1
|
Jin Y, Zhou W, Ge Q, Shen P, Xiao Y. Epidemiology and clinical features of Skin and Soft Tissue Infections Caused by PVL-Positive and PVL-Negative Methicillin-Resistant Staphylococcus aureus Isolates in inpatients in China: a single-center retrospective 7-year study. Emerg Microbes Infect 2024; 13:2316809. [PMID: 38323591 PMCID: PMC10883109 DOI: 10.1080/22221751.2024.2316809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/06/2024] [Indexed: 02/08/2024]
Abstract
Previous studies have mainly focused on outpatient cases of skin and soft tissue infections (SSTIs), with limited attention to inpatient occurrences. Thus, we aimed to compare the clinical parameters of inpatients with SSTIs, performed genomic characterization, and determined the subtypes of Panton-Valentine leucocidin (PVL) bacteriophages of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from these patients. We found that PVL-positive patients had shorter hospital stays (mean, 9 vs. 24 days; p < 0.001) and abscess resolution durations (mean, 8 vs. 13 days; p < 0.01). PVL-positive MRSA-induced SSTIs were more frequently associated with abscesses [36/55 (65.5%) vs. 15/124 (12.1%), p < 0.001], with 52.7% undergoing incision and drainage; over 80% of PVL-negative patients received incision, drainage, and antibiotics. In PVL-positive patients receiving empirical antibiotics, anti-staphylococcal agents such as vancomycin and linezolid were administered less frequently (32.7%, 18/55) than in PVL-negative patients (74.2%, 92/124), indicating that patients with PVL-positive SSTIs are more likely to require surgical drainage rather than antimicrobial treatment. We also found that the ST59 lineage was predominant, regardless of PVL status (41.3%, 74/179). Additionally, we investigated the linear structure of the lukSF-PV gene, revealing that major clusters were associated with specific STs, suggesting independent acquisition of PVL by different strain types and indicating that significant diversity was observed even within PVL-positive strains detected in the same facility. Overall, our study provides comprehensive insights into the clinical, genetic, and phage-related aspects of MRSA-induced SSTIs in hospitalized patients and contributes to a more profound understanding of the epidemiology and evolution of these pathogens in the Chinese population.
Collapse
Affiliation(s)
- Ye Jin
- Department of General Intensive Care Unit, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
- Key Laboratory of Early Warning and Intervention of Multiple Organ Failure, China National Ministry of Education, Hangzhou, Zhejiang, People's Republic of China
| | - Wangxiao Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Qi Ge
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Ping Shen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| |
Collapse
|
2
|
Wilkinson HN, Stafford AR, Rudden M, Rocha NDC, Kidd AS, Iveson S, Bell AL, Hart J, Duarte A, Frieling J, Janssen F, Röhrig C, de Rooij B, Ekhart PF, Hardman MJ. Selective Depletion of Staphylococcus aureus Restores the Skin Microbiome and Accelerates Tissue Repair after Injury. J Invest Dermatol 2024; 144:1865-1876.e3. [PMID: 38307323 DOI: 10.1016/j.jid.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
Our skin is home to a diverse community of commensal microorganisms integral to cutaneous function. However, microbial dysbiosis and barrier perturbation increase the risk of local and systemic infection. Staphylococcus aureus is a particularly problematic bacterial pathogen, with high levels of antimicrobial resistance and direct association with poor healing outcome. Innovative approaches are needed to selectively kill skin pathogens, such as S aureus, without harming the resident microbiota. In this study, we provide important data on the selectivity and efficacy of an S aureus-targeted endolysin (XZ.700) within the complex living skin/wound microbiome. Initial cross-species comparison using Nanopore long-read sequencing identified the translational potential of porcine rather than murine skin for human-relevant microbiome studies. We therefore performed an interventional study in pigs to assess the impact of endolysin administration on the microbiome. XZ.700 selectively inhibited endogenous porcine S aureus in vivo, restoring microbial diversity and promoting multiple aspects of wound repair. Subsequent mechanistic studies confirmed the importance of this microbiome modulation for effective healing in human skin. Taken together, these findings strongly support further development of S aureus-targeted endolysins for future clinical management of skin and wound infections.
Collapse
Affiliation(s)
- Holly N Wilkinson
- Biomedical Institute for Multimorbidity, Centre for Biomedicine, Hull York Medical School, The University of Hull, Hull, United Kingdom; Skin Research Centre, Hull York Medical School, The University of York, Heslington, United Kingdom.
| | - Amber R Stafford
- Biomedical Institute for Multimorbidity, Centre for Biomedicine, Hull York Medical School, The University of Hull, Hull, United Kingdom
| | - Michelle Rudden
- Biomedical Institute for Multimorbidity, Centre for Biomedicine, Hull York Medical School, The University of Hull, Hull, United Kingdom; Skin Research Centre, Hull York Medical School, The University of York, Heslington, United Kingdom
| | - Nina D C Rocha
- Biomedical Institute for Multimorbidity, Centre for Biomedicine, Hull York Medical School, The University of Hull, Hull, United Kingdom
| | - Alexandria S Kidd
- Biomedical Institute for Multimorbidity, Centre for Biomedicine, Hull York Medical School, The University of Hull, Hull, United Kingdom
| | - Sammi Iveson
- Biomedical Institute for Multimorbidity, Centre for Biomedicine, Hull York Medical School, The University of Hull, Hull, United Kingdom
| | | | | | - Ana Duarte
- Micreos Pharma B.V., Bilthoven, The Netherlands
| | | | | | | | | | | | - Matthew J Hardman
- Biomedical Institute for Multimorbidity, Centre for Biomedicine, Hull York Medical School, The University of Hull, Hull, United Kingdom; Skin Research Centre, Hull York Medical School, The University of York, Heslington, United Kingdom
| |
Collapse
|
3
|
Lam NM, Tsang TF, Qu J, Tsang MW, Tao Y, Kan CH, Zou Q, Chan KH, Chu AJ, Ma C, Yang X. Development of a luciferase-based Gram-positive bacterial reporter system for the characterization of antimicrobial agents. Appl Environ Microbiol 2024:e0071724. [PMID: 39016615 DOI: 10.1128/aem.00717-24] [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: 04/21/2024] [Accepted: 06/24/2024] [Indexed: 07/18/2024] Open
Abstract
Mechanistic investigations are of paramount importance in elucidating the modes of action of antibiotics and facilitating the discovery of novel drugs. We reported a luciferase-based reporter system using bacterial cells to unveil mechanisms of antimicrobials targeting transcription and translation. The reporter gene Nluc encoding NanoLuciferase (NanoLuc) was integrated into the genome of the Gram-positive model organism, Bacillus subtilis, to generate a reporter strain BS2019. Cellular transcription and translation levels were assessed by quantifying the amount of Nluc mRNA as well as the luminescence catalyzed by the enzyme NanoLuc. We validated this system using three known inhibitors of transcription (rifampicin), translation (chloramphenicol), and cell wall synthesis (ampicillin). The B. subtilis reporter strain BS2019 successfully revealed a decline in Nluc expression by rifampicin and NanoLuc enzyme activity by chloramphenicol, while ampicillin produced no observable effect. The assay was employed to characterize a previously discovered bacterial transcription inhibitor, CUHK242, with known antimicrobial activity against drug-resistant Staphylococcus aureus. Production of Nluc mRNA in our reporter BS2019 was suppressed in the presence of CUHK242, demonstrating the usefulness of the construct, which provides a simple way to study the mechanism of potential antibiotic candidates at early stages of drug discovery. The reporter system can also be modified by adopting different promoters and reporter genes to extend its scope of contribution to other fields of work. IMPORTANCE Discovering new classes of antibiotics is desperately needed to combat the emergence of multidrug-resistant pathogens. To facilitate the drug discovery process, a simple cell-based assay for mechanistic studies is essential to characterize antimicrobial candidates. In this work, we developed a luciferase-based reporter system to quantify the transcriptional and translational effects of potential compounds and validated our system using two currently marketed drugs. Reporter strains generated in this study provide readily available means for identifying bacterial transcription inhibitors as prospective novel antibacterials. We also provided a series of plasmids for characterizing promoters under various conditions such as stress.
Collapse
Affiliation(s)
- Nga Man Lam
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Tsz Fung Tsang
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Jiayi Qu
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Man Wai Tsang
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Yuan Tao
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Cheuk Hei Kan
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Qingyu Zou
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - King Hong Chan
- State Key Laboratory of Chemical Biology and Drug Discovery, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Adrian Jun Chu
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Cong Ma
- State Key Laboratory of Chemical Biology and Drug Discovery, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Xiao Yang
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| |
Collapse
|
4
|
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.
Collapse
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.
| |
Collapse
|
5
|
Damlakhy A, Khan ZA, Abdelqader A, Chernyshev D, Ross E. Multifaceted manifestations: A case report of MRSA pneumonia with sepsis, pyelonephritis, and ileus muscle abscess. Clin Case Rep 2024; 12:e8957. [PMID: 38813451 PMCID: PMC11133387 DOI: 10.1002/ccr3.8957] [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: 04/04/2024] [Revised: 04/24/2024] [Accepted: 05/04/2024] [Indexed: 05/31/2024] Open
Abstract
Methicillin-resistant staph aureus (MRSA) infections are challenging to treat, and with the emergence of community-associated MRSA (CA-MRSA) strains, early consideration of this pathogen in populations without typical risk factors is critical. Here we present a case of CA-MRSA pneumonia that resulted in Community-acquired pneumonia (CAP) with septic shock, pyelonephritis, and muscle abscess.
Collapse
Affiliation(s)
- Ahmad Damlakhy
- Department of Internal MedicineDetroit Medical Center, Wayne State UniversityDetroitMichiganUSA
| | - Zohaib A. Khan
- Department of Internal MedicineDetroit Medical Center, Wayne State UniversityDetroitMichiganUSA
| | - Anas Abdelqader
- Department of Internal MedicineDetroit Medical Center, Wayne State UniversityDetroitMichiganUSA
| | - Dmitrii Chernyshev
- Department of Internal MedicineDetroit Medical Center, Wayne State UniversityDetroitMichiganUSA
| | - Emily Ross
- Department of Internal MedicineCollege of Osteopathic Medicine, Michigan State UniversityEast LansingMichiganUSA
| |
Collapse
|
6
|
Von Rehlingen-Prinz F, Röhrs M, Sandiford N, Garcia EG, Schulmeyer J, Salber J, Lausmann C, Gehrke T, Citak M. Preoperative MRSA screening using a simple questionnaire prior elective total joint replacement. Arch Orthop Trauma Surg 2024:10.1007/s00402-024-05315-4. [PMID: 38653834 DOI: 10.1007/s00402-024-05315-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION The purpose of this study was to evaluate the management and results of our standarized protocol for preoperative identification of MRSA colonisation in patients undergoing primary total hip and knee replacement procedures. METHODS Following hospital protocol, between January 2016 and June 2019 37,745 patients awaiting elective joint replacement underwent a standardized questionnaire to assess the risk of MRSA infection, identifying patients requiring preoperative MRSA screening. An evaluation of the questionnaire identified effective questions for identifying infected patients. Furthermore, an analysis evaluated the impact of comorbidities or Charlson Comorbidity Index scores on positive MRSA colonization. Additionally, we evaluated the cost savings of targeted testing compared to testing all surgery patients. RESULTS Of the 37,745 patients, 8.057 (21.3%) were swabbed, with a total of 65 (0.81%) positive tests. From this group 27 (36.48%) who were treated were negative before surgery. Some of the questionnaire results were consistently associated with a higher chance of colonization, including hospitalization during the past year (47,7%), previous history of MRSA (44,6%), and agriculture or cattle farming related work (15,4%). By selectively testing high-risk patients identified through the questionnaire, we achieved a 79% reduction in costs compared to universal MRSA screening. CONCLUSION Our results suggest that the simple and standardized questionnaire is a valuable tool for preoperative screening, effectively identifying high-risk patients prone to MRSA colonisation. The risk of periprosthetic joint infection (PJI) and its associated sequelae may be reduced by this approach.
Collapse
Affiliation(s)
- Fidelius Von Rehlingen-Prinz
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Michael Röhrs
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany
| | - Nemandra Sandiford
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany
| | - Eva Gomez Garcia
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany
| | - Juan Schulmeyer
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany
| | - Jochen Salber
- Department of Surgery, Ruhr-University Bochum, Bochum, Germany
| | - Christian Lausmann
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany
| | - Thorsten Gehrke
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany
| | - Mustafa Citak
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany.
| |
Collapse
|
7
|
Crosby HA, Keim K, Kwiecinski JM, Langouët-Astrié CJ, Oshima K, LaRivière WB, Schmidt EP, Horswill AR. Host-derived protease promotes aggregation of Staphylococcus aureus by cleaving the surface protein SasG. mBio 2024; 15:e0348323. [PMID: 38511930 PMCID: PMC11005337 DOI: 10.1128/mbio.03483-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Staphylococcus aureus is one of the leading causes of hospital-acquired infections, many of which begin following attachment and accumulation on indwelling medical devices or diseased tissue. These infections are often linked to the establishment of biofilms, but another often overlooked key characteristic allowing S. aureus to establish persistent infection is the formation of planktonic aggregates. Such aggregates are physiologically similar to biofilms and protect pathogens from innate immune clearance and increase antibiotic tolerance. The cell-wall-associated protein SasG has been implicated in biofilm formation via mechanisms of intercellular aggregation but the mechanism in the context of disease is largely unknown. We have previously shown that the expression of cell-wall-anchored proteins involved in biofilm formation is controlled by the ArlRS-MgrA regulatory cascade. In this work, we demonstrate that the ArlRS two-component system controls aggregation, by repressing the expression of sasG by activation of the global regulator MgrA. We also demonstrate that SasG must be proteolytically processed by a non-staphylococcal protease to induce aggregation and that strains expressing functional full-length sasG aggregate significantly upon proteolysis by a mucosal-derived host protease found in human saliva. We used fractionation and N-terminal sequencing to demonstrate that human trypsin within saliva cleaves within the A domain of SasG to expose the B domain and induce aggregation. Finally, we demonstrated that SasG is involved in virulence during mouse lung infection. Together, our data point to SasG, its processing by host proteases, and SasG-driven aggregation as important elements of S. aureus adaptation to the host environment.IMPORTANCEHere, we demonstrate that the Staphylococcus aureus surface protein SasG is important for cell-cell aggregation in the presence of host proteases. We show that the ArlRS two-component regulatory system controls SasG levels through the cytoplasmic regulator MgrA. We identified human trypsin as the dominant protease triggering SasG-dependent aggregation and demonstrated that SasG is important for S. aureus lung infection. The discovery that host proteases can induce S. aureus aggregation contributes to our understanding of how this pathogen establishes persistent infections. The observations in this study demonstrate the need to strengthen our knowledge of S. aureus surface adhesin function and processing, regulation of adhesin expression, and the mechanisms that promote biofilm formation to develop strategies for preventing chronic infections.
Collapse
Affiliation(s)
- Heidi A. Crosby
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Klara Keim
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jakub M. Kwiecinski
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Christophe J. Langouët-Astrié
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Kaori Oshima
- Division of Pulmonary Sciences and Critical Care, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Wells B. LaRivière
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Eric P. Schmidt
- Division of Pulmonary Sciences and Critical Care, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alexander R. Horswill
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA
- Department of Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado, USA
| |
Collapse
|
8
|
Chen B, Li S, Lin S, Dong H. Investigating the relationship between muscle mass and nasal Methicillin-Resistant Staphylococcus aureus (MRSA) colonization: Analysis of the National Health and Nutrition Examination Survey (NHANES). PLoS One 2024; 19:e0294400. [PMID: 38166041 PMCID: PMC10760835 DOI: 10.1371/journal.pone.0294400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 11/01/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization is associated with an increased risk of infection disease. Low muscle mass has been linked to higher levels of inflammatory markers and weakened immune response, which may impact the susceptibility to nasal MRSA colonization. The relationship between muscle function and immune response to pathogens may be bidirectional. This study investigates the association between muscle mass and nasal MRSA colonization in adults. METHODS The present cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2004. Appendicular skeletal muscle mass (ASM) adjusted by body mass index (BMI) (ASM/BMI) was used to evaluate muscle mass. Multivariate logistic regression, adjusted for demographic and infection factors, was used to analyze the association between muscle mass and nasal colonization by MRSA. A subgroup analysis based on age and gender was performed to assess the impact of muscle mass on nasal MRSA colonization. RESULTS Nasal MRSA colonization was more prevalent in females, those with smaller household sizes, lower income, lower ASM/BMI, those who had stayed in healthcare facilities in the past 12 months, and individuals with diabetes and smoking habits. After adjusting for confounding factors, a dose-dependent association was found between decreasing quartiles of ASM/BMI and the risk of nasal MRSA colonization (p < 0.05). Additionally, per 1 unit increase in ASM/BMI was related to a 64% lower risk of nasal MRSA colonization. CONCLUSIONS This study suggests a significant negative correlation between ASM/BMI and the risk of nasal MRSA colonization. However, more prospective studies are required to investigate the causal relationship between muscle mass and colonization.
Collapse
Affiliation(s)
- Baixing Chen
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Shaoshuo Li
- Wuxi Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Wuxi, China
| | - Shi Lin
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Hang Dong
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
- Department of traumatology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| |
Collapse
|
9
|
Bavaro DF, Belati A, Bussini L, Cento V, Diella L, Gatti M, Saracino A, Pea F, Viale P, Bartoletti M. Safety and effectiveness of fifth generation cephalosporins for the treatment of methicillin-resistant staphylococcus aureus bloodstream infections: a narrative review exploring past, present, and future. Expert Opin Drug Saf 2024; 23:9-36. [PMID: 38145925 DOI: 10.1080/14740338.2023.2299377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/21/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) is a major issue in healthcare, since it is often associated with endocarditis or deep site foci. Relevant morbidity and mortality associated with MRSA-BSIs forced the development of new antibiotic strategies; in particular, this review will focus the attention on fifth-generation cephalosporins (ceftaroline/ceftobiprole), that are the only ß-lactams active against MRSA. AREAS COVERED The review discusses the available randomized controlled trials and real-world observational studies conducted on safety and effectiveness of ceftaroline/ceftobiprole for the treatment of MRSA-BSIs. Finally, a proposal of MRSA-BSI treatment flowchart, based on fifth-generation cephalosporins, is described. EXPERT OPINION The use of anti-MRSA cephalosporins is an acceptable choice either in monotherapy or combination therapy for the treatment of MRSA-BSIs due to their relevant effectiveness and safety. Particularly, their use may be advisable in combination therapy in case of severe infections (including endocarditis or persistent bacteriemia) or in monotherapy in subjects at higher risk of drugs-induced toxicity with older regimens. On the contrary, caution should be taken in case of suspected/ascertained central nervous system infections due to inconsistent data regarding penetration of these drugs in cerebrospinal fluid and brain tissues.
Collapse
Affiliation(s)
- Davide Fiore Bavaro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Infectious Disease Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alessandra Belati
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari "Aldo Moro", Bari, Italy
| | - Linda Bussini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Infectious Disease Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Valeria Cento
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Microbiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Lucia Diella
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari "Aldo Moro", Bari, Italy
| | - Milo Gatti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Annalisa Saracino
- Department of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari "Aldo Moro", Bari, Italy
| | - Federico Pea
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pierluigi Viale
- Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Infectious Disease Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Michele Bartoletti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Infectious Disease Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| |
Collapse
|
10
|
McGarry ME, Huang CY, Ly NP. Ethnic differences in staphylococcus aureus acquisition in cystic fibrosis. J Cyst Fibros 2023; 22:909-915. [PMID: 37460380 PMCID: PMC10802839 DOI: 10.1016/j.jcf.2023.07.004] [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: 10/17/2022] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Hispanic people with CF (pwCF) have increased morbidity than non-Hispanic White pwCF, including increased risk of Pseudomonas aeruginosa. We aimed to determine if Staphylococcus aureus (S. aureus) acquisition varies between Hispanic and non-Hispanic White pwCF. METHODS This longitudinal cohort study of pwCF ages 0-25 years in the CF Foundation Patient Registry compared acquisition of methicillin-sensitive S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), persistent MRSA between Hispanic and non-Hispanic White pwCF. Risk of acquisition was assessed by Kaplan-Meier survival curves and its association with ethnicity was evaluated using Cox regressions. Adjusted associations were evaluated using multivariate Cox models adjusting for sex, age of entry into CFFPR, CFTR variant severity, pancreatic insufficiency, CF-related diabetes, maternal education, insurance status. RESULTS Of 10,640 pwCF, 7.5% were Hispanic and 92.5% were non-Hispanic White. Hispanic pwCF had a 19% higher risk of acquiring MSSA (HR 1.19, 95% CI 1.10-1.28, p<0.001) and 13% higher risk of acquiring MRSA (HR 1.13, 95% CI 1.02-1.26, p = 0.02) than non-Hispanic White pwCF. The difference in persistent MRSA between ethnicities did not reach statistical significance. After adjusting for confounding variables, only the risk of MSSA was significantly associated with ethnicity. Compared to non-Hispanic White pwCF, Hispanic pwCF acquired MSSA and MRSA at younger median ages (4.9 vs. 3.8 years (p<0.001), 22.4 vs. 20.8 years (p = 0.02). CONCLUSION Hispanic pwCF <25 years of age have an increased risk of acquiring MSSA and acquired MSSA and MRSA at an earlier age. Differences in S. aureus acquisition may contribute to increased morbidity in Hispanic pwCF.
Collapse
Affiliation(s)
- Meghan E McGarry
- Division of Pediatric Pulmonology, Department of Pediatrics, University of California, 550 16th Ave, Box 0632, San Francisco, CA 94158, United States.
| | - Chiung-Yu Huang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
| | - Ngoc P Ly
- Division of Pediatric Pulmonology, Department of Pediatrics, University of California, 550 16th Ave, Box 0632, San Francisco, CA 94158, United States
| |
Collapse
|
11
|
Bostian PA, Vaida J, Brooks WC, Chaharbakhshi E, Dietz MJ, Klein AE, Murphy TR, Frye BM, Lindsey BA. A Novel Protocol for Nasal Decolonization Using Prolonged Application of an Alcohol-Based Nasal Antiseptic Reduces Surgical Site Infections in Total Joint Arthroplasty Patients: A Retrospective Cohort Study. Surg Infect (Larchmt) 2023; 24:651-656. [PMID: 37638795 DOI: 10.1089/sur.2022.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
Background: Current nasal decolonization strategies utilize pre-operative agents without consideration for short-term re-colonization or de novo colonization. Many strategies utilize an antibiotic-based agent, raising concerns of limited gram-negative antimicrobial coverage and the emergence of resistant bacterial strains. This study evaluated the clinical utility of a non-antibiotic, alcohol-based nasal decolonization agent in decreasing surgical site infection (SSI) rates after total joint arthroplasty. Patients and Methods: We retrospectively compared an 18-month cohort of elective primary total joint arthroplasty patients treated peri-operatively with an alcohol-based sanitizer to historical controls. The alcohol-based agent was administered pre-operatively the day of surgery and for two weeks after surgery. Patients were followed for 90 days and assessed for signs or symptoms of SSI. Patient and caregiver compliance was recorded. There were 779 patients included in the experimental group and 647 included in the historical control group. Results: Patients receiving alcohol-based nasal decolonization had a lower rate of SSI compared with controls not receiving nasal decolonization (0.64% [5/779] vs. 1.55% [10/647]; p = 0.048; odds ratio, 2.43). Utilization of an alcohol-based nasal sanitizer in the pre-operative and prolonged post-operative setting decreased infection rates by 41.3% in our elective total joint arthroplasty setting. Conclusions: When used pre- and post-operatively, alcohol-based nasal decolonization of bacteria in patients undergoing total joint arthroplasty led to a substantial decrease in SSIs.
Collapse
Affiliation(s)
- Phillip A Bostian
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - Justin Vaida
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - William C Brooks
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - Edwin Chaharbakhshi
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - Matthew J Dietz
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - Adam E Klein
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - T Ryan Murphy
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - Benjamin M Frye
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - Brock A Lindsey
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| |
Collapse
|
12
|
Huang J, Zhang W, Sun B, Jiang Q, Cao Y, Shang J, Zhang Y, Gu X, Lv C, Guo C, Li M, Li H, Guo X, Zhu Y, Huang S, Li Q. Genetic diversity, antibiotic resistance, and virulence characteristics of Staphylococcus aureus from raw milk over 10 years in Shanghai. Int J Food Microbiol 2023; 401:110273. [PMID: 37295267 DOI: 10.1016/j.ijfoodmicro.2023.110273] [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: 02/25/2023] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023]
Abstract
Staphylococcus aureus (S. aureus) is a major cause of foodborne infections and its persistence in raw milk is a multifaceted phenomenon that poses a considerable public health challenge. Our study investigated the prevalence, virulence genes, antibiotic resistance, and genetic characterization of S. aureus in raw milk in six Shanghai districts from 2013 to 2022. At 18 dairy farms, a total of 704 S. aureus strains were isolated from 1799 samples tested for drug sensitivity. The highest rates of antibiotic resistance were ampicillin (96.7 %), sulfamethoxazole (65 %), and erythromycin (21.6 %). Between 2018 and 2022, there was a significant decrease in the resistance rates of ceftiofur, ofloxacin, tilmicosin, erythromycin, clindamycin, amoxicillin-clavulanic acid, and sulfamethoxazole in comparison to the period from 2013 to 2017. There were 205 S. aureus strains chosen for whole genome sequencing (WGS), with no more than 2 strains of the same resistance phenotype from each farm per year. The prevalence of mecA-positive strains was 14.15 %, while other antibiotic resistance-associated genes were observed as follows: blaI (70.21 %), lnu(B) (5.85 %), lsa(E) (5.75 %), fexA (6.83 %), erm(C) (4.39 %), tet(L) (9.27 %), and dfrG (5.85 %). Isolates harboring the immune evasion cluster (IEC) genes (scn, chp, and sak) were predominantly categorized as sequence types (STs) 7, 188, 15, 59, and 398. The predominant cluster complexes were CC97, CC1, CC398, and CC1651. In 2017-2022, there was a transition in CC1 from the highly antibiotic-resistant ST9 strain that emerged between 2013 and 2018 to the low-resistant but highly virulent ST1 strain. Retrospective phylogenetic analysis elucidated the evolutionary history of the isolates and demonstrated that the human-animal host transition of S. aureus was linked to the genesis of MRSA CC398. The implementation of extended surveillance will aid in the development of innovative strategies to avoid the transmission of S. aureus along the dairy food chain and the occurrence of public health events.
Collapse
Affiliation(s)
- Jiewen Huang
- Department of Laboratory Medicine, College of Health Science and Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Wengang Zhang
- Shanghai Animal Disease Control Center, Shanghai 201103, China
| | - Bingqing Sun
- Shanghai Animal Disease Control Center, Shanghai 201103, China
| | - Qin Jiang
- Shanghai Animal Disease Control Center, Shanghai 201103, China
| | - Ying Cao
- Shanghai Animal Disease Control Center, Shanghai 201103, China
| | - Jun Shang
- Shanghai Animal Disease Control Center, Shanghai 201103, China
| | - Yu Zhang
- Shanghai Animal Disease Control Center, Shanghai 201103, China
| | - Xin Gu
- Shanghai Animal Disease Control Center, Shanghai 201103, China
| | - Chao Lv
- Department of Animal Health and Food Safety, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Chaoyi Guo
- Department of Animal Health and Food Safety, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Min Li
- Department of Animal Health and Food Safety, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hui Li
- Department of Laboratory Medicine, College of Health Science and Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaokui Guo
- Department of Animal Health and Food Safety, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yongzhang Zhu
- Department of Animal Health and Food Safety, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Shixin Huang
- Shanghai Animal Disease Control Center, Shanghai 201103, China.
| | - Qingtian Li
- Department of Laboratory Medicine, College of Health Science and Technology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| |
Collapse
|
13
|
Mills AG, Dupper AC, Chacko KI, Alburquerque B, Nadkarni D, Berbel Caban A, Fox L, Gitman MR, Obla A, van Bakel H, Altman DR. Methicillin-resistant Staphylococcus aureus bacteremia with elevated vancomycin minimum inhibitory concentrations. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e87. [PMID: 37179762 PMCID: PMC10173282 DOI: 10.1017/ash.2023.163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 05/15/2023]
Abstract
This case-control study of 25 cases with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with vancomycin minimum inhibitory concentration (MIC) ≥ 2 µg/mL and 391 controls (MIC < 2 µg/mL) characterized the clinical characteristics, treatments, and outcomes associated with elevated vancomycin MIC. Elevated vancomycin MIC was associated with baseline hemodialysis, prior MRSA colonization, and metastatic infection.
Collapse
Affiliation(s)
- Alexandra G. Mills
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amy C. Dupper
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kieran I. Chacko
- Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Bremy Alburquerque
- Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Devika Nadkarni
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ana Berbel Caban
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lindsey Fox
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Melissa R. Gitman
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ajay Obla
- Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Harm van Bakel
- Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, New York
- Icahn Genomics Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Deena R. Altman
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| |
Collapse
|
14
|
Natsir Kalla DS, Ruslin M, Aartman IHA, Helder MN, Forouzanfar T, Gilijamse M. Postoperative Daycare as a Safe and Cost-Effective Option for Secondary Alveolar Bone Graft (SABG) Surgery: A Retrospective Comparative Cohort Study. Cleft Palate Craniofac J 2023:10556656231171210. [PMID: 37097837 DOI: 10.1177/10556656231171210] [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: 04/26/2023] Open
Abstract
OBJECTIVE To evaluate the outcomes of Secondary Alveolar Bone Grafting (SABG) in patients treated either in daycare or with multiple day hospitalization (MDH) in relation to costs and complication rates. DESIGN Retrospective comparative cohort study. SETTING The data was collected from two settings: Postoperative daycare or MDH after oral cleft surgery in an Academic Medical Center in The Netherlands. PATIENTS Data of 137 patients with unilateral Cleft lip, alveolus, and palate (CLAP) treated between 2006-2018 were evaluated. Registered clinical variables: age, gender, cleft subtype, bone donor site, type of hospitalization, length of stay, additional surgery, complications, surgeons, and costs. INTERVENTIONS Closure of the alveolar cleft with/without closure of the anterior palate. MAIN OUTCOME MEASURES Univariate analyses. RESULTS Of the 137 patients, 46.7% were treated in MDH, and 53.3% in daycare. Total costs for daycare were significantly lower (P < .001). All patients treated in daycare received mandibular symphysis bone, whereas in MDH, 46.9% received iliac crest bone instead. Bone donor site was associated with postoperative care type. Complication rates were slightly but not significantly higher in daycare (26%) vs. MDH (14.1%) (P = .09). Most were Grade I (minor) according to Clavien Dindo classification. CONCLUSIONS Daycare after alveolar cleft surgery is about as safe as MDH, but significantly cheaper.
Collapse
Affiliation(s)
- Diandra S Natsir Kalla
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Irene H A Aartman
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marco N Helder
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Marjolijn Gilijamse
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Department of Maxillofacial Surgery, OLVG, Amsterdam, The Netherlands
| |
Collapse
|
15
|
Aytekin MN, Hasanoglu I, Öztürk R, Tosun N. Knowledge and attitudes of orthopedic surgeons regarding prosthesis joint infection. World J Orthop 2023; 14:240-247. [PMID: 37155512 PMCID: PMC10122778 DOI: 10.5312/wjo.v14.i4.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/25/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) is a critical complication after joint arthroplasty and is accompanied by increasing rates of morbidity and mortality. Several studies have aimed at preventing PJI.
AIM To research the knowledge level and attitudes of orthopedic surgeons, who play a key role in both preventing and managing PJI.
METHODS We conducted a web-based survey to evaluate orthopedic surgeons' knowledge level and attitudes regarding PJI. The Likert scale survey utilized consisted of 30 questions which were prepared based on the "Proceedings of the International Consensus on Periprosthetic Joint Infection".
RESULTS A total of 264 surgeons participated in the survey. Their average age was 44.8, and 173 participants (65.5%) had more than 10 years of experience. No statistically significant relationship was found between the PJI knowledge of the surgeons and their years of experience. However, participants who worked in training and research hospitals demonstrated higher levels of knowledge than the ones in the state hospitals. It was also noticed that surgeons' knowledge concerning the duration of antibiotic therapy and urinary infections was not consistent with their attitudes.
CONCLUSION Even though orthopedic surgeons have adequate knowledge about preventing and managing PJI, their attitudes might contradict their knowledge. Future studies are required to examine the causes and solutions of the contradictions between orthopedic surgeons' knowledge and attitudes.
Collapse
Affiliation(s)
- Mahmut Nedim Aytekin
- Department of Orthopedics and Traumatology, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara 06500, Turkey
| | - Imran Hasanoglu
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara City Hospital, Ankara 06500, Turkey
| | - Recep Öztürk
- Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 06200, Turkey
| | - Nihat Tosun
- Department of Orthopedics and Traumatology, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara 06500, Turkey
| |
Collapse
|
16
|
Barger SD, Lininger MR, Trotter RT, Mbegbu M, Kyman S, Tucker-Morgan K, Wood C, Coyne B, Russakoff B, Ceniceros K, Padilla C, Maltinsky S, Pearson T. Cross-sectional study of the association of social relationship resources with Staphylococcus aureus colonization in naturally occurring social groups along the US/Mexico border. PLoS One 2023; 18:e0284400. [PMID: 37053196 PMCID: PMC10101449 DOI: 10.1371/journal.pone.0284400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/29/2023] [Indexed: 04/14/2023] Open
Abstract
Asymptomatic carriage of Staphylococcus aureus is a major risk factor for subsequent clinical infection. Diminishing returns from mitigation efforts emphasize the need to better understand colonization, spread, and transmission of this opportunistic pathogen. While contact with other people presents opportunities for pathogen exposure and transmission, diversity of social connections may be protective against pathogens such as the common cold. This study examined whether social relationship resources, including the amount and diversity of social contacts, are associated with S. aureus colonization. Participants were community members (N = 443; 68% Hispanic) in naturally occurring social groups in southwestern Arizona. Four types of social relationships and loneliness were assessed, and samples from the skin, nose and throat were obtained to ascertain S. aureus colonization. Overall S. aureus prevalence was 64.8%. Neither the amount nor the diversity of social contacts were associated with S. aureus colonization. The concurrent validity of the social relationship assessments was supported by their moderate intercorrelations and by their positive association with self-rated health. The results suggest that the association of social network diversity and susceptibility to the common cold does not extend to S. aureus colonization. Conversely, colonization prevalence was not higher among those with more social contacts. The latter pattern suggests that social transmission may be relatively infrequent or that more intimate forms of social interaction may drive transmission and colonization resulting in high community prevalence of S. aureus colonization. These data inform communicable disease control efforts.
Collapse
Affiliation(s)
- Steven D. Barger
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States of America
| | - Monica R. Lininger
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, United States of America
| | - Robert T. Trotter
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States of America
- Department of Anthropology, Northern Arizona University, Flagstaff, AZ, United States of America
| | - Mimi Mbegbu
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States of America
| | - Shari Kyman
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States of America
| | | | - Colin Wood
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States of America
| | - Briana Coyne
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States of America
| | - Benjamin Russakoff
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States of America
| | - Kathya Ceniceros
- Northern Arizona University, Yuma, Arizona, United States of America
| | - Cristina Padilla
- Northern Arizona University, Yuma, Arizona, United States of America
| | - Sara Maltinsky
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States of America
| | - Talima Pearson
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States of America
- Pathogen & Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States of America
| |
Collapse
|
17
|
Key FM, Khadka VD, Romo-González C, Blake KJ, Deng L, Lynn TC, Lee JC, Chiu IM, García-Romero MT, Lieberman TD. On-person adaptive evolution of Staphylococcus aureus during treatment for atopic dermatitis. Cell Host Microbe 2023; 31:593-603.e7. [PMID: 37054679 PMCID: PMC10263175 DOI: 10.1016/j.chom.2023.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 02/14/2023] [Accepted: 03/10/2023] [Indexed: 04/15/2023]
Abstract
The opportunistic pathogen Staphylococcus aureus frequently colonizes the inflamed skin of people with atopic dermatitis (AD) and worsens disease severity by promoting skin damage. Here, we show, by longitudinally tracking 23 children treated for AD, that S. aureus adapts via de novo mutations during colonization. Each patient's S. aureus population is dominated by a single lineage, with infrequent invasion by distant lineages. Mutations emerge within each lineage at rates similar to those of S. aureus in other contexts. Some variants spread across the body within months, with signatures of adaptive evolution. Most strikingly, mutations in capsule synthesis gene capD underwent parallel evolution in one patient and across-body sweeps in two patients. We confirm that capD negativity is more common in AD than in other contexts, via reanalysis of S. aureus genomes from 276 people. Together, these findings highlight the importance of the mutation level when dissecting the role of microbes in complex disease.
Collapse
Affiliation(s)
- Felix M Key
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Veda D Khadka
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Carolina Romo-González
- Experimental Bacteriology Laboratory, National Institute for Pediatrics, Mexico City, Mexico
| | - Kimbria J Blake
- Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Liwen Deng
- Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | - Tucker C Lynn
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jean C Lee
- Division of Infectious Disease, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Isaac M Chiu
- Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA
| | | | - Tami D Lieberman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA; Broad Institute, Massachusetts Institute of Technology, Cambridge, MA, USA; Ragon Institute, Massachusetts Institute of Technology, Cambridge, MA, USA.
| |
Collapse
|
18
|
Lal AK, Sprawka N, Darji H, Waters T, Ricci Goodman J. MRSA screening: incidence and maternal postpartum outcomes in an obstetric population at a tertiary care center. Arch Gynecol Obstet 2023; 307:1203-1208. [PMID: 35396975 DOI: 10.1007/s00404-022-06552-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/23/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To assess the incidence of MRSA positive patients in pregnancy, as well as the postpartum outcomes in MRSA positive patients. METHODS This is a retrospective cohort study of women who underwent universal MRSA universal at a tertiary medical center. A MRSA swab was routinely collected as part of the patient's prenatal care at 35-37 weeks gestation or on admission to labor and delivery. Demographic information and decolonization antibiotics were collected by electronic medical record review, using ICD-9 codes. Outcome data were collected, including mode of delivery, hospital length of stay, endometritis, wound cellulitis, and wound infection. p < 0.05 was considered significant. A univariate logistic regression and a multivariable binary logistic regression model were used to analyze the strength of association between outcomes and MRSA status. Statistical analysis was performed with SAS, version 9.4. RESULTS The incidence of MRSA during the 4 year study period was 1.9% (82 MRSA positive out of 4369 total patients). 90.2% (74/82) of MRSA positive patients received decolonization antibiotics. No difference was noted in mode of delivery. Logistic regression failed to identify any significant differences in other relevant outcomes for MRSA positive women including endometritis 1.1 (0.1-17.5) [positive 0, versus negative 0.6% (n = 24)], wound cellulitis 5.9 (0.4-82.1) positive 0, versus negative 0.1% (Gorwitz et al. in J Infect Dis 197:1226-1234, 2008) and wound infection 3.3 (0.6-16.9) [positive 1.2%, versus negative 0.5% ( in Am J Infect Control 32:470-85, 2004)] when compared to MRSA negative women. CONCLUSION When universal MRSA screening was performed at an academic tertiary care center, the overall incidence of MRSA was low. MRSA positive and subsequently decolinzed patients did not have any identified increase in postpartum infectious morbidity, as compared to MRSA negative patients.
Collapse
Affiliation(s)
- Ann K Lal
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL, 60153, USA.
| | - Nicole Sprawka
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL, 60153, USA
| | - Himani Darji
- Biostatistics Core Clinical Research Office, Loyola University Chicago Health Sciences Division Center for Translational Research and Education, Chicago, IL, USA
| | - Thaddeus Waters
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL, 60153, USA
| | - Jean Ricci Goodman
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL, 60153, USA
| |
Collapse
|
19
|
Qasim Hameed H, Ahmed Saeed I, Abdalhadi Hussain E. Detection of lukf-pv gene in Staphylococcus aureus isolated from pregnant women with Urinary tract infection. BIONATURA 2023. [DOI: 10.21931/rb/2023.08.01.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Staphylococcus aureus is a human pathogen as well as commensal bacteria. S. aureus has colonized around 30% of the human population. This study aimed to diagnose Staphylococcus aureus by molecular techniques, correlate the resistance against selected antimicrobial substances with the presence of the lukf-pv gene, and find the sequence of lukf-pv gene for the isolates obtained to investigate the mutations of those obtained isolates. This study included 60 patients diagnosed by the hospital with a urinary tract infection in Teaching Medical City Hospital, Baghdad, and Al-Yarmouk Teaching Hospital, between January 2021 and July 2021. The isolates were cultured on a blood agar overnight; then, isolates were diagnosed by VITEK as S. aureus. DNA has been isolated from all the included samples. A specific region of the 16SRNA gene has been amplified to diagnose S. aureus by molecular techniques. Then possession of the lukf-pv gene was tested by PCR, then amplified products were sequenced to detect the mutations within the lukf-pv gene. The finding appeared that blood group O+ has the highest rate of bacterial infection, the lowest is O- (1.7%), and the highest rate is shown within people not suffering from complicated diseases (65%). Of the 60 isolates, 60 (100%) were confirmed by 16sRNA gene amplification and were positive, among which 37 (61.6%) were lukf-pv positive. Results of the lukf-pv gene sequences showed around 501 bits score and 96% compatibility (ID: CP076105.1). The current study showed that antibiotics Cefoxitin, Benzylpenicillin, Oxacillin, Clindamycin, Fusidic acid, Rifampicin, Erythromycin, Vancomycin, and Teicoplanin had the highest resistance to antibiotics and as follow;100 %, 100 %, 40.54 %, 27.03 %, 27.03 %, 16.22 %, 13.51 %, and 10.81 %, respectively.
Keywords: Staphylococcus aureus, 16sRNA and lukf-pv genes
Collapse
Affiliation(s)
- Hiba Qasim Hameed
- Department of Biology, College of Education for pure science Ibn-Al Haitham, University of Baghdad, Baghdad, Iraq
| | - Inas Ahmed Saeed
- Department of Microbiology ,Collage of Medicine, University of Babylon
| | - Enas Abdalhadi Hussain
- Department of Biology, College of Education for pure science Ibn-Al Haitham, University of Baghdad, Baghdad, Iraq
| |
Collapse
|
20
|
Gido CD, Herdendorf TJ, Geisbrecht BV. Characterization of two distinct neutrophil serine protease-binding modes within a Staphylococcus aureus innate immune evasion protein family. J Biol Chem 2023; 299:102969. [PMID: 36736422 PMCID: PMC9996362 DOI: 10.1016/j.jbc.2023.102969] [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: 11/28/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/03/2023] Open
Abstract
Extracellular adherence protein domain (EAPs) proteins are a class of innate immune evasion proteins secreted by the human pathogen Staphylococcus aureus. EAPs are potent and selective inhibitors of cathepsin-G (CG) and neutrophil elastase (NE), which are the two most abundant neutrophil serine proteases (NSPs). Previous work from our group has shown that the prototypical EAP, EapH1, relies on plasticity within a single inhibitory site to block the activities of CG and NE. However, whether other EAPs follow similar structure-function relationships is unclear. To address this question, we studied the inhibitory properties of the first (Eap1) and second (Eap2) domains of the modular extracellular adherence protein of S. aureus and determined their structures when bound to CG and NE, respectively. We observed that both Eap1 and Eap2 displayed time-dependent inhibition of CG (on the order of 10-9 M) and of NE (on the order of 10-10 M). We also found that whereas the structures of Eap1 and Eap2 bound to CG showed an overall inhibitory mode like that seen previously for EapH1, the structures of Eap1 and Eap2 bound to NE revealed a new inhibitory mode involving a distal region of the EAP domain. Using site-directed mutagenesis of Eap1 and Eap2, along with enzyme assays, we confirmed the roles of interfacial residues in NSP inhibition. Taken together, our work demonstrates that EAPs can form structurally divergent complexes with two closely related serine proteases and further suggests that certain EAPs may be capable of inhibiting two NSPs simultaneously.
Collapse
Affiliation(s)
- Carson D Gido
- Department of Biochemistry & Molecular Biophysics, Kansas State University, Manhattan, Kansas, USA
| | - Timothy J Herdendorf
- Department of Biochemistry & Molecular Biophysics, Kansas State University, Manhattan, Kansas, USA
| | - Brian V Geisbrecht
- Department of Biochemistry & Molecular Biophysics, Kansas State University, Manhattan, Kansas, USA.
| |
Collapse
|
21
|
Lynch JP, Zhanel GG. Escalation of antimicrobial resistance among MRSA part 1: focus on global spread. Expert Rev Anti Infect Ther 2023; 21:99-113. [PMID: 36470275 DOI: 10.1080/14787210.2023.2154653] [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: 12/12/2022]
Abstract
INTRODUCTION Staphylococcus aureus produce numerous virulence factors that influence tissue invasion, cytotoxicity, membrane damage, and intracellular persistence allowing them to be very common human pathogens. S. aureus isolates exhibit considerable diversity though specific genotypes have been associated with antimicrobial resistance (AMR) and toxin gene profiles. MRSA is an important pathogen causing both community-acquired (CA) and healthcare-acquired (HCA) infections. Importantly, over the past several decades, both HCA-MRSA and CA-MRSA have spread all over the globe. Even more concerning is that CA-MRSA clones have disseminated into hospitals and HCA-MRSA have entered the community. Factors that enhance spread of MRSA include: poor antimicrobial stewardship and inadequate infection control. The emergence and spread of multidrug resistant (MDR) MRSA has limited therapeutic options. AREAS COVERED The authors discuss the escalation of MRSA, both HCA-MRSA and CA-MRSA across the globe. A literature search of MRSA was performed via PubMed (up to September 2022), using the key words: antimicrobial resistance; β-lactams; community-associated MRSA; epidemiology; infection; multidrug resistance; Staphylococcus aureus. EXPERT OPINION Over the past several decades, MRSA has spread all over the globe. We encourage the judicious use of antimicrobials in accordance with antimicrobial stewardship programs along with infection control measures to minimize the spread of MRSA.
Collapse
Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at Ucla, Los Angeles, CA, USA
| | - George G Zhanel
- Professor-Department of Medical Microbiology and Infectious Diseases, Department of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
22
|
Travis S, Green KD, Gilbert NC, Tsodikov OV, Garneau-Tsodikova S, Thompson MK. Inhibition of Fosfomycin Resistance Protein FosB from Gram-Positive Pathogens by Phosphonoformate. Biochemistry 2023; 62:109-117. [PMID: 36525630 DOI: 10.1021/acs.biochem.2c00566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The Gram-positive pathogen Staphylococcus aureus is a leading cause of antimicrobial resistance related deaths worldwide. Like many pathogens with multidrug-resistant strains, S. aureus contains enzymes that confer resistance through antibiotic modification(s). One such enzyme present in S. aureus is FosB, a Mn2+-dependent l-cysteine or bacillithiol (BSH) transferase that inactivates the antibiotic fosfomycin. fosB gene knockout experiments show that the minimum inhibitory concentration (MIC) of fosfomycin is significantly reduced when the FosB enzyme is not present. This suggests that inhibition of FosB could be an effective method to restore fosfomycin activity. We used high-throughput in silico-based screening to identify small-molecule analogues of fosfomycin that inhibited thiol transferase activity. Phosphonoformate (PPF) was a top hit from our approach. Herein, we have characterized PPF as a competitive inhibitor of FosB from S. aureus (FosBSa) and Bacillus cereus (FosBBc). In addition, we have determined a crystal structure of FosBBc with PPF bound in the active site. Our results will be useful for future structure-based development of FosB inhibitors that can be delivered in combination with fosfomycin in order to increase the efficacy of this antibiotic.
Collapse
Affiliation(s)
- Skye Travis
- Department of Chemistry & Biochemistry, The University of Alabama, 250 Hackberry Lane, Tuscaloosa, Alabama 35487, United States
| | - Keith D Green
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 South Limestone Street, Lexington, Kentucky 40536, United States
| | - Nathaniel C Gilbert
- Department of Biological Sciences, Louisiana State University, Baton Rouge, Louisiana 70803, United States
| | - Oleg V Tsodikov
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 South Limestone Street, Lexington, Kentucky 40536, United States
| | - Sylvie Garneau-Tsodikova
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, 789 South Limestone Street, Lexington, Kentucky 40536, United States
| | - Matthew K Thompson
- Department of Chemistry & Biochemistry, The University of Alabama, 250 Hackberry Lane, Tuscaloosa, Alabama 35487, United States
| |
Collapse
|
23
|
Gerbig GR, Piontkivska H, Smith TC, White R, Mukherjee J, Benson H, Rosenbaum M, Leibler JH. Genetic characterization of Staphylococcus aureus isolated from Norway rats in Boston, Massachusetts. Vet Med Sci 2023; 9:272-281. [PMID: 36524786 PMCID: PMC9856981 DOI: 10.1002/vms3.1020] [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] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Despite the importance of domesticated animals in the generation and transmission of antibiotic-resistant Staphylococcus aureus, the role of wild animals, specifically rodents, in the ecology of S. aureus remains unclear. We recovered and genotyped S. aureus isolates from wild Norway rats (Rattus norvegicus) in Boston, Massachusetts to examine genetic relationships between common human and animal S. aureus isolates in a large US metropolitan area. METHODS We collected and necropsied 63 rats from June 2016 to June 2017. Nasal, foot pad, fur, and fecal swabs were collected. Staphylococcus aureus was isolated using culture-based methods and polymerase chain reaction confirmation. S. aureus isolates were spa typed, tested for antibiotic susceptibility, and whole genome sequenced. Assembled sequences were uploaded to the Comprehensive Antibiotic Resistance Database to identify antibiotic resistance elements. A phylogenetic tree was constructed using the neighbor-joining method with the maximum composite likelihood distance in MEGA7. RESULTS We recovered 164 Gram-positive bacterial isolates from Norway rats. Nineteen isolates from eight individual rats were confirmed as S. aureus (prevalence: 12.9% (8/63)). All S. aureus isolates were methicillin-susceptible S. aureus (MSSA), pvl-negative, and resistant to penicillin. Two isolates displayed resistance to erythromycin. Four different S. aureus spa types were detected (t933, t10751, t18202, and t189). Thirteen unique antibiotic resistance elements were identified, and all isolates shared genes mepR, mgrA, arlR, and S. aureus norA. Phylogenetic analysis if the 19 S. aureus isolates revealed they were genetically similar to four clades of S. aureus with similar resistance gene profiles isolated from both human- and animal-derived S. aureus, as well as formed a distinct phylogenetic cluster composed only of rat isolates. CONCLUSIONS Wild rodents may serve as a reservoir or vector of antibiotic resistance genes in the urban environment with relevance for human and animal health.
Collapse
Affiliation(s)
| | | | - Tara C. Smith
- College of Public HealthKent State UniversityKentOhioUSA
| | - Ruairi White
- Department of Infectious Disease and Global Health, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachussetsUSA
| | - Jean Mukherjee
- Department of Infectious Disease and Global Health, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachussetsUSA
| | - Hayley Benson
- Department of Infectious Disease and Global Health, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachussetsUSA
| | - Marieke Rosenbaum
- Department of Infectious Disease and Global Health, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachussetsUSA
| | - Jessica H. Leibler
- Department of Environmental HealthBoston University School of Public HealthBostonMassachusettsUSA
| |
Collapse
|
24
|
Zhang K, Jia Y, Qian Y, Jiang X, Zhang S, Liu B, Cao J, Song Y, Mao W. Staphylococcus aureus increases Prostaglandin E 2 secretion in cow neutrophils by activating TLR2, TLR4, and NLRP3 inflammasome signaling pathways. Front Microbiol 2023; 14:1163261. [PMID: 37168122 PMCID: PMC10165004 DOI: 10.3389/fmicb.2023.1163261] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/24/2023] [Indexed: 05/13/2023] Open
Abstract
Introduction In clinical settings, dairy cows are often attacked by pathogenic bacteria after delivery, especially Staphylococcus aureus (S. aureus). Neutrophils have long been regarded as essential for host defense against S. aureus. Prostaglandin E2 (PGE2) can additionally be used as an inflammatory mediator in pathological conditions to promote the repair of inflammatory injuries. However, whether S. aureus can promote the accumulation of PGE2 after the infection of neutrophils in cows and its mechanism remain unclear. Lipoprotein is an important immune bioactive ingredient of S. aureus. Methods In this study, the changes in neutrophils were monitored in dairy cows infected with wild-type S. aureus (SA113) and an S. aureus lipoprotein-deficient strain (Δlgt); meanwhile, we established whether pattern recognition receptors mediate this process and whether S. aureus lipoproteins are necessary for causing the release of PGE2 from cow neutrophils. Results The results showed that Δlgt was less effective than SA113 in inducing the production of IL-1β, IL-6, IL-8, IL-10, and PGE2 within neutrophils; furthermore, TLR2, TLR4, and NLRP3 receptors were found to mediate the inducible effect of lipoprotein on the above inflammation mediators and cytokines, which depended on MAPK and Caspase-1 signaling pathways. In addition, TLR2, TLR4, and NLRP3 inhibitors significantly inhibited PGE2 and cytokine secretion, and PGE2 was involved in the interaction of S. aureus and neutrophils in dairy cows, which could be regulated by TLR2, TLR4, and NLRP3 receptors. We also found that S. aureus was more likely to be killed by neutrophils when it lacked lipoprotein and TLR2, TLR4, and NLRP3 were involved, but PGE2 seemed to have no effect. Discussion Taken together, these results suggest that lipoprotein is a crucial component of S. aureus in inducing cytokine secretion by neutrophils as well as killing within neutrophils, which could be accomplished by the accumulation of PGE2 by activating MAPK and the Caspase-1 signaling pathways through TLR2, TLR4, and NLRP3 receptors. These results will contribute to a better understanding of the interaction between S. aureus and host immune cells in dairy cows.
Collapse
Affiliation(s)
- Kai Zhang
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Huhhot, China
- Key Laboratory of Animal Clinical Treatment Technology, Ministry of Agriculture, Huhhot, China
| | - Yan Jia
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Huhhot, China
- Key Laboratory of Animal Clinical Treatment Technology, Ministry of Agriculture, Huhhot, China
| | - Yinghong Qian
- Inner Mongolia Academy of Agricultural and Animal Husbandry Sciences, Huhhot, China
| | - Xueying Jiang
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Huhhot, China
- Key Laboratory of Animal Clinical Treatment Technology, Ministry of Agriculture, Huhhot, China
| | - Shuangyi Zhang
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Huhhot, China
- Key Laboratory of Animal Clinical Treatment Technology, Ministry of Agriculture, Huhhot, China
| | - Bo Liu
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Huhhot, China
- Key Laboratory of Animal Clinical Treatment Technology, Ministry of Agriculture, Huhhot, China
| | - Jinshan Cao
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Huhhot, China
- Key Laboratory of Animal Clinical Treatment Technology, Ministry of Agriculture, Huhhot, China
| | - Yongli Song
- Stem Cell and Microbiology, Inner Mongolia University, Huhhot, China
| | - Wei Mao
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Huhhot, China
- Key Laboratory of Animal Clinical Treatment Technology, Ministry of Agriculture, Huhhot, China
- *Correspondence: Wei Mao
| |
Collapse
|
25
|
Boncompain CA, Suárez CA, Squeff M, Belluzo V, Piccirilli G, Molteni A, Fernández Bussy RA, Morbidoni HR. Phenotypic and molecular characterization of Staphylococcus aureus isolates conducted in nares of psoriatic patients attending a public hospital in Argentina. Rev Argent Microbiol 2023; 55:3-11. [PMID: 35760653 DOI: 10.1016/j.ram.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 12/14/2021] [Accepted: 02/14/2022] [Indexed: 11/28/2022] Open
Abstract
Although Staphylococcus aureus increases its relative abundance in psoriasis when compared with the microbiome of healthy subjects, it is not the most important microorganism underlying this disease. However, there is scant data on the role and molecular features of S. aureus strains in psoriasis; therefore, the aim of this study was to evaluate nasal carriage of this microorganism, its phenotypic and molecular characteristics as well as the impact of host factors on its carriage in psoriatic patients. The presence of S. aureus was analyzed in nasal swabs from 46 healthy volunteers and 50 psoriatic patients by conventional microbiology techniques. Nasal carriage of S. aureus was higher in psoriatic patients than in the control group (37.24% vs 22.98%, respectively), being associated to sex (male), age (adults) and severity of the disease (more frequent in moderate and severe cases). Determination of antibiotic resistance detected 12% of β-lactam resistant isolates, with variable accompanying resistance to macrolides, aminoglycosides and fluoroquinolones. No resistance to rifampicin, vancomycin, mupirocin or trimethoprim/sulfamethoxazole was found. A preliminary molecular characterization of the isolates was performed by PCR amplification of virulence genes. Molecular characterization of the strains did not reveal a predominant strain in psoriatic patients. Although we established host factors related to increased carriage of S. aureus in psoriatic patients, we could not establish the predominance of one type of strain. Genomic and transcriptomic analysis of the isolated strains would be necessary to address this point.
Collapse
Affiliation(s)
- Carina A Boncompain
- Laboratorio de Microbiología Molecular, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario, Argentina
| | - Cristian A Suárez
- Laboratorio de Microbiología Molecular, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas, CONICET, Argentina
| | - Mario Squeff
- Cátedra de Dermatología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario, Argentina
| | - Valeria Belluzo
- Cátedra de Dermatología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario, Argentina
| | - Gustavo Piccirilli
- Cátedra de Dermatología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario, Argentina
| | - Ana Molteni
- Cátedra de Dermatología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario, Argentina
| | - Ramón A Fernández Bussy
- Cátedra de Dermatología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario, Argentina.
| | - Héctor R Morbidoni
- Laboratorio de Microbiología Molecular, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario, Argentina; Consejo de Investigaciones, Universidad Nacional de Rosario, Maipú 1065, Rosario, Argentina.
| |
Collapse
|
26
|
Zhang C, Liang B, Xiong Z, Liang Z, Cai H, Zhong H, Xie Y, Xie Y, Liu X, Xie S, Lan F, Zhou Z. Distribution of Biocide Resistance Genes and Association with Clonal Complex Genotypes in Staphylococcus aureus Isolated from School-Age Children in Guangzhou. Infect Drug Resist 2022; 15:7165-7175. [PMID: 36514798 PMCID: PMC9741823 DOI: 10.2147/idr.s387528] [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: 08/25/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose Chlorhexidine and mupirocin are often prescribed to children in affected communities to prevent colonization and transmission of Staphylococcus aureus, but this has led to an increasing rate of biocide resistance. In this study, we aimed to determine the distribution of biocide resistance genes among S. aureus isolates from school-age children in Guangzhou, investigate chlorhexidine gluconate and mupirocin susceptibility and clonal complex (CC) genotypes in strains carrying biocide-resistance genes, and further explore the role of biofilms in this resistance. Patients and Methods Antibiotic resistance and multilocus sequence genotyping were performed on 722 S. aureus isolates from previous study. The distribution of nine biocide genes (qacA/B, mupA, mepA, sepA, norA, lmrS, smr, mupB, qacG) was determined by PCR. Isolates carrying qacA/B or mupA genes were further tested for susceptibility to chlorhexidine gluconate (CHG) and mupirocin and biofilm formation abilities. Results The most prevalent of the nine biocide resistance genes were mepA (95.57%), followed by norA (78.81%), lmrS (77.01%), and sepA (58.17%). The qacG gene was not detected. Distribution of sepA was significantly decreased in CC30 and CC45 genotypes, and presence of sepA was associated with resistance to antibiotics such as CLI, ERY, TCY, SXT, CIP, and LVX. In addition, 64 (94.1%, n=68) qacA/B+ isolates showed CHG resistance, 12 (100.0%, n=12) mupA+ isolates were mupirocin resistant, and 4 (80%, n=5) and 5 (100%, n=5) qacA/B+mupA+ isolates were CHG and mupirocin resistant, respectively. Of these 85 isolates, 98.8% (n=84) had different degrees of biofilm-forming abilities, which were positively associated with CHG and mupirocin resistance. Conclusion The distribution of biocide resistance genes was associated with special CCs. The qacA/B and mupA genes are highly associated with resistance to CHG and mupirocin, and biofilm formation was found to contribute to this biocide resistance.
Collapse
Affiliation(s)
- Chao Zhang
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China,Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Bingshao Liang
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Zhile Xiong
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China,Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Zhuwei Liang
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China,Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Hao Cai
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Huamin Zhong
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Yongqiang Xie
- Clinical Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Yuanwei Xie
- Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Xiaochun Liu
- Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Shiying Xie
- Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Fangjun Lan
- Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China
| | - Zhenwen Zhou
- Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China,Correspondence: Zhenwen Zhou, Clinical Laboratory, Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, People’s Republic of China, Tel +86 13925097897, Email
| |
Collapse
|
27
|
Zukowska A, Zukowski M. Surgical Site Infection in Cardiac Surgery. J Clin Med 2022; 11:jcm11236991. [PMID: 36498567 PMCID: PMC9738257 DOI: 10.3390/jcm11236991] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/20/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
Surgical site infections (SSIs) are one of the most significant complications in surgical patients and are strongly associated with poorer prognosis. Due to their aggressive character, cardiac surgical procedures carry a particular high risk of postoperative infection, with infection incidence rates ranging from a reported 3.5% and 26.8% in cardiac surgery patients. Given the specific nature of cardiac surgical procedures, sternal wound and graft harvesting site infections are the most common SSIs. Undoubtedly, DSWIs, including mediastinitis, in cardiac surgery patients remain a significant clinical problem as they are associated with increased hospital stay, substantial medical costs and high mortality, ranging from 3% to 20%. In SSI prevention, it is important to implement procedures reducing preoperative risk factors, such as: obesity, hypoalbuminemia, abnormal glucose levels, smoking and S. aureus carriage. For decolonisation of S. aureus carriers prior to cardiac surgery, it is recommended to administer nasal mupirocin, together with baths using chlorhexidine-based agents. Perioperative management also involves antibiotic prophylaxis, surgical site preparation, topical antibiotic administration and the maintenance of normal glucose levels. SSI treatment involves surgical intervention, NPWT application and antibiotic therapy.
Collapse
Affiliation(s)
- Agnieszka Zukowska
- Department of Infection Control, Regional Hospital Stargard, 73-110 Stargard, Poland
| | - Maciej Zukowski
- Department of Anesthesiology, Intensive Care and Acute Intoxication, Pomeranian Medical University, 70-204 Szczecin, Poland
- Correspondence: ; Tel.: +48-504-451-924
| |
Collapse
|
28
|
Chen B, Li S, Lin S, Huang M, Dong H. The association between antibiotics and community-associated Staphylococcus aureus colonization in the United States population: Analysis of the National Health and Nutrition Examination Survey (NHANES). Medicine (Baltimore) 2022; 101:e31702. [PMID: 36397391 PMCID: PMC9666097 DOI: 10.1097/md.0000000000031702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Staphylococcus aureus nasal colonization is a seriously opportunistic infection. However, there is a lack of research of relationship between antibiotics and S aureus colonization in the general population. Through a cross-sectional investigation, this study intends to establish the parameters related to S aureus nasal colonization, specifically the function antibiotics play in colonization. The key information from 2001 to 2004 was abstracted from National Health and Nutrition Examination Survey (NHANES), including information on general demographics, health care status, antibiotic prescription, diabetes, alcohol consumption, and tobacco smoke exposure. The participants colonized with methicillin-susceptible S aureus (MSSA), or methicillin-resistant S aureus (MRSA) were defined as the case group, and the control group was subjects without positive S aureus colonization. Univariate and multivariate logistic regression models were used to identify the variables associated with MSSA and MRSA colonization. The records of 18,607 individuals were included, involving 13,205 cases without S aureus colonization, 5195 cases with MSSA, and 207 cases with MRSA. In the multivariate logistic regression analysis, the risk of MSSA colonization was significantly reduced with fluoroquinolone use (75% risk reduction, P = .02), sulfonamide use (98% risk reduction, P < .01), tetracycline use (81% risk reduction, P < .01) and antibiotic combination therapy (risk reduction 76%, P < .01). Female, race and total household size were strongly associated with MSSA carriage. On the other hand, regarding MRSA colonization, fluoroquinolone use, long-term care, and former smoker were positively associated with MRSA colonization, while high income was negatively associated with MRSA colonization. More proper use of broad-spectrum antibiotics contributes to reducing MSSA colonization. Former smokers should also practice better personal hygiene to limit the possibility of MRSA colonization.
Collapse
Affiliation(s)
- Baixing Chen
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Shaoshuo Li
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Shi Lin
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Mingling Huang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Hang Dong
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
- Department of traumatology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
- *Correspondence: Hang Dong, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province 523900, China (e-mail: )
| |
Collapse
|
29
|
Dealing with Hidden Threats: The Antimicrobial Effect of the Embalming Process. Microorganisms 2022; 10:microorganisms10112180. [PMID: 36363772 PMCID: PMC9693414 DOI: 10.3390/microorganisms10112180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Individuals naturally carry bacteria and other microbes as part of their natural flora, with some being opportunistic pathogens. Approximately 30% of the population is known to carry Staphylococcus aureus in their nasal cavity, an organism that causes infections ranging from soft tissue abscesses to toxic shock syndrome. This problem is compounded by the presence of antibiotic-resistant strains such as Methicillin-Resistant Staphylococcus aureus (MRSA). Commensal bacteria present on cadavers pose a risk to those who handle the body. As a Medical School Anatomy laboratory that performs hands-on cadaveric dissection, we wanted to know whether the embalming process is sufficient to kill all commensal bacteria that pose a risk to staff and students. Even if these strains do not cause disease in these individuals, secondary transmission could occur to friends and family, who may be at higher risk of acquiring an infection. Embalming is assumed to eliminate all microbial contamination on the body. However, there are limited studies to confirm this. This study characterises the incidence of antibiotic sensitive and resistant bacteria in cadavers donated for medical teaching and research. We have screened for Methicillin-Resistant Organisms (MRO) and Extended-Spectrum Beta-Lactamase (ESBL) producing bacteria. In this study group of cadavers, approximately 46% (16/35) carry an MRO, while 51% (18/35) carry an ESBL positive organism prior to embalming. By determining the organisms’ presence pre- and post-embalming, we can evaluate the embalming procedure’s effectiveness. Our results show embalming eliminates detectable microbes in about 51% (18/35) of the cadavers. MRO dropped by 75% (16 to 4 positive cadavers), while ESBL organisms went down by almost 95% (from 18 to 1 positive cadaver). There was a further decrease in the number of positive cadavers after storage at 4 °C to 6% (2/32). Thus, although the embalming process does not immediately sterilise all the cadavers, prolonged storage at 4 °C can further reduce the number of viable bacteria.
Collapse
|
30
|
Popovich KJ, Weinstein RA. Questioning Old Staphylococcus aureus Beliefs With New Technology. J Infect Dis 2022; 227:1028-1030. [PMID: 36322783 DOI: 10.1093/infdis/jiac439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Kyle J Popovich
- Rush University Medical Center/Cook County Health, Section of Infectious Diseases, University Medical Center , Chicago, Illinois , USA
| | - Robert A Weinstein
- Rush University Medical Center/Cook County Health, Section of Infectious Diseases, University Medical Center , Chicago, Illinois , USA
| |
Collapse
|
31
|
McNeil JC, Joseph M, Sommer LM, Flores AR. Staphylococcus aureus Colonization in Healthy Children during the First Year of the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic. J Pediatr 2022; 249:101-105.e1. [PMID: 35772509 PMCID: PMC9235215 DOI: 10.1016/j.jpeds.2022.06.025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 01/05/2023]
Abstract
The early severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic was temporally associated with a reduction in many childhood infections, although the impact on bacterial colonization is unknown. We longitudinally assessed Staphylococcusaureus colonization prior to and through the first year of the pandemic. We observed a decline in methicillin-resistant Staphylococcus aureus colonization associated with SARS-CoV-2 prevention mandates.
Collapse
Affiliation(s)
- J Chase McNeil
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.
| | - Marritta Joseph
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX
| | - Lauren M Sommer
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX
| | - Anthony R Flores
- Division of Infectious Diseases, Department of Pediatrics, University of Texas Health Science Center, Houston, TX
| |
Collapse
|
32
|
Westgeest AC, Schippers EF, Sijbom M, Visser LG, de Boer MGJ, Numans ME, Lambregts MMC. Exploring the Barriers in the Uptake of the Dutch MRSA ‘Search and Destroy’ Policy Using the Cascade of Care Approach. Antibiotics (Basel) 2022; 11:antibiotics11091216. [PMID: 36139995 PMCID: PMC9495217 DOI: 10.3390/antibiotics11091216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/03/2022] [Accepted: 09/04/2022] [Indexed: 12/04/2022] Open
Abstract
The Dutch ‘search and destroy’ policy consists of screening patients with an increased risk of methicillin-resistant Staphylococcus aureus (MRSA) carriership and subsequent decolonization treatment when carriership is found. Decolonization therapy of individual MRSA carriers is effective. However, the effectiveness of the national ‘search and destroy’ policy is dependent on the entire cascade of care, including identification, referral, and subsequent treatment initiation in MRSA carriers. The aim of this study was to evaluate the leakages in the cascade of MRSA decolonization care. We assessed familiarity with the ‘search and destroy’ policy and the barriers in the uptake of MRSA eradication care using a questionnaire among 114 Dutch general practitioners. The main reasons for treatment were planned hospital visits, occupational reasons, and infections. The main reasons for refraining from eradication treatment were unfamiliarity with the ‘search and destroy’ policy and the assumption that MRSA carriership is often self-limiting. To optimize the continuity of the cascade of care, interventions should be aimed at supporting general practitioners and facilitating treatment and referral.
Collapse
Affiliation(s)
- Annette C. Westgeest
- Department of Infectious Diseases, Leiden University Medical Center, 2333 Leiden, The Netherlands
- Department of Internal Medicine, Haga Teaching Hospital, 2545 The Hague, The Netherlands
| | - Emile F. Schippers
- Department of Infectious Diseases, Leiden University Medical Center, 2333 Leiden, The Netherlands
- Department of Internal Medicine, Haga Teaching Hospital, 2545 The Hague, The Netherlands
| | - Martijn Sijbom
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Leo G. Visser
- Department of Infectious Diseases, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Mark G. J. de Boer
- Department of Infectious Diseases, Leiden University Medical Center, 2333 Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Mattijs E. Numans
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Merel M. C. Lambregts
- Department of Infectious Diseases, Leiden University Medical Center, 2333 Leiden, The Netherlands
- Correspondence:
| | | |
Collapse
|
33
|
Scapoli L, Palmieri A, Pellati A, Carinci F, Lauritano D, Arcuri C, Baggi L, Gatto R, Martinelli M. Prevalence of Staphylococcus aureus and mec-A Cassette in the Throat of Non-Hospitalized Individuals Randomly Selected in Central Italy. Antibiotics (Basel) 2022; 11:antibiotics11070949. [PMID: 35884203 PMCID: PMC9312079 DOI: 10.3390/antibiotics11070949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 12/04/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a cause of life-threatening infections that are difficult to treat because of resistance to several antibiotics. Most documented MRSA infections are acquired nosocomially or among community with frequent contact with health facilities. However, an increasing attention to community acquired MRSA strains appears justified. A population of Central Italy was investigated for the presence of S. aureus and for the methicillin-resistance determinant mec-A gene. Exclusion was due to systemic diseases, pathologies or therapies inducing systemic immunosuppression, facial trauma or poor oral hygiene. Throat swabs obtained from 861 randomly selected participants were tested for the presence of DNA sequences of S. aureus and the mec-A gene by real-time PCR. The DNA of S. aureus was detected in 199 specimens (23.1%), while the mec-A gene was detected in 27 samples (3.1%). The prevalence of patients carrying methicillin-resistant strains was higher in younger and older strata. The prevalence of mec-A among S. aureus positive samples was 7.5%. Our data confirm that S. aureus and methicillin-resistant strains are common in the throat of the general population of Central Italy. Although the PCR methods used in this study are different from traditional culture-based approaches, the observed prevalence was consistent to those observed in Italians and other populations. Considering that carriers have a higher risk to develop post surgically life-threatening infections, it is worth evaluating a preventive approach based on rapid PCR screening of incoming patients to reduce the risk of developing health-care-associated infections.
Collapse
Affiliation(s)
- Luca Scapoli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy; (L.S.); (M.M.)
| | - Annalisa Palmieri
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy; (L.S.); (M.M.)
- Correspondence:
| | - Agnese Pellati
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (A.P.); (F.C.); (D.L.)
| | - Francesco Carinci
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (A.P.); (F.C.); (D.L.)
| | - Dorina Lauritano
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (A.P.); (F.C.); (D.L.)
| | - Claudio Arcuri
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00113 Rome, Italy; (C.A.); (L.B.)
| | - Luigi Baggi
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00113 Rome, Italy; (C.A.); (L.B.)
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, School of Dentistry, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Marcella Martinelli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy; (L.S.); (M.M.)
| |
Collapse
|
34
|
Adediran T, Hitchcock S, O’Hara LM, Michalski JM, Johnson JK, Calfee DP, Miller LG, Hazen TH, Harris AD, Rasko DA. Comparative Genomics Identifies Features Associated with Methicillin-Resistant Staphylococcus aureus (MRSA) Transmission in Hospital Settings. mSphere 2022; 7:e0011622. [PMID: 35578992 PMCID: PMC9241550 DOI: 10.1128/msphere.00116-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/03/2022] [Indexed: 01/28/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health concern in the United States. Patients colonized and/or infected can transmit MRSA to healthcare workers and subsequent patients However, the components of this transmission chain are just becoming evident, including certain patient factors, specific patient-healthcare worker interactions, and microbial factors. We conducted a comparative genomic analysis of 388 isolates from four hospitals in three states: Maryland, California, and New York. Isolates from nasal surveillance or clinical cultures were categorized as high, moderate, or low transmission surrogate outcomes based on the number of times the species was identified on the gloves or gowns of healthcare providers. The comparative analyses included a single gene, multigene, and core genome phylogenetic analysis, as well as a genome-wide association analysis to identify molecular signatures associated with the observed transmission surrogate outcomes, geographic origin, or sample source of isolation. Based on the phylogenetic analysis, 95% (n = 372) of the MRSA isolates were from four well-described genomic clades, with most of the isolates being part of the USA300 containing clade (n = 187; 48%). Genome-wide association studies also identified genes that were exclusive or prevalent among specific geographic locations. The identified genes provide insights into the transmission dynamics of MRSA isolates providing additional insights into the basis of the geographical differences of MRSA for molecular diagnostics. IMPORTANCE Methicillin-resistant Staphylococcus aureus (MRSA) is considered a serious threat to public health and contributes to the dissemination of S. aureus in both the healthcare and community setting. Transmission of MRSA between patients via healthcare worker (HCW) has been described. However, what is not understood are the genetic determinants that contribute to the transmission of MRSA from patients to HCWs. In this study, we demonstrated that certain genes may be associated with transmission in the hospital setting.
Collapse
Affiliation(s)
- Timileyin Adediran
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Stephanie Hitchcock
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Lyndsay M. O’Hara
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jane M. Michalski
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - J. Kristie Johnson
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - David P. Calfee
- Division of Infectious Diseases, Weill Cornell Medicine, New York, USA
| | - Loren G. Miller
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California, USA
| | - Tracy H. Hazen
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Anthony D. Harris
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - David A. Rasko
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
35
|
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.
Collapse
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
| |
Collapse
|
36
|
Poyraz O, Sater MRA, Miller LG, McKinnell JA, Huang SS, Grad YH, Marttinen P. Modelling methicillin-resistant Staphylococcus aureus decolonization: interactions between body sites and the impact of site-specific clearance. J R Soc Interface 2022; 19:20210916. [PMID: 35702866 PMCID: PMC9198502 DOI: 10.1098/rsif.2021.0916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) can colonize multiple body sites, and carriage is a risk factor for infection. Successful decolonization protocols reduce disease incidence; however, multiple protocols exist, comprising diverse therapies targeting multiple body sites, and the optimal protocol is unclear. Standard methods cannot infer the impact of site-specific components on successful decolonization. Here, we formulate a Bayesian coupled hidden Markov model, which estimates interactions between body sites, quantifies the contribution of each therapy to successful decolonization, and enables predictions of the efficacy of therapy combinations. We applied the model to longitudinal data from a randomized controlled trial (RCT) of an MRSA decolonization protocol consisting of chlorhexidine body and mouthwash and nasal mupirocin. Our findings (i) confirmed nares as a central hub for MRSA colonization and nasal mupirocin as the most crucial therapy and (ii) demonstrated all components contributed significantly to the efficacy of the protocol and the protocol reduced self-inoculation. Finally, we assessed the impact of hypothetical therapy improvements in silico and found that enhancing MRSA clearance at the skin would yield the largest gains. This study demonstrates the use of advanced modelling to go beyond what is typically achieved by RCTs, enabling evidence-based decision-making to streamline clinical protocols.
Collapse
Affiliation(s)
- Onur Poyraz
- Department of Computer Science, Aalto University School of Science, Aalto, Finland
| | - Mohamad R A Sater
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Loren G Miller
- Division of Infectious Diseases, Lundquist Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - James A McKinnell
- Division of Infectious Diseases, Lundquist Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Susan S Huang
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Yonatan H Grad
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Pekka Marttinen
- Department of Computer Science, Aalto University School of Science, Aalto, Finland
| |
Collapse
|
37
|
Cella E, Sutcliffe CG, Tso C, Paul E, Ritchie N, Colelay J, Denny E, Grant LR, Weatherholtz RC, Hammitt LL, Azarian T. Carriage prevalence and genomic epidemiology of Staphylococcus aureus among Native American children and adults in the Southwestern USA. Microb Genom 2022; 8. [PMID: 35551692 PMCID: PMC9465076 DOI: 10.1099/mgen.0.000806] [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] [Indexed: 11/18/2022] Open
Abstract
Native American individuals in the Southwestern USA experience a higher burden of invasive Staphylococcus aureus disease than the general population. However, little is known about S. aureus carriage in these communities. A cross-sectional study was conducted to determine the carriage prevalence, risk factors and genomic epidemiology of S. aureus among Native American children (<5 years, n=121) and adults (≥18 years, n=167) in the Southwestern USA. Short- and long-read sequencing data were generated using Illumina and Oxford Nanopore Technology platforms to produce high-quality hybrid assemblies, and antibiotic-resistance, virulence and pangenome analyses were performed. S. aureus carriage prevalence was 20.7 % among children, 30.2 % among adults 18–64 years and 16.7 % among adults ≥65 years. Risk factors among adults included recent surgery, prior S. aureus infection among household members, and recent use of gyms or locker rooms by household members. No risk factors were identified among children. The bacterial population structure was dominated by clonal complex 1 (CC1) (21.1 %), CC5 (22.2 %) and CC8 (22.2 %). Isolates from children and adults were intermixed throughout the phylogeny. While the S. aureus population was diverse, the carriage prevalence was comparable to that in the general USA population. Genomic and risk-factor data suggest household, community and healthcare transmission are important components of the local epidemiology.
Collapse
Affiliation(s)
- Eleonora Cella
- University of Central Florida, 4110 Libra Drive, Orlando, FL 32816, USA
| | - Catherine G Sutcliffe
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Carol Tso
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Ella Paul
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Nina Ritchie
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Janene Colelay
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Estar Denny
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Lindsay R Grant
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA.,Present address: Global Pneumococcal Vaccines, Scientific Affairs and Epidemiology, Pfizer Inc, USA
| | - Robert C Weatherholtz
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Laura L Hammitt
- Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, USA
| | - Taj Azarian
- University of Central Florida, 4110 Libra Drive, Orlando, FL 32816, USA
| |
Collapse
|
38
|
R. Borgogna T, M. Voyich J. Examining the Executioners, Influenza Associated Secondary Bacterial Pneumonia. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.101666] [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: 11/08/2022] Open
Abstract
Influenza infections typically present mild to moderate morbidities in immunocompetent host and are often resolved within 14 days of infection onset. Death from influenza infection alone is uncommon; however, antecedent influenza infection often leads to an increased susceptibility to secondary bacterial pneumonia. Bacterial pneumonia following viral infection exhibits mortality rates greater than 10-fold of those of influenza alone. Furthermore, bacterial pneumonia has been identified as the major contributor to mortality during each of the previous four influenza pandemics. Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pyogenes are the most prevalent participants in this pathology. Of note, these lung pathogens are frequently found as commensals of the upper respiratory tract. Herein we describe influenza-induced host-changes that lead to increased susceptibility to bacterial pneumonia, review virulence strategies employed by the most prevalent secondary bacterial pneumonia species, and highlight recent findings of bacterial sensing and responding to the influenza infected environment.
Collapse
|
39
|
Dreyfuss I, Ramnot A, Jean-Pierre PH, French F, Hernandez L, Nouri K. Review of the Current Antibiotic Guidelines used in Dermatologic Surgery. Dermatol Ther 2022; 35:e15557. [PMID: 35524368 DOI: 10.1111/dth.15557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/17/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Abstract
Antibiotics have been used as a prophylaxis for dermatologic procedures. We will review the various procedures that specific antibiotics with dosages are used for, depending on the procedure, diagnosis, and circumstance of the patient. We will examine the current and updated guidelines used in dermatologic surgery and the overlapping guidelines across other fields. Physicians must consider the side effects of antibiotics and the resistance that may occur as a result before using the class or level of prophylaxis. Initial evaluation for alcohol, chlorhexidine or iodine should be measured as well. Updated guidelines aim to address the contraindications of antibiotics, yet further research is needed to avoid antibiotic resistance and to explore alternative methods of antibiotic application, such as intranasal and intravenous. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Isabella Dreyfuss
- Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine
| | - Amanda Ramnot
- Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine
| | - Philippe H Jean-Pierre
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine
| | - Fabio French
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine
| | - Loren Hernandez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine
| | - Keyvan Nouri
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine
| |
Collapse
|
40
|
Jaiswal R, Garg A, Tripathi P, Venkatesh V. Epidemiology of Panton Valentine Leukocidin in clinical Staphylococcus aureus isolates - A prospective study at a tertiary care centre in North India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
41
|
Everybody nose: molecular and clinical characteristics of nasal colonization during active methicillin-resistant Staphylococcus aureus bloodstream infection. BMC Infect Dis 2022; 22:400. [PMID: 35462538 PMCID: PMC9036699 DOI: 10.1186/s12879-022-07371-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Healthcare-associated infections pose a potentially fatal threat to patients worldwide and Staphylococcus aureus is one of the most common causes of healthcare-associated infections. S. aureus is a common commensal pathogen and a frequent cause of bacteremia, with studies demonstrating that nasal and blood isolates from single patients match more than 80% of the time. Here we report on a contemporary collection of colonizing isolates from those with methicillin-resistant S. aureus (MRSA) bloodstream infections to evaluate the diversity within hosts, and detail the clinical features associated with concomitant nasal colonization.
Methods
Swabs of the bilateral anterior nares were obtained from patients diagnosed with MRSA bacteremia. A single colony culture from the blood and an average of 6 colonies from the nares were evaluated for MRSA growth. For the nares cultures, we typed multiple isolates for staphylococcal protein A (spa) and derived the clonal complexes. Demographic and clinical data were obtained retrospectively from the electronic medical record system and analysed using univariate and multivariable regression models.
Results
Over an 11-month period, 68 patients were diagnosed with MRSA bloodstream infection, 53 were swabbed, and 37 (70%) were colonized with MRSA in the anterior nares. We performed molecular typing on 213 nasal colonies. Spa types and clonal complexes found in the blood were also detected in the nares in 95% of the cases. We also found that 11% of patients carried more than one clone of MRSA in the nares. Male sex and history of prior hospitalization within the past 90 days increased odds for MRSA colonization.
Conclusion
The molecular epidemiological landscape of colonization in the setting of invasive disease is diverse and defining the interplay between colonization and invasive disease is critical to combating invasive MRSA disease.
Collapse
|
42
|
Ong ZX, Kannan B, Becker DL. Exploiting transposons in the study of Staphylococcus aureus pathogenesis and virulence. Crit Rev Microbiol 2022; 49:297-317. [PMID: 35438613 DOI: 10.1080/1040841x.2022.2052794] [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: 11/03/2022]
Abstract
The opportunistic pathogen Staphylococcus aureus has an extremely complex relationship with humans. While the bacteria can exist as a commensal in many, it can cause a wide range of diseases and infections when turned pathogenic. Its presence is a determinant of chronicity and poor prognosis in numerous diseases, and its genomic plasticity causes S. aureus antimicrobial resistance to be one of the most dire contemporary medical problems to solve. Genetic manipulation of S. aureus has led to numerous findings that are vital in the fight against its pathogenesis. The utilisation of transposon mutant libraries for the systematic inspection of the S. aureus genome led to many landmark discoveries pertaining to the bacteria's pathogenicity, antimicrobial resistance acquisition, and virulence regulation. In this review, we describe mutant libraries, and their significant contributions, from various S. aureus strains created with commonly used transposons. The general workflow for the construction of libraries will be presented, along with a discussion of the challenges of undertaking the task of large-scale library construction. As the accessibility of transposon mutant library construction, screening, and analysis increases, this genetic tool could be further exploited in the study of the S. aureus genome.
Collapse
Affiliation(s)
- Zi Xin Ong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Skin Research Institute, Singapore.,Nanyang Institute of Technology in Health and Medicine, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore
| | - Bavani Kannan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Skin Research Institute, Singapore
| | - David L Becker
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Skin Research Institute, Singapore
| |
Collapse
|
43
|
Morizane A, Uehara Y, Kitamura S, Komori M, Matsushita M, Takeuchi S, Seo H. Staphylococcus aureus
nasal colonization increases the risk of cedar pollinosis. J Gen Fam Med 2022; 23:172-176. [PMID: 35509329 PMCID: PMC9062552 DOI: 10.1002/jgf2.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background One‐third of the people in Japan are colonized with Staphylococcus aureus (S. aureus) and suffer from virulence factor‐mediated subclinical inflammation of the nares. We investigated whether subclinical inflammation contributed to cedar pollinosis affecting 20 million people annually. Methods The study participants were 814 inhabitants of the A or B prefectures. We compared the colonization rate and population structure of S. aureus, in association with the prevalence of cedar pollinosis, between participants in these two areas. Results A prefecture had twice the annual amount of airborne cedar pollen compared with B. The prevalence of cedar pollinosis was significantly higher in A (23.5%) than in B (13.1%) (p = 0.0004). Moreover, the prevalence of cedar pollinosis was higher in female participants (23.3%) than in male participants (14.7%) (p = 0.003). In addition, the prevalence of cedar pollinosis was higher in S. aureus carriers (24.2%) than in S. aureus noncarriers (17.9%) (p = 0.03). The isolation rate of clonal complex (CC) 508 was higher in the A group (21%) than in the B group (7%) (p = 0.015). Conclusion Nasal colonization of S. aureus is a major risk factor for cedar pollinosis. However, the direct mechanism of this risk is currently unknown. The prevalence of cedar pollinosis in the research area was proportional to the amount of cedar pollen. The prevalence of cedar pollinosis was higher in S. aureus carriers (24.2%) than in S. aureus noncarriers (17.9%) (p = 0.03). The prevalence of cedar pollinosis was higher in female participants (23.3%) than in male participants (14.7%) (p = 0.003).
Collapse
Affiliation(s)
- Atsushi Morizane
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| | - Yoshio Uehara
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| | - Satoko Kitamura
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| | - Masahiro Komori
- Department of Otolaryngology Kochi Medical School Nankoku Japan
| | | | - Seisho Takeuchi
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| | - Hiromi Seo
- Department of General Medicine Kochi Medical School Hospital Nankoku Japan
| |
Collapse
|
44
|
Increased dietary manganese impairs NET formation rendering neutrophils ineffective at combating Staphylococcus aureus. Infect Immun 2022; 90:e0068521. [PMID: 35191757 DOI: 10.1128/iai.00685-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dietary metals can modify the risk to infection. Previously, we demonstrated that heightened dietary manganese (Mn) during systemic Staphylococcus aureus infection increases S. aureus virulence. However, immune cells also operate in these same environments and the effect of dietary Mn on neutrophil function in vivo has not been assessed. This study reveals that increased concentrations of Mn impairs mitochondrial respiration and superoxide production in neutrophils responding to S. aureus. As a result, high Mn accelerates primary degranulation, while impairing suicidal neutrophil extracellular trap (NET) formation, which decreases bactericidal activity. In vivo, elevated dietary Mn accumulated extracellularly in the heart, indicating that excess Mn may be more bioavailable in the heart. Coinciding with this phenotype, neutrophil function in the heart was most impacted by a high Mn diet, as neutrophils produced lower levels of mitochondrial superoxide and underwent less suicidal NET formation. Consistent with an ineffective neutrophil response when mice are on a high Mn diet, S. aureus burdens were increased in the heart and mice were more susceptible to systemic infection. Therefore, elevated dietary Mn not only affects S. aureus but also renders neutrophils less capable of restricting staphylococcal infection.
Collapse
|
45
|
Hatcher JB, de Castro-Abeger A, LaRue RW, Hingorani M, Mawn L, Donahue SP, Sternberg P, Shieh C. MRSA Decolonization and the Eye: A Potential New Tool for Ophthalmologists. Semin Ophthalmol 2022; 37:541-553. [DOI: 10.1080/08820538.2022.2039220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Jeremy B Hatcher
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Alex de Castro-Abeger
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Richard W LaRue
- Department of Medicine, Division of Infectious Disease, Vanderbilt Medical Center, Nashville, TN, United States
| | - Melanie Hingorani
- Department of Paediatrics, Moorfields Eye Hospital, NHS Foundation Trust, London, UK
| | - Louise Mawn
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Sean P Donahue
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Paul Sternberg
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Christine Shieh
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, United States
| |
Collapse
|
46
|
Popovich KJ, Thiede SN, Zawitz C, Payne D, Aroutcheva A, Schoeny M, Green SJ, Snitkin ES, Weinstein RA. Genomic Analysis of Community Transmission Networks for MRSA among Females Entering a Large Inner-City Jail. Open Forum Infect Dis 2022; 9:ofac049. [PMID: 35211635 PMCID: PMC8863081 DOI: 10.1093/ofid/ofac049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/25/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It is unclear if there are differences in MRSA risk between sexes in high-risk populations.
Methods
Females incarcerated at the Cook County Jail were enrolled within 72 hours of intake. Surveillance cultures (nares, throat, groin) were collected to determine prevalence of MRSA colonization. A survey was administered to identify colonization predictors. Univariate and multivariate analyses were performed to identify predictors of colonization at intake. Genomic sequencing was performed on MRSA colonization and archived clinical isolates.
Results
250 women were enrolled (70% AA, 15% Hispanic) with 70% previously in jail. The prevalence of MRSA colonization at intake was 20%, with 42% of those colonized solely in the throat or groin. Univariate predictors of MRSA colonization at entrance were illicit drug use, unstable housing, engaging in anal sex, recent exchange of sex for drugs/money, and a higher number of recent sexual partners. With multivariate adjustment for race/ethnicity, use of needles for illicit drugs was a significant predictor of MRSA. Use of illicit drugs was also associated with inclusion in a genomic cluster.
Nares colonization was significantly associated with not being in a genomic cluster (18.8% vs 78.6%, p<0.001), whereas exclusive extra-nasal colonization was associated (OR 15.89, p<0.001).
Conclusion
We found that a high proportion (20%) of females entered jail colonized with MRSA, suggesting that previously reported sex disparities of a lower risk in women may not apply to high-risk populations. Our findings suggest high-risk activities or venues in the community for MRSA, with potential for directing sex-specific interventions.
Collapse
Affiliation(s)
- Kyle J Popovich
- Rush University Medical Center/Cook County Health, Chicago, IL, USA
| | | | - Chad Zawitz
- Cermak Health Services, Cook County Health, Chicago, IL, USA
| | - Darjai Payne
- Rush University Medical Center, Chicago, IL, USA
| | - Alla Aroutcheva
- Rush University Medical Center/Cook County Health, Chicago, IL, USA
| | | | | | | | | |
Collapse
|
47
|
Matsumoto M, Kozakai M, Furuta RA, Matsubayashi K, Satake M. Association of Staphylococcus aureus in platelet concentrates with skin diseases in blood donors: Limitations of cultural bacterial screening. Transfusion 2022; 62:621-632. [PMID: 35045189 DOI: 10.1111/trf.16804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Bacterial contamination in platelet concentrates (PCs) is a major problem in transfusion medicine. Contamination with Staphylococcus aureus is occasionally missed, even with cultural screening. STUDY DESIGN AND METHODS Donors implicated in S. aureus-contaminated PC were followed up. Skin and nasal swab specimens from six donors and S. aureus isolated from PCs related to these donors were subjected to multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) to determine the identity of bacteria. To evaluate the validity of the screening method using BacT/ALERT 3D, we spiked S. aureus and three other bacterial species as comparisons into PCs and investigated their growth pattern. RESULTS S. aureus was isolated from all nasal specimens and from the arm skin specimens of three donors with atopic dermatitis. In all cases, the S. aureus strains isolated from the PC and those from the nasal and skin specimens of the same donor showed concordant results using MLST and PFGE. In the spiking study, S. aureus showed irregular detectability over 24 to 48 h post-spike periods, whereas the three other bacterial species were detected in all culture bottles after a 24-h post-spike period. DISCUSSION The strain identity of S. aureus between donor and PC suggests that the contaminants were derived from those colonized in the donor. Furthermore, S. aureus yielded false-negative results using BacT/ALERT 3D.
Collapse
Affiliation(s)
- Mami Matsumoto
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Moe Kozakai
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Rika A Furuta
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Keiji Matsubayashi
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Masahiro Satake
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| |
Collapse
|
48
|
Valverde Villar AM, Gutiérrez Del Álamo Oms J, Neira Borrajo I, de Miguel Fernández S, Flox Benítez P, Llopis Miró R. Screening of MRSA colonization in patients undergoing total joint arthroplasty. J Infect Prev 2021; 22:283-288. [PMID: 34880951 DOI: 10.1177/17571774211013410] [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: 03/07/2020] [Accepted: 04/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Periprosthetic infection is commonly caused by Staphylococcus aureus and, if resistant to methicillin (MRSA), is associated with increase in severity and costs to patient and healthcare systems. MRSA colonizes 1-5% of the population, therefore using a screening and decolonisation protocol the risk of periprosthetic infection could be reduced. The objective of our study is to report the results of a preoperative MRSA screening and management protocol utilised at our hospital. Methods All patients undergoing a total joint arthroplasty at our hospital were preoperatively screened for MRSA colonization with swab samples of five different locations. Exposure to risk factors were investigated in colonised patients and they were treated for 5 days prior surgery with nasal mupirocin, chlorhexidine sponges and oral tablets. Results During the 48 months of the study, MRSA colonisation was identified in 22 (1.01%) of 2188 patients operated. The culture was positive only in the nasal swab in 55 patients. In five patients the nasal culture was negative, but they had another positive swab culture (three in the groin and two perianal). None of the patients reported a history of recent antibiotic treatment or hospitalization. Conclusion At our institution, the prevalence of MRSA colonisation is 1.01% in patients undergoing hip and knee arthroplasty. Interestingly, our screening protocol included samples from five different anatomic locations, and it is important to highlight that we found patients with negative nares culture and positive cultures in other locations. Therefore, the number of carriers may be underdiagnosed if only nasal samples are obtained. Level of evidence IV.
Collapse
Affiliation(s)
- A M Valverde Villar
- Department of Orthopaedic Surgery, Hospital Universitario Santa Cristina, Madrid, Spain
| | | | - I Neira Borrajo
- Department of Orthopaedic Surgery, Hospital Universitario Santa Cristina, Madrid, Spain
| | - S de Miguel Fernández
- Department of Clinical Analysis, Hospital Universitario Santa Cristina, Madrid, Spain
| | - P Flox Benítez
- Department of Pharmacy, Hospital Universitario Santa Cristina, Madrid, Spain
| | - R Llopis Miró
- Department of Orthopaedic Surgery, Hospital Universitario Santa Cristina, Madrid, Spain
| |
Collapse
|
49
|
Smith RM, Lautenbach E, Omulo S, Araos R, Call DR, Kumar GCP, Chowdhury F, McDonald CL, Park BJ. Human Colonization With Multidrug-Resistant Organisms: Getting to the Bottom of Antibiotic Resistance. Open Forum Infect Dis 2021; 8:ofab531. [PMID: 34805441 DOI: 10.1093/ofid/ofab531] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/14/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Rachel M Smith
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ebbing Lautenbach
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sylvia Omulo
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, USA
| | - Rafael Araos
- Instituto de Ciencias e Innovación en Medicina Universidad del Desarrollo, Santiago, Chile
| | - Douglas R Call
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, USA
| | | | | | | | - Benjamin J Park
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
50
|
Abstract
Rhinoplasty is widely regarded as one of the more technically challenging surgeries, owing in part to the many possible short- and long-term complications that can arise. Although severe complications are uncommon, unforeseen complications can lead to esthetic and functional compromise, patient dissatisfaction, and need for revision surgery. The rhinoplasty surgeon must be prepared to counsel patients and identify and manage the range of complications that may result from this procedure. This article reviews some of the most frequently encountered complications related to rhinoplasty and their management approaches.
Collapse
Affiliation(s)
- Danielle F Eytan
- Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, 222 E 41st Street, 8th. Floor, New York, NY 10017, USA.
| | - Tom D Wang
- Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, SJH01, Portland, OR 97239, USA
| |
Collapse
|