antioxidant and antibacterial effects against resistant microorganisms, suggesting its potential as a promising compound for the treatment of resistant infections in future research.
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Affiliation(s)
- Nafiseh Farazandehnia
- Department of Microbiology, Faculty of Biological Science, North of Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Farzaneh Sotoudegan
- Quality Control of Medicines and Supplements Group, Pharmaceutical Quality Assurance Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Akhavan Sepahy
- Department of Microbiology, Faculty of Biological Science, North of Tehran Branch, Islamic Azad University, Tehran, Iran.
| | - Mohamad Reza Fazeli
- Quality Control of Medicines and Supplements Group, Pharmaceutical Quality Assurance Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.
- Department of Drug and Food Control, Pharmaceutical Quality Assurance Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Abbas Akhavan Sepahy, Iran.
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Piewngam P, Otto M. Staphylococcus aureus colonisation and strategies for decolonisation. THE LANCET. MICROBE 2024; 5:e606-e618. [PMID: 38518792 PMCID: PMC11162333 DOI: 10.1016/s2666-5247(24)00040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/24/2024]
Abstract
Staphylococcus aureus is a leading cause of death by infectious diseases worldwide. Treatment of S aureus infections is difficult due to widespread antibiotic resistance, necessitating alternative approaches and measures for prevention of infection. Because S aureus infections commonly arise from asymptomatic colonisation, decolonisation is considered a key approach for their prevention. Current decolonisation procedures include antibiotic-based and antiseptic-based eradication of S aureus from the nose and skin. However, despite the widespread implementation and partial success of such measures, S aureus infection rates remain worrisome, and resistance to decolonisation agents is on the rise. In this Review we outline the epidemiology and mechanisms of S aureus colonisation, describe how colonisation underlies infection, and discuss current and novel approaches for S aureus decolonisation, with a focus on the latest findings on probiotic strategies and the intestinal S aureus colonisation site.
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Affiliation(s)
- Pipat Piewngam
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, US National Institutes of Health, Bethesda, MD, USA
| | - Michael Otto
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, US National Institutes of Health, Bethesda, MD, USA.
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Hu W, Wang Y, Zhou L, Chu K, Jin P, Liang Q, Li J, Tan Z, Zhu F. Nasal Staphylococcus aureus Carriage and Antimicrobial Resistance Profiles Among Community-Dwelling Adults in Jiangsu, China. Infect Dis Ther 2024; 13:1215-1233. [PMID: 38700654 PMCID: PMC11128426 DOI: 10.1007/s40121-024-00969-4] [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: 03/05/2024] [Accepted: 03/27/2024] [Indexed: 05/28/2024] Open
Abstract
INTRODUCTION Persistent nasal carriage has been associated with Staphylococcus aureus infection. Previous S. aureus studies in Asia have primarily focused on clinical patients, providing limited information on persistent nasal carriage among the general adult population. METHODS This study examined 143 healthy adults in a community in Jiangsu, China. Nasal swab samples were collected 10 times. The colonization status was identified using SPA typing. We also determined antimicrobial susceptibility, genotype, and genomic characteristics of S. aureus. RESULTS The prevalence of S. aureus nasal carriage among the community individuals was on average 16.78%. The carriage rates of methicillin-resistant S. aureus and multidrug-resistant S. aureus were 6.29% and 7.69%, respectively. We identified 8.39% persistent carriers, 39.16% intermittent carriers, and 52.45% noncarriers. Furthermore, family members displayed concordance in terms of genotype and genomic characteristics. CONCLUSION Persistent nasal sampling captured intermittent carriers that were missed during short-term sampling, thus highlighting the necessity for regular community testing. SPA typing can serve as a rapid method for determining S. aureus colonization. The potential for intrafamilial transmission of S. aureus is evident, with persistent carriers being the most probable source of infection.
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Affiliation(s)
- Wenjing Hu
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Yang Wang
- Department of Science and Education, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lu Zhou
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Kai Chu
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Pengfei Jin
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Qi Liang
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Jingxin Li
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Zhongming Tan
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
| | - Fengcai Zhu
- School of Public Health, Southeast University, Nanjing, Jiangsu, China.
- National Health Commission Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Medical Innovation Center, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
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Weldegebreal F, Urgesa K, Ayele F, Bogale K, Shume T, Ahmed M, Debebe S, Tebeje F, Asmerom H, Tesfa T, Mekonnen S. Nasal carriage rate, associated factors, and antimicrobial susceptibility patterns of methicillin resistance Staphylococcus aureus among pre-clinical undergraduate students at the College of Health and Medical Sciences, Haramaya University, Ethiopia. Front Public Health 2024; 12:1354461. [PMID: 38846602 PMCID: PMC11155450 DOI: 10.3389/fpubh.2024.1354461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/15/2024] [Indexed: 06/09/2024] Open
Abstract
Background Staphylococcus aureus nasal carriage has been linked to higher rates of infection and morbidity. People with Methicillin-resistant Staphylococcus aureus can be a potential source of infection for others. University students living together in crowded conditions increase their risk of acquiring infections. The prevalence of S. aureus, particularly Methicillin-resistant Staphylococcus aureus nasal carriage, in Ethiopian university students is sparse. Objective This study aimed to determine the nasal carriage rate, associated factors, and antimicrobial susceptibility patterns of methicillin-resistant Staphylococcus aureus among pre-clinical students at the College of Health and Medical Sciences, Haramaya University, Ethiopia, from 1 July to 30 August 2022. Methods An institutional-based cross-sectional study was conducted among 270 randomly selected pre-clinical Health and Medical Sciences students. Data on associated factors were collected using pre-tested, structured questionnaires. A nasal swab was taken from each participant and sent to the microbiology laboratory via Amies transport media in a cold chain. There, it was cultivated using conventional techniques. The isolated colonies were found to be S. aureus, and its antimicrobial susceptibility was performed using the Kirby-Bauer disk diffusion method on Muller-Hinton agar. Methicillin-resistant Staphylococcus aureus expressing using cefoxitin based on CLSI breakpoint. Data were entered into Epi-Data version 4.4.2.1 and exported to the Statistical Package for Social Sciences (SPSS) software version 25 for analysis. Pearson's chi-square test was performed to predict the associations between variables. A p-value less than 0.05 was regarded as statistically significant. Result Methicillin-resistant Staphylococcus aureus nasal carriage was 5.9% (95% CI: 3.09-8.7) of cases of S. aureus nasal colonization, which was found to be 12.96% (95% CI: 8.85-16.96). Methicillin-resistant Staphylococcus aureus nasal colonization was significantly associated with the history of cigarette smoking (p = 0.000), intake of khat (p = 0.042), nose-picking habit (p = 0.003), history of sharing personal goods (p = 0.021), and history of hospitalizations (p = 0.00). All of the Methicillin-resistant Staphylococcus aureus isolates were resistant to ampicillin and cefoxitin. Conclusion Based on the findings, a considerable proportion of healthy students harbored Methicillin-resistant Staphylococcus aureus strains associated with behavioral factors. Furthermore, these isolates showed high resistance to cefoxitin and ampicillin. Hence, it is crucial to regularly test pre-clinical students to prevent endogenous infections and the spread of Methicillin-resistant Staphylococcus aureus.
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Affiliation(s)
- Fitsum Weldegebreal
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Laboratory Bacteriology Research, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan, Belgium
| | - Kedir Urgesa
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Firayad Ayele
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kasahun Bogale
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Taddese Shume
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Ahmed
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sileshi Debebe
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fikru Tebeje
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tewodros Tesfa
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Shambel Mekonnen
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Chapman JE, George SE, Wolz C, Olson ME. Biofilms: A developmental niche for vancomycin-intermediate Staphylococcus aureus. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2024; 117:105545. [PMID: 38160879 DOI: 10.1016/j.meegid.2023.105545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
Staphylococcus aureus are gram-positive bacteria responsible for a wide array of diseases, ranging from skin and soft tissue infections to more chronic illnesses such as toxic shock syndrome, osteomyelitis, and endocarditis. Vancomycin is currently one of the most effective antibiotics available in treating patients infected with methicillin-resistant S. aureus (MRSA), however the emergence of vancomycin-resistant S. aureus (VRSA), and more commonly vancomycin-intermediate S. aureus (VISA), threaten the future efficacy of vancomycin. Intermediate resistance to vancomycin occurs due to mutations within the loci of Staphylococcal genes involved in cell wall formation such as rpoB, graS, and yycG. We hypothesized the VISA phenotype may also arise as a result of the natural stress occurring within S. aureus biofilms, and that this phenomenon is mediated by the RecA/SOS response. Wildtype and recA null mutant/lexAG94E strains of S. aureus biofilms were established in biofilm microtiter assays or planktonic cultures with or without the addition of sub-inhibitory concentrations of vancomycin (0.063 mg/l - 0.25 mg/L ciprofloxacin, 0.5 mg/l vancomycin). Efficiency of plating techniques were used to quantify the subpopulation of biofilm-derived S. aureus cells that developed vancomycin-intermediate resistance. The results indicated that a greater subpopulation of cells from wildtype biofilms (4.16 × 102 CFUs) emerged from intermediate-resistant concentrations of vancomycin (4 μg/ml) compared with the planktonic counterpart (1.53 × 101 CFUs). Wildtype biofilms (4.16 × 102 CFUs) also exhibited greater resistance to intermediate-resistant concentrations of vancomycin compared with strains deficient in the recA null mutant (8.15 × 101 CFUs) and lexA genes (8.00 × 101 CFUs). While the VISA phenotype would be an unintended consequence of genetic diversity and potentially gene transfer in the biofilm setting, it demonstrates that mutations occurring within biofilms allow for S. aureus to adapt to new environments, including the presence of widely used antibiotics.
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Affiliation(s)
- Jenelle E Chapman
- Department of Medical Microbiology, Immunology, and Cell Biology, Southern Illinois University School of Medicine, USA
| | - Shilpa E George
- Interfaculty Institute of Microbiology and Infection Medicine, University of Tübingen, Germany
| | - Christiane Wolz
- Interfaculty Institute of Microbiology and Infection Medicine, University of Tübingen, Germany
| | - Michael E Olson
- Department of Medical Microbiology, Immunology, and Cell Biology, Southern Illinois University School of Medicine, USA.
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van der Schoor AS, Voor In 't Holt AF, Zandijk WHA, Bruno MJ, Gommers D, van den Akker JPC, Hendriks JM, Severin JA, Klaassen CHW, Vos MC. Dynamics of Staphylococcus aureus in patients and the hospital environment in a tertiary care hospital in the Netherlands. Antimicrob Resist Infect Control 2023; 12:148. [PMID: 38124120 PMCID: PMC10734193 DOI: 10.1186/s13756-023-01349-2] [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: 07/16/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The dynamics of Staphylococcus aureus in patients and the hospital environment are relatively unknown. We studied these dynamics in a tertiary care hospital in the Netherlands. METHODS Nasal samples were taken from adult patients at admission and discharge. Isolates cultured from clinical samples taken before and during hospitalization from these patients were included. Environmental samples of patient rooms were taken over a three-year period. Finally, isolates from clinical samples from patients with an epidemiological link to S. aureus positive rooms were included. Staphylococcal protein A (spa) typing was performed. RESULTS Nasal samples were taken from 673 patients. One hundred eighteen (17.5%) were positive at admission and discharge, 15 (2.2%) patients acquired S. aureus during hospitalization. Nineteen patients had a positive clinical sample during hospitalization, 15.9% of the S. aureus were considered as from an exogenous source. One hundred and forty (2.8%) environmental samples were S. aureus positive. No persistent contamination of surfaces was observed. Isolates were highly diverse: spa typing was performed for 893 isolates, identifying 278 different spa types, 161 of these spa types were observed only once. CONCLUSION Limited transmission could be identified between patients and the hospital environment, and from patient-to-patient. Exogenous acquisition was assumed to occur in 15% of clinical samples. Environmental contamination was infrequent, temporarily, and coincided with the strain from the patient admitted to the room at that time. MRSA was rare and not found in the environment.
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Affiliation(s)
- Adriënne S van der Schoor
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Anne F Voor In 't Holt
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Willemien H A Zandijk
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Marco J Bruno
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Diederik Gommers
- Department of Adult Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Johanna M Hendriks
- Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Juliëtte A Severin
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Corné H W Klaassen
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Margreet C Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Schleusener J, Lohan SB, Busch L, Zamudio Díaz DF, Opitz N, Sicher C, Lichtenthäler T, Danker K, Dommerich S, Filler T, Meinke MC, Zwicker P. Irradiation of human oral mucosa by 233 nm far UV-C LEDs for the safe inactivation of nosocomial pathogens. Sci Rep 2023; 13:22391. [PMID: 38104221 PMCID: PMC10725486 DOI: 10.1038/s41598-023-49745-3] [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: 10/13/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023] Open
Abstract
The inactivation of multi resistant pathogens is an important clinical need. One approach is UV-C irradiation, which was previously not possible in vivo due to cytotoxicity. Recently, far UV-C irradiation at λ < 240 nm was successfully used on skin with negligible damage. A potential application site is the nasal vestibule, where MRSA accumulates and cannot be treated using antiseptics. We irradiated 3D mucosa models and excised human mucosa with 222 and 233 nm far UV-C in comparison to 254 nm and broadband UV-B. Eradication efficiency was evaluated by counting colony forming units; irritation potential was evaluated by hen's egg-chorioallantoic membrane assay and trans epithelial electrical resistance; cell viability was assessed by MTT. DNA damage and cell protective mechanisms were evaluated immunohistopathologically. On mucosa models, MRSA reduced by ≈ 5 log10 for 60 mJ/cm2 irradiation at 233 nm. A slightly increased cell viability was observed after 24 h. Lower doses showed lower irritation potential than the positive controls or commercial mouthwash, while 80 mJ/cm2 had strong irritation potential. DNA damage occurred only superficially and decreased after 24 h. On excised human mucosa, < 10% of keratinocytes were affected after 150 mJ/cm2 222 nm or 60 mJ/cm2 233 nm.
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Affiliation(s)
- Johannes Schleusener
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Silke B Lohan
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Loris Busch
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Department of Pharmaceutics and Biopharmaceutics, Philipps-Universität Marburg, Robert‑Koch‑Str. 4, 35032, Marburg, Germany
| | - Daniela F Zamudio Díaz
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Technische Universität Berlin, Institute of Food Technology and Food Chemistry, Gustav-Meyer-Allee 25, 13355, Berlin, Germany
| | - Nevin Opitz
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand‑Sauerbruch‑Str., 17475, Greifswald, Germany
| | - Claudia Sicher
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand‑Sauerbruch‑Str., 17475, Greifswald, Germany
| | - Tom Lichtenthäler
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand‑Sauerbruch‑Str., 17475, Greifswald, Germany
| | - Kerstin Danker
- Institute of Biochemistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Steffen Dommerich
- Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Thomas Filler
- Ferdinand-Braun-Institut (FBH), Gustav‑Kirchhoff‑Str. 4, 12489, Berlin, Germany
| | - Martina C Meinke
- Center of Experimental and Applied Cutaneous Physiology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Paula Zwicker
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand‑Sauerbruch‑Str., 17475, Greifswald, Germany
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Rigaill J, Gavid M, Fayolle M, Morgene MF, Lelonge Y, Grattard F, Pozzetto B, Crépin A, Prades JM, Laurent F, Botelho-Nevers E, Berthelot P, Verhoeven PO. Staphylococcus aureus nasal colonization level and intracellular reservoir: a prospective cohort study. Eur J Clin Microbiol Infect Dis 2023; 42:621-629. [PMID: 36964269 DOI: 10.1007/s10096-023-04591-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/15/2023] [Indexed: 03/26/2023]
Abstract
Staphylococcus aureus is a major pathogen in humans. The nasal vestibule is considered as the main reservoir of S. aureus. However, even though the nasal cavity may also be colonized by S. aureus, the relationships between the two sites are still unclear. We conducted a prospective study in humans to assess the S. aureus colonization profiles in the vestibule and nasal cavity, and to investigate the presence of intracellular S. aureus in the two sites. Patients undergoing ear, nose, and throat surgery were swabbed during endoscopy to determine S. aureus nasal load, genotype, and presence of intracellular S. aureus. Among per-operative samples from 90 patients, the prevalence of S. aureus carriage was 32.2% and 33.3% in the vestibule and the nasal cavity, respectively. The mean S. aureus load was 4.10 and 4.25 log10 CFU/swab for the nasal vestibule and nasal cavity, respectively (P > 0.05). Genotyping of S. aureus revealed that all nasal strains isolated from a given individual belong to the same clonal complex and spa-type. An intracellular carriage was observed in 5.6% of the patients, all of whom exhibited a S. aureus vestibule load higher than 3 log10 CFU/swab. An intracellular niche was observed in the vestibule as well as in the nasal cavity. In conclusion, the nasal cavity was also found to be a major site of S. aureus carriage in humans and should draw attention when studying host-pathogen interactions related to the risk of infection associated with colonization.
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Affiliation(s)
- Josselin Rigaill
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Marie Gavid
- Department of Ear Nose Throat Surgery, University Hospital of St-Etienne, St-Etienne, France
| | - Martin Fayolle
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Mohamed Fedy Morgene
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
| | - Yann Lelonge
- Department of Ear Nose Throat Surgery, University Hospital of St-Etienne, St-Etienne, France
| | - Florence Grattard
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Bruno Pozzetto
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France
| | - Adeline Crépin
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
| | - Jean-Michel Prades
- Department of Ear Nose Throat Surgery, University Hospital of St-Etienne, St-Etienne, France
| | - Frédéric Laurent
- CIRI - Centre International de Recherche en Infectiologie, Staphylococcal Pathogenesis team, Université de Lyon, Inserm, U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Department of Bacteriology, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Elisabeth Botelho-Nevers
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Diseases, University Hospital of St-Etienne, St-Etienne, France
| | - Philippe Berthelot
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Faculty of Medicine, University Jean Monnet, St-Etienne, France
- Department of Infectious Diseases, University Hospital of St-Etienne, St-Etienne, France
| | - Paul O Verhoeven
- CIRI - Centre International de Recherche en Infectiologie, GIMAP team, Université de Lyon, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Lyon, France.
- Faculty of Medicine, University Jean Monnet, St-Etienne, France.
- Department of Infectious Agents and Hygiene, University Hospital of St-Etienne, St-Etienne, France.
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Piewngam P, Khongthong S, Roekngam N, Theapparat Y, Sunpaweravong S, Faroongsarng D, Otto M. Probiotic for pathogen-specific Staphylococcus aureus decolonisation in Thailand: a phase 2, double-blind, randomised, placebo-controlled trial. THE LANCET. MICROBE 2023; 4:e75-e83. [PMID: 36646104 PMCID: PMC9932624 DOI: 10.1016/s2666-5247(22)00322-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/04/2022] [Accepted: 10/20/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Decolonisation is considered a valuable means to reduce Staphylococcus aureus infection rates. However, previous topical strategies targeting the nose or skin had little success, and oral antibiotic-based decolonisation is ill advised because of eradication of the microbiota and development of antibiotic resistance. We previously showed that the probiotic Bacillus subtilis significantly diminished S aureus at the main intestinal colonisation site via specific bacterial interaction in mice; in this study, we tested this probiotic approach to control S aureus colonisation in humans. METHODS We did a single-centre, phase 2, double-blind, randomised, placebo-controlled trial in adults from the Songkhla region of Thailand who were colonised by S aureus. Eligible participants were adults (aged ≥18 years) without history of intestinal disease, antibiotic treatment, or hospital admission within the previous 90 days. Participants were excluded if they were pregnant, breastfeeding, taking probiotics, or had diarrhoea. Participants were allocated (1:1) to groups by computer randomisation in blocks of four, and research coordinators were masked to group allocation. Participants received 250 mg of probiotic B subtilis MB40 or placebo once per day for 30 days and S aureus colonisation was determined after the last dose was received. The primary outcome was colonisation by S aureus (continuous, mean decrease in colony-forming-unit count) in the intestine (by faecal counts) and nares (by nasal swabs) after intervention (30-day regimen of B subtilis probiotic). This trial is registered with the Thai Clinical Trials Registry, TCTR20210128003. FINDINGS The trial was done between Jan 29 and June 30, 2021, with enrolment taking place from Jan 29 to April 6, 2021. 115 participants were colonised by S aureus, either in the intestine (n=84), nose (n=50), or both (n=19), and were randomly assigned to treatment (n=55) and placebo groups (n=60). Oral probiotic B subtilis resulted in significant reduction of S aureus in stool (96·8%; p<0·0001) and nose (65·4%; p=0·0002). There were no differences in adverse effects or significant microbiome changes between the intervention and placebo groups. INTERPRETATION B subtilis probiotic eliminated more than 95% of the total S aureus colonising the human body without altering the microbiota. This probiotic strategy offers several key advantages over presently used decolonisation strategies for potential use in people with chronic or long-term risk of S aureus infection. Furthermore, by establishing a defining role of the intestinal colonisation site, our findings call for revisiting fundamental notions about S aureus colonisation. FUNDING National Research Council of Thailand and US National Institutes of Health.
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Affiliation(s)
- Pipat Piewngam
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, US National Institutes of Health, Bethesda, MD, USA
| | - Sunisa Khongthong
- Faculty of Veterinary Science, Rajamangala University of Technology Srivijaya, Nakhon Si Thammarat, Thailand
| | - Natthrit Roekngam
- Department of Pharmaceutical Technology, Prince of Songkla University, Songkhla, Thailand
| | - Yongyuth Theapparat
- Interdisciplinary Graduate School of Nutraceutical and Functional Food, Prince of Songkla University, Songkhla, Thailand
| | - Somkiat Sunpaweravong
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Damrongsak Faroongsarng
- Drug Delivery System Excellence Centre, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand
| | - Michael Otto
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, US National Institutes of Health, Bethesda, MD, USA.
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10
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MRSA carriage among healthcare workers in a Vietnamese intensive care unit: a prospective cohort study. Drug Target Insights 2022; 16:71-77. [PMID: 36636735 PMCID: PMC9808530 DOI: 10.33393/dti.2022.2504] [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: 10/10/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Little is known about the magnitude and patterns of methicillin-resistant Staphylococcus aureus (MRSA) carriage among intensive care unit (ICU) healthcare workers (HCWs), especially in lower-middle-income countries like Vietnam. Materials and methods: A prospective cohort study was conducted on HCWs working in the adult ICU of the Hospital for Tropical Diseases in Vietnam between October 28 and December 20, 2019. These HCWs included physicians, nurses, and nursing assistants who were responsible for all essential medical activities and basic patient care. A questionnaire was used to collect participants’ information, including age, sex, profession, ICU working time, and underlying diseases. Hand and nasal swabs were collected weekly for 8 consecutive weeks for MRSA screening. Staphylococcal isolates were checked for catalase and coagulase and, for methicillin resistance using cefoxitin disk diffusion, then rechecked on the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Results: Among 55 HCWs, 16 (29.1%) carried MRSA in their noses or hands. MRSA intermittent hand carriage was documented in 2 (3.6%) HCWs. Among 53 HCWs undertaking nasal swabs, 13 (24.5%) were MRSA persistent and 3 (5.6%) were intermittent carriers. The MRSA carriage rate was highest among nursing assistants (50%, 4/8). More HCWs with underlying diseases were found to be MRSA carriers (31.8%, 7/22) compared with those without comorbidities (27.3%, 9/33). Conclusion: MRSA carriage among HCWs is not rare. The findings highlight an urgent need to review and update the local infection prevention and control measures to prevent MRSA transmission from HCWs to patients.
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11
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Zajmi A, Shiranee F, Gee Hoon Tang S, A.M. Alhoot M, Abdul Karim S. Multidrug-Resistant Staphylococcus aureus as Coloniser in Healthy Individuals. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.108410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Staphylococcus aureus is a common human pathogen that can cause mild superficial infections to deep-seated abscesses and sepsis. One of the characteristics of S. aureus is the ability to colonise healthy individuals while leaving them asymptomatic. These carriers’ risk harbouring an antibiotic-resistant strain that may be harmful to the individual and the community. S. aureus carriage in healthcare personnel is being studied extensively in many parts of the world. However, the relationship between colonisation and disease among those with no previous exposure to healthcare remains untouched. Colonisation of the nasal cavity and its surrounding by pathogenic organisms such as S. aureus leads to the increased risk of infection. Hospital-acquired infections associated with S. aureus infections are common and studies related to these types of infections among various study groups are largely documented. However, over the last decade, an increase in community-associated methicillin-resistant S. aureus has been noted, increasing the need to identify the prevalence of the organism among healthy individuals and assessing the antibiotic resistance patterns. Systemic surveillance of the community for colonisation of S. aureus and identifying the antibiotic-resistant pattern is critical to determine the appropriate empiric antibiotic treatment.
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12
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Tzani-Tzanopoulou P, Rozumbetov R, Taka S, Doudoulakakis A, Lebessi E, Chanishvili N, Kakabadze E, Bakuradze N, Grdzelishvili N, Goderdzishvili M, Legaki E, Andreakos E, Papadaki M, Megremis S, Xepapadaki P, Kaltsas G, Akdis CA, Papadopoulos NG. Development of an in vitro homeostasis model between airway epithelial cells, bacteria and bacteriophages: a time-lapsed observation of cell viability and inflammatory response. J Gen Virol 2022; 103. [PMID: 36748697 DOI: 10.1099/jgv.0.001819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Bacteriophages represent the most extensive group of viruses within the human virome and have a significant impact on general health and well-being by regulating bacterial population dynamics. Staphylococcus aureus, found in the anterior nostrils, throat and skin, is an opportunistic pathobiont that can cause a wide range of diseases, from chronic inflammation to severe and acute infections. In this study, we developed a human cell-based homeostasis model between a clinically isolated strain of S. aureus 141 and active phages for this strain (PYOSa141) isolated from the commercial Pyophage cocktail (PYO). The cocktail is produced by Eliava BioPreparations Ltd. (Tbilisi, Georgia) and is used as an add-on therapy for bacterial infections, mainly in Georgia. The triptych interaction model was evaluated by time-dependent analysis of cell death and inflammatory response of the nasal and bronchial epithelial cells. Inflammatory mediators (IL-8, CCL5/RANTES, IL-6 and IL-1β) in the culture supernatants were measured by enzyme-linked immunosorbent assay and cell viability was determined by crystal violet staining. By measuring trans-epithelial electrical resistance, we assessed the epithelial integrity of nasal cells that had differentiated under air-liquid interface conditions. PYOSa141 was found to have a prophylactic effect on airway epithelial cells exposed to S. aureus 141 by effectively down-regulating bacterial-induced inflammation, cell death and epithelial barrier disruption in a time-dependent manner. Overall, the proposed model represents an advance in the way multi-component biological systems can be simulated in vitro.
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Affiliation(s)
- Panagiota Tzani-Tzanopoulou
- Allergy and Clinical Immunology Unit, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Ramazan Rozumbetov
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Styliani Taka
- Allergy and Clinical Immunology Unit, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Evangelia Lebessi
- Department of Microbiology, Panagiotis & Aglaia Kyriakou Children's Hospital, Athens, Greece
| | - Nina Chanishvili
- Laboratory for Genetics of Microorganisms and Bacteriophages, Eliava Institute of Bacteriophages, Microbiology & Virology, Tbilisi, Georgia
| | - Elene Kakabadze
- Laboratory for Genetics of Microorganisms and Bacteriophages, Eliava Institute of Bacteriophages, Microbiology & Virology, Tbilisi, Georgia
| | - Nata Bakuradze
- Laboratory for Genetics of Microorganisms and Bacteriophages, Eliava Institute of Bacteriophages, Microbiology & Virology, Tbilisi, Georgia
| | - Nino Grdzelishvili
- Laboratory for Genetics of Microorganisms and Bacteriophages, Eliava Institute of Bacteriophages, Microbiology & Virology, Tbilisi, Georgia.,Ilia State University, Tbilisi, Georgia
| | | | - Evangelia Legaki
- Allergy and Clinical Immunology Unit, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Andreakos
- Centre for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Maria Papadaki
- Centre for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Spyridon Megremis
- Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK
| | - Paraskevi Xepapadaki
- Allergy and Clinical Immunology Unit, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Grigoris Kaltsas
- Department of Electrical and Electronic Engineering, University of West Attica, Athens, Greece
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Nikolaos G Papadopoulos
- Allergy and Clinical Immunology Unit, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.,Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK
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13
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Nasal microbiome disruption and recovery after mupirocin treatment in Staphylococcus aureus carriers and noncarriers. Sci Rep 2022; 12:19738. [PMID: 36396730 PMCID: PMC9671894 DOI: 10.1038/s41598-022-21453-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022] Open
Abstract
Nasal decolonization procedures against the opportunistic pathogen Staphylococcus aureus rely on topical antimicrobial drug usage, whose impact on the nasal microbiota is poorly understood. We examined this impact in healthy S. aureus carriers and noncarriers. This is a prospective interventional cohort study of 8 S. aureus carriers and 8 noncarriers treated with nasal mupirocin and chlorhexidine baths. Sequential nasal swabs were taken over 6 months. S. aureus was detected by quantitative culture and genotyped using spa typing. RNA-based 16S species-level metabarcoding was used to assess the living microbial diversity. The species Dolosigranulum pigrum, Moraxella nonliquefaciens and Corynebacterium propinquum correlated negatively with S. aureus carriage. Mupirocin treatment effectively eliminated S. aureus, D. pigrum and M. nonliquefaciens, but not corynebacteria. S. aureus recolonization in carriers occurred more rapidly than recolonization by the dominant species in noncarriers (median 3 vs. 6 months, respectively). Most recolonizing S. aureus isolates had the same spa type as the initial isolate. The impact of mupirocin-chlorhexidine treatment on the nasal microbiota was still detectable after 6 months. S. aureus recolonization predated microbiota recovery, emphasizing the strong adaptation of this pathogen to the nasal niche and the transient efficacy of the decolonization procedure.
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14
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Stensen DB, Cañadas RAN, Småbrekke L, Olsen K, Nielsen CS, Svendsen K, Hanssen AM, Ericson JU, Simonsen GS, Bongo LA, Furberg AS. Social network analysis of Staphylococcus aureus carriage in a general youth population. Int J Infect Dis 2022; 123:200-209. [DOI: 10.1016/j.ijid.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/26/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
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15
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Blum FC, Whitmire JM, Bennett JW, Carey PM, Ellis MW, English CE, Law NN, Tribble DR, Millar EV, Merrell DS. Nasal microbiota evolution within the congregate setting imposed by military training. Sci Rep 2022; 12:11492. [PMID: 35798805 PMCID: PMC9263147 DOI: 10.1038/s41598-022-15059-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/17/2022] [Indexed: 11/26/2022] Open
Abstract
The human microbiome is comprised of a complex and diverse community of organisms that is subject to dynamic changes over time. As such, cross-sectional studies of the microbiome provide a multitude of information for a specific body site at a particular time, but they fail to account for temporal changes in microbial constituents resulting from various factors. To address this shortcoming, longitudinal research studies of the human microbiome investigate the influence of various factors on the microbiome of individuals within a group or community setting. These studies are vital to address the effects of host and/or environmental factors on microbiome composition as well as the potential contribution of microbiome members during the course of an infection. The relationship between microbial constituents and disease development has been previously explored for skin and soft tissue infections (SSTIs) within congregate military trainees. Accordingly, approximately 25% of the population carries Staphylococcus aureus within their nasal cavity, and these colonized individuals are known to be at increased risk for SSTIs. To examine the evolution of the nasal microbiota of U.S. Army Infantry trainees, individuals were sampled longitudinally from their arrival at Fort Benning, Georgia, until completion of their training 90 days later. These samples were then processed to determine S. aureus colonization status and to profile the nasal microbiota using 16S rRNA gene-based methods. Microbiota stability differed dramatically among the individual trainees; some subjects exhibited great stability, some subjects showed gradual temporal changes and some subjects displayed a dramatic shift in nasal microbiota composition. Further analysis utilizing the available trainee metadata suggests that the major drivers of nasal microbiota stability may be S. aureus colonization status and geographic origin of the trainees. Nasal microbiota evolution within the congregate setting imposed by military training is a complex process that appears to be affected by numerous factors. This finding may indicate that future campaigns to prevent S. aureus colonization and future SSTIs among high-risk military trainees may require a ‘personalized’ approach.
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Affiliation(s)
- Faith C Blum
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Jeannette M Whitmire
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Jason W Bennett
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Patrick M Carey
- Benning Martin Army Community Hospital, Fort Benning, GA, USA
| | | | - Caroline E English
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Natasha N Law
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - David R Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Eugene V Millar
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - D Scott Merrell
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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16
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Essigmann HT, Hanis CL, DeSantis SM, Perkison WB, Aguilar DA, Jun G, Robinson DA, Brown EL. Worsening Glycemia Increases the Odds of Intermittent but Not Persistent Staphylococcus aureus Nasal Carriage in Two Cohorts of Mexican American Adults. Microbiol Spectr 2022; 10:e0000922. [PMID: 35583495 PMCID: PMC9241628 DOI: 10.1128/spectrum.00009-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/21/2022] [Indexed: 12/14/2022] Open
Abstract
Numerous host and environmental factors contribute to persistent and intermittent nasal Staphylococcus aureus carriage in humans. The effects of worsening glycemia on the odds of S. aureus intermittent and persistent nasal carriage was established in two cohorts from an adult Mexican American population living in Starr County, Texas. The anterior nares were sampled at two time points and the presence of S. aureus determined by laboratory culture and spa-typing. Persistent carriers were defined by the presence of S. aureus of the same spa-type at both time points, intermittent carriers were S. aureus-positive for 1 of 2 swabs, and noncarriers were negative for S. aureus at both time points. Diabetes status was obtained through personal interview and physical examination that included a blood draw for the determination of percent glycated hemoglobin A1c (%HbA1c), fasting plasma glucose, and other blood chemistry values. Using logistic regression and general estimating equations, the odds of persistent and intermittent nasal carriage compared to noncarriers across the glycemic spectrum was determined controlling for covariates. Increasing fasting plasma glucose and %HbA1c in the primary and replication cohort, respectively, were significantly associated with increasing odds of S. aureus intermittent, but not persistent nasal carriage. These data suggest that increasing dysglycemia is a risk factor for intermittent S. aureus nasal carriage potentially placing those with poorly controlled diabetes at an increased risk of acquiring an S. aureus infection. IMPORTANCE Factors affecting nasal S. aureus colonization have been studied primarily in the context of persistent carriage. In contrast, few studies have examined factors affecting intermittent nasal carriage with this pathogen. This study demonstrates that the odds of intermittent but not persistent nasal carriage of S. aureus significantly increases with worsening measures of dysglycemia. This is important in the context of poorly controlled diabetes since the risk of becoming colonized with one of the primary organisms associated with diabetic foot infections can lead to increased morbidity and mortality.
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Affiliation(s)
- Heather T. Essigmann
- Center for Infectious Disease, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - Craig L. Hanis
- Human Genetics Center, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - Stacia M. DeSantis
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center, Houston, Texas, USA
| | - William B. Perkison
- Human Genetics Center, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - David A. Aguilar
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Goo Jun
- Human Genetics Center, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - D. Ashley Robinson
- Department of Microbiology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Eric L. Brown
- Center for Infectious Disease, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
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17
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Functional in-vitro evaluation of the non-specific effects of BCG vaccination in a randomised controlled clinical study. Sci Rep 2022; 12:7808. [PMID: 35552463 PMCID: PMC9096342 DOI: 10.1038/s41598-022-11748-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/19/2022] [Indexed: 11/09/2022] Open
Abstract
Bacille Calmette-Guérin (BCG), the only currently licenced tuberculosis vaccine, may exert beneficial non-specific effects (NSE) in reducing infant mortality. We conducted a randomised controlled clinical study in healthy UK adults to evaluate potential NSE using functional in-vitro growth inhibition assays (GIAs) as a surrogate of protection from four bacteria implicated in infant mortality. Volunteers were randomised to receive BCG intradermally (n = 27) or to be unvaccinated (n = 8) and were followed up for 84 days; laboratory staff were blinded until completion of the final visit. Using GIAs based on peripheral blood mononuclear cells, we observed a significant reduction in the growth of the Gram-negative bacteria Escherichia coli and Klebsiella pneumonia following BCG vaccination, but no effect for the Gram-positive bacteria Staphylococcus aureus and Streptococcus agalactiae. There was a modest association between S. aureus nasal carriage and growth of S. aureus in the GIA. Our findings support a causal link between BCG vaccination and improved ability to control growth of heterologous bacteria. Unbiased assays such as GIAs are potentially useful tools for the assessment of non-specific as well as specific effects of TB vaccines. This study was funded by the Bill and Melinda Gates Foundation and registered with ClinicalTrials.gov (NCT02380508, 05/03/2015; completed).
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18
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Calabrese C, Seccia V, Pelaia C, Spinelli F, Morini P, Rizzi A, Detoraki A. S. aureus and IgE-mediated diseases: pilot or copilot? A narrative review. Expert Rev Clin Immunol 2022; 18:639-647. [PMID: 35507006 DOI: 10.1080/1744666x.2022.2074402] [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: 11/04/2022]
Abstract
INTRODUCTION S. aureus is a major opportunistic pathogen that has been implicated in the pathogenesis of several chronic inflammatory diseases including bronchial asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), chronic spontaneous urticaria (CSU), and atopic dermatitis. S. aureus can induce the production of both polyclonal and specific IgE that can elicit an inflammatory cascade. AREAS COVERED The link between the sensitization to S. aureus enterotoxins and the severity of several chronic inflammatory diseases is reviewed in detail, as well as its therapeutic implications. EXPERT OPINION An anti-IgE strategy to inhibit S. aureus enterotoxins would be a valid approach to treat several endotypes of severe asthma, CRSwNP and CSU in which IgE against S. aureus enterotoxins should represent, not only a marker of severity of the diseases but also a target of a treatment.
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Affiliation(s)
- Cecilia Calabrese
- Department of Translational Medical Sciences, Institute of Respiratory Diseases, University of Campania "L. Vanvitelli", Naples, Italy
| | - Veronica Seccia
- Otolaryngology Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Corrado Pelaia
- Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy
| | | | | | | | - Aikaterini Detoraki
- Division of Internal Medicine and Clinical Immunology, Department of Internal Medicine, Clinical Immunology, Clinical Pathology and Infectious Diseases, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
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19
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Ngo QV, Faass L, Sähr A, Hildebrand D, Eigenbrod T, Heeg K, Nurjadi D. Inflammatory Response Against Staphylococcus aureus via Intracellular Sensing of Nucleic Acids in Keratinocytes. Front Immunol 2022; 13:828626. [PMID: 35281009 PMCID: PMC8907419 DOI: 10.3389/fimmu.2022.828626] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/07/2022] [Indexed: 12/02/2022] Open
Abstract
Staphylococcus aureus is one of the clinically most relevant pathogens causing infections. Humans are often exposed to S. aureus. In approximately one-third of the healthy population it can be found on the skin either for long or short periods as colonizing "commensals", without inducing infections or an inflammatory immune response. While tolerating S. aureus seems to be limited to certain individuals and time periods in most cases, Staphylococcus epidermidis is tolerated permanently on the skin of almost all individuals without activating overwhelming skin inflammation. To investigate this, we co-cultured a keratinocyte cell line (HaCaT) with viable S. aureus or S. epidermidis to study the differences in the immune activation. S. aureus activated keratinocytes depicted by a profound IL-6 and IL-8 response, whereas S. epidermidis did not. Our data indicate that internalization of S. aureus and the subsequent intracellular sensing of bacterial nucleic acid may be essential for initiating inflammatory response in keratinocytes. Internalized dsRNA activates IL-6 and IL-8 release, but not TNF-α or IFNs by human keratinocytes. This is a non-specific effect of dsRNA, which can be induced using Poly(I:C), as well as RNA from S. aureus and S. epidermidis. However, only viable S. aureus were able to induce this response as these bacteria and not S. epidermidis were actively internalized by HaCaT. The stimulatory effect of S. aureus seems to be independent of the TLR3, -7 and -8 pathways.
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Affiliation(s)
- Quang Vinh Ngo
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
- Deutsches Zentrum für Infektionsforschung (DZIF), Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Larissa Faass
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
- Max von Pettenkofer Institute, Chair for Medical Microbiology and Hygiene, Ludwig Maximilians University Munich, Munich, Germany
| | - Aline Sähr
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
| | - Dagmar Hildebrand
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
| | - Tatjana Eigenbrod
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
| | - Klaus Heeg
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
- Deutsches Zentrum für Infektionsforschung (DZIF), Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Dennis Nurjadi
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, Heidelberg, Germany
- Deutsches Zentrum für Infektionsforschung (DZIF), Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
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20
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Allport J, Choudhury R, Bruce-Wootton P, Reed M, Tate D, Malviya A. Efficacy of mupirocin, neomycin and octenidine for nasal Staphylococcus aureus decolonisation: a retrospective cohort study. Antimicrob Resist Infect Control 2022; 11:5. [PMID: 35012641 PMCID: PMC8744346 DOI: 10.1186/s13756-021-01043-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) causes significant morbidity. Methicillin sensitive Staphylococcus aureus (MSSA) is the most frequent organism, and the majority are endogenous. Decolonisation reduces PJIs but there is a paucity of evidence comparing treatments. Aims; compare 3 nasal decolonisation treatments at (1) achieving MSSA decolonisation, (2) preventing PJI. METHODS Our hospital prospectively collected data on our MSSA decolonisation programme since 2013, including; all MSSA carriers, treatment received, MSSA status at time of surgery and all PJIs. Prior to 2017 MSSA carriers received nasal mupirocin or neomycin, from August 2017 until August 2019 nasal octenidine was used. RESULTS During the study period 15,958 primary hip and knee replacements were performed. 3200 (20.1%) were MSSA positive at preoperative screening and received decolonisation treatment, 698 mupirocin, 1210 neomycin and 1221 octenidine. Mupirocin (89.1%) and neomycin (90.9%) were more effective at decolonisation than octenidine (50.0%, P < 0.0001). There was no difference in PJI rates (P = 0.452). CONCLUSIONS Mupirocin and neomycin are more effective than octenidine at MSSA decolonisation. There was poor correlation between the MSSA status after treatment (on day of surgery) and PJI rates. Further research is needed to compare alternative MSSA decolonisation treatments.
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Affiliation(s)
- J Allport
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK.
| | - R Choudhury
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - P Bruce-Wootton
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - M Reed
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - D Tate
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
| | - A Malviya
- Northumbria Healthcare NHS Trust, Department of Trauma and Orthopaedics, Wansbeck General Hospital, Woodhorn Lane, Ashington, NE63 9JJ, UK
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21
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Frosini SM, Bond R, King R, Feudi C, Schwarz S, Loeffler A. Effect of topical antimicrobial therapy and household cleaning on meticillin-resistant Staphylococcus pseudintermedius carriage in dogs. Vet Rec 2021; 190:e937. [PMID: 34582577 DOI: 10.1002/vetr.937] [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: 02/22/2021] [Revised: 07/30/2021] [Accepted: 08/28/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Meticillin-resistant Staphylococcus pseudintermedius (MRSP) is a multidrug-resistant canine pathogen with a low zoonotic potential. This study investigated MRSP carriage and clearance through topical antimicrobial therapy and household cleaning in dogs recovered from MRSP infection. METHODS Dogs were swabbed for MRSP carriage; household contamination was assessed using contact plates. Carrier dogs were allocated randomly to receive topical fusidic acid and chlorhexidine/miconazole treatment combined with owners implementing a household hygiene protocol (H&T) or implementation of hygiene alone (H) over three weeks. Carriage-negative dogs were monitored monthly. The relatedness of isolates over time was investigated by pulsed-field gel electrophoresis (PFGE). RESULTS At inclusion, MRSP carriage was confirmed in 31/46 (67.4%) index dogs and 16/24 (66.7%) contact dogs, and contamination was found in 18/40 (45%) environments. In dogs completing all cycles, interventions cleared carriage in 5/9 (55.6%) dogs in group H&T and 2/6 (33.3%) in group H. Environmental contamination was infrequent but associated with carrier dogs (p = 0.047). Monthly monitoring of initially negative dogs showed intermittent carriage in 9/14 dogs. PFGE-concordance was found among all 34 MRSP isolated from eight index dogs over time. CONCLUSION MRSP carriage was common in dogs after recovery from infection. Topical antimicrobial therapy temporarily eliminated carriage but recurrence was frequent. Management efforts must include the prevention of recurrent infections and hygiene.
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Affiliation(s)
- Siân-Marie Frosini
- Department of Clinical Services and Sciences, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Ross Bond
- Department of Clinical Services and Sciences, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Ruth King
- Department of Clinical Services and Sciences, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Claudia Feudi
- Institute of Microbiology and Epizootics, Centre for Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Stefan Schwarz
- Institute of Microbiology and Epizootics, Centre for Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Anette Loeffler
- Department of Clinical Services and Sciences, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
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22
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Jauneikaite E, Pichon B, Mosavie M, Fallowfield JL, Davey T, Thorpe N, Nelstrop A, Sriskandan S, Lamb LE. Staphylococcus argenteus transmission among healthy Royal Marines: A molecular epidemiology case-study. J Infect 2021; 83:550-553. [PMID: 34469709 DOI: 10.1016/j.jinf.2021.08.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/03/2021] [Accepted: 08/26/2021] [Indexed: 11/17/2022]
Abstract
Objectives During a prospective study of S. aureus carriage in Royal Marines recruits, six S. argenteus strains were identified in four recruits. As S. argenteus sepsis leads to mortality similar to S. aureus, we determined the potential for within same troop transmission, to evaluate future outbreak risk. Methods We used whole-genome sequencing to characterise S. argenteus and investigate phylogenetic relationships between isolates. Results S. argenteus strains (t5078, ST2250) were detected in 4/40 recruits in the same troop (training cohort) in weeks 1, 6 or 15 of training. No mec, tsst or LukPV genes were detected. We identified differences of 1-17 core SNPs between S. argenteus from different recruits. In two recruits, two S. argenteus strains were isolated; these could be distinguished by 2 and 15 core SNPs. Conclusions The identification of S. argenteus within a single troop from the total recruit population suggests a common source for transmission, though high number of SNPs were identified, both within-host and within-cluster. The high number of SNPs between some isolates may indicate a common source of diverse isolates or a high level of S. argenteus mutation in carriage. S. argenteus is newly recognized species; and understanding of the frequency of genetic changes during transmission and transition from asymptomatic carriage to disease is required.
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Affiliation(s)
- Elita Jauneikaite
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London W2 1PG, UK.
| | - Bruno Pichon
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London W2 1PG, UK; Healthcare Associated Infection and Antimicrobial Resistance, National Infection Service, Public Health England, Colindale, UK
| | - Mia Mosavie
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London W2 1PG, UK
| | | | | | | | - Andrew Nelstrop
- Commando Training Centre Royal Marines, Lympstone, UK; Defence Primary Healthcare, Plymouth, UK
| | - Shiranee Sriskandan
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London W2 1PG, UK
| | - Lucy E Lamb
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London W2 1PG, UK; Academic Department of Military Medicine, Royal Centre for Defence Medicine (Research and Academia), Birmingham, UK; Royal Free London NHS Foundation Trust, London NW3 2QG, UK.
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23
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Wang M, van den Berg S, Mora Hernández Y, Visser AH, Vera Murguia E, Koedijk DGAM, Bellink C, Bruggen H, Bakker-Woudenberg IAJM, van Dijl JM, Buist G. Differential binding of human and murine IgGs to catalytic and cell wall binding domains of Staphylococcus aureus peptidoglycan hydrolases. Sci Rep 2021; 11:13865. [PMID: 34226629 PMCID: PMC8257689 DOI: 10.1038/s41598-021-93359-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/28/2021] [Indexed: 12/27/2022] Open
Abstract
Staphylococcus aureus is an opportunistic pathogen causing high morbidity and mortality. Since multi-drug resistant S. aureus lineages are nowadays omnipresent, alternative tools for preventive or therapeutic interventions, like immunotherapy, are urgently needed. However, there are currently no vaccines against S. aureus. Surface-exposed and secreted proteins are regarded as potential targets for immunization against S. aureus infections. Yet, many potential staphylococcal antigens of this category do not elicit protective immune responses. To obtain a better understanding of this problem, we compared the binding of serum IgGs from healthy human volunteers, highly S. aureus-colonized patients with the genetic blistering disease epidermolysis bullosa (EB), or immunized mice to the purified S. aureus peptidoglycan hydrolases Sle1, Aly and LytM and their different domains. The results show that the most abundant serum IgGs from humans and immunized mice target the cell wall-binding domain of Sle1, and the catalytic domains of Aly and LytM. Interestingly, in a murine infection model, these particular IgGs were not protective against S. aureus bacteremia. In contrast, relatively less abundant IgGs against the catalytic domain of Sle1 and the N-terminal domains of Aly and LytM were almost exclusively detected in sera from EB patients and healthy volunteers. These latter IgGs may contribute to the protection against staphylococcal infections, as previous studies suggest that serum IgGs protect EB patients against severe S. aureus infection. Together, these observations focus attention on the use of particular protein domains for vaccination to direct potentially protective immune responses towards the most promising epitopes within staphylococcal antigens.
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Affiliation(s)
- Min Wang
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands
| | - Sanne van den Berg
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yaremit Mora Hernández
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands
| | - Aafke Hinke Visser
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands
| | - Elias Vera Murguia
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands
| | - Dennis G A M Koedijk
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands
| | - Channah Bellink
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands
| | - Hilde Bruggen
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands
| | - Irma A J M Bakker-Woudenberg
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands.
| | - Girbe Buist
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, HPC EB80, P.O. box 30001, 9700 RB, Groningen, the Netherlands
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24
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Ménard G, Morin-Le Bihan A, Isly H, Auger G, Le Neindre K, King LA, Martins-Simões P, Tristan A, Donnio PY. Clustered cases of infections due to an uncommon methicillin-resistant Staphylococcus aureus originating in a maternity ward. Infect Dis Now 2021; 51:540-546. [PMID: 34198001 DOI: 10.1016/j.idnow.2021.06.305] [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: 03/03/2021] [Revised: 05/18/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We aimed to report a community outbreak of an uncommon methicillin-resistant Staphylococcus aureus (MRSA) originating in a maternity ward. PATIENTS AND METHODS Cases were defined by epidemiological, clinical, and microbiological investigations. Microbiological investigations included phenotypic analysis, molecular typing, and whole-genome sequencing. To control the outbreak, we applied both national recommendations to prevent in-hospital transmission and the French High Council for Public Health guidelines on the management of community-acquired MRSA infections. RESULTS Between March and July 2016, seven patients with MRSA infections were identified: six skin and soft tissue infections and one pulmonary infection, including six microbiologically confirmed infections. Infections occurred in community settings, but a link with the same maternity ward was found for all patients. All MRSA strains had a t690 spa type, were tetracycline-resistant, and produced Panton-Valentine leukocidin. All isolates belonged to the sequence type 88 (ST88). CONCLUSION This outbreak highlights the largely underestimated risk of healthcare-associated infections in maternity wards. Healthcare workers should be aware of the importance of standard hygiene precautions and use of alcohol-based hand sanitizers for neonates and mothers.
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Affiliation(s)
- G Ménard
- CHU de Rennes, service de bactériologie-hygiène hospitalière, 35033 Rennes, France; Université de Rennes 1, unité Inserm U1230, 35043 Rennes, France.
| | - A Morin-Le Bihan
- CHU de Rennes, service de bactériologie-hygiène hospitalière, 35033 Rennes, France
| | - H Isly
- CHU de Rennes, service d'obstétrique, 35033 Rennes, France
| | - G Auger
- CHU de Rennes, service de bactériologie-hygiène hospitalière, 35033 Rennes, France
| | - K Le Neindre
- CHU de Rennes, service de bactériologie-hygiène hospitalière, 35033 Rennes, France; Université de Rennes 1, unité Inserm U1230, 35043 Rennes, France
| | - L A King
- Santé Publique France, Rennes, France
| | - P Martins-Simões
- Hospices civils de Lyon, Centre national de référence des staphylocoques, institut des agents infectieux, 69004 Lyon, France
| | - A Tristan
- Hospices civils de Lyon, Centre national de référence des staphylocoques, institut des agents infectieux, 69004 Lyon, France
| | - P Y Donnio
- CHU de Rennes, service de bactériologie-hygiène hospitalière, 35033 Rennes, France; Université de Rennes 1, unité Inserm U1230, 35043 Rennes, France
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25
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Wood C, Sahl J, Maltinsky S, Coyne B, Russakoff B, Yagüe DP, Bowers J, Pearson T. SaQuant: a real-time PCR assay for quantitative assessment of Staphylococcus aureus. BMC Microbiol 2021; 21:174. [PMID: 34103012 PMCID: PMC8188689 DOI: 10.1186/s12866-021-02247-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/31/2021] [Indexed: 11/10/2022] Open
Abstract
Background Molecular assays are important tools for pathogen detection but need to be periodically re-evaluated with the discovery of additional genetic diversity that may cause assays to exclude target taxa or include non-target taxa. A single well-developed assay can find broad application across research, clinical, and industrial settings. Pathogen prevalence within a population is estimated using such assays and accurate results are critical for formulating effective public health policies and guiding future research. A variety of assays for the detection of Staphylococcus aureus are currently available. The utility of commercial assays for research is limited, given proprietary signatures and lack of transparent validation. Results In silico testing of existing peer-reviewed assays show that most suffer from a lack of sensitivity and specificity. We found no assays that were specifically designed and validated for quantitative use. Here we present a qPCR assay, SaQuant, for the detection and quantification of S. aureus as might be collected on sampling swabs. Sensitivity and specificity of the assay was 95.6 and 99.9 %, respectively, with a limit of detection of between 3 and 5 genome equivalents and a limit of quantification of 8.27 genome equivalents. The presence of DNA from non-target species likely to be found in a swab sample, did not impact qualitative or quantitative abilities of the assay. Conclusions This assay has the potential to serve as a valuable tool for the accurate detection and quantification of S. aureus collected from human body sites in order to better understand the dynamics of prevalence and transmission in community settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02247-6.
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Affiliation(s)
- Colin Wood
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Jason Sahl
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Sara Maltinsky
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Briana Coyne
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Benjamin Russakoff
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | | | - Jolene Bowers
- Translational Genomics Research Institute, Flagstaff, AZ, USA
| | - Talima Pearson
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA.
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Identification of Nasal Gammaproteobacteria with Potent Activity against Staphylococcus aureus: Novel Insights into the "Noncarrier" State. mSphere 2021; 6:6/1/e01015-20. [PMID: 33408227 PMCID: PMC7802429 DOI: 10.1128/msphere.01015-20] [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] [Indexed: 02/07/2023] Open
Abstract
Nasal carriage of Staphylococcus aureus is a risk factor for infection, but it is not yet understood why some individuals carry nasal S. aureus persistently, intermittently, or seemingly not at all when tested via culture methods. This study compared the nasal microbiomes of established S. aureus carriers and noncarriers, identified species associated with noncarriage, and tested them for anti-S. aureus activity using assays developed to model the nutrient-limited nasal mucosa. Staphylococcus aureus nasal carriage provides the bacterial reservoir for opportunistic infection. In comparing the nasal microbiomes of culture-defined persistent S. aureus carriers versus noncarriers, we detected S. aureus DNA in all noses, including those with an established history of S. aureus negativity based on culture. Colonization with Gammaproteobacteria, including Klebsiella aerogenes, Citrobacter koseri, Moraxella lincolnii, and select Acinetobacter spp., was associated with S. aureus noncarriage. We next developed physiological competition assays for testing anti-S. aureus activity of isolated nasal species, utilizing medium modeling the nutrient-limited fluid of the nasal mucosa, polarized primary nasal epithelia, and nasal secretions. K. aerogenes from the nose of an S. aureus noncarrier demonstrated >99% inhibition of S. aureus recovery in all assays, even when S. aureus was coincubated in 9-fold excess. Secreted S. aureus inhibitory proteins from K. aerogenes and M. lincolnii were heat-stable and <30 kDa, fitting the profile of antimicrobial peptides. C. koseri, Acinetobacter haemolyticus, Acinetobacter junii, and Acinetobacter schindleri inhibited S. aureus recovery on nasal epithelia in a contact-dependent manner, while several other species either had no effect or promoted S. aureus growth. Collectively, this project is one of the first to identify resident nasal microbial species that impede S. aureus survival, and it implies that detectable nasal S. aureus results from shifts in microbial community composition. IMPORTANCE Nasal carriage of Staphylococcus aureus is a risk factor for infection, but it is not yet understood why some individuals carry nasal S. aureus persistently, intermittently, or seemingly not at all when tested via culture methods. This study compared the nasal microbiomes of established S. aureus carriers and noncarriers, identified species associated with noncarriage, and tested them for anti-S. aureus activity using assays developed to model the nutrient-limited nasal mucosa. We determined that all nostril swabs contain S. aureus DNA, even swabs from hosts considered to be long-term noncarriers. Select members of the Gammaproteobacteria class were more prevalent in noncarrier than carrier nostrils and demonstrated potent activity against multiple strains of S. aureus. The results described here provide a better understanding of how the nasal microbiome controls S. aureus growth and viability and may be useful in the design of improved S. aureus decolonization strategies.
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Żelaźniewicz A, Nowak-Kornicka J, Figura R, Groyecka-Bernard A, Sorokowski P, Pawłowski B. Pharyngeal Detection of Staphylococcus aureus as a Possible Factor Related to Disgust Sensitivity in Humans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218286. [PMID: 33182475 PMCID: PMC7665136 DOI: 10.3390/ijerph17218286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/26/2022]
Abstract
Disgust triggers behavioral avoidance of pathogen-carrying and fitness-reducing agents. However, because of the cost involved, disgust sensitivity should be flexible, varying as a function of an individual’s immunity. Asymptomatic colonization with Staphylococcus aureus often results from weakened immunity and is a potential source of subsequent infections. In this study, we tested if pharyngeal colonization with S. aureus, evaluated based on a single swab collection, is related to an individual’s disgust sensitivity, measured with the Three Domain Disgust Scale. Levels of immunomodulating hormones (cortisol and testosterone), general health, and body adiposity were controlled. Women (N = 95), compared to men (N = 137), displayed higher sexual disgust sensitivity, but the difference between individuals with S. aureus and without S. aureus was significant only in men, providing support for prophylactic hypothesis, explaining inter-individual differences in disgust sensitivity. Men (but not women) burdened with asymptomatic S. aureus presence in pharynx exhibit higher pathogen disgust (p = 0.04) compared to individuals in which S. aureus was not detected. The positive relationship between the presence of the pathogen and sexual disgust was close to the statistical significance level (p = 0.06), and S. aureus colonization was not related with moral disgust domain.
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Affiliation(s)
- Agnieszka Żelaźniewicz
- Department of Human Biology, University of Wroclaw, 50-138 Wroclaw, Poland; (J.N.-K.); (R.F.); (B.P.)
- Correspondence:
| | - Judyta Nowak-Kornicka
- Department of Human Biology, University of Wroclaw, 50-138 Wroclaw, Poland; (J.N.-K.); (R.F.); (B.P.)
| | - Renata Figura
- Department of Human Biology, University of Wroclaw, 50-138 Wroclaw, Poland; (J.N.-K.); (R.F.); (B.P.)
| | - Agata Groyecka-Bernard
- Institute of Psychology, University of Wroclaw, 50-529 Wroclaw, Poland; (A.G.-B.); (P.S.)
| | - Piotr Sorokowski
- Institute of Psychology, University of Wroclaw, 50-529 Wroclaw, Poland; (A.G.-B.); (P.S.)
| | - Bogusław Pawłowski
- Department of Human Biology, University of Wroclaw, 50-138 Wroclaw, Poland; (J.N.-K.); (R.F.); (B.P.)
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28
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Nørreslet LB, Edslev SM, Andersen PS, Plum F, Holt J, Kjerulf A, Ebbehøj NE, Clausen ML, Flachs EM, Agner T. Colonization with Staphylococcus aureus in patients with hand eczema: Prevalence and association with severity, atopic dermatitis, subtype and nasal colonization. Contact Dermatitis 2020; 83:442-449. [PMID: 32720317 DOI: 10.1111/cod.13679] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/24/2020] [Accepted: 07/26/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND While Staphylococcus aureus (S. aureus) colonization has been thoroughly studied in atopic dermatitis (AD), where S. aureus is related to flares and considered a trigger factor, S. aureus colonization in hand eczema (HE) has only been sparsely studied. OBJECTIVES To examine the 1-week prevalence of S. aureus colonization in HE patients, and its association with severity, HE subtype, AD, and nasal S. aureus colonization compared with healthy controls. METHODS In a case-control study of 50 adult HE patients and 50 healthy controls, bacterial swabs from lesional skin (patients only), non-lesional skin (dorsal hand), and the nasal cavity were sampled for culturing of S. aureus on days 1, 3, 5 and 8. Participants were characterized by demographics, AD, HE subtype, filaggrin gene mutation status, and HE severity. RESULTS Twenty-seven HE patients (54%) were colonized with S. aureus on the hand compared to one control (2%) (P < .01). Nasal S. aureus colonization was found in 72% of patients and 22% of controls (P < .01). For patients, S. aureus colonization on the hands was associated with an atopic HE subtype and HE severity (P = .01 and P < .01, respectively). CONCLUSIONS Both hand and nasal S. aureus colonization were highly prevalent among HE-patients and may have an impact on the persistence of HE.
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Affiliation(s)
- Line B Nørreslet
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sofie M Edslev
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institute, Copenhagen, Denmark
| | - Paal S Andersen
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institute, Copenhagen, Denmark
| | - Frederik Plum
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jette Holt
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institute, Copenhagen, Denmark
| | - Anne Kjerulf
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institute, Copenhagen, Denmark
| | - Niels E Ebbehøj
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Maja-Lisa Clausen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Esben M Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tove Agner
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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29
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Ménard G, Bonnaure-Mallet M, Donnio PY. Adhesion of Staphylococcus aureus to epithelial cells: an in vitro approach to study interactions within the nasal microbiota. J Med Microbiol 2020; 69:1253-1261. [PMID: 32909934 DOI: 10.1099/jmm.0.001248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Staphylococcus aureus is a skin and mucous commensal bacterium of warm-blooded animals. In humans, the nose is the main ecological niche of S. aureus, and nasal carriage is a risk factor for developing an endogenous infection. S. aureus nasal colonization is a multifactorial process, involving inter-species interactions among the nasal microbiota.Aims. The objectives of this study were to characterize the microbiota of carriers and non-carriers of S. aureus and to demonstrate the importance of inter-species relationships in the adhesion of S. aureus, a key step in nasal colonization.Methodology. First, we characterized the nasal microbiota from 30 S. aureus carriers and non-carriers by a culturomic approach. We then evaluated the adhesion of S. aureus, first alone and then along with other bacteria of the nasal microbiota. To do that, we used an in vitro model to measure the interactions among bacteria in the presence of epithelial cells.Results. Analysis of the nasal microbiota of the carriers and non-carriers of S. aureus made it possible to observe that each microbiota has specific features in terms of composition. However, this composition differs significantly between carriers and non-carriers mainly through two bacterial groups: coagulase-negative staphylococci and corynebacteria. In a second part, adhesion of S. aureus to epithelial cells showed competition between S. aureus and these bacteria, suggesting a limitation of nasal colonization by S. aureus.Conclusion. These findings demonstrate the existence of a negative correlation between S. aureus and other species which inhibits adhesion and could limit nasal colonization.
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Affiliation(s)
- Guillaume Ménard
- Univ Rennes, CHU Rennes, Inserm BRM UMR 1230, F-35000 Rennes, France
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Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves. Infect Control Hosp Epidemiol 2020; 41:1396-1401. [PMID: 32762778 DOI: 10.1017/ice.2020.336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate the effect of the burden of Staphylococcus aureus colonization of nursing home residents on the risk of S. aureus transmission to healthcare worker (HCW) gowns and gloves. DESIGN Multicenter prospective cohort study. SETTING AND PARTICIPANTS Residents and HCWs from 13 community-based nursing homes in Maryland and Michigan. METHODS Residents were cultured for S. aureus at the anterior nares and perianal skin. The S. aureus burden was estimated by quantitative polymerase chain reaction detecting the nuc gene. HCWs wore gowns and gloves during usual care activities; gowns and gloves were swabbed and then cultured for the presence of S. aureus. RESULTS In total, 403 residents were enrolled; 169 were colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA) and comprised the study population; 232 were not colonized and thus were excluded from this analysis; and 2 were withdrawn prior to being swabbed. After multivariable analysis, perianal colonization with S. aureus conferred the greatest odds for transmission to HCW gowns and gloves, and the odds increased with increasing burden of colonization: adjusted odds ratio (aOR), 2.1 (95% CI, 1.3-3.5) for low-level colonization and aOR 5.2 (95% CI, 3.1-8.7) for high level colonization. CONCLUSIONS Among nursing home patients colonized with S. aureus, the risk of transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. Our findings inform future infection control practices for both MRSA and MSSA in nursing homes.
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Israelsson E, Chaussabel D, Fischer RSB, Moore HC, Robinson DA, Dunkle JW, Essigmann HT, Record S, Brown EL. Characterization of peripheral blood mononuclear cells gene expression profiles of pediatric Staphylococcus aureus persistent and non-carriers using a targeted assay. Microbes Infect 2020; 22:540-549. [PMID: 32758644 DOI: 10.1016/j.micinf.2020.07.006] [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: 01/09/2020] [Revised: 06/26/2020] [Accepted: 07/25/2020] [Indexed: 11/28/2022]
Abstract
Defects in innate immunity affect many different physiologic systems and several studies of patients with primary immunodeficiency disorders demonstrated the importance of innate immune system components in disease prevention or colonization of bacterial pathogens. To assess the role of the innate immune system on nasal colonization with Staphylococcus aureus, innate immune responses in pediatric S. aureus nasal persistent carriers (n = 14) and non-carriers (n = 15) were profiled by analyzing co-clustered gene sets (modules). We stimulated previously frozen peripheral blood mononuclear cells (PBMCs) from these subjects with i) a panel of TLR ligands, ii) live S. aureus (either a mixture of strains or stimulation with respective carriage isolates), or iii) heat-killed S. aureus. We found no difference in responses between carriers and non-carriers when PBMCs were stimulated with a panel of TLR ligands. However, PBMC gene expression profiles differed between persistent and non-S. aureus carriers following stimulation with either live or dead S. aureus. These observations suggest that individuals susceptible to persistent carriage with S. aureus may possess differences in their live/dead bacteria recognition pathway and that innate pathway signaling is different between persistent and non-carriers of S. aureus.
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Affiliation(s)
- Elisabeth Israelsson
- Department of Systems Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Damien Chaussabel
- Systems Biology Department, Sidra Medical and Research Center, Doha, Qatar
| | - Rebecca S B Fischer
- Texas A&M Health Science Center School of Public Health, Department of Epidemiology and Biostatistics, College Station, TX, USA
| | - Heather C Moore
- Baylor College of Medicine, Complex Care Clinic, Texas Children's Hospital, Houston, TX, USA
| | - D Ashley Robinson
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jesse W Dunkle
- Icahn School of Medicine, Mount Sinai Hospital, Institute for Advanced Medicine, New York, NY, USA
| | - Heather T Essigmann
- Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Sharron Record
- Texas Children's Hospital, Department of Pediatrics, TX, USA
| | - Eric L Brown
- Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA.
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Hogan PG, Mork RL, Thompson RM, Muenks CE, Boyle MG, Sullivan ML, Morelli JJ, Williams CV, Sanchez N, Hunstad DA, Wardenburg JB, Gehlert SJ, Burnham CAD, Rzhetsky A, Fritz SA. Environmental Methicillin-resistant Staphylococcus aureus Contamination, Persistent Colonization, and Subsequent Skin and Soft Tissue Infection. JAMA Pediatr 2020; 174:552-562. [PMID: 32227144 PMCID: PMC7105954 DOI: 10.1001/jamapediatrics.2020.0132] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
IMPORTANCE The longitudinal association among persistent Staphylococcus aureus colonization, household environmental contamination, and recurrent skin and soft tissue infection (SSTI) is largely unexplored to date. OBJECTIVES To identify factors associated with persistent S aureus colonization and recurrent SSTI in households with children with community-associated methicillin-resistant S aureus (MRSA) SSTI. DESIGN, SETTING, AND PARTICIPANTS This 12-month prospective cohort study included 150 children with community-associated MRSA SSTI, 542 household contacts, and 154 pets enrolled from January 3, 2012, through October 20, 2015. A total of 5 quarterly home visits were made to 150 households in the St Louis, Missouri, region. Statistical analysis was performed from September 18, 2018, to January 7, 2020. EXPOSURES Covariates used in S aureus strain persistence and interval SSTI models included S aureus colonization and contamination measures, personal hygiene and sharing habits, health history, activities external to the home, and household characteristics (eg, cleanliness, crowding, home ownership, and pets). Serial samples to detect S aureus were collected from household members at 3 anatomic sites, from pets at 2 anatomic sites, and from environmental surfaces at 21 sites. MAIN OUTCOMES AND MEASURES Molecular epidemiologic findings of S aureus isolates were assessed via repetitive-sequence polymerase chain reaction. Individual persistent colonization was defined as colonization by an identical strain for 2 consecutive samplings. Longitudinal, multivariable generalized mixed-effects logistic regression models were used to assess factors associated with persistent S aureus personal colonization, environmental contamination, and interval SSTI. RESULTS Among 692 household members in 150 households, 326 (47%) were male and 366 (53%) were female, with a median age of 14.82 years (range, 0.05-82.25 years). Of 540 participants completing all 5 samplings, 213 (39%) were persistently colonized with S aureus, most often in the nares and with the strain infecting the index patient at enrollment. Nine pets (8%) were persistently colonized with S aureus. Participants reporting interval intranasal mupirocin application were less likely to experience persistent colonization (odds ratio [OR], 0.44; 95% credible interval [CrI], 0.30-0.66), whereas increasing strain-specific environmental contamination pressure was associated with increased individual persistent colonization (OR, 1.17; 95% CrI, 1.06-1.30). Strains with higher colonization pressure (OR, 1.47; 95% CrI, 1.25-1.71) and MRSA strains (OR, 1.57; 95% CrI, 1.16-2.19) were more likely to persist. Seventy-six index patients (53%) and 101 household contacts (19%) reported interval SSTIs. Individuals persistently colonized with MRSA (OR, 1.56; 95% CrI, 1.17-2.11), those with a history of SSTI (OR, 2.55; 95% CrI, 1.88-3.47), and index patients (OR, 1.54; 95% CrI, 1.07-2.23) were more likely to report an interval SSTI. CONCLUSIONS AND RELEVANCE The study findings suggest that recurrent SSTI is associated with persistent MRSA colonization of household members and contamination of environmental surfaces. Future studies may elucidate the effectiveness of specific combinations of personal decolonization and environmental decontamination efforts in eradicating persistent strains and mitigating recurrent SSTIs.
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Affiliation(s)
- Patrick G. Hogan
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Ryan L. Mork
- Graduate Program in the Biophysical Sciences, University of Chicago, Chicago, Illinois,Committee of Microbiology, University of Chicago, Chicago, Illinois,Institute for Genomics and Systems Biology, University of Chicago, Chicago, Illinois
| | - Ryley M. Thompson
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Carol E. Muenks
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Mary G. Boyle
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Melanie L. Sullivan
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - John J. Morelli
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Caroline V. Williams
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Nataly Sanchez
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - David A. Hunstad
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri,Department of Molecular Microbiology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | | | - Sarah J. Gehlert
- Department of Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Carey-Ann D. Burnham
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri,Department of Molecular Microbiology, Washington University School of Medicine in St Louis, St Louis, Missouri,Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, Missouri,Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Andrey Rzhetsky
- Department of Human Genetics, University of Chicago, Chicago, Illinois
| | - Stephanie A. Fritz
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
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Erikstrup LT, Dinh KM, Andersen PS, Skov RL, Kaspersen KA, Nielsen KR, Ellermann-Eriksen S, Erikstrup C. Cohort description: The Danish Blood Donor Staphylococcus aureus Carriage Study. Clin Epidemiol 2019; 11:885-900. [PMID: 31572018 PMCID: PMC6757111 DOI: 10.2147/clep.s218637] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/20/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose Staphylococcus aureus carriage poses an increased risk of S. aureus infection. The aim of this study was to investigate the colonization of S. aureus among healthy individuals and to establish a prospective cohort and biobank for research in the health consequences of colonization. Population and methods The Danish Blood Donor S. aureus Carriage Study (DBDSaCS) was established in 2014. So far, a total of 6082 healthy participants have been included with nasal swabs and repeated swabs are performed at subsequent donations. Samples from the first 2217 participants were cultured using a two-step method to evaluate the effect of using enrichment broth. Furthermore, 262 participants were sampled from both the nares and the throat. All participants completed a questionnaire with self-reported health, anthropometric measurements, current smoking status, and physical activity. Plasma samples, nasal swab transport media, and S. aureus isolates were stored. Results The prevalence of S. aureus nasal colonization was 41%. The prevalence of colonization was higher in men (46%) than women (34%), lower for smokers, and decreased with increasing age (<25 years: 44% vs >55 years: 35%). In participants swabbed from the nose and throat, the prevalence of S. aureus colonization after enrichment was 55% with significantly higher prevalence in the throat (45%) than in the nose (40%). The use of an enrichment broth increased the proportion of S. aureus colonization. Conclusion We describe a large and growing cohort of healthy individuals established to investigate predictors for S. aureus carriage and the health consequences of carriage. Multiple projects using data from DBDSaCS linked with Danish health registers, biomarkers, and genetic markers are ongoing. Results will be published in the coming years.
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Affiliation(s)
| | - Khoa Manh Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Paal Skytt Andersen
- Bacteria, Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark.,Department Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Robert Leo Skov
- Bacteria, Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark
| | | | - Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
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Wagner Mackenzie B, Baker J, Douglas RG, Taylor MW, Biswas K. Detection and quantification of Staphylococcus in chronic rhinosinusitis. Int Forum Allergy Rhinol 2019; 9:1462-1469. [PMID: 31483577 DOI: 10.1002/alr.22425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/05/2019] [Accepted: 08/09/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND The sinonasal microbiota has been implicated in chronic rhinosinusitis (CRS) pathogenesis, particularly related to the presence of Staphylococcus aureus. Staphylococcus epidermidis is also prevalent within the sinonasal microbiota and may inhibit S. aureus colonization. We investigated polymerase chain reaction (PCR) primer pairs for measuring absolute abundances of S. aureus and S. epidermidis, then compared bacterial community composition and absolute abundances of these species between CRS patients and controls. METHODS Six candidate Staphylococcus species-specific primer pairs were tested in silico and in vitro against pure bacterial isolates. Quantitative PCR (qPCR) for absolute quantification of S. aureus, S. epidermidis, and overall bacterial load were assessed in 40 CRS (CRS without nasal polyposis [CRSsNP] = 22, CRS with nasal polyposis [CRSwNP] = 18) patients and 14 controls. Amplicon sequencing of the V3-V4 hypervariable regions of the 16S ribosomal RNA (rRNA) bacterial gene were conducted to investigate community composition. RESULTS Primer pairs targeting the gmk gene of S. aureus and nrd gene from S. epidermidis were the most specific and sensitive primers. S. aureus (CRSsNP = 81.8% occurrence, CRSwNP = 83%, control = 92.9%) and S. epidermidis (CRSsNP = 95.5%, CRSwNP = 100%, control = 92.9%) were very prevalent, as indicated by qPCR results. Both CRSsNP and CRSwNP had significantly (p < 0.05) higher bacterial load when compared with controls (p < 0.05 for both). No significant correlation was observed between S. aureus and S. epidermidis abundances (p > 0.05). CONCLUSION Bacterial community sequencing detected Staphylococcus-assigned sequences in nearly all patients; however, it could not differentiate between S. aureus and S. epidermidis. Here, we present primer pairs that can distinguish between these species. We report a very high prevalence of S. aureus in both CRS patients and controls.
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Affiliation(s)
| | - Jesse Baker
- Department of Surgery, The University of Auckland, Auckland, New Zealand.,School of Biological Sciences and Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Richard G Douglas
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Michael W Taylor
- School of Biological Sciences and Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Kristi Biswas
- School of Biological Sciences and Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
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Randomized Controlled Trial of Preoperative Topical Decolonization to Reduce Surgical Site Infection for Staphylococcus aureus Nasal Swab-Negative Mohs Micrographic Surgery Patients. Dermatol Surg 2019; 45:229-233. [PMID: 30204741 DOI: 10.1097/dss.0000000000001662] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Surgical site infection (SSI) is mainly due to endogenous bacteria. Topical decolonization is a preoperative intervention currently advised for proven nasal carriers of Staphylococcus aureus (S. aureus). OBJECTIVE The authors assessed whether topical decolonization could be of benefit for patients who are not nasal carriers of S. aureus. METHODS AND MATERIALS The authors performed a randomized controlled trial of S. aureus nasal swab-negative patients. Five days before Mohs surgery topical decolonization with nasal mupirocin and chlorhexidine, body wash was started. The control group had no intervention. RESULTS In the week after Mohs surgery, the infection rate in the intervention group was 2% (n = 661, 14) and that of the control group was 4% (n = 689, 29). CONCLUSION Topical decolonization reduces SSI in nasal swab-negative Mohs surgery patients.
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Tracking Staphylococcus aureus in the intensive care unit using whole-genome sequencing. J Hosp Infect 2019; 103:13-20. [PMID: 31039382 DOI: 10.1016/j.jhin.2019.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/22/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Staphylococcus aureus remains an important bacterial pathogen worldwide. This study utilized known staphylococcal epidemiology to track S. aureus between different ecological reservoirs in one 10-bed intensive care unit (ICU). METHODS Selected hand-touch surfaces, staff hands and air were screened systematically 10 times during 10 months, with patients screened throughout the study. S. aureus isolates were subjected to spa typing and epidemiological analyses, followed by whole-genome sequencing to provide single nucleotide polymorphism (SNP) data. RESULTS Multiple transmission pathways between patients and reservoirs were investigated. There were 34 transmission events, of which 29 were highly related (<25 SNPs) and five were possibly related (<50 SNPs). Twenty (59%) transmission events occurred between colonized patients and their own body sites (i.e. autogenous spread); four (12%) were associated with cross-transmission between patients; four (12%) occurred between patients and hand-touch sites (bedrails and intravenous pump); four (12%) linked airborne S. aureus with staff hands and bedrail; and two (6%) linked bed tables, bedrail and cardiac monitor. CONCLUSION Colonized patients are responsible for repeated introduction of new S. aureus into the ICU, whereupon a proportion spread to hand-touch sites in (or near) the patient zone. This short-term reservoir for S. aureus imposes a colonization/infection risk for subsequent patients. More than half of ICU-acquired S. aureus infection originated from the patients' own flora, while staff hands and air were rarely implicated in onward transmission. Control of staphylococcal infection in the ICU is best served by patient screening, systematic cleaning of hand-touch surfaces and continued emphasis on hand hygiene.
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Abdulgader SM, Robberts L, Ramjith J, Nduru PM, Dube F, Gardner-Lubbe S, Zar HJ, Nicol MP. Longitudinal Population Dynamics of Staphylococcus aureus in the Nasopharynx During the First Year of Life. Front Genet 2019; 10:198. [PMID: 30930937 PMCID: PMC6428701 DOI: 10.3389/fgene.2019.00198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/25/2019] [Indexed: 11/22/2022] Open
Abstract
Background:Staphylococcus aureus colonization is a risk factor for invasive disease. Few studies have used strain genotype data to study S. aureus acquisition and carriage patterns. We investigated S. aureus nasopharyngeal carriage in infants in an intensively sampled South African birth cohort. Methods: Nasopharyngeal swabs were collected at birth and fortnightly from 137 infants through their first year of life. S. aureus was characterized by spa-typing. The incidence of S. aureus acquisition, and median carriage duration for each genotype was determined. S. aureus carriage patterns were defined by combining the carrier index (proportion of samples testing positive for S. aureus) with genotype diversity measures. Persistent or prolonged carriage were defined by a carrier index ≥0.8 or ≥0.5, respectively. Risk factors for time to acquisition of S. aureus were determined. Results: Eighty eight percent (121/137) of infants acquired S. aureus at least once. The incidence of acquisition at the species and genotype level was 1.83 and 2.8 episodes per child-year, respectively. No children had persistent carriage (defined as carrier index of >0.8). At the species level 6% had prolonged carriage, while only 2% had prolonged carriage with the same genotype. Carrier index correlated with the absolute number of spa-CCs carried by each infant (r = 0.5; 95% CI 0.35–0.62). Time to first acquisition of S. aureus was shorter in children from households with ≥5 individuals (HR 1.06, 95% CI 1.07–1.43), with S. aureus carrier mothers (HR; 1.5, 95% CI 1.2–2.47), or with a positive tuberculin skin test during the first year of life (HR; 1.81, 95% CI 0.97–3.3). Conclusion: Using measures of genotype diversity, we showed that S. aureus NP carriage is highly dynamic in infants. Prolonged carriage with a single strain occurred rarely; persistent carriage was not observed. A correlation was observed between carrier index and genotype diversity.
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Affiliation(s)
- Shima M Abdulgader
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lourens Robberts
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jordache Ramjith
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Polite M Nduru
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Felix Dube
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Molecular and Cell Biology, Faculty of Science, University of Cape Town, Cape Town, South Africa
| | - Sugnet Gardner-Lubbe
- Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Mark P Nicol
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Institute of Infectious Disease & Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
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Szafrańska AK, Junker V, Steglich M, Nübel U. Rapid cell division of Staphylococcus aureus during colonization of the human nose. BMC Genomics 2019; 20:229. [PMID: 30894139 PMCID: PMC6425579 DOI: 10.1186/s12864-019-5604-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Staphylococcus aureus is an important opportunistic pathogen and a commensal bacterium, thriving in the nasal cavities of 20% of the human population. Little is known about the dynamics of asymptomatic colonization and the occasional transition to infectious disease. RESULTS In this study, we inferred that S. aureus cells replicate every one to three hours on average while colonizing the human nose, based on two independent lines of genomic evidence. First, we collected nasal swab samples from human subjects, extracted and sequenced metagenomic DNA, and analyzed the distribution of sequencing coverage along the staphylococcal chromosome. Calibration of this data by comparison to a laboratory culture enabled measuring S. aureus cell division rates in nasal samples. Second, we applied mutation accumulation experiments paired with genome sequencing to measure spontaneous mutation rates at a genome scale. Relating these mutation rates to annual evolutionary rates confirmed that nasal S. aureus continuously pass several thousand cell divisions per year when averaged over large, globally distributed populations and over many years, corresponding to generation times of less than two hours. CONCLUSIONS The cell division rates we determined were higher than the fastest documented rates during fulminant disease progression (in a mouse model of systemic infection) and much higher than those previously measured in expectorated sputum from cystic fibrosis patients. This paper supplies absolute in-vivo generation times for an important bacterial commensal, indicating that colonization of the human upper respiratory tract is characterized by a highly dynamic equilibrium between bacterial growth and removal.
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Affiliation(s)
- Anna K Szafrańska
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstr. 7B, 38124, Braunschweig, Germany.,German Center for Infection Research (DZIF), Braunschweig site, Germany
| | - Vera Junker
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstr. 7B, 38124, Braunschweig, Germany
| | - Matthias Steglich
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstr. 7B, 38124, Braunschweig, Germany.,German Center for Infection Research (DZIF), Braunschweig site, Germany
| | - Ulrich Nübel
- Leibniz Institute DSMZ - German Collection of Microorganisms and Cell Cultures, Inhoffenstr. 7B, 38124, Braunschweig, Germany. .,German Center for Infection Research (DZIF), Braunschweig site, Germany. .,Braunschweig Integrated Centre of Systems Biology (BRICS), Technical University Braunschweig, Braunschweig, Germany.
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Midturi JK, Ranganath S. Prevention and Treatment of Multidrug-Resistant Organisms in End-Stage Renal Disease. Adv Chronic Kidney Dis 2019; 26:51-60. [PMID: 30876618 DOI: 10.1053/j.ackd.2018.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/14/2018] [Accepted: 09/20/2018] [Indexed: 02/07/2023]
Abstract
Chronic kidney disease patients are at high risk for infections because of multidrug-resistant organisms. Infections are the second most common cause of death in patients with ESRD. Patients with ESRD are prone to infections given alterations in immunity, increased rates of colonization with multidrug-resistant organisms, increased hospitalizations, and interactions with health care systems. Infections range from urinary tract infections, pneumonia, skin and soft tissue infections, central line-associated bloodstream infections to sepsis. A coordinated collaborative effort using a multipronged approach must be stressed to reduce the burden of infections. Preventive measures such as hand hygiene, antibiotic stewardship, immunizations, and minimizing central venous catheters are critical to curtail infections with multidrug-resistant organisms. Empirical and targeted treatment for multidrug-resistant organisms may require collaboration with infectious disease providers to improve outcomes in these serious infections. It is imperative to address multidrug-resistant organisms in ESRD patients at this juncture to improve medical outcomes now and for the future.
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Comprehensive modeling reveals proximity, seasonality, and hygiene practices as key determinants of MRSA colonization in exposed households. Pediatr Res 2018; 84:668-676. [PMID: 30135590 PMCID: PMC6294678 DOI: 10.1038/s41390-018-0113-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/28/2018] [Accepted: 07/03/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Staphylococcus aureus is the leading cause of skin and soft tissue infections (SSTIs). To develop interventions to prevent recurrent infections, household attributes and individual practices influencing S. aureus colonization must be discerned. METHODS Households of healthy children with methicillin-resistant S. aureus (MRSA) SSTI (n = 150; 671 participants) were interviewed regarding health history, activities, and hygiene practices. S. aureus colonization was assessed in household members, and recovered isolates were typed by repetitive sequence-based PCR. RESULTS The number of unique strain types in a household (median 1, range 0-7) correlated with the number of colonized individuals (p < 0.001). The MRSA infecting strain type colonized a household member in 57% of 91 households with an available infecting strain, and was the most common strain type recovered in 45% of these households. In multivariable models, household MRSA colonization burden (p < 0.001), sharing a bedroom with MRSA-colonized individuals (p = 0.03), renting dwelling (p = 0.048), and warmer seasons (p = 0.02) were associated with increased MRSA colonization. Increasing age (p = 0.02), bathing at least daily (p = 0.01), and antibacterial soap use (p = 0.03) correlated with reduced MRSA colonization. CONCLUSIONS This study identified practices that correlate with MRSA colonization, which will inform physician counseling and multifaceted interventions among MRSA-affected households to mitigate MRSA in the community.
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Sakr A, Brégeon F, Mège JL, Rolain JM, Blin O. Staphylococcus aureus Nasal Colonization: An Update on Mechanisms, Epidemiology, Risk Factors, and Subsequent Infections. Front Microbiol 2018; 9:2419. [PMID: 30349525 PMCID: PMC6186810 DOI: 10.3389/fmicb.2018.02419] [Citation(s) in RCA: 263] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 09/21/2018] [Indexed: 02/02/2023] Open
Abstract
Up to 30% of the human population are asymptomatically and permanently colonized with nasal Staphylococcus aureus. To successfully colonize human nares, S. aureus needs to establish solid interactions with human nasal epithelial cells and overcome host defense mechanisms. However, some factors like bacterial interactions in the human nose can influence S. aureus colonization and sometimes prevent colonization. On the other hand, certain host characteristics and environmental factors can predispose to colonization. Nasal colonization can cause opportunistic and sometimes life-threatening infections such as surgical site infections or other infections in non-surgical patients that increase morbidity, mortality as well as healthcare costs.
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Affiliation(s)
- Adèle Sakr
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France.,Service de Pharmacologie Clinique et Pharmacovigilance, AP-HM, Pharmacologie Intégrée et Interface Clinique et Industriel, Institut des Neurosciences Timone - UMR AMU-INSERM 1106, Aix-Marseille Université, Marseille, France
| | - Fabienne Brégeon
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - Jean-Louis Mège
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - Jean-Marc Rolain
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - Olivier Blin
- Service de Pharmacologie Clinique et Pharmacovigilance, AP-HM, Pharmacologie Intégrée et Interface Clinique et Industriel, Institut des Neurosciences Timone - UMR AMU-INSERM 1106, Aix-Marseille Université, Marseille, France
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Hanson BM, Kates AE, O'Malley SM, Mills E, Herwaldt LA, Torner JC, Dawson JD, Farina SA, Klostermann C, Wu JY, Quick MK, Forshey BM, Smith TC. Staphylococcus aureus in the nose and throat of Iowan families. Epidemiol Infect 2018; 146:1777-1784. [PMID: 29932041 PMCID: PMC6135667 DOI: 10.1017/s0950268818001644] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 04/16/2018] [Accepted: 05/23/2018] [Indexed: 12/23/2022] Open
Abstract
The study objective was to determine the prevalence of Staphylococcus aureus colonisation in the nares and oropharynx of healthy persons and identify any risk factors associated with such S. aureus colonisation. In total 263 participants (177 adults and 86 minors) comprising 95 families were enrolled in a year-long prospective cohort study from one urban and one rural county in eastern Iowa, USA, through local newspaper advertisements and email lists and through the Keokuk Rural Health Study. Potential risk factors including demographic factors, medical history, farming and healthcare exposure were assessed. Among the participants, 25.4% of adults and 36.1% minors carried S. aureus in their nares and 37.9% of adults carried it in their oropharynx. The overall prevalence was 44.1% among adults and 36.1% for minors. Having at least one positive environmental site for S. aureus in the family home was associated with colonisation (prevalence ratio: 1.34, 95% CI: 1.07-1.66). The sensitivity of the oropharyngeal cultures was greater than that of the nares cultures (86.1% compared with 58.2%, respectively). In conclusion, the nares and oropharynx are both important colonisation sites for healthy community members and the presence of S. aureus in the home environment is associated with an increased probability of colonisation.
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Affiliation(s)
| | | | | | - E. Mills
- University of Iowa, Iowa City, Iowa, USA
| | | | | | | | | | | | - J. Y. Wu
- University of Iowa, Iowa City, Iowa, USA
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Association Between Contact Sports and Colonization with Staphylococcus aureus in a Prospective Cohort of Collegiate Athletes. Sports Med 2018; 47:1011-1019. [PMID: 27577687 DOI: 10.1007/s40279-016-0618-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Athletes have a higher risk of infection with Staphylococcus aureus than the general population. Most studies in athletes have included primarily male contact sports participants and have not assessed S. aureus carriage over time. We aimed to examine the epidemiology and risk factors of S. aureus carriage in a cohort of male and female collegiate athletes. STUDY DESIGN We conducted a prospective cohort study of 377 varsity collegiate athletes from August 2008 to April 2010. A baseline questionnaire ascertained risk factors for colonization. Nasal and oropharyngeal swabs were obtained at enrollment and monthly thereafter to detect S. aureus colonization. The primary outcome was S. aureus colonization, both with methicillin-susceptible and methicillin-resistant S. aureus, as defined by bacterial culture and molecular confirmation. Secondary outcomes were time to colonization with S. aureus and carriage profile, defined as non-carrier, intermittent carrier, or persistent carrier. RESULTS Overall, 224 contact sports and 153 non-contact sports athletes were enrolled. Contact sports athletes had a higher risk of carrying S. aureus over time: They had higher odds of being colonized with MRSA (OR 2.36; 95 % CI 1.13-4.93) and they tended to carry S. aureus for longer periods of time (intermittent carriage OR 3.60; 95 % CI 2.02-6.40; persistent carriage OR 2.39; 95 % CI 1.21-4.72). Athletes engaged in contact sports also acquired S. aureus more quickly (HR 1.61; 95 % CI 1.02-2.55). CONCLUSIONS Staphylococcus aureus carriage was common in contact sports athletes. These findings suggest that efforts to prevent transmission of S. aureus among athletes should be focused on contact sports teams.
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Development of a New Application for Comprehensive Viability Analysis Based on Microbiome Analysis by Next-Generation Sequencing: Insights into Staphylococcal Carriage in Human Nasal Cavities. Appl Environ Microbiol 2018; 84:AEM.00517-18. [PMID: 29625975 DOI: 10.1128/aem.00517-18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/27/2018] [Indexed: 01/08/2023] Open
Abstract
The nasal carriage rate of Staphylococcus aureus in human is 25 to 30%, and S. aureus sporadically causes severe infections. However, the mechanisms underlying staphylococcal carriage remain largely unknown. In the present study, we constructed an rpoB-based microbiome method for staphylococcal species discrimination. Based on a microbiome scheme targeting viable cell DNA using propidium monoazide (PMA) dye (PMA microbiome method), we also developed a new method to allow the comprehensive viability analysis of any bacterial taxon. To clarify the ecological distribution of staphylococci in the nasal microbiota, we applied these methods in 46 nasal specimens from healthy adults. PMA microbiome results showed that Staphylococcaceae and Corynebacteriaceae were the most predominant viable taxa (average relative abundance: 0.435262 and 0.375195, respectively), and Staphylococcus epidermidis exhibited the highest viability in the nasal microbiota. Staphylococcus aureus detection rates from nasal specimens by rpoB-based conventional and PMA microbiome methods were 84.8% (39 of 46) and 69.5% (32 of 46), respectively, which substantially exceeded the values obtained by a culture method using identical specimens (36.9%). Our results suggest that Staphylococcaceae species, especially S. epidermidis, adapted most successfully to human nasal cavity. High detection of S. aureus DNA by microbiome methods suggests that almost all healthy adults are consistently exposed to S. aureus in everyday life. Furthermore, the large difference in S. aureus detection rates between culture and microbiome methods suggests that S. aureus cells frequently exist in a viable but nonculturable state in nasal cavities. Our method and findings will contribute to a better understanding of the mechanisms underlying carriage of indigenous bacteria.IMPORTANCE Metagenomic analyses, such as 16S rRNA microbiome methods, have provided new insights in various research fields. However, conventional 16S rRNA microbiome methods do not permit taxonomic analysis of only the viable bacteria in a sample and have poor resolving power below the genus level. Our new schemes allowed for viable cell-specific analysis and species discrimination, and nasal microbiome data using these methods provided some interesting findings regarding staphylococcal nasal carriage. According to our comprehensive viability analysis, the high viability of Staphylococcus species, especially Staphylococcus epidermidis, in human nasal carriage suggests that this taxon has adapted most successfully to human nasal tissue. Also, a higher detection rate of S. aureus DNA by microbiome methods (84.8%) than by a culture method (36.9%) suggests that almost all healthy adults are consistently exposed to Staphylococcus aureus in the medium and long term. Our findings will contribute to a better understanding of the mechanisms underlying the carriage of indigenous bacteria.
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Slingerland BCGC, Keehnen M, Ouwerling B, Tavakol M, Snijders SV, Verbrugh HA, Vos MC, Remarque EJ, Langermans JAM, van Wamel WJB. An experimental Staphylococcus aureus carriage and decolonization model in rhesus macaques (Macaca mulatta). PLoS One 2018; 13:e0194718. [PMID: 29649257 PMCID: PMC5896908 DOI: 10.1371/journal.pone.0194718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 03/08/2018] [Indexed: 11/18/2022] Open
Abstract
Our human model of nasal colonization and eradication of S. aureus is limited by safety issues. As rhesus macaques are closely related to humans and natural hosts for S. aureus, we developed an experimental decolonization and inoculation protocol in these animals. Animals were screened for nasal carriage of S. aureus and 20 carriers were selected. Decolonization was attempted using nasal mupirocin (10 animals) or mupirocin plus trimethoprim/sulfadiazine intramuscularly (10 animals) both once daily for 5 days, and checked by follow-up cultures for 10 weeks. Intranasal inoculation was performed with S. aureus strain 8325–4 in culture-negative animals. 11/20 animals, of which 5 received mupirocin and 6 the combination treatment, became culture-negative for S. aureus for 10 weeks and these 11 animals were subsequently inoculated. Swabs were taken once a week for 5 weeks to test for the presence of the inoculated strain. In 3 animals, strain 8325–4 was cultured from the nose 1 week after inoculation, indicating short-term survival of this strain only, a finding similar to that previously found in our human model. These data demonstrate that rhesus macaques may constitute a relevant animal model to perform S. aureus eradication and inoculation studies with relatively limited invasive handling of the animals.
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Affiliation(s)
- Bibi C. G. C. Slingerland
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
- * E-mail:
| | - Merei Keehnen
- Animal Science Department, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | - Boudewijn Ouwerling
- Animal Science Department, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | - Mehri Tavakol
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | - Susan V. Snijders
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | - Henri A. Verbrugh
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | - Margreet C. Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | - Edmond J. Remarque
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | - Jan A. M. Langermans
- Animal Science Department, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | - Willem J. B. van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
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Ouidri MA. Screening of nasal carriage of methicillin-resistant Staphylococcus aureus during admission of patients to Frantz Fanon Hospital, Blida, Algeria. New Microbes New Infect 2018; 23:52-60. [PMID: 29692907 PMCID: PMC5913062 DOI: 10.1016/j.nmni.2018.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 02/04/2018] [Accepted: 02/09/2018] [Indexed: 11/18/2022] Open
Abstract
A study was performed of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) strains isolated from nasal preoperative samples. Of 663 samples assessed, staphylococcus was detected in 143 (21.57%). The disc diffusion method (cefoxitin 30 μg), a screening test (oxacillin 6 μg/mL) and a search for Protein Binding Additional Penicillin 2 (PLP2a) allowed the detection and confirmation of resistance to methicillin for 36 strains, a rate of 5.43% of the total population studied. Eight MRSA carriers received care in the trauma service, 14 in cardiology, five in ear, nose and throat, four in neurosurgery and paediatrics, and one in SCI. Thirty-six methicillin-resistant of the nasal portage strains are in their great majority, 27 of 36, rather limited multi-R character (two to three families namely resistance: tetracyclines, fluoroquinolones, aminoglycosides, macrolides). One of the MRSA strains was found to have intermediate sensitivity to vancomycin.
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47
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Strommenger B, Layer F, Werner G. Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus in Workers in the Food Industry. STAPHYLOCOCCUS AUREUS 2018. [PMCID: PMC7150186 DOI: 10.1016/b978-0-12-809671-0.00009-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Staphylococcus aureus is part of the common flora on the skin and mucous membranes of mammals and approximately 20–30% of humans are persistently colonized, mainly by mostly susceptible human-adapted isolates. In contrast, colonization with methicillin-resistant S. aureus is rare (approximately 1%), predominantly transient and associated with prior contact to the health care system. Additionally, in recent years livestock-associated S. aureus clones contributed to colonization in humans, especially in those working in close contact to farm animals. A considerable percentage of colonizing S. aureus isolates is equipped with enterotoxin genes. Humans carrying enterotoxigenic isolates represent a contamination source when handling food, thus generating a continuous risk of S. aureus food intoxication. Molecular characterization of isolates colonizing humans and obtained from food, respectively, enables the tracing of food-related outbreaks back to the source of food intoxication. We will summarize current knowledge about the S. aureus population colonizing humans, including those in close contact to animals and food, respectively. Additionally, we will review data on the molecular characterization of S. aureus isolates related to staphylococcal foodborne disease and the elucidation of staphylococcal foodborne outbreaks. Staphylococcal food poisoning is a common foodborne disease, mediated by the ingestion of enterotoxins produced by enterotoxigenic strains of S. aureus. For several outbreaks of foodborne S. aureus disease, colonized personnel could be identified as the source of food contamination. However, because of the widespread occurrence of enterotoxigenic strains as human colonizers and the often transient nature of colonization, the source of contamination cannot always be identified unambiguously. Therefore, compliance with hygiene measures is the most important requirement to prevent food contamination by both human colonization and environmental S. aureus reservoirs.
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Santosaningsih D, Santoso S, Setijowati N, Rasyid HA, Budayanti NS, Suata K, Widhyatmoko DB, Purwono PB, Kuntaman K, Damayanti D, Prakoeswa CRS, Laurens M, van Nierop JWI, Nanninga GL, Oudenes N, de Regt M, Snijders SV, Verbrugh HA, Severin JA. Prevalence and characterisation of Staphylococcus aureus causing community-acquired skin and soft tissue infections on Java and Bali, Indonesia. Trop Med Int Health 2017; 23:34-44. [PMID: 29124834 DOI: 10.1111/tmi.13000] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To define the role of Staphylococcus aureus in community settings among patients with skin and soft tissue infections (SSTI) in Indonesia. METHODS Staphylococcus aureus were cultured from anterior nares, throat and wounds of 567 ambulatory patients presenting with SSTI. The mecA gene and genes encoding Panton-Valentine leukocidin (PVL; lukF-PV and lukS-PV) and exfoliative toxin (ET; eta and etb) were determined by PCR. Clonal relatedness among methicillin-resistant S. aureus (MRSA) and PVL-positive S. aureus was analysed using multilocus variable-number tandem-repeat analysis (MLVA) typing, and multilocus sequence typing (MLST) for a subset of isolates. Staphylococcal cassette chromosome mec (SCCmec) was determined for all MRSA isolates. Moreover, determinants for S. aureus SSTI, and PVL/ET-positive vs PVL/ET-negative S. aureus were assessed. RESULTS Staphylococcus aureus were isolated from SSTI wounds of 257 (45.3%) patients, eight (3.1%) of these were MRSA. Genes encoding PVL and ETs were detected in 21.8% and 17.5% of methicillin-susceptible S. aureus (MSSA), respectively. PVL-positive MRSA was not detected. Nasopharyngeal S. aureus carriage was an independent determinant for S. aureus SSTI (odds ratio [OR] 1.8). Primary skin infection (OR 5.4) and previous antibiotic therapy (OR 3.5) were associated with PVL-positive MSSA. Primary skin infection (OR 2.2) was the only factor associated with ET-positive MSSA. MLVA typing revealed two more prevalent MSSA clusters. One ST1-MRSA-SCCmec type IV isolate and a cluster of ST239-MRSA-SCCmec type III were found. CONCLUSIONS Community-acquired SSTI in Indonesia was frequently caused by PVL-positive MSSA, and the hospital-associated ST239-MRSA may have spread from the hospital into the community.
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Affiliation(s)
- Dewi Santosaningsih
- Department of Microbiology, Faculty of Medicine, Brawijaya University/Dr. Saiful Anwar Hospital, Malang, Indonesia.,Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sanarto Santoso
- Department of Microbiology, Faculty of Medicine, Brawijaya University/Dr. Saiful Anwar Hospital, Malang, Indonesia
| | - Nanik Setijowati
- Department of Public Health, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Harun A Rasyid
- Department of Public Health, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Nyoman S Budayanti
- Department of Microbiology, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia
| | - Ketut Suata
- Department of Microbiology, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Indonesia
| | - Dicky B Widhyatmoko
- Department of Microbiology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Priyo B Purwono
- Department of Microbiology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Kuntaman Kuntaman
- Department of Microbiology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Damayanti Damayanti
- Department of Dermatology and Venereology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Cita R S Prakoeswa
- Department of Dermatology and Venereology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Mitchell Laurens
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands.,BaseClear BV, Leiden, The Netherlands
| | - Josephine W I van Nierop
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geraldine L Nanninga
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Neline Oudenes
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michelle de Regt
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Susan V Snijders
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Henri A Verbrugh
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Juliëtte A Severin
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
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Sørensen AIV, Toft N, Boklund A, Espinosa-Gongora C, Græsbøll K, Larsen J, Halasa T. A mechanistic model for spread of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) within a pig herd. PLoS One 2017; 12:e0188429. [PMID: 29182655 PMCID: PMC5705068 DOI: 10.1371/journal.pone.0188429] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 11/07/2017] [Indexed: 12/18/2022] Open
Abstract
Before an efficient control strategy for livestock-associated methicillin resistant Staphylococcus aureus (LA-MRSA) in pigs can be decided upon, it is necessary to obtain a better understanding of how LA-MRSA spreads and persists within a pig herd, once it is introduced. We here present a mechanistic stochastic discrete-event simulation model for spread of LA-MRSA within a farrow-to-finish sow herd to aid in this. The model was individual-based and included three different disease compartments: susceptible, intermittent or persistent shedder of MRSA. The model was used for studying transmission dynamics and within-farm prevalence after different introductions of LA-MRSA into a farm. The spread of LA-MRSA throughout the farm mainly followed the movement of pigs. After spread of LA-MRSA had reached equilibrium, the prevalence of LA-MRSA shedders was predicted to be highest in the farrowing unit, independent of how LA-MRSA was introduced. LA-MRSA took longer to spread to the whole herd if introduced in the finisher stable, rather than by gilts in the mating stable. The more LA-MRSA positive animals introduced, the shorter time before the prevalence in the herd stabilised. Introduction of a low number of intermittently shedding pigs was predicted to frequently result in LA-MRSA fading out. The model is a potential decision support tool for assessments of short and long term consequences of proposed intervention strategies or surveillance options for LA-MRSA within pig herds.
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Affiliation(s)
| | - Nils Toft
- National Veterinary Institute, Technical University of Denmark, Lyngby, Denmark
| | - Anette Boklund
- National Veterinary Institute, Technical University of Denmark, Lyngby, Denmark
| | | | - Kaare Græsbøll
- National Veterinary Institute, Technical University of Denmark, Lyngby, Denmark
| | - Jesper Larsen
- Microbiology and Infection Control, Statens Serum Institute, Copenhagen, Denmark
| | - Tariq Halasa
- National Veterinary Institute, Technical University of Denmark, Lyngby, Denmark
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50
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Flaxman A, van Diemen PM, Yamaguchi Y, Allen E, Lindemann C, Rollier CS, Milicic A, Wyllie DH. Development of persistent gastrointestinal S. aureus carriage in mice. Sci Rep 2017; 7:12415. [PMID: 28963555 PMCID: PMC5622074 DOI: 10.1038/s41598-017-12576-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 09/01/2017] [Indexed: 01/09/2023] Open
Abstract
One fifth to one quarter of the human population is asymptomatically, naturally and persistently colonised by Staphylococcus aureus. Observational human studies indicate that although the whole population is intermittently exposed, some individuals lose S. aureus rapidly. Others become persistent carriers, as assessed by nasal cultures, with many individuals colonised for decades. Current animal models of S. aureus colonisation are expensive and normally require antibiotics. Importantly, these animal models have not yet contributed to our poor understanding of the dichotomy in human colonisation status. Here, we identify a single strain of S. aureus found to be persistently colonising the gastrointestinal tract of BALB/c mice. Phylogenetic analyses suggest it diverged from a human ST15 lineage in the recent past. We show that murine carriage of this organism occurs in the bowel and nares, is acquired early in life, and can persist for months. Importantly, we observe the development of persistent and non-persistent gastrointestinal carriage states in genetically identical mice. We developed a needle- and antibiotic-free model in which we readily induced S. aureus colonisation of the gastrointestinal tract experimentally by environmental exposure. Using our experimental model, impact of adaptive immunity on S. aureus colonisation could be assessed. Vaccine efficacy to eliminate colonisation could also be investigated using this model.
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Affiliation(s)
- Amy Flaxman
- Jenner Institute, University of Oxford, The Henry Wellcome Building for Molecular Physiology, Oxford, UK
| | - Pauline M van Diemen
- Jenner Institute, University of Oxford, The Henry Wellcome Building for Molecular Physiology, Oxford, UK
| | - Yuko Yamaguchi
- Jenner Institute, University of Oxford, The Henry Wellcome Building for Molecular Physiology, Oxford, UK
| | - Elizabeth Allen
- Jenner Institute, University of Oxford, The Henry Wellcome Building for Molecular Physiology, Oxford, UK
| | - Claudia Lindemann
- Jenner Institute, University of Oxford, The Henry Wellcome Building for Molecular Physiology, Oxford, UK
| | - Christine S Rollier
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, CCVTM, Oxford, UK.,The NIHR Oxford Biomedical Research Centre, Oxford University Hospitals, Oxford, UK
| | | | - David H Wyllie
- Jenner Institute, University of Oxford, The Henry Wellcome Building for Molecular Physiology, Oxford, UK.
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