1
|
Moue I, Shimoda M, Kokutou H, Hanawa T, Tanaka Y. Community-Acquired Methicillin-Resistant Staphylococcus aureus Strain Positive for the Panton-Valentine Leucocidin Gene in a Middle-Aged Patient With Multiple Septic Pulmonary Emboli. Cureus 2024; 16:e56243. [PMID: 38623107 PMCID: PMC11016984 DOI: 10.7759/cureus.56243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/17/2024] Open
Abstract
A 59-year-old man suffered from fever and chest pain for three days following an accidental bite to a lip ulcer. His lower lip showed swelling and tenderness, and chest computed tomography showed multiple bilateral nodules. He was diagnosed with septic pulmonary embolism and a lip abscess, and blood, sputum, and lip abscess cultures confirmed the presence of methicillin-resistant Staphylococcus aureus (MRSA). Despite the initiation of vancomycin, he rapidly developed respiratory failure and septic shock, necessitating intubation and noradrenaline support. Gentamicin was added on the seventh day of admission due to an insufficient effect, and vancomycin was switched to linezolid on the 14th day of admission. However, his respiratory failure persisted as bilateral pneumothorax developed. Blood culture was negative on the 14th day after admission, but the patient died on the 15th day after admission. The MRSA isolate was tested for the presence of the Panton-Valentine leukocidin (PVL) gene in conjunction with the USA300 strain. The prevalence of community-acquired (CA)-MRSA in the USA300 clone is increasing but still low in Japan, and this type of infection is commonly observed in people of all ages; this case is the first instance reported in Japan of a middle-aged patient with septic pulmonary embolism. Given the anticipated global increase in CA-MRSA infection caused by the USA300 clone and the emergence of USA300 with altered pathogenicity, it may be crucial to suspect PVL-positive CA-MRSA infections even in middle-aged or elderly patients presenting with septic pulmonary embolism as community infections.
Collapse
Affiliation(s)
- Iori Moue
- Respiratory Disease Center, Fukujuji Hospital, Kiyose, JPN
| | | | | | - Tomoko Hanawa
- Department of General Medicine, Kyorin University Faculty of Medicine, Mitaka, JPN
| | | |
Collapse
|
2
|
Parente R, Fumagalli MR, Di Claudio A, Cárdenas Rincón CL, Erreni M, Zanini D, Iapichino G, Protti A, Garlanda C, Rusconi R, Doni A. A Multilayered Imaging and Microfluidics Approach for Evaluating the Effect of Fibrinolysis in Staphylococcus aureus Biofilm Formation. Pathogens 2023; 12:1141. [PMID: 37764949 PMCID: PMC10534389 DOI: 10.3390/pathogens12091141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
The recognition of microbe and extracellular matrix (ECM) is a recurring theme in the humoral innate immune system. Fluid-phase molecules of innate immunity share regulatory roles in ECM. On the other hand, ECM elements have immunological functions. Innate immunity is evolutionary and functionally connected to hemostasis. Staphylococcus aureus (S. aureus) is a major cause of hospital-associated bloodstream infections and the most common cause of several life-threatening conditions such as endocarditis and sepsis through its ability to manipulate hemostasis. Biofilm-related infection and sepsis represent a medical need due to the lack of treatments and the high resistance to antibiotics. We designed a method combining imaging and microfluidics to dissect the role of elements of the ECM and hemostasis in triggering S. aureus biofilm by highlighting an essential role of fibrinogen (FG) in adhesion and formation. Furthermore, we ascertained an important role of the fluid-phase activation of fibrinolysis in inhibiting biofilm of S. aureus and facilitating an antibody-mediated response aimed at pathogen killing. The results define FG as an essential element of hemostasis in the S. aureus biofilm formation and a role of fibrinolysis in its inhibition, while promoting an antibody-mediated response. Understanding host molecular mechanisms influencing biofilm formation and degradation is instrumental for the development of new combined therapeutic approaches to prevent the risk of S. aureus biofilm-associated diseases.
Collapse
Affiliation(s)
- Raffaella Parente
- Multiscale ImmunoImaging Unit (mIIu), IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Maria Rita Fumagalli
- Multiscale ImmunoImaging Unit (mIIu), IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Alessia Di Claudio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
| | - Cindy Lorena Cárdenas Rincón
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
| | - Marco Erreni
- Multiscale ImmunoImaging Unit (mIIu), IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
| | - Damiano Zanini
- Multiscale ImmunoImaging Unit (mIIu), IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Giacomo Iapichino
- Department of Anesthesia and Intensive Care Units, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Alessandro Protti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
- Department of Anesthesia and Intensive Care Units, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Cecilia Garlanda
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Roberto Rusconi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| | - Andrea Doni
- Multiscale ImmunoImaging Unit (mIIu), IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
| |
Collapse
|
3
|
Frost I, Van Boeckel TP, Pires J, Craig J, Laxminarayan R. Global geographic trends in antimicrobial resistance: the role of international travel. J Travel Med 2019; 26:5496989. [PMID: 31115466 DOI: 10.1093/jtm/taz036] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Rising antimicrobial resistance (AMR) is a threat to modern medicine, and increasing international mobility facilitates the spread of AMR. Infections with resistant organisms have higher morbidity and mortality, are costlier to treat, result in longer hospital stays and place a greater burden on health systems than infections caused by susceptible organisms. Here we review the role of travel in the international dissemination of AMR and consider actions at the levels of travelers, travel medicine practitioners and policymakers that would mitigate this threat. RESULTS Resistant pathogens do not recognize international borders; travelers to areas with high AMR prevalence are likely to be exposed to resistant bacteria and return to their home countries colonized. Medical tourists go between health facilities with drastically different rates of AMR, potentially transmitting highly resistant strains.Drug-resistant bacteria have been found in every continent; however, differences between countries in the prevalence of AMR depend on multiple factors. These include levels of antibiotic consumption (including inappropriate use), access to clean water, adequate sanitation, vaccination coverage, the availability of quality healthcare and access to high-quality medical products. CONCLUSIONS Travelers to areas with high levels of AMR should have vaccines up to date, be aware of ways of treating and preventing travelers' diarrhea (other than antibiotic use) and be informed on safe sexual practices. The healthcare systems of low- and middle-income countries require investment to reduce the transmission of resistant strains by improving access to clean water, sanitation facilities and vaccines. Efforts are needed to curb inappropriate antibiotic use worldwide. In addition, more surveillance is needed to understand the role of the movement of humans, livestock and food products in resistance transmission. The travel medicine community has a key role to play in advocating for the recognition of AMR as a priority on the international health agenda. KEY POLICY RECOMMENDATIONS AMR is a threat to modern medicine, and international travel plays a key role in the spread of highly resistant strains. It is essential that this is addressed at multiple levels. Individual travelers can reduce antibiotic consumption and the likelihood of infection. Travelers should have up-to-date vaccines and be informed on methods of preventing and treating travelers' diarrhea, other than use of antibiotics and on safe sexual practices, such as condom use. Healthcare facilities need to be aware of the travel history of patients to provide appropriate treatment to those who are at high risk of exposure and to prevent further spread. Internationally, in countries without reliable and universal access to clean water, sanitation and hygiene, investment is needed to reduce the emergence and spread of resistance and ensure the antimicrobials available are of assured quality. High-income countries must ensure their use of antimicrobials is appropriate to reduce selection for AMR. Surveillance across all countries is needed to monitor and respond to this emerging threat.
Collapse
Affiliation(s)
- Isabel Frost
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Amity Institute of Public Health, Amity University, Noida, India
| | - Thomas P Van Boeckel
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Swiss Federal Institute of Technology Zurich, Department of Earth Systems Science, Institute for Integrative Biology, ETH Zurich, Zurich, Switzerland
| | - João Pires
- Swiss Federal Institute of Technology Zurich, Department of Earth Systems Science, Institute for Integrative Biology, ETH Zurich, Zurich, Switzerland
| | - Jessica Craig
- Center for Disease Dynamics, Economics & Policy, New Delhi, India
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Princeton Environmental Institute, Princeton University, New Jersey, USA
| |
Collapse
|
4
|
Murai T, Okazaki K, Kinoshita K, Uehara Y, Zuo H, Lu Y, Ono Y, Sasaki T, Hiramatsu K, Horikoshi Y. Comparison of USA300 with non-USA300 methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Int J Infect Dis 2018; 79:134-138. [PMID: 30503654 DOI: 10.1016/j.ijid.2018.11.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/25/2018] [Accepted: 11/26/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Reports of USA300 methicillin-resistant Staphylococcus aureus (MRSA) strain were still scarce in neonatal intensive care units (NICUs) and the relationship of USA300 MRSA to clinical infections is still controversial. The primary outcome was the incidence of MRSA infections caused by the USA300 and non-USA300 strains at a NICU in Japan. METHODS This retrospective cohort study was conducted between November 2011 and October 2016 at Tokyo Metropolitan Children's Medical Center in Japan. All MRSA isolated after 48h of hospitalization were included for analysis by pulsed-field gel electrophoresis (PFGE) using the standard USA300 strain. Genes were tested for Panton-Valentine leukocidin (PVL) and arginine catabolic mobile element (ACME). A whole genome sequence was performed for representative isolates of USA300. RESULTS In total, 109 MRSA isolates were included for analysis. PFGE classified 34 and 75 isolates of USA300 and non-USA300 MRSA, respectively. Both PVL and ACME genes were detected in USA300 and non-USA300 strains at rate of 100% (34/34) and 5.3% (4/75), respectively (P<0.05). There was no statistically significant difference in the proportion of clinical diseases between USA- 300 and non-USA 300 strains. CONCLUSIONS Infants with USA300 MRSA infection did not differ significantly from those with non-USA300 MRSA infection.
Collapse
Affiliation(s)
- Takemi Murai
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
| | - Kaoru Okazaki
- Division of Neonatology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Kazue Kinoshita
- Division of Molecular Laboratory, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Yuki Uehara
- Department of Infection Control Science, Juntendo University, Graduate School of Medicine, Tokyo, Japan; Department of General Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Hui Zuo
- Department of Infection Control Science, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Yujie Lu
- Department of Infection Control Science, Juntendo University, Graduate School of Medicine, Tokyo, Japan; Department of General Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Yuki Ono
- Department of Infection Control Science, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Takashi Sasaki
- Infection Control Science Research Center, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Keiichi Hiramatsu
- Infection Control Science Research Center, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Yuho Horikoshi
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| |
Collapse
|
5
|
Chen S, Popovich J, Iannuzo N, Haydel SE, Seo DK. Silver-Ion-Exchanged Nanostructured Zeolite X as Antibacterial Agent with Superior Ion Release Kinetics and Efficacy against Methicillin-Resistant Staphylococcus aureus. ACS APPLIED MATERIALS & INTERFACES 2017; 9:39271-39282. [PMID: 29083147 DOI: 10.1021/acsami.7b15001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
As antibiotic resistance continues to be a major public health problem, antimicrobial alternatives have become critically important. Nanostructured zeolites have been considered as an ideal host for improving popular antimicrobial silver-ion-exchanged zeolites, because with very short diffusion path lengths they offer advantages in ion diffusion and release over their conventional microsized zeolite counterparts. Herein, comprehensive studies are reported on materials characteristics, silver-ion release kinetics, and antibacterial properties of silver-ion-exchanged nanostructured zeolite X with comparisons to conventional microsized silver-ion-exchanged zeolite (∼2 μm) as a reference. The nanostructured zeolites are submicrometer-sized aggregates (100-700 nm) made up of primary zeolite particles with an average primary particle size of 24 nm. The silver-ion-exchanged nanostructured zeolite released twice the concentration of silver ions at a rate approximately three times faster than the reference. The material exhibited rapid antimicrobial activity against methicillin-resistant Staphylococcus aureus (MRSA) with minimum inhibitory concentration (MIC) values ranging from 4 to 16 μg/mL after 24 h exposure in various growth media and a minimum bactericidal concentration (MBC; >99.9% population reduction) of 1 μg/mL after 2 h in water. While high concentrations of silver-ion-exchanged nanostructured zeolite X were ineffective at reducing MRSA biofilm cell viability, efficacy increased at lower concentrations. In consideration of potential medical applications, cytotoxicity of the silver-ion-exchanged nanostructured zeolite X was also investigated. After 4 days of incubation, significant reduction in eukaryotic cell viability was observed only at concentrations 4-16-fold greater than the 24 h MIC, indicating low cytotoxicity of the material. Our results establish silver-ion-exchanged nanostructured zeolites as an effective antibacterial material against dangerous antibiotic-resistant bacteria.
Collapse
Affiliation(s)
- Shaojiang Chen
- School of Molecular Sciences, ‡School of Life Sciences, and §Biodesign Institute Center for Immunotherapy, Vaccines, and Virotherapy, Arizona State University , Tempe, Arizona 85287, United States
| | - John Popovich
- School of Molecular Sciences, ‡School of Life Sciences, and §Biodesign Institute Center for Immunotherapy, Vaccines, and Virotherapy, Arizona State University , Tempe, Arizona 85287, United States
| | - Natalie Iannuzo
- School of Molecular Sciences, ‡School of Life Sciences, and §Biodesign Institute Center for Immunotherapy, Vaccines, and Virotherapy, Arizona State University , Tempe, Arizona 85287, United States
| | - Shelley E Haydel
- School of Molecular Sciences, ‡School of Life Sciences, and §Biodesign Institute Center for Immunotherapy, Vaccines, and Virotherapy, Arizona State University , Tempe, Arizona 85287, United States
| | - Dong-Kyun Seo
- School of Molecular Sciences, ‡School of Life Sciences, and §Biodesign Institute Center for Immunotherapy, Vaccines, and Virotherapy, Arizona State University , Tempe, Arizona 85287, United States
| |
Collapse
|
6
|
Ko YP, Flick MJ. Fibrinogen Is at the Interface of Host Defense and Pathogen Virulence in Staphylococcus aureus Infection. Semin Thromb Hemost 2016; 42:408-21. [PMID: 27056151 PMCID: PMC5514417 DOI: 10.1055/s-0036-1579635] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Fibrinogen not only plays a pivotal role in hemostasis but also serves key roles in antimicrobial host defense. As a rapidly assembled provisional matrix protein, fibrin(ogen) can function as an early line of host protection by limiting bacterial growth, suppressing dissemination of microbes to distant sites, and mediating host bacterial killing. Fibrinogen-mediated host antimicrobial activity occurs predominantly through two general mechanisms, namely, fibrin matrices functioning as a protective barrier and fibrin(ogen) directly or indirectly driving host protective immune function. The potential of fibrin to limit bacterial infection and disease has been countered by numerous bacterial species evolving and maintaining virulence factors that engage hemostatic system components within vertebrate hosts. Bacterial factors have been isolated that simply bind fibrinogen or fibrin, promote fibrin polymer formation, or promote fibrin dissolution. Staphylococcus aureus is an opportunistic gram-positive bacterium, the causative agent of a wide range of human infectious diseases, and a prime example of a pathogen exquisitely sensitive to host fibrinogen. Indeed, current data suggest fibrinogen serves as a context-dependent determinant of host defense or pathogen virulence in Staphylococcus infection whose ultimate contribution is dictated by the expression of S. aureus virulence factors, the path of infection, and the tissue microenvironment.
Collapse
Affiliation(s)
- Ya-Ping Ko
- Center for Infectious and Inflammatory Diseases, Institute for Biosciences and Technology, Texas A&M Health Science Center, Houston, Texas
| | - Matthew J. Flick
- Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| |
Collapse
|
7
|
Rasid O, Cavaillon JM. Recent developments in severe sepsis research: from bench to bedside and back. Future Microbiol 2016; 11:293-314. [PMID: 26849633 DOI: 10.2217/fmb.15.133] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Severe sepsis remains a worldwide threat, not only in industrialized countries, due to their aging population, but also in developing countries where there still are numerous cases of neonatal and puerperal sepsis. Tools for early diagnosis, a prerequisite for rapid and appropriate antibiotic therapy, are still required. In this review, we highlight some recent developments in our understanding of the associated systemic inflammatory response that help deciphering pathophysiology (e.g., epigenetic, miRNA, regulatory loops, compartmentalization, apoptosis and synergy) and discuss some of the consequences of sepsis (e.g., immune status, neurological and muscular alterations). We also emphasize the challenge to better define animal models and discuss past failures in clinical investigations in order to define new efficient therapies.
Collapse
Affiliation(s)
- Orhan Rasid
- Unit Cytokines & Inflammation, Institut Pasteur, 28 rue Dr. Roux, Paris, France
| | - Jean-Marc Cavaillon
- Unit Cytokines & Inflammation, Institut Pasteur, 28 rue Dr. Roux, Paris, France
| |
Collapse
|
8
|
Determinants of Outcome in Hospitalized Patients With Methicillin-Resistant Staphylococcus aureus Bloodstream Infection: Results From National Surveillance in Canada, 2008-2012. Infect Control Hosp Epidemiol 2016; 37:390-7. [PMID: 26782274 DOI: 10.1017/ice.2015.323] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Bloodstream infection (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with considerable morbidity and mortality. OBJECTIVE To determine the incidence of MRSA BSI in Canadian hospitals and to identify variables associated with increased mortality. METHODS Prospective surveillance for MRSA BSI conducted in 53 Canadian hospitals from January 1, 2008, through December 31, 2012. Thirty-day all-cause mortality was determined, and logistic regression analysis was used to identify variables associated with mortality. RESULTS A total of 1,753 patients with MRSA BSI were identified (incidence, 0.45 per 1,000 admissions). The most common sites presumed to be the source of infection were skin/soft tissue (26.6%) and an intravascular catheter (22.0%). The most common spa types causing MRSA BSI were t002 (USA100/800; 55%) and t008 (USA300; 29%). Thirty-day all-cause mortality was 23.8%. Mortality was associated with increasing age (odds ratio, 1.03 per year [95% CI, 1.02-1.04]), the presence of pleuropulmonary infection (2.3 [1.4-3.7]), transfer to an intensive care unit (3.2 [2.1-5.0]), and failure to receive appropriate antimicrobial therapy within 24 hours of MRSA identification (3.2 [2.1-5.0]); a skin/soft-tissue source of BSI was associated with decreased mortality (0.5 [0.3-0.9]). MRSA genotype and reduced susceptibility to vancomycin were not associated with risk of death. CONCLUSIONS This study provides additional insight into the relative impact of various host and microbial factors associated with mortality in patients with MRSA BSI. The results emphasize the importance of ensuring timely receipt of appropriate antimicrobial agents to reduce the risk of an adverse outcome.
Collapse
|
9
|
A Comparison of Clinical Features between Community-Associated and Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Keratitis. J Ophthalmol 2015; 2015:923941. [PMID: 25653870 PMCID: PMC4306370 DOI: 10.1155/2015/923941] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 12/24/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose. To compare the clinical features of community-associated (CA) and healthcare-associated (HA) methicillin-resistant Staphylococcus aureus (MRSA) keratitis. Methods. Patients presenting with culture-proven MRSA keratitis between January 1, 2006, and December 31, 2010, at Chang Gung Memorial Hospital, Taiwan, were included in this study. The patients' demographic and clinical information were reviewed retrospectively. Antibiotic susceptibility was verified using the disk diffusion method. Results. Information on 26 patients with MRSA keratitis was collected, including 12 cases of CA-MRSA and 14 cases of HA-MRSA. All MRSA isolates were susceptible to vancomycin; the only difference in drug susceptibility was that CA-MRSA isolates were more susceptible to trimethoprim/sulfamethoxazole than HA-MRSA (P = .034). The most common risk factor for MRSA keratitis was ocular surface disease. No significant differences were observed between the 2 groups in terms of clinical features, treatments, and visual outcomes. Conclusion. In Taiwan, CA-MRSA rivals HA-MRSA as a critical cause of MRSA keratitis. Furthermore, CA-MRSA isolates are multidrug resistant. CA-MRSA and HA-MRSA keratitis are clinically indistinguishable, although larger studies are warranted to further evaluate this association.
Collapse
|
10
|
Wang L, Le X, Li L, Ju Y, Lin Z, Gu Q, Xu J. Discovering New Agents Active against Methicillin-Resistant Staphylococcus aureus with Ligand-Based Approaches. J Chem Inf Model 2014; 54:3186-97. [DOI: 10.1021/ci500253q] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Ling Wang
- Research
Center for Drug Discovery and Institute of Human Virology, School
of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China
| | - Xiu Le
- Research
Center for Drug Discovery and Institute of Human Virology, School
of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China
| | - Long Li
- Research
Center for Drug Discovery and Institute of Human Virology, School
of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China
| | - Yingchen Ju
- Research
Center for Drug Discovery and Institute of Human Virology, School
of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China
| | - Zhongxiang Lin
- College
of Chemical Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Qiong Gu
- Research
Center for Drug Discovery and Institute of Human Virology, School
of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China
| | - Jun Xu
- Research
Center for Drug Discovery and Institute of Human Virology, School
of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China
| |
Collapse
|
11
|
Qiao Y, Ning X, Chen Q, Zhao R, Song W, Zheng Y, Dong F, Li S, Li J, Wang L, Zeng T, Dong Y, Yao K, Yu S, Yang Y, Shen X. Clinical and molecular characteristics of invasive community-acquired Staphylococcus aureus infections in Chinese children. BMC Infect Dis 2014; 14:582. [PMID: 25377600 PMCID: PMC4225039 DOI: 10.1186/s12879-014-0582-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 10/23/2014] [Indexed: 12/20/2022] Open
Abstract
Background This study aims to investigate the clinical features of invasive community-acquired Staphylococcus aureus (CA-SA) infection in Chinese children and analyze its molecular features. Methods Clinical data and invasive CA-SA isolates were prospectively collected. Pediatric risk of mortality (PRISM) score was used for disease severity measurement. Molecular typing was then performed, followed by expression analysis for virulence genes. Results Among 163 invasive CA-SA infection cases, 71 (43.6%) were methicillin-resistant SA (MRSA) infections and 92 (56.4%) were methicillin-susceptible SA (MSSA). A total of 105 (64.4%) children were younger than 1 year old, and 79.7% (129/163) were under 3 years age. Thirteen kinds of diseases were observed, in which bacteremia and pneumonia accounted for 65.6% (107/163) and 52.8% (86/163), respectively. A total of 112 (68.1%) patients had two or more infective sites simultaneously, and four cases (2.5%) died. CA-MSSA more frequently caused multi-sites infections, bacteremia, and musculoskeletal infection than MRSA. A total of 25 sequence types (STs) were detected. MRSA mainly comprised ST59 (49/71, 69%), whereas the most frequent clonotypes were ST88 (15/92, 16.3%), ST25 (13/92, 14.1%), ST7 (13/92, 14.1%), ST2155 (12/92, 13%), and ST188 (9/92, 9.8%) for MSSA. Seven STs were common to both MSSA and MRSA groups. No differences in clinical presentation or PRISM score were found between the two groups or among different ST. The expression levels of the four known virulence genes varied among the six main ST clones. Conclusions Invasive CA-SA infections were characterized by high incidence and multi-site infections in young children in China. The clinical manifestations of CA-MSSA were more frequently associated with multi-site infections, bacteremia and musculoskeletal infection than those of CA-MRSA. Isolated genotypes may be relevant to the expressions of virulence genes, but not to clinical manifestations. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0582-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xuzhuang Shen
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, PR China.
| |
Collapse
|
12
|
Popovich KJ, Hayden MK. Delineating the Epidemiology-Host-Microbe Relationship for Methicillin-ResistantStaphylococcus aureusInfection. J Infect Dis 2014; 211:1857-9. [DOI: 10.1093/infdis/jiu555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 10/01/2014] [Indexed: 01/03/2023] Open
|