1
|
Motomura Y, Miyazaki M, Kamada M, Morimoto S, Nakamura Y, Satho T, Takata T, Kashige N. Genotypic Shift and Diversification of MRSA Blood Stream Isolates in a University Hospital Setting: Evidence from a 12-Year Observational Study. Antibiotics (Basel) 2024; 13:670. [PMID: 39061352 PMCID: PMC11273934 DOI: 10.3390/antibiotics13070670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 07/13/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
There have been few reports regarding the long-term trends in the genotypes of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates. Therefore, this study was performed to investigate the longitudinal trends in the genotypes of MRSA bloodstream isolates obtained from hospitalized patients during a 12-year study period from 2010 to 2021 at a tertiary care university hospital. Over the 12-year period from 2010 to 2021, we conducted a genetic investigation focusing on 245 MRSA strains isolated from the blood of hospitalized patients. The genotypes of the MRSA bloodstream isolates were determined by Staphylococcal Cassette Chromosome mec (SCCmec) typing, accessory gene regulator (agr) typing, PCR-based ORF typing (POT), and multilocus sequence typing (MLST). Strains with the same POT type detected in two or more isolates were designated as epidemic clones, while strains without a common POT type were classified as sporadic clones. Until 2015, isolates with SCCmec II/agr II were prevalent, but isolates with SCCmec IV/agr III increased from 2016. A total of 128 strains (52%) were identified as epidemic clones, while 117 strains (48%) were classified as sporadic clones. The detection rate of sporadic clones increased significantly since 2016 (p < 0.05). The epidemic clones were classified into three clusters, with MRSA of clonal complex (CC) 1 being prominent after 2016. This study showed that the genotypes of MRSA bloodstream isolates underwent a shift from SCCmec II/agr II type to SCCmec IV/agr III type, with a notable increase in MRSA of CC1, after 2016. There was a significant increase in the proportion of sporadic strains among the isolates, suggesting the diversification of genotypes.
Collapse
Affiliation(s)
- Yuka Motomura
- Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka 814-0180, Japan; (Y.M.); (M.M.); (T.S.); (N.K.)
| | - Motoyasu Miyazaki
- Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka 814-0180, Japan; (Y.M.); (M.M.); (T.S.); (N.K.)
- Department of Pharmacy, Fukuoka University Chikushi Hospital, Fukuoka 818-8502, Japan
| | - Mitsuhiro Kamada
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka 814-0180, Japan;
| | - Shinichi Morimoto
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (S.M.); (Y.N.)
| | - Yoshihiko Nakamura
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (S.M.); (Y.N.)
| | - Tomomitsu Satho
- Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka 814-0180, Japan; (Y.M.); (M.M.); (T.S.); (N.K.)
| | - Tohru Takata
- Department of Oncology, Hematology, and Infectious Diseases, Fukuoka University Hospital, Fukuoka 814-0180, Japan
- Department of Infection Control, Fukuoka University Hospital, Fukuoka 814-0180, Japan
| | - Nobuhiro Kashige
- Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka 814-0180, Japan; (Y.M.); (M.M.); (T.S.); (N.K.)
| |
Collapse
|
2
|
Yamaguchi T, Furuno K, Komori K, Abe T, Sato T, Ogihara S, Aoki K, Ishii Y, Tateda K. Evolutionary dynamics of the novel ST22-PT methicillin-resistant Staphylococcus aureus clone co-harbouring Panton-Valentine leucocidin and duplicated toxic shock syndrome toxin 1 genes. Clin Microbiol Infect 2024; 30:779-786. [PMID: 38408643 DOI: 10.1016/j.cmi.2024.02.020] [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: 11/06/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES Globally, the isolation of community-associated methicillin-resistant Staphylococcus aureus (MRSA) harbouring both the Panton-Valentine leucocidin (PVL) and toxic shock syndrome toxin 1 (TSST-1) genes is rare. However, we encountered an outbreak of the ST22-PT clone exhibiting this phenotype in Japan. Notably, the TSST-1 gene was duplicated in most of the strains. This study aimed to elucidate the mechanisms underlying this gene duplication. METHODS A total of 90 MRSA isolates were collected from the skin of outpatients in Fukuoka City, Japan, between 2017 and 2019. Whole-genome sequencing was performed on MRSA strains that were PVL and TSST-1 positive. RESULTS A total of 43 (47.8%) strains produced TSST-1, 20 (22.2%) produced PVL, and 16 (17.8%) produced both. Fifteen isolates were classified as ST22/SCCmec type IVa (ST22-PT clone) and one as ST1/SCCmec type V (ST1-PT clone). Three distinct ST22-PT clones were identified: Fukuoka clone I (one PVL gene and one TSST-1 gene), Fukuoka clone II (addition of a TSST-1 gene to Fukuoka clone I), and Fukuoka clone III (marked by a chromosomal inversion in a large region from Fukuoka clone II). DISCUSSION Fukuoka clone I may have integrated a novel pathogenicity island bearing the TSST-1 gene, leading to the emergence of Fukuoka clone II with a duplicated TSST-1 gene. This duplication subsequently instigated a chromosomal inversion in a large region owing to the homologous sequence surrounding TSST-1, giving rise to Fukuoka clone III. These findings provide crucial insights into the genetic evolution of MRSA.
Collapse
Affiliation(s)
- Tetsuo Yamaguchi
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan.
| | - Kenji Furuno
- Department of General Pediatrics & Emergency Medicine, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Kohji Komori
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Tomoko Abe
- Department of Clinical Laboratory, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Takahiro Sato
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan; Department of General Medicine and Emergency Care, Toho University Omori Medical Center, Tokyo, Japan
| | - Shinji Ogihara
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Kotaro Aoki
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| |
Collapse
|
3
|
Kaneko H, Kanai M, Saito T, Yanagi Y, Kobayashi H, Kurihara R, Ikeda M, Nemoto O, Baba N, Matsuzaki Y, Sawamura D, Shimoe F, Inaba Y, Kobayashi Y, Kawasaki S, Ueki T, Funatsu S, Shirahama S, Oba M, Hasegawa T, Furukawa H, Miyata T, Isonokami M, Fujita S, Nakaminami H. Significant increase in the prevalence of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus, particularly the USA300 variant ΨUSA300, in the Japanese community. Microbiol Spectr 2023; 11:e0124823. [PMID: 37929951 PMCID: PMC10715091 DOI: 10.1128/spectrum.01248-23] [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: 03/23/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
IMPORTANCE USA300 is an MRSA clone producing PVL, a toxin associated with SSTIs. ΨUSA300 is a USA300 variant recently identified in Japan by Takadama et al. (15). Here, we found that the prevalence rate of PVL-positive MRSA in S. aureus was elevated in the Japanese community, and ΨUSA300 accounted for most of them. ΨUSA300 strains have been isolated from several areas in Japan and were associated with deep-seated SSTIs. This study highlighted the emerging threat posed by ΨUSA300 in Japan.
Collapse
Affiliation(s)
- Hiroshi Kaneko
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Miki Kanai
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Takumi Saito
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Yuka Yanagi
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Hana Kobayashi
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Rikuto Kurihara
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Masami Ikeda
- Department of Dermatology, Takamatsu Red Cross Hospital, Kagawa, Japan
| | | | - Naoko Baba
- Department of Dermatology, Kanagawa Children’s Medical Center, Kanagawa, Japan
| | - Yasushi Matsuzaki
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Daisuke Sawamura
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | | | | | | | - Toru Ueki
- Ueki Dermatology Plastic Surgery, Tokyo, Japan
| | | | - Shigeho Shirahama
- Department of Dermatology, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - Misao Oba
- Department of Dermatology, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | | | | | - Toshiko Miyata
- Division of Dermatology, Saitama Citizens Medical Center, Saitama, Japan
| | | | | | - Hidemasa Nakaminami
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| |
Collapse
|
4
|
Shinohara K, Uehara Y, Teruya K, Sasaki T, Baba T, Nakaminami H, Kananizadeh P, Morimoto Y, Kikuchi Y, Oka S. Emergence of community-associated methicillin-resistant Staphylococcus aureus ΨUSA300 among Japanese people with HIV, resulted from stepwise mutations in 2010s. Sci Rep 2023; 13:8322. [PMID: 37221358 DOI: 10.1038/s41598-023-35171-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/14/2023] [Indexed: 05/25/2023] Open
Abstract
Although infection with the methicillin-resistant Staphylococcus aureus (MRSA) clone USA300 is extremely rare in Japan, the uniquely evolved clone ΨUSA300 has been reported in Japan. An outbreak of a distinct USA300 clone was recently reported in an HIV/AIDS referral hospital in Tokyo. The present study investigated the evolutionary origin and genetic diversity of USA300-related clones causing regional outbreaks among people living with HIV (PLWHIV) in Tokyo. MRSA isolates collected from PLWHIV in an HIV/AIDS referral center in Tokyo were subjected to whole-genome sequencing and their genetic features were compared with those of previously described USA300 MRSA genomes. Of the 28 MRSAs isolated in 2016-2019, 23 (82.1%) were identified as USA300, with 22 (95.6%) of the latter identified as ΨUSA300. Although the genomic structure of ΨUSA300 was identical to the structures of reference USA300 strains, one clade (cluster A) was found to have acquired 29 previously identified lineage-specific mutations in a stepwise manner. The estimated divergence dates of ΨUSA300 and Cluster A were 2009 and 2012, respectively. These findings suggested that the ΨUSA300 clone had spread among PLWHIVs in Tokyo in the early 2010s, with stepwise acquisition of lineage-specific nonsynonymous mutations.
Collapse
Affiliation(s)
- Koh Shinohara
- AIDS Clinical Center, The National Center for Global Health and Medicine, Tokyo, Japan
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Uehara
- Department of Microbiology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
- Department of Infectious Diseases, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
| | - Katsuji Teruya
- AIDS Clinical Center, The National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Sasaki
- Animal Research Center, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tadashi Baba
- Graduate School of Nursing, Seisen Jogakuin College, Nagano, Japan
| | - Hidemasa Nakaminami
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Pegah Kananizadeh
- Department of Microbiology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yuh Morimoto
- Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Yoshimi Kikuchi
- AIDS Clinical Center, The National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, The National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
5
|
Changes in the Genotypic Characteristics of Community-Acquired Methicillin-Resistant Staphylococcus aureus Collected in 244 Medical Facilities in Japan between 2010 and 2018: a Nationwide Surveillance. Microbiol Spectr 2022; 10:e0227221. [PMID: 35758725 PMCID: PMC9431082 DOI: 10.1128/spectrum.02272-21] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Although community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged worldwide, no nationwide CA-MRSA surveillance has been conducted in Japan to determine the changes in its molecular characteristics over time. We aimed to characterize the molecular epidemiology of Panton-Valentine leucocidin (PVL)-positive CA-MRSA strains collected from across Japan in the past decade. We isolated 1,770 MRSA strains from the skin and pus samples of outpatients of 244 medical facilities in 31 prefectures between 2010 and 2018 (2010, 2012, 2014, 2016, and 2018). Regions, hospitals, and periods in which strains were isolated and patient age group and sex were tabulated. Staphylococcal cassette chromosome mec (SCCmec) typing, detection of virulence factor genes, and antimicrobial susceptibility testing were performed. Whole-genome analysis was performed for the PVL-positive strains isolated in 2018. All strains harbored the mecA gene. Compared to that in 2010, the percentage of SCCmec type IV increased in 2018, with a corresponding increase in the proportion of PVL-positive strains (10% to 26%). Of the isolates obtained in 2018, clonal complex 8 (CC8) was dominant among PVL-positive strains. Core-genome single-nucleotide polymorphism analysis, using whole-genome sequencing, suggested that the CC8 PVL-positive strains spread throughout Japan over the last decade. Furthermore, a unique ST22 clone carrying both the PVL- and toxic shock syndrome toxin-1-encoding genes has emerged. We demonstrated that the molecular epidemiology of CA-MRSA in Japan differs from that in Europe and the United States; thus, it is crucial to monitor the trend of changes in CA-MRSA characteristics in Japan. IMPORTANCE Community-associated MRSA, which is a multidrug-resistant organism and can cause infections in otherwise-healthy individuals, has become a global problem. This paper describes a nationwide surveillance conducted in Japan to investigate changes in molecular epidemiological characteristics of CA-MRSA over the past decade and provides a detailed review of the characteristics of Panton-Valentine leucocidin (PVL)-positive strains isolated in 2018. Although CA-MRSA is rare in Japan to date, we found that the isolation of PVL-positive strains has been increasing over the past decade. In particular, the PVL-positive strains wherein CC8 was dominant exhibited high interstrain similarity, suggesting that a limited number of clones have spread over the past decade. Furthermore, a unique ST22 clone carrying both PVL-encoding and toxic shock syndrome toxin-1-encoding genes has emerged. This study shows that various changes can be observed when molecular epidemiological analysis, combined with next-generation sequencing, is conducted over a long period.
Collapse
|
6
|
Hosaka Y, Yahara K, Clark A, Kitagawa H, Hisatsune J, Sugai M, Shibayama K, Stelling J. Surveillance of multidrug resistance phenotypes in Staphylococcus aureus in Japan and correlation with whole-genome sequence findings. J Hosp Infect 2022; 123:34-42. [PMID: 35202748 DOI: 10.1016/j.jhin.2022.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/25/2022] [Accepted: 02/10/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Antimicrobial resistance in Staphylococcus aureus imposes a high disease burden. Both phenotypic and genotypic monitoring are key to understanding and containing emerging resistant strains. AIM Phenotypic monitoring of emerging resistance in S. aureus and correlation of priority strain phenotypes with whole genome sequencing (WGS) findings. METHODS Antimicrobial susceptibility test results of >40,000 isolates from 213 participating hospitals from 2011 to 2019 were exported from the national Japan Nosocomial Infections Surveillance (JANIS) database. Longitudinal and geographic distribution and prevalence of distinct multidrug resistance phenotypes ('resistance profiles') of S. aureus were examined among hospitals and prefectures. We further conducted a genome sequence analysis of strains with specific resistance profiles of concern. FINDINGS The overall prevalence of meticillin-resistant S. aureus (MRSA) decreased from 40.3% to 35.1% from 2011 to 2019. However, among dozens of S. aureus resistance profiles, only one profile of a type of MRSA, exhibited a statistically significant increase in inpatient frequency, exceeding 10% during the nine years. This MRSA profile showed resistance to oxacillin, erythromycin, and levofloxacin. Analysis of WGS results of S. aureus isolates with this phenotype revealed that most belonged to clonal complex 8, and all carried SCCmec IV, typical of community-acquired MRSA. CONCLUSION Tracking distinct resistance profiles deepened our understanding of the overall decrease in MRSA and led to recognition of the emergence of a new resistance phenotype. This study provides a model for future epidemiological research on antimicrobial resistance correlating multidrug resistance phenotypes with selective genome sequencing, which can be applied to other bacterial species.
Collapse
Affiliation(s)
- Yumiko Hosaka
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Adam Clark
- WHO Collaborating Centre for Surveillance of Antimicrobial Resistance, Brigham and Women's Hospital, Boston, MA, USA
| | - Hiroki Kitagawa
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan; Department of surgery, Hiroshima University Graduate School of Medicine, Hiroshima, Japan
| | - Junzo Hisatsune
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keigo Shibayama
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - John Stelling
- WHO Collaborating Centre for Surveillance of Antimicrobial Resistance, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| |
Collapse
|
7
|
Hamada M, Yamaguchi T, Sato A, Ono D, Aoki K, Kajiwara C, Kimura S, Maeda T, Sasaki M, Murakami H, Ishii Y, Tateda K. Increased Incidence and Plasma-Biofilm Formation Ability of SCC mec Type IV Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated From Patients With Bacteremia. Front Cell Infect Microbiol 2021; 11:602833. [PMID: 33842382 PMCID: PMC8032974 DOI: 10.3389/fcimb.2021.602833] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 02/12/2021] [Indexed: 12/15/2022] Open
Abstract
In Japan, Staphylococcal cassette chromosome mec (SCCmec) type IV methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly prominent cause of bacteremia, but the virulence of most of these strains is unclear. We aimed to investigate the relationship between the molecular characteristics and the ability to form biofilms in the presence of blood plasma (plasma-biofilms) of MRSA strains isolated from bloodstream infections. In this study, the molecular characteristics and biofilms of MRSA strains isolated from blood cultures between 2015 and 2017 were analyzed by PCR-based assays, crystal violet staining, and confocal reflection microscopy methods. Among the 90 MRSA isolates, the detection rate of SCCmec type II clones decreased from 60.7 to 20.6%. The SCCmec type IV clone replaced the SCCmec type II clone as the dominant clone, with a detection rate increasing from 32.1 to 73.5%. The plasma-biofilm formation ability of the SCCmec type IV clone was higher than the SCCmec type II clone and even higher in strains harboring the cna or arcA genes. Plasma-biofilms, mainly composed of proteins, were formed quickly and strongly. Our study demonstrated the increased plasma-biofilm formation ability of SCCmec type IV strains.
Collapse
Affiliation(s)
- Masakaze Hamada
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Tetsuo Yamaguchi
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Ayami Sato
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
- Department of Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Daisuke Ono
- Department of Infectious Diseases and Infection Control, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Kotaro Aoki
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Chiaki Kajiwara
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Soichiro Kimura
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Tadashi Maeda
- Department of General Medicine and Emergency Care, Toho University Omori Medical Center, Tokyo, Japan
| | - Masakazu Sasaki
- Department of Clinical Laboratories, Toho University Omori Medical Center, Tokyo, Japan
| | - Hinako Murakami
- Department of Clinical Laboratories, Toho University Omori Medical Center, Tokyo, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
- Department of Clinical Laboratories, Toho University Omori Medical Center, Tokyo, Japan
| |
Collapse
|
8
|
Wang B, Yao Y, Wei P, Song C, Wan S, Yang S, Zhu GM, Liu HM. Housefly Phormicin inhibits Staphylococcus aureus and MRSA by disrupting biofilm formation and altering gene expression in vitro and in vivo. Int J Biol Macromol 2020; 167:1424-1434. [PMID: 33202277 DOI: 10.1016/j.ijbiomac.2020.11.096] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 11/24/2022]
Abstract
The increasing drug resistance of pathogenic bacteria is a crisis that threatens public health. Antimicrobial peptides (AMPs) have been suggested to be potentially effective alternatives to solve this problem. Here, we tested housefly Phormicin-derived peptides for effects on Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) infections in vitro and in vivo. A decreased bacterial load of MRSA was observed in the mouse scald model after treatment with Phormicin and in the positive control group (vancomycin). A mouse scrape model indicated that Phormicin helps the host fight drug-resistant MRSA infections. The protective effect of Phormicin on MRSA was confirmed in the Hermetia illucens larvae model. Phormicin also disrupted the formation of S. aureus and MRSA biofilms. Furthermore, this effect coincided with the downregulation of biofilm formation-related gene expression (agrC, sigB, RNAIII, altA, rbf, hla, hld, geh and psmɑ). Notably, virulence genes and several regulatory factors were also altered by Phormicin treatment. Based on these findings, housefly Phormicin helps the host inhibit MRSA infection through effects on biofilm formation and related gene networks. Therefore, housefly Phormicin potential represents a candidate agent for clinical MRSA chemotherapy.
Collapse
Affiliation(s)
- Bing Wang
- Engineering Research Center of Medical Biotechnology, Guizhou Medical University, Guiyang 550025, Guizhou, China; Key Laboratory of Biology and Medical Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China; School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China; Key Laboratory of Environmental Pollution Monitoring and Disease Control, China Ministry of Education (Guizhou Medical University), Guiyang 550025, Guizhou, China.
| | - Yang Yao
- Engineering Research Center of Medical Biotechnology, Guizhou Medical University, Guiyang 550025, Guizhou, China; School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China
| | - PengWei Wei
- Engineering Research Center of Medical Biotechnology, Guizhou Medical University, Guiyang 550025, Guizhou, China; School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China
| | - ChaoRong Song
- Engineering Research Center of Medical Biotechnology, Guizhou Medical University, Guiyang 550025, Guizhou, China; School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China
| | - Shan Wan
- Department of Microbial Immunology, The first affiliated hospital of Guizhou Medical University, Guiyang, 550025, Guizhou, China
| | - SuWen Yang
- Engineering Research Center of Medical Biotechnology, Guizhou Medical University, Guiyang 550025, Guizhou, China; School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China
| | - Gui Ming Zhu
- Engineering Research Center of Medical Biotechnology, Guizhou Medical University, Guiyang 550025, Guizhou, China; Key Laboratory of Biology and Medical Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China; School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China; Key Laboratory of Environmental Pollution Monitoring and Disease Control, China Ministry of Education (Guizhou Medical University), Guiyang 550025, Guizhou, China
| | - Hong Mei Liu
- Engineering Research Center of Medical Biotechnology, Guizhou Medical University, Guiyang 550025, Guizhou, China; Key Laboratory of Biology and Medical Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China; School of Biology and Engineering, Guizhou Medical University, Guiyang 550025, Guizhou, China.
| |
Collapse
|
9
|
Hayakawa K, Yamaguchi T, Ono D, Suzuki H, Kamiyama J, Taguchi S, Kiyota K. Two Cases of Intrafamilial Transmission of Community-Acquired Methicillin-Resistant Staphylococcus aureus Producing Both PVL and TSST-1 Causing Fatal Necrotizing Pneumonia and Sepsis. Infect Drug Resist 2020; 13:2921-2927. [PMID: 32903848 PMCID: PMC7445494 DOI: 10.2147/idr.s262123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 08/06/2020] [Indexed: 01/09/2023] Open
Abstract
Introduction Staphylococcus aureus produces numerous toxins, such as toxic shock syndrome toxin 1 (TSST-1) and Panton–Valentine leukocidin (PVL). We isolated community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) strains producing both TSST-1 and PVL isolated from severe necrotizing pneumonia cases in a Nepali family. Detection of these CA-MRSA strains is rare in the world, and infection with these strains can take a rapidly progressive and lethal course. In this study, we traced the clinical course of this case and conducted a genetic analysis of the isolated strains. Case Report We described 2 familial cases (a 20-year-old male and 61-year-old female) of severe necrotizing pneumonia caused by CA-MRSA with the TSST-1 and PVL genes. A 20-year-old Nepalese male was admitted to our hospital after a 3-day history of high fever and coughing. Despite resuscitation efforts, he died of multiple organ failure. A 61-year-old Nepalese female was admitted to our hospital with a complaint of high fever and dyspnea for 1 day. She was the grandmother of the male subject and mostly stayed at his residence in Japan. We administered intravenous antibiotics, including anti-MRSA antibiotics, and she improved in 2 weeks. The sequence type of the isolates was ST22/SCCmec type IVa, and the spa type was t005. The virulence genes detected were as follows: PVL gene (lukSF-pv), TSST-1 gene (tst-1), sec, seg, sei, sel, sem, sen, seo, and seu. ST22 was not the dominant CA-MRSA clone type in Japan. Some of the reports demonstrated that PVL-/TSST-1-positive ST22-MRSA strains are prevalent in Nepal. Therefore, the MRSA strains were thought to be acquired from Nepal. Conclusion These cases highlight the emergence of TSST-1- and PVL-positive CA-MRSA infection and its association with life-threatening community-acquired necrotizing pneumonia. Clinicians should note the possibility of introducing MRSA strains from abroad and be aware of this illness to initiate appropriate treatment.
Collapse
Affiliation(s)
- Katsura Hayakawa
- Department of Emergency and Critical Care Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Tetsuo Yamaguchi
- Department of Microbiology and Infection Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Daisuke Ono
- Department of Microbiology and Infection Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Hajime Suzuki
- Department of Emergency and Critical Care Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Jiro Kamiyama
- Department of Emergency and Critical Care Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Shigemasa Taguchi
- Department of Emergency and Critical Care Medicine, Saitama Red Cross Hospital, Saitama, Japan
| | - Kazuya Kiyota
- Department of Emergency and Critical Care Medicine, Saitama Red Cross Hospital, Saitama, Japan
| |
Collapse
|
10
|
Observational study of skin and soft-tissue Staphylococcus aureus infection in patients infected with HIV-1 and epidemics of Panton-Valentine leucocidin-positive community-acquired MRSA infection in Osaka, Japan. J Infect Chemother 2020; 26:1254-1259. [PMID: 32747209 DOI: 10.1016/j.jiac.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/09/2020] [Accepted: 07/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND In patients infected with human immunodeficiency virus (HIV)-1 at our hospital, we observed increases in skin and soft-tissue infections (SSTIs) by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Therefore, we analyzed factors related to CA-MRSA infection and performed a molecular epidemiological investigation. METHODS HIV-1-infected patients were diagnosed with SSTIs related to S. aureus between 2007 and 2017, and MRSA was classified into community and hospital-acquired types according to published criteria. Information was collected retrospectively from clinical records, and multivariate analysis by logistic regression was performed concerning factors related to CA-MRSA infection. We evaluated the staphylococcal cassette chromosome mec (SCCmec) type, multilocus sequence type, and the presence of genes encoding Panton-Valentine leucocidin (PVL) in 27 MRSA samples isolated during and after 2015. RESULTS We found 218 episodes of SSTIs in 169 patients, and among initial episodes of SSTIs, the MRSA ratio was higher from 2015 to 2017 relative to that from 2007 to 2014 (88% vs. 44%; p < 0.0001). Multivariate analysis showed that in men having sex with men [MSM; odds ratio (OR): 13] and exhibiting onset during and after 2015 (OR: 5.4), CD4+ cell count ≥200 cells/μL (OR: 5.6) and the presence of lesions in the lower abdomen or buttocks (OR: 9.5) were independent factors related to CA-MRSA infection. Additionally, PVL+/ST8/SCCmec type IV MRSA was the predominant pathogen (22 cases; 81%). CONCLUSIONS These data describe an increased prevalence of SSTIs due to PVL-positive ST8-MRSA-IV, not previously considered epidemic in Japan, in MSM infected with HIV-1 in Osaka, Japan.
Collapse
|
11
|
Nakaminami H, Ozawa K, Sasai N, Ikeda M, Nemoto O, Baba N, Matsuzaki Y, Sawamura D, Shimoe F, Inaba Y, Kobayashi Y, Kawasaki S, Ueki T, Funatsu S, Shirahama S, Noguchi N. Current status of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus isolated from patients with skin and soft tissue infections in Japan. J Dermatol 2020; 47:1280-1286. [PMID: 32696497 DOI: 10.1111/1346-8138.15506] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/17/2020] [Indexed: 11/30/2022]
Abstract
The USA300 clone, which produces Panton-Valentine leukocidin (PVL), is a major pathogenic community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clone that causes intractable skin infections. Recently, PVL-positive CA-MRSA, including USA300 clones, have emerged in both communities and hospitals in Japan. To prevent an outbreak of PVL-positive MRSA, infected patients should be treated with effective antimicrobial agents at community clinics. Herein, we investigate molecular epidemiological characteristics of PVL-positive MRSA isolated from outpatients with skin and soft tissue infections (SSTI), which are common community-onset infectious diseases. The detection rate of MRSA was 24.9% (362 strains) out of 1455 S. aureus strains isolated between 2013 and 2017. Among the MRSA strains, 15.5% (56 strains) were PVL-positive strains and associated with deep-seated skin infections. Molecular epidemiological analyses of PVL-positive MRSA showed that USA300 was the predominant clone (53.6%, 30 strains) and was identified in Kanto (18 strains), Kagawa (nine strains), Tohoku (two strains) and Hokkaido (one strain). Notably, minocycline and fusidic acid were effective against all PVL-positive MRSA strains. Hence, our data reveals the current status of PVL-positive MRSA isolated from patients with SSTI in Japan. Continuous surveillance of CA-MRSA is necessary to monitor latest prevalence rates and identify effective antimicrobial agents for PVL-positive MRSA strains.
Collapse
Affiliation(s)
- Hidemasa Nakaminami
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Kazuya Ozawa
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Nao Sasai
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Masami Ikeda
- Department of Dermatology, Takamatsu Red Cross Hospital, Kagawa, Japan
| | | | - Naoko Baba
- Department of Dermatology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Yasushi Matsuzaki
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Daisuke Sawamura
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | | | | | | | - Toru Ueki
- Ueki Dermatology Plastic Surgery, Tokyo, Japan
| | | | - Shigeho Shirahama
- Department of Dermatology, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - Norihisa Noguchi
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| |
Collapse
|
12
|
Virulence factors and clonal diversity of Staphylococcus aureus in colonization and wound infection with emphasis on diabetic foot infection. Eur J Clin Microbiol Infect Dis 2020; 39:2235-2246. [PMID: 32683595 PMCID: PMC7669779 DOI: 10.1007/s10096-020-03984-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022]
Abstract
Foot ulcer is a common complication in diabetic subjects and infection of these wounds contributes to increased rates of morbidity and mortality. Diabetic foot infections are caused by a multitude of microbes and Staphylococcus aureus, a major nosocomial and community-associated pathogen, significantly contributes to wound infections as well. Staphylococcus aureus is also the primary pathogen commonly associated with diabetic foot osteomyelitis and can cause chronic and recurrent bone infections. The virulence capability of the pathogen and host immune factors can determine the occurrence and progression of S. aureus infection. Pathogen-related factors include complexity of bacterial structure and functional characteristics that provide metabolic and adhesive properties to overcome host immune response. Even though, virulence markers and toxins of S. aureus are broadly similar in different wound models, certain distinguishing features can be observed in diabetic foot infection. Specific clonal lineages and virulence factors such as TSST-1, leukocidins, enterotoxins, and exfoliatins play a significant role in determining wound outcomes. In this review, we describe the role of specific virulence determinants and clonal lineages of S. aureus that influence wound colonization and infection with special reference to diabetic foot infections.
Collapse
|
13
|
Draft Genome Sequence of the Panton-Valentine Leucocidin-Producing Staphylococcus aureus Sequence Type 154 Strain NRL 08/001, Isolated from a Fatal Case of Necrotizing Pneumonia. Microbiol Resour Announc 2019; 8:8/47/e01299-19. [PMID: 31753953 PMCID: PMC6872895 DOI: 10.1128/mra.01299-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Panton-Valentine leucocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) strains cause life-threatening diseases. We present a draft genome sequence of PVL-positive MRSA sequence type 154 (ST154) strain NRL 08/001, isolated from a fatal case of necrotizing pneumonia. The genome consists of 2.9 Mb over 39 contigs and harbors novel composite island staphylococcal cassette chromosome mec element (SCCmec)-mercury composite type 2B&5.
Collapse
|
14
|
Kaku N, Ohnishi T, Matsumoto T, Watanabe S, Yanagihara K. Molecular characteristics of methicillin-resistant Staphylococcus aureus isolated from skin and soft tissue infections collected in the Japanese nationwide surveillance. J Dermatol 2019; 46:1205-1209. [PMID: 31553075 DOI: 10.1111/1346-8138.15093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/27/2019] [Indexed: 11/26/2022]
Abstract
Skin and soft tissue infections (SSTI) are a common infection among both outpatients and inpatients. The most frequently isolated bacterium in SSTI was Staphylococcus aureus, a quarter of which was methicillin-resistant S. aureus (MRSA). In this study, to investigate molecular epidemiology of the 141 MRSA strains collected in the Japanese nationwide surveillance, we performed multiplex real-time polymerase chain reaction to detect staphylococcal cassette chromosome mec (SCCmec) type and virulence genes. The percentage of SCCmec types I, II, III and IV was 1.4%, 52.5%, 5.7% and 40.4%, respectively. According to the SCCmec type, we classified the strains into health-care-associated (HA)-MRSA (n = 84) and community-associated (CA)-MRSA (n = 57). Among the virulence genes, the percentage of enterotoxin C gene-positive strains was significantly higher in CA-MRSA than in HA-MRSA. No significant differences were detected between the two groups in terms of antibiotic susceptibility and patients' background information, classification of SSTI or symptoms of SSTI.
Collapse
Affiliation(s)
- Norihito Kaku
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takamitsu Ohnishi
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Tetsuya Matsumoto
- Department of Infectious Diseases, International University of Health and Welfare, Chiba, Japan
| | - Shinichi Watanabe
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
15
|
Yamaguchi T, Ando R, Matsumoto T, Ishii Y, Tateda K. Association between cell growth and vancomycin resistance in clinical community-associated methicillin-resistant Staphylococcus aureus. Infect Drug Resist 2019; 12:2379-2390. [PMID: 31534353 PMCID: PMC6682180 DOI: 10.2147/idr.s209591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/21/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES We investigated the association between the rate of cell growth and vancomycin (VAN) resistance by comparing the genomic and phenotypic characteristics of different sized colonies isolated from a single origin. METHODS Vancomycin-intermediate Staphylococcus aureus (VISA) strain TMUS2136 was isolated from the pus of a patient with a brain abscess and a chronic subdural abscess. This strain grew slowly and formed colonies poorly on agar plates within 24 h of incubation. However, variously sized colonies were observed after 48 h of incubation. We isolated five strains from different sized colonies and compared their VAN susceptibility and genomic sequences using next-generation sequencing. RESULTS The five strains showed different rates of growth and susceptibilities to VAN (range of MIC after 48 h of incubation; 3-5 mg/L), and slower growing strains tended to be more VAN resistant. Deletion of the spdC gene and SNPs in the sarA gene was confirmed in all five strains and six SNPs in other genes (including mreC, hssS, prs, SA2339, sun, and SA1132) were confirmed when comparing the five strains. CONCLUSIONS Deletion of the spdC gene, a novel virulence factor of S. aureus, and SNPs in the sarA gene may be associated with VAN resistance. It was hypothesized that any of the six genes in which SNPs were detected could affect cell growth rate and VAN resistance in slow-VISA strains.
Collapse
Affiliation(s)
- Tetsuo Yamaguchi
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Rina Ando
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | | | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| |
Collapse
|
16
|
Kobayashi T, Nakaminami H, Ohtani H, Yamada K, Nasu Y, Takadama S, Noguchi N, Fujii T, Matsumoto T. An outbreak of severe infectious diseases caused by methicillin-resistant Staphylococcus aureus USA300 clone among hospitalized patients and nursing staff in a tertiary care university hospital. J Infect Chemother 2019; 26:76-81. [PMID: 31375457 DOI: 10.1016/j.jiac.2019.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/08/2019] [Accepted: 07/11/2019] [Indexed: 11/30/2022]
Abstract
The USA300 clone, which produces Panton-Valentine leukocidin (PVL), is a major highly pathogenic community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clone that is spreading throughout the world. Although the prevalence of the USA300 clone in Japan was very limited a decade ago, its incidence has been increasing in both community and hospital settings in recent years. There is great concern that the USA300 clone will cause more complicated diseases and become a serious threat to immunocompromised patients in hospital settings. Here, we report an outbreak of severe infectious diseases in a tertiary care university hospital involving the incidence of deep infections, including bacteremia, and continuous and frequent isolation of MRSA strains for five months from six patients and a healthy nursing staff member in the same ward. The genotype of all MRSA isolates was identical to that of the USA300 clone. Furthermore, pulsed-field gel electrophoresis analysis indicated that all MRSA had the same patterns. These data demonstrate that a USA300 clone outbreak had occurred in the hospital. Fortunately, this outbreak was terminated subsequent to the interventions of the infection control team and all patients recovered following the appropriate therapies. Our report demonstrates that patients carrying highly pathogenic CA-MRSA have the potential to become a source of nosocomial outbreaks that can spread to healthy healthcare workers. Therefore, stricter standard precautions should be applied for all patients at the time of admission to prevent such nosocomial outbreaks.
Collapse
Affiliation(s)
- Takehito Kobayashi
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Hidemasa Nakaminami
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Hiroshi Ohtani
- Division of General Medicine, Tachikawa Sogo Hospital, 4-1 Midori-Cho, Tachikawa, Tokyo 190-8578, Japan
| | - Kanako Yamada
- Department of Infection Prevention and Control, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0998, Japan
| | - Yutaka Nasu
- Department of Infection Prevention and Control, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0998, Japan
| | - Shunsuke Takadama
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Norihisa Noguchi
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Takeshi Fujii
- Department of Infection Prevention and Control, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0998, Japan
| | - Tetsuya Matsumoto
- Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; Department of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita City, Chiba Prefecture, 286-8686, Japan.
| |
Collapse
|
17
|
Tateda K, Ohno A, Ishii Y, Murakami H, Yamaguchi K. Investigation of the susceptibility trends in Japan to fluoroquinolones and other antimicrobial agents in a nationwide collection of clinical isolates: A longitudinal analysis from 1994 to 2016. J Infect Chemother 2019; 25:594-604. [PMID: 30954447 DOI: 10.1016/j.jiac.2019.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/21/2019] [Accepted: 03/09/2019] [Indexed: 10/27/2022]
Abstract
The susceptibilities of clinical isolates to fluoroquinolones and other antimicrobial agents were surveyed to obtain an accurate understanding of trends in incidence and antimicrobial resistance. The samples were collected from across Japan, biennially or triennially, between 1994 and 2016 and a defined level of resistance to fluoroquinolone was determined. Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae exhibited stable and high rates of susceptibility to fluoroquinolones over the period examined. For methicillin-resistant Staphylococcus aureus the rate of resistance to levofloxacin and ciprofloxacin was 81.3-93.5% and 83.2-94.2%, respectively, which was markedly higher than that of methicillin-susceptible S. aureus, while sitafloxacin-resistant methicillin-susceptible and methicillin-resistant S. aureus were isolated at 0.3-0.7% and 16.9-36.5%, respectively. The rate of levofloxacin or ciprofloxacin-resistant Escherichia coli increased from around 2-3% between 1994 and 1998 to around 35% in 2016, but the rate of fluoroquinolone-susceptible Klebsiella pneumoniae stayed high at over 94.6% during the study period. Although no fluoroquinolone-resistance in clinical isolates of Salmonella spp. was detected from 1994 to 2002, the resistance rate increased slightly after 2004 and reached to 1.9%-4.7% in 2016. The rate of fluoroquinolone-susceptible Pseudomonas aeruginosa isolated from urinary tract and respiratory tract infections improved during the period examined from 41.8-67.0% to 91.2-94.2%, and from 78.9-88.5% to 90.1-94.6%, respectively. Against Acinetobacter spp., the susceptibility rate of fluoroquinolones was almost constant at around 90%, but one multidrug-resistant isolate was detected in 2013. Overall, the susceptibility to fluoroquinolones was maintained over 20 years against tested bacteria except for MRSA and E. coli.
Collapse
Affiliation(s)
- Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan; Department of Clinical Laboratory, Toho University Omori Medical Center, Japan.
| | - Akira Ohno
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
| | - Hinako Murakami
- Department of Clinical Laboratory, Toho University Omori Medical Center, Japan
| | - Keizo Yamaguchi
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
| | | |
Collapse
|
18
|
Takigawa Y, Fujiwara K, Saito T, Nakasuka T, Ozeki T, Okawa S, Takada K, Iwamoto Y, Kayatani H, Minami D, Sato K, Nagao M, Shibayama T. Rapidly Progressive Multiple Cavity Formation in Necrotizing Pneumonia Caused by Community-acquired Methicillin-resistant Staphylococcus aureus Positive for the Panton-Valentine Leucocidin Gene. Intern Med 2019; 58:685-691. [PMID: 30333405 PMCID: PMC6443543 DOI: 10.2169/internalmedicine.1454-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/03/2018] [Indexed: 11/15/2022] Open
Abstract
A 66-year-old man was transferred to our hospital for pneumonia that was resistant to sulbactam/ampicillin and levofloxacin therapy. Chest computed tomography showed the rapidly progressive formation of multiple cavities. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated, and the patient was diagnosed with necrotizing pneumonia caused by community-acquired MRSA (CA-MRSA). The MRSA strain had type IV staphylococcus cassette chromosome mec and genes encoding Panton-Valentine leucocidin (PVL). CA-MRSA necrotizing pneumonia with the PVL gene is rare; only three cases have been previously reported in Japan. We administered anti-MRSA antibiotics and the patient achieved complete clinical and radiological improvement.
Collapse
Affiliation(s)
- Yuki Takigawa
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Keiichi Fujiwara
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Takashi Saito
- Department of Infectious Diseases, National Hospital Organization Okayama Medical Center, Japan
| | - Takamasa Nakasuka
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Taichi Ozeki
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Sachi Okawa
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Kenji Takada
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Yoshitaka Iwamoto
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Hiroe Kayatani
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Daisuke Minami
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Ken Sato
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Miki Nagao
- Department of Clinical Laboratory, Kyoto University Hospital, Japan
| | - Takuo Shibayama
- Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center, Japan
| |
Collapse
|
19
|
Uehara Y, Sasaki T, Baba T, Lu Y, Imajo E, Sato Y, Tanno S, Furuichi M, Kawada M, Hiramatsu K. Regional outbreak of community-associated methicillin-resistant Staphylococcus aureus ST834 in Japanese children. BMC Infect Dis 2019; 19:35. [PMID: 30626342 PMCID: PMC6327381 DOI: 10.1186/s12879-018-3646-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 12/20/2018] [Indexed: 12/01/2022] Open
Abstract
Background Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection has recently become a challenging problem worldwide and in Japan. We experienced 10 pediatric patients infected with CA-MRSA and hospitalized from 2011 to 2014 in a tertiary care hospital in Saitama, Japan, and assessed the characteristic of the strains using a whole genome sequencing (WGS)-based approach. Methods CA-MRSA strains isolated from infected patients who required hospitalization for treatment were evaluated in this study. Antimicrobial susceptibility tests, molecular typing by PCR and pulse-field gel electrophoresis (PFGE) were performed to characterize MRSA strains. WGS was performed for detailed genetic analysis. Results A total of 582 MRSA strains (35.2%) were identified among 1625 S. aureus strains collected during the study period. Ten MRSA strains (1.7%) were defined as CA-MRSA clinically, and all were isolated from pediatric patients. All strains mainly caused purulent lymphadenitis, were susceptible to fluoroquinolone and tetracycline, exhibited sequence type (ST) 834 or its single-locus variants and contained staphylococcal cassette chromosome mec (SCCmec) type IVc. Phylogenic analysis by PFGE and WGS revealed close relatedness of all strains, with the number of single nucleotide polymorphisms ranging from 35 to 119 by WGS. Out of the ten strains, nine possessed the genomic island SaPISaitama2 containing tst, sec and sel genes. SaPISaitama2 comprises a mosaic of genomic islands SaPIm4 and SaPIm1 harbored by a hospital-associated MRSA strain Mu50. Conclusions This study describes a regional outbreak of ST834-related CA-MRSA in children with a unique pathogenicity island in Japan. Pediatric patient tropism of this clone could be enhanced by susceptibility to fluoroquinolones and tetracyclines, which cannot be prescribed to children. Electronic supplementary material The online version of this article (10.1186/s12879-018-3646-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yuki Uehara
- Department of Infection Control Science, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. .,Department of Microbiology, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. .,Department of General Medicine, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Takashi Sasaki
- Department of Microbiology, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Infection Control Science Research Center, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tadashi Baba
- Department of Microbiology, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Infection Control Science Research Center, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yujie Lu
- Infection Control Science Research Center, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Eri Imajo
- Department of Laboratory Medicine, Saitama City Hospital, 2460, Mimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Yuka Sato
- Department of Laboratory Medicine, Saitama City Hospital, 2460, Mimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Shigeru Tanno
- Department of Laboratory Medicine, Saitama City Hospital, 2460, Mimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Munehiro Furuichi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Miki Kawada
- Department of Infectious Diseases, Saitama City Hospital, 2460, Mimuro, Midori-ku, Saitama, 336-8522, Japan
| | - Keiichi Hiramatsu
- Department of Infection Control Science, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Department of Microbiology, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Infection Control Science Research Center, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| |
Collapse
|
20
|
Leong HN, Kurup A, Tan MY, Kwa ALH, Liau KH, Wilcox MH. Management of complicated skin and soft tissue infections with a special focus on the role of newer antibiotics. Infect Drug Resist 2018; 11:1959-1974. [PMID: 30464538 PMCID: PMC6208867 DOI: 10.2147/idr.s172366] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Complicated skin and soft tissue infections (cSSTIs) represent the severe form of infectious disease that involves deeper soft tissues. Involvement of methicillin-resistant Staphylococcus aureus (MRSA) further complicates cSSTI with increased hospitalization, health care costs, and overall mortality. Various international guidelines provide recommendations on the management of cSSTIs, with the inclusion of newer antibiotics. This literature-based review discusses the overall management of cSSTI, including appropriate use of antibiotics in clinical practice. Successful treatment of cSSTIs starts with early and precise diagnosis, including identification of causative pathogen and its load, determination of infection severity, associated complications, and risk factors. The current standard-of-care for cSSTIs involves incision, drainage, surgical debridement, broad-spectrum antibiotic therapy, and supportive care. In recent years, the emergence of newer antibiotics (eg, ceftaroline, tigecycline, daptomycin, linezolid, etc) has provided clinicians wider options of antimicrobial therapy. Selection of antibiotics should be based on the drug characteristics, effectiveness, safety, and treatment costs, alongside other aspects such as host factors and local multidrug resistance rates. However, larger studies on newer antibiotics are warranted to refine the decision making on the appropriate antimicrobial therapy. Local Antimicrobial Stewardship Program strategies in health care settings could guide clinicians for early initiation of specific treatments to combat region-specific antimicrobial resistance, minimize adverse effects, and to improve outcomes such as reduction in Clostridium difficile infections. These strategies involving iv-to-oral switch, de-escalation to narrow-spectrum antibiotics, and dose optimization have an impact on the overall improvement of cSSTI therapy outcomes, especially in countries like Singapore that has a high disease burden.
Collapse
Affiliation(s)
- Hoe Nam Leong
- Rophi Clinic, Mount Elizabeth Novena Specialist Centre, Singapore, Singapore,
| | - Asok Kurup
- Infectious Diseases Care Private Ltd, Mount Elizabeth Medical Centre, Singapore, Singapore
| | - Mak Yong Tan
- My Orthopaedic Clinic, Gleneagles Medical Centre, Singapore, Singapore
| | - Andrea Lay Hoon Kwa
- Department of Pharmacy, Singapore General Hospital, Singapore, Singapore.,Emerging Infectious Diseases Program, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Kui Hin Liau
- LIAU KH Specialist Clinic, Mount Elizabeth Novena Specialist Centre, Singapore, Singapore
| | - Mark H Wilcox
- Department of Medical Microbiology, Leeds Teaching Hospitals and University of Leeds, Leeds, UK
| |
Collapse
|
21
|
Harada T, Taguchi M, Kawahara R, Kanki M, Kawatsu K. Prevalence and Antimicrobial Susceptibility of Bacterial Pathogens in Ready-to-Eat Foods Retailed in Osaka Prefecture, Japan. J Food Prot 2018; 81:1450-1458. [PMID: 30080122 DOI: 10.4315/0362-028x.jfp-18-035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The potential human health risk of Japanese ready-to-eat (RTE) foods was investigated by determining the contamination by foodborne bacterial pathogens, the prevalence of opportunistic and nosocomial pathogens, and the antibiotic susceptibility of the isolates recovered from 96 samples of lightly pickled vegetables, 88 samples of Western-style desserts, and 98 samples of RTE fish and seafood products sold at retail in Osaka, Japan. Staphylococcus aureus, including isolates producing staphylococcal enterotoxin (SE), were isolated from six lightly pickled vegetable products, seven Western-style dessert products, and three RTE fish and seafood products. Of these isolates, one SEC-producing isolate from a cake was identified as community-acquired methicillin-resistant S. aureus, which was multilocus sequence type 8 and staphylococcal cassette chromosome mec type IV. Enterobacteriaceae species, including Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Serratia marcescens, Citrobacter freundii-Citrobacter braakii, and/or the Enterobacter cloacae complex, were isolated from 92 (95.8%) of the lightly pickled vegetable products, 39 (44.3%) of the Western-style dessert products, and 74 (75.5%) of the RTE fish and seafood products. On the basis of the antimicrobial susceptibility profiles of the opportunistic and nosocomial Enterobacteriaceae pathogens, the third-generation cephalosporin, fosfomycin, and quinolone resistance determinants were investigated. We detected AmpC products of the CIT group and a qnrB9 product in 5 and 1 C. freundii-C. braakii isolates, respectively, and fosA gene products in 15 E. cloacae complex isolates. Because RTE foods are consumed without a heating process, the spread of bacterial pathogens from contaminated food to human consumers is possible. RTE foods must be handled using hygienic procedures from the processing steps to the table to reduce the prevalence of potentially pathogenic or pathogenic bacteria and to prevent bacterial growth.
Collapse
Affiliation(s)
- Tetsuya Harada
- Osaka Institute of Public Health, Nakamichi 1-3-69, Higashinari-ku, Osaka 537-0025, Japan
| | - Masumi Taguchi
- Osaka Institute of Public Health, Nakamichi 1-3-69, Higashinari-ku, Osaka 537-0025, Japan
| | - Ryuji Kawahara
- Osaka Institute of Public Health, Nakamichi 1-3-69, Higashinari-ku, Osaka 537-0025, Japan
| | - Masashi Kanki
- Osaka Institute of Public Health, Nakamichi 1-3-69, Higashinari-ku, Osaka 537-0025, Japan
| | - Kentaro Kawatsu
- Osaka Institute of Public Health, Nakamichi 1-3-69, Higashinari-ku, Osaka 537-0025, Japan
| |
Collapse
|
22
|
Harada D, Nakaminami H, Miyajima E, Sugiyama T, Sasai N, Kitamura Y, Tamura T, Kawakubo T, Noguchi N. Change in genotype of methicillin-resistant Staphylococcus aureus (MRSA) affects the antibiogram of hospital-acquired MRSA. J Infect Chemother 2018; 24:563-569. [DOI: 10.1016/j.jiac.2018.03.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/26/2018] [Accepted: 03/08/2018] [Indexed: 11/29/2022]
|
23
|
Nakaminami H, Takadama S, Ito A, Hasegawa M, Jono C, Noguchi M, Shoshi M, Wajima T, Fujii T, Maruyama H, Sakamoto H, Ito Y, Okamoto S, Masaki Y, Tsuchiya K, Nishinarita S, Noguchi N. Characterization of SCC mec type IV methicillin-resistant Staphylococcus aureus clones increased in Japanese hospitals. J Med Microbiol 2018; 67:769-774. [PMID: 29676727 DOI: 10.1099/jmm.0.000735] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Recently, the prevalence of staphylococcal cassette chromosome mec (SCCmec) type IV isolates, which are the major community-acquired methicillin-resistant Staphylococcus aureus (MRSA), have increased in Japanese hospitals. The aim of this study was to elucidate the detailed molecular epidemiological features of the SCCmec type IV clones in Japanese hospitals. When 2589 MRSA isolated from four hospitals in Tokyo, Japan between 2010 and 2014 were analysed, the proportion of SCCmec type IV overtook that of type II, which was the major type of hospital-acquired MRSA in 2014. Multilocus sequence typing showed that CC1 was the most predominant clone in the SCCmec type IV isolates. The clinical departments that the patients belonged to, pulsed-field gel electrophoresis analysis and antimicrobial susceptibility profiles suggested that the origin of the CC1-SCCmec type IV (CC1-IV) clone was a community setting. Our data show that the CC1-IV clone is becoming a predominant MRSA clone in Japanese hospitals.
Collapse
Affiliation(s)
- Hidemasa Nakaminami
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Shunsuke Takadama
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Ayumu Ito
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Mariko Hasegawa
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Chika Jono
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Miyuki Noguchi
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Manami Shoshi
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Takeaki Wajima
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Takeshi Fujii
- Department of Infectious Diseases, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0998, Japan
| | - Hiroshi Maruyama
- Department of Surgery, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
| | - Haruo Sakamoto
- Department of Oral Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa, Hachioji, Tokyo 192-0032, Japan
| | - Yutaka Ito
- Department of Digestive Surgery, National Hospital Organization Disaster Medical Center, 3256 Midori, Tachikawa, Tokyo 190-0014, Japan
| | - Satsuki Okamoto
- Department of Pediatrics, Fussa Hospital, 1-6-1 Kamidaira, Fussa, Tokyo 197-8511, Japan
| | - Yukiyoshi Masaki
- Department of Surgery, Ome Municipal General Hospital, 4-16-5 Higashiome, Ome, Tokyo 198-0042, Japan
| | - Kayoko Tsuchiya
- Department of Respiratory Medicine, Tachikawa Sogo Hospital, 1-16-15 Nishiki, Tachikawa, Tokyo 190-8578, Japan
| | - Susumu Nishinarita
- Department of Internal Medicine, Akiru Municipal Medical Center, 78-1 Hikita, Akiruno, Tokyo 197-0834, Japan
| | - Norihisa Noguchi
- Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| |
Collapse
|
24
|
Maeda N, Hagiya H, Takiuchi T, Kusakabe S, Maeda T, Kimura K, Iwai S, Kawasaki K, Hori Y, Morii E, Kanakura Y, Kimura T, Tomono K. Persistent methicillin-resistant Staphylococcus aureus bacteremia owing to placental abscess. J Infect Chemother 2018; 24:975-979. [PMID: 29804839 DOI: 10.1016/j.jiac.2018.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/05/2018] [Accepted: 05/01/2018] [Indexed: 10/16/2022]
Abstract
Staphylococcus aureus as a pathogen in human gestational membranes, a rather rare phenomenon, has recently been the focus of several researches. S. aureus forms biofilms on these membranes and potentially causes chorioamnionitis in pregnant women. We report a case of persistent methicillin-resistant S. aureus (MRSA) bacteremia owing to placental infection, causing chorioamnionitis and preterm birth. A 29-year-old Japanese woman at the 27th gestational week was diagnosed with acute promyelocytic leukemia and underwent all-trans retinoic acid therapy. Soon after hospitalization, the patient presented with persistent MRSA bacteremia of unknown origin. Despite various antimicrobial therapies, she experienced 12 MRSA bacteremia episodes over 6 weeks. However, after child birth, MRSA bacteremia disappeared without any complications. A pathologic examination of her placenta revealed placenta abscess, resulting in a diagnosis of MRSA-associated chorioamnionitis. Molecular analysis proved that a single MRSA strain (SCCmec Type IVa), which tested negative for Panton-Valentine leukocidin and toxic shock syndrome toxin-1, caused the obstinate infection. We should be aware that persistent MRSA bacteremia in pregnant women can originate from placental abscess.
Collapse
Affiliation(s)
- Naomi Maeda
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| | - Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Japan.
| | - Tsuyoshi Takiuchi
- Department of Obstetrics and Gynecology, Osaka University Hospital, Japan
| | | | - Tetsuo Maeda
- Department of Hematology, Osaka University Hospital, Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation, Osaka University Hospital, Japan
| | - Sayuri Iwai
- Department of Obstetrics and Gynecology, Osaka University Hospital, Japan
| | | | - Yumiko Hori
- Department of Pathology, Osaka University Hospital, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Hospital, Japan
| | | | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Hospital, Japan
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Japan
| |
Collapse
|
25
|
Dissemination of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus USA300 clone in multiple hospitals in Tokyo, Japan. Clin Microbiol Infect 2018; 24:1211.e1-1211.e7. [PMID: 29454850 DOI: 10.1016/j.cmi.2018.02.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/07/2018] [Accepted: 02/10/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Panton-Valentine leukocidin (PVL) gene (lukS/F-PV)-positive community-acquired methicillin-resistant Staphylococcus aureus (MRSA), particularly the USA300 clone, is a health concern worldwide. Recently, community-acquired MRSA clones have been found to spread and persist in hospital settings. We aimed to investigate the prevalence and molecular epidemiologic features of lukS/F-PV-positive MRSA in Japanese hospitals. METHODS A total of 3433 MRSA isolated from nine hospitals in 2011-2015 were assessed. Molecular epidemiologic analysis performed by staphylococcal cassette chromosome mec typing, PVL typing, arginine catabolic mobile element typing, detection of virulence determinants, multilocus sequence typing, pulsed-field gel electrophoresis and antimicrobial susceptibility testing. RESULTS The detection rate of lukS/F-PV was increased annually from 0.6% (5/817) in 2011 to 3.1% (17/544) in 2015. Molecular epidemiologic analysis for 64 lukS/F-PV-positive MRSA isolates revealed that 42 isolates (65.6%) were the USA300 clone. Resistance rates of levofloxacin and gentamicin among lukS/F-PV-positive isolates increased annually as a result of increased prevalence of the multidrug-resistant USA300 clone. CONCLUSIONS This is the first report on dissemination of the USA300 clone and PVL-positive MRSA in multiple Japanese hospitals. Our data strongly suggest that the USA300 clone may become epidemic in Japanese hospitals.
Collapse
|
26
|
Osaka S, Okuzumi K, Koide S, Tamai K, Sato T, Tanimoto K, Tomita H, Suzuki M, Nagano Y, Shibayama K, Arakawa Y, Nagano N. Genetic shifts in methicillin-resistant Staphylococcus aureus epidemic clones and toxin gene profiles in Japan: comparative analysis among pre-epidemic, epidemic and post-epidemic phases. J Med Microbiol 2018; 67:392-399. [PMID: 29458554 DOI: 10.1099/jmm.0.000687] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The decline in methicillin-resistant Staphylococcus aureus (MRSA) isolation rates has become a general observation worldwide, including Japan. We hypothesized that some genetic shift in MRSA might cause this phenomenon, and therefore we investigated the genetic profiles among MRSA clinical isolates obtained from three different epidemic phases in Japan. METHODOLOGY A total of 353 MRSA isolates were selected from 202 medical facilities in 1990 (pre-epidemic phase), 2004 (epidemic phase) and 2016 (post-epidemic phase). Molecular typing was performed by PCR detection of 22 genes using the polymerase chain reaction (PCR)-based ORF typing (POT) system, including an additional eight genes including small genomic islets and seven toxin genes. RESULTS Isolates with a POT1 of score 93, identified as presumed clonal complex (pCC)5-staphylococcal cassette chromosome mec (SCCmec) type II including ST5-SCCmec type II New York/Japan clone, represented the major epidemic MRSA lineage in 1990 and 2004. In 2016, however, a marked decrease in isolates with a POT1 score of 93, along with changes in the epidemiology of toxin genes carried, was noted, where the carriers of tst genes including the tst-sec combination were markedly reduced, and those possessing the seb gene alone were markedly increased. Rather, isolates with a POT1 score of 106, including pCC1 or pCC8 among the isolates with SCCmec type IV, which often links to community-associated MRSA, were predominant. Interestingly, the pCC1 and pCC8 lineages were related to sea and tst-sec carriage, respectively. CONCLUSIONS Over time, a transition in MRSA genetic profiles from a POT1 score of 93 in 1990 and 2004 to 106 in 2014 was found in Japan.
Collapse
Affiliation(s)
- Shunsuke Osaka
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Nagano, Japan
| | - Katsuko Okuzumi
- Division of Infection Control, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Shota Koide
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Nagano, Japan
| | | | - Tomoaki Sato
- Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Tanimoto
- Department of Bacteriology, Gunma University, Graduate School of Medicine, Gunma, Japan
| | - Haruyoshi Tomita
- Department of Bacteriology, Gunma University, Graduate School of Medicine, Gunma, Japan
| | - Masahiro Suzuki
- Department of Microbiology, Fujita health University, Aichi, Japan
| | - Yukiko Nagano
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshichika Arakawa
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Noriyuki Nagano
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Nagano, Japan
| |
Collapse
|
27
|
Lin J, Wu C, Ou Q, Lin D, Zhang T, Bai C, Zheng H, Ye J, Wang X, Li Y, Ye X, Yao Z. Nasal colonization of Staphylococcus aureus colonal complex 5: Prevalence, influencing factors, and phenotypic and molecular characteristics in pregnant Chinese women. Am J Infect Control 2017. [PMID: 28629756 DOI: 10.1016/j.ajic.2017.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Colonal complex 5 (CC5) has been referred to as the most pandemic community-associated Staphylococcus aureus in most Asian countries. However, few studies have focused on CC5 isolates in pregnant women. The aim of this study was to determine the prevalence and phenotypic and molecular characteristics of S aureus and methicillin-resistant S aureus (MRSA) CC5 nasal colonization in pregnant Chinese women. METHODS We performed a cross-sectional study between August and November 2015 in 2 hospitals in Shenzhen, China. Pregnant women were asked to complete questionnaires, and nasal swabs were collected. Log-binomial regression models were used to explore factors influencing S aureus and MRSA nasal colonization between the CC5 and non-CC5 or non-S aureus groups. Polymerase chain reaction assays were used to detect the molecular characteristics of isolates. RESULTS Overall, 2,172 pregnant women were included in this study. The prevalence of S aureus and MRSA was 25.60% (n = 556) and 5.62% (n = 122), respectively. The multilocus sequence typing of S aureus isolates was diversified. A lower frequency of daily handwashing (<7) and weekly bathing (<7) were risk factors for the prevalence of S aureus (adjusted prevalence ratio [aPR], 1.13; 95% confidence interval [CI], 1.03-1.41 and aPR, 1.22; 95% CI, 1.03-1.45) and MRSA (aPR, 1.96; 95% CI, 1.23-3.14 and aPR, 1.47; 95% CI, 1.21-2.44) nasal colonization in the CC5 groups of pregnant women. CONCLUSIONS The prevalence of S aureus and MRSA nasal colonization was moderate. The molecular characteristics of S aureus and MRSA isolates indicated possible cross-transmission among multiple resources. A higher frequency of daily handwashing and weekly bathing significantly decreased the prevalence of S aureus and MRSA CC5 nasal colonization in the pregnant women.
Collapse
|
28
|
Miura Y, Yamaguchi T, Nakamura I, Koyama S, Tamai K, Okanda T, Matsumoto T. Epidemiological Trends Observed from Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Isolates from Blood Cultures at a Japanese University Hospital, 2012-2015. Microb Drug Resist 2017; 24:70-75. [PMID: 28708463 DOI: 10.1089/mdr.2017.0008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite increasing reports of skin and soft tissue infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Japan, the extent to which these strains cause nosocomial infections remains unknown, and this is especially true for bloodstream infections. In this study, we molecularly characterized MRSA isolates from Japanese blood samples. Among the 151 MRSA isolates collected from 53 medical facilities in 2011, 115 (76%) and 30 (20%) were classified as staphylococcal cassette chromosome mec (SCCmec) types II and IV, respectively, while the Panton-Valentine leukocidin (PVL) gene was detected in only two isolates. Among 66 MRSA isolates collected from Tokyo Medical University Hospital between 2012 and 2015, 43 (65%) and 20 (30%) were classifiable as SCCmec types II and IV, respectively. In 2015, highly virulent strains, such as the SCCmec type IV/PVL and SCCmec type IV/ toxic shock syndrome toxin-1 clonal types, increased in number. Therefore, the SCCmec type IV clone may cause invasive infections not only in community settings but also in healthcare settings in Japan.
Collapse
Affiliation(s)
- Yuri Miura
- 1 Department of Microbiology Laboratory, Tokyo Medical University Hospital , Tokyo, Japan
| | - Tetsuo Yamaguchi
- 2 Department of Microbiology and Infectious Diseases, Toho University School of Medicine , Tokyo, Japan .,3 Department of Microbiology, Tokyo Medical University , Tokyo, Japan
| | - Itaru Nakamura
- 4 Department of Infection Control and Prevention, Tokyo Medical University Hospital , Tokyo, Japan
| | - Shinobu Koyama
- 5 Department of Microbiology Laboratory, Miroku Medical Laboratory Co., Ltd. , Nagano, Japan
| | - Kiyoko Tamai
- 5 Department of Microbiology Laboratory, Miroku Medical Laboratory Co., Ltd. , Nagano, Japan
| | - Takashi Okanda
- 3 Department of Microbiology, Tokyo Medical University , Tokyo, Japan
| | - Tetsuya Matsumoto
- 3 Department of Microbiology, Tokyo Medical University , Tokyo, Japan .,4 Department of Infection Control and Prevention, Tokyo Medical University Hospital , Tokyo, Japan
| |
Collapse
|
29
|
Miyazaki H, Midorikawa N, Fujimoto S, Miyoshi N, Yoshida H, Matsumoto T. Antimicrobial effects of lysophosphatidylcholine on methicillin-resistant Staphylococcus aureus. Ther Adv Infect Dis 2017; 4:89-94. [PMID: 28748087 DOI: 10.1177/2049936117714920] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Methicillin-resistant Staphylococcus aureus (MRSA) is an important health care-associated and community-associated pathogen and causes a large number of infections worldwide. For the purpose of application to topical treatment of MRSA infection, we examined the antimicrobial effects of lysophosphatidylcholine (LPC) on MRSA strains. We also investigated the combination effect of LPC and gentamicin on MRSA growth. METHODS The LPC minimum inhibitory concentrations (MIC) for Gram-positive (S. aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae) and Gram-negative (Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, and Pseudomonas aeruginosa) bacteria were measured by the broth microdilution method. The mechanism of LPC-mediated MRSA killing was investigated by membrane permeability analysis with DiSC3(5) fluorescence and growth curve analysis. Lastly, the effects of LPC on gentamicin-induced bactericidal activity were determined in combination treatment studies with 15 gentamicin-resistant MRSA isolates from the skin, nose, or ears. RESULTS The LPC MIC for Gram-positive bacteria varied between 32 µg/ml and >2048 µg/ml, whereas that for all Gram-negative bacteria was >2048 µg/ml. Consistently, membrane permeability analysis showed that LPC was substantially more effective in inducing membrane permeability in Gram-positive bacteria than in Gram-negative counterparts. Growth curve analysis in cotreatment studies demonstrated that LPC has intrinsic bactericidal effects and can also potentiate gentamicin sensitivity in resistant MRSA strains. CONCLUSIONS Our study demonstrates that LPC exhibits intrinsic antimicrobial effects and can enhance the antimicrobial effects of gentamicin for resistant MRSA strains, suggesting that LPC may be a beneficial additive in topical antibiotics for superficial skin infections.
Collapse
Affiliation(s)
- Haruko Miyazaki
- Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Naoko Midorikawa
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Saki Fujimoto
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Natsumi Miyoshi
- Department of Microbiology, Tokyo Medical University, Tokyo, Japan
| | - Hideto Yoshida
- Department of Fine Chemicals, Institute of Product Development, Research & Development Division, Kewpie Corporation, Tokyo, Japan
| | | |
Collapse
|
30
|
Aung MS, Kawaguchiya M, Urushibara N, Sumi A, Ito M, Kudo K, Morimoto S, Hosoya S, Kobayashi N. Molecular Characterization of Methicillin-ResistantStaphylococcus aureusfrom Outpatients in Northern Japan: Increasing Tendency of ST5/ST764 MRSA-IIa with Arginine Catabolic Mobile Element. Microb Drug Resist 2017; 23:616-625. [DOI: 10.1089/mdr.2016.0176] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Meiji Soe Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mitsuyo Kawaguchiya
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Noriko Urushibara
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ayako Sumi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masahiko Ito
- Sapporo Clinical Laboratory, Inc., Sapporo, Japan
| | - Kenji Kudo
- Sapporo Clinical Laboratory, Inc., Sapporo, Japan
| | | | - Shino Hosoya
- Mito Kyodo General Hospital, University of Tsukuba, Mito, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
| |
Collapse
|
31
|
Watanabe S, Ohnishi T, Yuasa A, Kiyota H, Iwata S, Kaku M, Watanabe A, Sato J, Hanaki H, Manabe M, Suzuki T, Otsuka F, Aihara M, Iozumi K, Tamaki T, Funada Y, Shinozaki M, Kobayashi M, Okuda M, Kikyo G, Kikuchi K, Okada Y, Takeshima M, Kaneko O, Ogawa N, Ito R, Okuyama R, Shimada S, Shimizu T, Hatta N, Manabu M, Tsutsui K, Tanaka T, Miyachi Y, Asada H, Furukawa F, Kurokawa I, Iwatsuki K, Hide M, Muto M, Yamamoto O, Niihara H, Takagaki K, Kubota Y, Sayama K, Sano S, Furue M, Kanekura T. The first nationwide surveillance of antibacterial susceptibility patterns of pathogens isolated from skin and soft-tissue infections in dermatology departments in Japan. J Infect Chemother 2017. [PMID: 28645883 DOI: 10.1016/j.jiac.2017.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
To investigate the trends of antimicrobial resistance in pathogens isolated from skin and soft-tissue infections (SSTI) at dermatology departments in Japan, a Japanese surveillance committee conducted the first nationwide survey in 2013. Three main organisms were collected from SSTI at 30 dermatology departments in medical centers and 10 dermatology clinics. A total of 860 strains - 579 of Staphylococcus aureus, 240 of coagulase-negative Staphylococci, and 41 of Streptococcus pyogenes - were collected and shipped to a central laboratory for antimicrobial susceptibility testing. The patient profiles were also studied. Among all 579 strains of S. aureus, 141 (24.4%) were methicillin-resistant (MRSA). Among 97 Staphylococcus epidermidis strains, 54 (55.7%) were methicillin-resistant (MRSE). MRSA and MRSE were more frequently isolated from inpatients than from outpatients. Furthermore, these methicillin-resistant strains were also isolated more frequently from patients with histories of taking antibiotics within 4 weeks and hospitalization within 1 year compared to those without. However, there were no significant differences in MIC values and susceptibility patterns of the MRSA strains between patients with a history of hospitalization within 1 year and those without. Therefore, most of the isolated MRSA cases at dermatology departments are not healthcare-acquired, but community-acquired MRSA. S. pyogenes strains were susceptible to most antibiotics except macrolides. The information in this study is not only important in terms of local public health but will also contribute to an understanding of epidemic clones of pathogens from SSTI.
Collapse
Affiliation(s)
- Shinichi Watanabe
- Dermatological Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan.
| | - Takamitsu Ohnishi
- Dermatological Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Akira Yuasa
- Dermatological Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Hiroshi Kiyota
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | - Satoshi Iwata
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | - Mitsuo Kaku
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | - Akira Watanabe
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | - Hideaki Hanaki
- Infection Control Laboratory & Infection Control Research Center, Kitasato University, Tokyo, Japan
| | - Motomu Manabe
- Department of Dermatology and Plastic Surgery, Akita University, Graduate School of Medicine and Faculty of Medicine, Akita, Japan
| | - Tamio Suzuki
- Department of Dermatology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Fujio Otsuka
- Department of Dermatology, Center for Medical Education and Training, University of Tsukuba Hospital, Ibaraki, Japan
| | - Michiko Aihara
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Ken Iozumi
- Department of Dermatology, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Takeshi Tamaki
- Department of Dermatology, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | | | | | - Go Kikyo
- Go Dermatology Clinic, Tokyo, Japan
| | | | | | | | | | | | - Rie Ito
- Department of Dermatology, Saitama Cooperative Hospital, Saitama, Japan
| | - Ryuhei Okuyama
- Department of Dermatology, Shinshu University School of Medicine, Nagano, Japan
| | - Shinji Shimada
- Department of Dermatology, University of Yamanashi Hospital, Yamanashi, Japan
| | - Tadamichi Shimizu
- Department of Dermatology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Naohito Hatta
- Department of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Maeda Manabu
- Department of Dermatology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Kiyohiro Tsutsui
- Department of Dermatology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Toshihiro Tanaka
- Department of Dermatology, Shiga University of Medical Science, Shiga, Japan
| | - Yoshiki Miyachi
- Department of Dermatology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Hideo Asada
- Department of Dermatology, Nara Medical University Hospital, Nara, Japan
| | - Fukumi Furukawa
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | | | - Keiji Iwatsuki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Michihiro Hide
- Department of Dermatology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiko Muto
- Department of Dermatology, Yamaguchi University, Graduate School of Medicine, Yamaguchi, Japan
| | - Osamu Yamamoto
- Department of Dermatology, Tottori University Hospital, Tottori, Japan
| | - Hiroyuki Niihara
- Department of Dermatology, Shimane University Hospital, Shimane, Japan
| | - Kenji Takagaki
- Department of Dermatology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Yasuo Kubota
- Department of Dermatology, Kagawa University Hospital, Kagawa, Japan
| | - Koji Sayama
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School Hospital, Kochi, Japan
| | - Masutaka Furue
- Department of Dermatology, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takuro Kanekura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| |
Collapse
|
32
|
Fan Y, Wang X, Li L, Yao Z, Chen S, Ye X. Potential Relationship between Phenotypic and Molecular Characteristics in Revealing Livestock-Associated Staphylococcus aureus in Chinese Humans without Occupational Livestock Contact. Front Microbiol 2016; 7:1517. [PMID: 27729903 PMCID: PMC5037164 DOI: 10.3389/fmicb.2016.01517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/09/2016] [Indexed: 01/20/2023] Open
Abstract
While some studies have defined Staphylococcus aureus based on its clonal complex and resistance pattern, few have explored the relations between the genetic lineages and antibiotic resistance patterns and immune evasion cluster (IEC) genes. Our aim was to investigate the potential relationship between phenotypic and molecular characteristics so as to reveal livestock-associated S. aureus in humans. The study participants were interviewed, and they provided two nasal swabs for S. aureus analysis. All S. aureus and methicillin-resistant S. aureus (MRSA) were tested for antibiotic susceptibility, multilocus sequence type and IEC genes. Of the 1162 participants, 9.3% carried S. aureus, including MRSA (1.4%) and multidrug-resistant S. aureus (MDRSA, 2.8%). The predominant multidrug-resistant pattern among MDRSA isolates was non-susceptibility to erythromycin, clindamycin and tetracycline. The most common S. aureus genotypes were ST7, ST6, ST188, and ST59, and the predominant MRSA genotype was ST7. Notably, the livestock-associated S. aureus isolates (IEC-negative CC9, IEC-negative tetracycline-resistant CC398, and IEC-negative tetracycline-resistant CC5) were found in people with no occupational livestock contact. These findings reveal a potential relationship between S. aureus CCs and IEC genes and antibiotic resistance patterns in defining livestock-associated S. aureus in humans and support growing concern about the potential livestock-to-human transmission of livestock-associated S. aureus by non-occupational livestock contact.
Collapse
Affiliation(s)
- Yanping Fan
- School of Public Health, Guangdong Pharmaceutical University Guangzhou, China
| | - Xiaolin Wang
- School of Public Health, Guangdong Pharmaceutical University Guangzhou, China
| | - Ling Li
- School of Public Health, Guangdong Pharmaceutical University Guangzhou, China
| | - Zhenjiang Yao
- School of Public Health, Guangdong Pharmaceutical University Guangzhou, China
| | - Sidong Chen
- School of Public Health, Guangdong Pharmaceutical University Guangzhou, China
| | - Xiaohua Ye
- School of Public Health, Guangdong Pharmaceutical University Guangzhou, China
| |
Collapse
|
33
|
Huh K, Chung DR. Changing epidemiology of community-associated methicillin-resistant Staphylococcus aureus in the Asia-Pacific region. Expert Rev Anti Infect Ther 2016; 14:1007-1022. [PMID: 27645549 DOI: 10.1080/14787210.2016.1236684] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become an important threat to public health in the Asia-Pacific region, which is characterized by a large population and relatively insufficient resources. Better understanding on the current status of CA-MRSA in the region is of paramount importance. Areas covered: This article reviews the published literatures on the prevalence, molecular epidemiology, colonization, and hospital spread of CA-MRSA. Expert commentary: The burden of CA-MRSA has been increasing in the past two decades. The molecular epidemiology of CA-MRSA in the Asia-Pacific region shows a marked diversity in each country. Still, some strains - multilocus sequence type (MLST) ST59, ST30, ST72, ST8, and ST772 - are unique clones that have successfully established themselves as predominant, often spreading into nosocomial settings. More coordinated and comprehensive surveillance to understand the true epidemiology of CA-MRSA in the Asia-Pacific region is urgently needed.
Collapse
Affiliation(s)
- Kyungmin Huh
- a Division of Infectious Diseases, Department of Internal Medicine , Armed Forces Capital Hospital , Seongnam , Korea
| | - Doo Ryeon Chung
- b Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul , Korea
| |
Collapse
|
34
|
Kuroda T, Kinoshita Y, Niwa H, Shinzaki Y, Tamura N, Hobo S, Kuwano A. Meticillin-resistant Staphylococcus aureus colonisation and infection in Thoroughbred racehorses and veterinarians in Japan. Vet Rec 2016; 178:473. [PMID: 27114407 DOI: 10.1136/vr.103576] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2015] [Indexed: 11/04/2022]
Abstract
Meticillin-resistant Staphylococcus aureus (MRSA) infections have been confirmed in hospitalised Thoroughbred racehorses at the hospitals of two training centres in Japan since 2009. To investigate the source of infection, the authors examined the rate of nasal MRSA colonisation in 600 healthy Thoroughbred racehorses, 53 veterinarians and 16 office staff at the racehorse hospitals of the two training centres. MRSA was not isolated from healthy Thoroughbred racehorses or hospital office staff. However, MRSA was isolated from 16 veterinarians (30.1 per cent), and the colonisation rate was significantly higher in veterinarians than in the office staff of the same hospitals. Also, 10 of the 16 MRSA strains (62.5 per cent) isolated from veterinarians were classified as type II by staphylococcal cassette chromosome mec (SCCmec) typing and ST5 by multilocus sequence typing. Pulsed-field gel electrophoresis analysis demonstrated that these 10 MRSA strains of SCCmec type II and ST5 were genetically identical or very similar to 9 MRSA strains isolated from infected horses hospitalised at these hospitals between 2009 and 2013. These results indicate that SCCmec type II and ST5 MRSA strains were probably transmitted between veterinarians and infected horses.
Collapse
Affiliation(s)
- T Kuroda
- Clinical Science & Pathobiology Division, Equine Research Institute, Japan Racing Association, Tokami-Cho 321-4, Utsunomiya, Tochigi 320-0856, Japan
| | - Y Kinoshita
- Microbiology Division, Epizootic Research Center, Equine Research Institute, Japan Racing Association, Shiba 1400-4, Shimotsuke, Tochigi 329-0412, Japan
| | - H Niwa
- Microbiology Division, Epizootic Research Center, Equine Research Institute, Japan Racing Association, Shiba 1400-4, Shimotsuke, Tochigi 329-0412, Japan
| | - Y Shinzaki
- Racehorse Clinic, Ritto Training Center, Japan Racing Association, Misono 1028, Ritto, Shiga 520-3085, Japan
| | - N Tamura
- Clinical Science & Pathobiology Division, Equine Research Institute, Japan Racing Association, Tokami-Cho 321-4, Utsunomiya, Tochigi 320-0856, Japan
| | - S Hobo
- Department of Domestic Animal Internal Medicine, Clinical Veterinary Science, Veterinary Medicine, Joint Faculty of Veterinary Medicine, Kagoshima University, Korimoto 1-21-24, Kagoshima, Kagoshima 890-0065, Japan
| | - A Kuwano
- Clinical Science & Pathobiology Division, Equine Research Institute, Japan Racing Association, Tokami-Cho 321-4, Utsunomiya, Tochigi 320-0856, Japan
| |
Collapse
|