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Xin W, Gao Y, Yue B. Recent Advances in Multifunctional Hydrogels for the Treatment of Osteomyelitis. Front Bioeng Biotechnol 2022; 10:865250. [PMID: 35547176 PMCID: PMC9081433 DOI: 10.3389/fbioe.2022.865250] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Osteomyelitis (OM), a devastating disease caused by microbial infection of bones, remains a major challenge for orthopedic surgeons. Conventional approaches for prevention and treatment of OM are unsatisfactory. Various alternative strategies have been proposed, among which, hydrogel-based strategies have demonstrated potential due to their unique properties, including loadable, implantable, injectable, printable, degradable, and responsive to stimuli. Several protocols, including different hydrogel designs, selection of antimicrobial agent, co-administration of bone morphogenetic protein 2 (BMP 2), and nanoparticles, have been shown to improve the biological properties, including antimicrobial effects, osteo-induction, and controlled drug delivery. In this review, we describe the current and future directions for designing hydrogels and their applications to improve the biological response to OM in vivo.
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Wang X, Lin D, Huang Z, Zhang J, Xie W, Liu P, Jing H, Wang J. Clonality, virulence genes, and antibiotic resistance of Staphylococcus aureus isolated from blood in Shandong, China. BMC Microbiol 2021; 21:281. [PMID: 34657588 PMCID: PMC8522240 DOI: 10.1186/s12866-021-02344-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/01/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Bloodstream infection (BSI) caused by Staphylococcus aureus (S. aureus) can be life-threatening and pose a great challenge to infection control and clinical treatment. However, little information exists regarding the characterization of S. aureus in BSI patients in Shandong, China. To identify the clonality, virulence genes, and antibiotic resistance of S. aureus in blood, a total of 101 nonrepetitive blood isolates were collected. The antibiotic resistance phenotypes were determined, and virulence genes were analyzed with polymerase chain reaction (PCR). Finally, the genetic relatedness was investigated with Staphylococcus chromosomal cassette mec (SCCmec) typing for methicillin-resistant S. aureus (MRSA) isolates, Staphylococcal protein A (spa), and multilocus sequence typing (MLST) for all of 101 isolates. RESULTS Of the 101 S. aureus isolates, 24 MRSA isolates and 77 methicillin-susceptible S. aureus (MSSA) isolates were identified. Overall, MRSA isolates had higher resistance rates than MSSA isolates when exposed to any of the 15 antibiotics tested in this study except for trimethoprim/sulfamethoxazole. Among the 17 virulence genes tested in this study, hla, hld, and hlg could be detected in all isolates. MRSA isolates were more likely to carry seb and hlb genes, while MSSA isolates were more likely to carry seg and sei genes. Thirty-five sequence types (STs) and 49 spa types were identified, of which ST59-t437 and ST398-t571 were the most abundant. These two genotypes were also the most abundant ST-spa types in MRSA and MSSA isolates, but their abundances shifted over time, with ST398-t571 being the predominant genotype from 2016 to 2017, and ST59-t437 from 2018 to 2020. Besides, all the ST59-t437 isolates harbored hlgb gene, whereas most (88.9%) ST398-t571 did not. In addition, twenty-four MRSA isolates were subject to SCCmec typing. SCCmec IVa was the most prevalent SCCmec type, and all the ST59-t437 MRSA isolates were SCCmec IVa. We also observed 15 new STs, and some of them were MRSA. CONCLUSION These findings provide additional observations and epidemiological data for blood S. aureus isolates, which can improve future infection-control measures and aid in potential clinical treatments in hospitals and other clinical settings.
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Affiliation(s)
- Xuezhi Wang
- Department of Laboratory Medicine, Foshan Fourth People's Hospital, Foshan, 528000, Guangdong, China
| | - Dongzi Lin
- Department of Laboratory Medicine, Foshan Fourth People's Hospital, Foshan, 528000, Guangdong, China
| | - Zengqi Huang
- Department of Laboratory Medicine, Foshan Fourth People's Hospital, Foshan, 528000, Guangdong, China
| | - Jinmei Zhang
- Department of Laboratory Medicine, Foshan Fourth People's Hospital, Foshan, 528000, Guangdong, China
| | - Wenyan Xie
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, 250014, Shandong, China
| | - Pen Liu
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, 250014, Shandong, China
| | - Huaiqi Jing
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Changping, Beijing, 102206, People's Republic of China
| | - Jiazheng Wang
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, 250014, Shandong, China.
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Egyir B, Bentum J, Attram N, Fox A, Obeng-Nkrumah N, Appiah-Korang L, Behene E, Kumordjie S, Yeboah C, Agbodzi B, Bentil RE, Tagoe R, Kofi Adu Tabi B, Owusu F, Dayie NTKD, Donkor ES, Nsaful J, Asah-Opoku K, Nyarko E, Asumanu E, Larsen AR, Wolfe DM, Letizia AG. Whole Genome Sequencing and Antimicrobial Resistance of Staphylococcus aureus from Surgical Site Infections in Ghana. Pathogens 2021; 10:pathogens10020196. [PMID: 33673230 PMCID: PMC7918159 DOI: 10.3390/pathogens10020196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022] Open
Abstract
Staphylococcus aureus (S. aureus) is a common cause of surgical site infections (SSIs) globally. Data on the occurrence of methicillin-susceptible S. aureus (MSSA) as well as methicillin-resistant S. aureus (MRSA) among patients with surgical site infections (SSIs) in sub-Saharan African are scarce. We characterized S. aureus from SSIs in Ghana using molecular methods and antimicrobial susceptibility testing (AST). Wound swabs or aspirate samples were collected from subjects with SSIs. S. aureus was identified by matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF-MS); AST was performed by Kirby-Bauer disk diffusion, and results were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guideline. Detection of spa, mecA, and pvl genes was performed by polymerase chain reaction (PCR). Whole-genome sequencing (WGS) was done using the Illumina MiSeq platform. Samples were collected from 112 subjects, with 13 S. aureus isolates recovered. Of these, 92% were sensitive to co-trimoxazole, 77% to clindamycin, and 54% to erythromycin. Multi-drug resistance was detected in 5 (38%) isolates. The four mecA gene-positive MRSA isolates detected belonged to ST152 (n = 3) and ST5 (n = 1). In total, 62% of the isolates were positive for the Panton-Valentine leukocidin (pvl) toxin gene. This study reports, for the first time, a pvl-positive ST152-t355 MRSA clone from SSIs in Ghana. The occurrence of multi-drug-resistant S. aureus epidemic clones suggests that continuous surveillance is required to monitor the spread and resistance trends of S. aureus in hospital settings in the country.
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Affiliation(s)
- Beverly Egyir
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Correspondence:
| | - Jeannette Bentum
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Naiki Attram
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Anne Fox
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra 00233, Ghana;
| | - Labi Appiah-Korang
- Department of Microbiology, Korle-Bu Teaching Hospital, Accra 00233, Ghana;
| | - Eric Behene
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Selassie Kumordjie
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Clara Yeboah
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Bright Agbodzi
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Ronald Essah Bentil
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Rhodalyn Tagoe
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
| | - Blessing Kofi Adu Tabi
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
| | - Felicia Owusu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra 00233, Ghana; (J.B.); (R.T.); (B.K.A.T.); (F.O.)
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Nicholas T. K. D. Dayie
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana; (N.T.K.D.D.); (E.S.D.)
| | - Eric S. Donkor
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana; (N.T.K.D.D.); (E.S.D.)
| | - Josephine Nsaful
- Department of Surgery, Korle-bu Teaching Hospital, Accra 00233, Ghana;
| | - Kwaku Asah-Opoku
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Accra 00233, Ghana;
| | - Edward Nyarko
- 37 Military Hospital, Accra 00233, Ghana; (E.N.); (E.A.)
| | - Edward Asumanu
- 37 Military Hospital, Accra 00233, Ghana; (E.N.); (E.A.)
| | - Anders Rhod Larsen
- Statens Serum Institut, Department of Bacteria, Parasites and Fungi, Reference Laboratory for Antimicrobial Resistance, Artillerivej 5, DK-2300 Copenhagen, Denmark;
| | - David M. Wolfe
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
| | - Andrew G. Letizia
- Naval Medical Research Unit—Three, Ghana Detachment, Accra 00233, Ghana; (N.A.); Ghana; (A.F.); (E.B.); (S.K.); (C.Y.); (B.A.); (R.E.B.); (D.M.W.); (A.G.L.)
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Genovese C, La Fauci V, D'Amato S, Squeri A, Anzalone C, Costa GB, Fedele F, Squeri R. Molecular epidemiology of antimicrobial resistant microorganisms in the 21th century: a review of the literature. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:256-273. [PMID: 32420962 PMCID: PMC7569612 DOI: 10.23750/abm.v91i2.9176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/10/2020] [Indexed: 12/26/2022]
Abstract
Healthcare-associated infections (HAIs) are the most frequent and severe complication acquired in healthcare settings with high impact in terms of morbidity, mortality and costs. Many bacteria could be implicated in these infections, but, expecially multidrug resistance bacteria could play an important role. Many microbial typing technologies have been developed until to the the bacterial whole-genome sequencing and the choice of a molecular typing method therefore will depend on the skill level and resources of the laboratory and the aim and scale of the investigation. In several studies the molecular investigation of pathogens involved in HAIs was performed with many microorganisms identified as causative agents such as Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Clostridium difficile, Acinetobacter spp., Enterobacter spp., Enterococcus spp., Staphylococcus aureus and several more minor species. Here, we will describe the most and least frequently reported clonal complex, sequence types and ribotypes with their worldwide geographic distribution for the most important species involved in HAIs.
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Affiliation(s)
- Cristina Genovese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - Vincenza La Fauci
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - Smeralda D'Amato
- Postgraduate Medical School in Hygiene and Preventive Medicine, University of Messina, Italy.
| | - Andrea Squeri
- Department of Human Pathology of the adult and developmental age Gaetano Barresi, University of Messina, Messina, Italy.
| | - Carmelina Anzalone
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - Gaetano Bruno Costa
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
| | - Francesco Fedele
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
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Li Y, Li G, Sha X, Li L, Zhang K, Liu D, Hao Y, Cui X, Wang L, Wang H. An intelligent vancomycin release system for preventing surgical site infections of bone tissues. Biomater Sci 2020; 8:3202-3211. [PMID: 32374304 DOI: 10.1039/d0bm00255k] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
An intelligent anti-bacterial system can be constructed on implants during surgery.
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Affiliation(s)
- Yuan Li
- College of Medicine
- Southwest Jiaotong University
- Chengdu 610036
- China
- CAS Center for Excellence in Nanoscience
| | - Guang Li
- College of Medicine
- Hebei North University
- Zhangjiakou 075000
- China
| | - Xiaoling Sha
- College of Medicine
- Southwest Jiaotong University
- Chengdu 610036
- China
- CAS Center for Excellence in Nanoscience
| | - Litao Li
- Department of Orthopaedics
- The 8thMedical Center of Chinese PLA General Hospital
- Beijing 100000
- China
| | - Kuo Zhang
- CAS Center for Excellence in Nanoscience
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety
- National Center for Nanoscience and Technology (NCNST)
- Beijing 100000
- China
| | - Daohong Liu
- Department of Orthopaedics
- The 8thMedical Center of Chinese PLA General Hospital
- Beijing 100000
- China
| | - Yanfei Hao
- Department of Orthopaedics
- The 8thMedical Center of Chinese PLA General Hospital
- Beijing 100000
- China
| | - Xu Cui
- Department of Orthopaedics
- The 8thMedical Center of Chinese PLA General Hospital
- Beijing 100000
- China
| | - Lei Wang
- CAS Center for Excellence in Nanoscience
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety
- National Center for Nanoscience and Technology (NCNST)
- Beijing 100000
- China
| | - Hao Wang
- CAS Center for Excellence in Nanoscience
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety
- National Center for Nanoscience and Technology (NCNST)
- Beijing 100000
- China
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Li X, Fang F, Zhao J, Lou N, Li C, Huang T, Li Y. Molecular characteristics and virulence gene profiles of Staphylococcus aureus causing bloodstream infection. Braz J Infect Dis 2018; 22:487-494. [PMID: 30594541 PMCID: PMC9425660 DOI: 10.1016/j.bjid.2018.12.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/17/2022] Open
Abstract
Background The rate of methicillin-resistant Staphylococcus aureus (MRSA) among the total of S. aureus isolates decreased to 35.3% in 2017 in China. It is unclear whether the molecular characteristics of S. aureus isolates have changed as the rate decreased. Objective This study aimed to investigate the molecular characteristics and virulence genes profile of S. aureus isolates causing bloodstream infection and analyze the correlation between the prevalence rates of the common sequence types and MRSA. Methods A total of 112 S. aureus strains from eight hospitals of four cities, including 32 MRSA isolates, were identified and evaluated through multilocus sequence typing, spa typing, and determination of virulence genes. Results Twenty-five STs were identified, of which ST5 (21.4%) was the most prevalent, whereas the prevalence of ST239 correlated with the rate of MRSA among all S. aureus isolates. Forty-six spa types were identified, of which t2460 (14.3%) was the most common. clfa, hla, seb, fnbA and hlb were the prevailing virulence genes. 81.3% MRSA and 45.0% methicillin-sensitive S. aureus (MSSA) isolates harbored six or more tested virulence genes. ST5-t2460, seldom noted in bloodborne S. aureus isolates in China, was the most common clone. The prevalence of harboring six or more virulence genes in ST5-t2460 and ST188-t189 were 93.8% and 8.3%, respectively. Conclusion ST5-t2460 was the most common clone in S. aureus causing bloodstream infection followed by ST188-t189, which had never been noted in China before. Moreover, ST5-t2460 harbored more virulence genes than ST188-t189, and the prevalence of ST239 clone decreased with the proportion of MRSA among all S. aureus isolates.
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Affiliation(s)
- Xuehan Li
- Wuhan University, Zhongnan Hospital, Department of Laboratory Medicine, Wuhan, China
| | - Fang Fang
- Wuhan University, Zhongnan Hospital, Department of Laboratory Medicine, Wuhan, China
| | - Jin Zhao
- Wuhan University, Zhongnan Hospital, Department of Laboratory Medicine, Wuhan, China
| | - Ning Lou
- Wuhan University, Zhongnan Hospital, Department of Laboratory Medicine, Wuhan, China
| | - Chenglin Li
- Peking Union Medical College & Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases & Fuwai Hospital, Center of Laboratory Medicine, Beijing, China
| | - Tao Huang
- Hainan General Hospital, Department of Laboratory Medicine, Haikou, China.
| | - Yirong Li
- Wuhan University, Zhongnan Hospital, Department of Laboratory Medicine, Wuhan, China.
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Liu Y, Du FL, Liu PP, Mei YF, Wan LG, Wei DD, Xu HY, Zhang W. Molecular Epidemiology and Virulence Features of Staphylococcus aureus Bloodstream Isolates in a Regional Burn Center in China, 2012–2016. Microb Drug Resist 2018; 24:1354-1360. [PMID: 29565724 DOI: 10.1089/mdr.2017.0209] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Yang Liu
- Department of Clinical Microbiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Fang-ling Du
- Department of Clinical Microbiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Pan-pan Liu
- Department of Clinical Microbiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yan-fang Mei
- Department of Clinical Microbiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - La-gen Wan
- Department of Clinical Microbiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dan-dan Wei
- Department of Clinical Microbiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Heng-yi Xu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Wei Zhang
- Department of Respiration, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Liu P, Hao Y, Ding Y, Yuan Z, Liu Y, Cai K. Fabrication of enzyme-responsive composite coating for the design of antibacterial surface. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:160. [PMID: 30350231 DOI: 10.1007/s10856-018-6171-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 10/12/2018] [Indexed: 06/08/2023]
Abstract
In this study, a type of bacteria enzyme-triggered antibacterial surface with a controlled release of Ag ions was developed. Firstly, chitosan-silver nanocomposites (Chi@Ag NPs) were in situ synthesized via using ascorbic acid as reducing agent. Chi@Ag NPs were characterized by transmission electron microscopy, ultraviolet-visible spectroscopy, X-ray diffraction and X-ray photoelectron spectroscopy. Subsequently, Chi@Ag NPs and hyaluronic acid (HA) were used to fabricate antibacterial composite coating via Layer-by-Layer (LBL) self-assembly method. The successful construction of Chi@Ag NPs/HA composite coating was confirmed by scanning electron microscopy, energy dispersive spectroscopy and contact angle measurements, respectively. Then, the amount of released Ag ion was analyzed by inductively coupled plasma atomic emission spectrometry, which demonstrated that the release of Ag ions from the surface could be triggered by enzyme (e.g. hyaluronidase). A series of antibacterial tests in vitro, including zone of inhibition test, bacterial viability assay, antibacterial rate measurement and bacteria adhesion observation, demonstrated that the enzyme-responsive surface could inhibit the growth of bacteria. On the whole, this study provides an alternative approach for the fabrication of antibacterial surfaces on synthetic materials in various fields with the minimal side effects on surrounding environment and human body.
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Affiliation(s)
- Peng Liu
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, 400044, Chongqing, China.
| | - Yansha Hao
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, 400044, Chongqing, China
| | - Yao Ding
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, 400044, Chongqing, China
| | - Zhang Yuan
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, 400044, Chongqing, China
| | - Yisi Liu
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, 400044, Chongqing, China
| | - Kaiyong Cai
- Key Laboratory of Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, 400044, Chongqing, China.
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Chen K, Lin S, Li P, Song Q, Luo D, Liu T, Zeng L, Zhang W. Characterization of Staphylococcus aureus isolated from patients with burns in a regional burn center, Southeastern China. BMC Infect Dis 2018; 18:51. [PMID: 29370771 PMCID: PMC5785813 DOI: 10.1186/s12879-018-2955-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 01/09/2018] [Indexed: 11/10/2022] Open
Abstract
Background S.aureus is a predominant pathogen that causes infection in critically ill patients, but little information exists regarding the characterization of S. aureus from different sources in burn patients in southeastern China. Methods We enrolled 125 patients with S. aureus infection in burns center between Jan 2014 and Dec 2015. S. aureus isolates were characterized by antimicrobial susceptibility test, toxin gene detection, and molecular typing with multilocus sequence type, staphylococcal protein A (spa) type, and staphylococcal cassette chromosome mec (SCCmec) type. Results Sixty-eight MRSA were isolated from SSTI and 31 from non-SSTI patients, respectively. Overall, the drug-resistant ability of S. aureus isolated from SSTI was higher than that from non-SSTI groups. SCCmecIII-CC239-t030 was the most common clone (38 from SSTIs, and 8 from non-SSTIs). Seg was the most common enterotoxin gene (21 from SSTIs and 33 from non-SSTIs). Isolates from SSTIs was more likely to carry seb (P = 0.04), while those from non-SSTIs tended to carry sea and seg (P = 0.002 and 0.01, respectively). Although isolates carried four hemolysin genes, there was no significant difference between them (P > 0.05). Conclusion SCCmecIII-CC239-t030 was the most common clone in Jiangxi burns center, China. The molecular characterization of S. aureus was quite different between SSTI and non-SSTI groups.
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Affiliation(s)
- Kaisen Chen
- Department of clinical laboratory, The first Affiliated Hospital of Nanchang university, Nanchang, 330006, China
| | - Shirong Lin
- Department of emergency, The first Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Peiqun Li
- The College of Public Health of Nanchang University, Nanchang, 330006, China
| | - Qiuyue Song
- The College of Public Health of Nanchang University, Nanchang, 330006, China
| | - Dong Luo
- Department of emergency, The first Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Tao Liu
- Department of respiration, The first Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Lingbing Zeng
- Department of respiration, The first Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Wei Zhang
- Department of respiration, The first Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
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Liu X, Deng S, Huang J, Huang Y, Zhang Y, Yan Q, Wang Y, Li Y, Sun C, Jia X. Dissemination of macrolides, fusidic acid and mupirocin resistance among Staphylococcus aureus clinical isolates. Oncotarget 2017; 8:58086-58097. [PMID: 28938539 PMCID: PMC5601635 DOI: 10.18632/oncotarget.19491] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/19/2017] [Indexed: 12/20/2022] Open
Abstract
As an increasingly common cause of skin infections worldwide, the prevalence of antibiotic-resistant Staphylococcus aureus (S. aureus) across China has not been well documented. This literature aims to study the resistance profile to commonly used antibiotics, including macrolides, fusidic acid (FA) and mupirocin, and its relationship to the genetic typing in 34 S. aureus strains, including 6 methicillin-resistant S. aureus (MRSA), isolated from a Chinese hospital. The MIC results showed 27 (79.4%), 1 (2.9%) and 6 (17.6%) isolates were resistant to macrolides, FA and mupirocin, respectively. Among 27 macrolide-resistant S. aureus isolates, 5 (18.5%) were also resistant to mupirocin and 1 (3.7%) to FA. A total of 13 available resistant genes were analyzed in 28 antibiotic-resistant strains using polymerase chain reaction (PCR). The positive rates of macrolide-resistant ermA, ermB, ermC, erm33 and low level mupirocin-resistant ileS mutations were 11.1%, 25.9%, 51.9%, 7.4% and 100%, respectively. Other determinants for FA- and high level mupirocin-resistance were not found. The results of multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) revealed 13 sequence types (STs) and 18 clusters in 23 resistant gene positive S. aureus isolates. Among these STs, ST5 was most prevalent, accounting for 18.2%. Notably, various clusters were found with similar resistance phenotype and genotype, exhibiting a weak genetic relatedness and high genetic heterogeneities. In conclusion, macrolides, especially erythromycin, are not appropriate to treat skin infections caused by S. aureus, and more effective measures are required to reduce the dissemination of macrolides, FA and mupirocin resistance of the pathogen.
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Affiliation(s)
- Xingmei Liu
- Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu 610500, China
| | - Shanshan Deng
- School of Laboratory Medicine, Chengdu Medical College, Chengdu 610500, China
| | - Jinwei Huang
- Institute of Antibiotics, The Fifth Affiliated Hospital, Wenzhou Medical University, Lishui 323000, China
| | - Yaling Huang
- Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu 610500, China
| | - Yu Zhang
- Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu 610500, China
| | - Qin Yan
- Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu 610500, China
| | - Yanhong Wang
- Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu 610500, China
| | - Yanyue Li
- Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu 610500, China
| | - Chengfu Sun
- Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu 610500, China
| | - Xu Jia
- Non-Coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu 610500, China
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11
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Song Z, Gu FF, Guo XK, Ni YX, He P, Han LZ. Antimicrobial Resistance and Molecular Characterization of Staphylococcus aureus Causing Childhood Pneumonia in Shanghai. Front Microbiol 2017; 8:455. [PMID: 28377752 PMCID: PMC5360135 DOI: 10.3389/fmicb.2017.00455] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 03/06/2017] [Indexed: 11/13/2022] Open
Abstract
Staphylococcus aureus or methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing pneumonia among children. To estimate the prevalence and molecular properties of S. aureus in children pneumonia in Shanghai, China, 107 hospitalized children with S. aureus pneumonia from two children's hospitals from January 2014 through June 2015 were studied. S. aureus isolates from the respiratory specimens were characterized by antimicrobial susceptibility, agr typing, toxin genes, multilocus sequence typing (MLST), spa, and SCCmec typing. Fifty-eight (54.2%, 58/107) were MSSA (methicillin-susceptible Staphylococcus aureus) and 49 (45.8%, 49/107) were MRSA. No isolates were found resistant to teicoplanin, sulfamethoxazole/trimethoprim, rifampicin, quinupristin/dalfopristin, linezolid, or vancomycin. However, these isolates showed high resistant rates to erythromycin, fosfomycin-trometamol and clindamycin. The agrI (87/107, 81.3%) was the most common agr allele, followed by agrIII(10/107, 9.3%), agrII(9/107, 8.4%), and agrIV(1/107, 0.9%). Six pvl-positive isolates (3 MRSA and 3 MSSA) and 7 isolates of livestock associated clone ST398 (4 MRSA, 3 MSSA) were identified. CC59 was found in 35 isolates (33 MRSA and 2 MSSA), constituting majority of MRSA (33/49, 67.35%). The dominant CC were CC59 (32.7%), CC188 (13.1%), CC7 (12.1%) and CC398 (9.3%) while t172 (16.8%), t189 (12.1%), t437 (9.3%), and t091 (9.3%) were the most common spa types. In conclusion, more particular concern should appeal to ST59-SCCmecIV-t172/t437 as it is the most common epidemic clone causing pneumonia among children in Shanghai.
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Affiliation(s)
- Zhen Song
- Faculty of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China
| | - Fei-Fei Gu
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China
| | - Xiao-Kui Guo
- Department of Immunology and Microbiology, Institutes of Medical Sciences, Shanghai Jiao Tong University School of Medicine Shanghai, China
| | - Yu-Xing Ni
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China
| | - Ping He
- Department of Immunology and Microbiology, Institutes of Medical Sciences, Shanghai Jiao Tong University School of Medicine Shanghai, China
| | - Li-Zhong Han
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China
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12
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Gu FF, Chen Y, Dong DP, Song Z, Guo XK, Ni YX, Han LZ. Molecular Epidemiology of Staphylococcus aureus among Patients with Skin and Soft Tissue Infections in Two Chinese Hospitals. Chin Med J (Engl) 2017; 129:2319-24. [PMID: 27647191 PMCID: PMC5040018 DOI: 10.4103/0366-6999.190673] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Staphylococcus aureus is one of the predominant causes of skin and soft tissue infections (SSTIs), but limited data were available regarding the characterization of S. aureus from SSTIs patients in Jiangsu Province in China. We aimed to investigate the molecular epidemiology of S. aureus among SSTIs patients in two hospitals of Jiangsu Province. Methods: Sixty-two patients with SSTIs from two Chinese hospitals in Jiangsu Province were enrolled in this study, and 62 S. aureus isolates were collected from February 2014 to January 2015. S. aureus isolates were characterized by antimicrobial susceptibility testing, toxin gene detection, and molecular typing with sequence type, Staphylococcus protein A gene type, accessory gene regulator (agr) group, and Staphylococcal cassette chromosome mec type. Results: Sixteen (25.8%) methicillin-resistant S. aureus (MRSA) isolates were detected, and there was no isolate found resistant to vancomycin, teicoplanin, sulfamethoxazole-trimethoprim, and linezolid. The sei was the toxin gene most frequently found, and no lukS/F-PV-positive isolates were detected among the SSTIs’ patients. Molecular analysis revealed that ST398 (10/62, 16.1%; 2 MRSA and 8 methicillin-susceptible S. aureus) to be the dominant clone, followed by ST5 (8/62, 12.9%) and ST7 (8/62, 12.9%). Conclusions: The livestock ST398 was the most common clone among patients with S. aureus SSTIs in Jiangsu Province, China. Surveillance and further studies on the important livestock ST398 clone in human infections are necessarily requested.
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Affiliation(s)
- Fei-Fei Gu
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ye Chen
- Laboratory, Haian Hospital, Nantong University, Nantong, Jiangsu 226600, China
| | - De-Ping Dong
- Laboratory, Haian Hospital, Nantong University, Nantong, Jiangsu 226600, China
| | - Zhen Song
- Faculty of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiao-Kui Guo
- Department of Microbiology and Parasitology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yu-Xing Ni
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Li-Zhong Han
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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13
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Cui Z, Feng T, Gu F, Li Q, Dong K, Zhang Y, Zhu Y, Han L, Qin J, Guo X. Characterization and complete genome of the virulent Myoviridae phage JD007 active against a variety of Staphylococcus aureus isolates from different hospitals in Shanghai, China. Virol J 2017; 14:26. [PMID: 28179010 PMCID: PMC5299689 DOI: 10.1186/s12985-017-0701-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 02/07/2017] [Indexed: 11/25/2022] Open
Abstract
Background The implementation of phage therapy is re-emerging with the increase in widespread antibiotic-resistant bacteria. Methods Staphylococcus phage JD007 was characterized and its complete genome sequence analysed. Results Staphylococcus phage JD007 was classified as belonging to the Myoviridae family based on its morphology, as observed by transmission electron microscopy. Its lytic activity was stable between pH 5–11 and below 42 °C; moreover, an absorbance curve showed that nearly 90% of the viral particles had adsorbed to its host after a 20 min co-incubation. The complete genome size is 141,836 bp, making JD007 one of the largest Staphylococcus phages of Myoviridae. No identifiable resistance or virulence genes were found in the JD007 genome. JD007 was able to lyse 95% of S. aureus isolates, including the prevalent ST239-MRSA and ST59-MRSA strains isolated from different hospitals in Shanghai, China, and inhibition assays showed that JD007 could inhibit S. aureus growth at a multiplicity of infection of 0.1. Conclusions The results suggested that Staphylococcus phage JD007 can potentially be used in phage therapy or for the detection of S. aureus. Electronic supplementary material The online version of this article (doi:10.1186/s12985-017-0701-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zelin Cui
- Department of Immunology and Microbiology, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China. .,Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
| | - Tingting Feng
- Department of Clinical Pharmacy, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Feifei Gu
- Department of Clinical Microbiology, Shanghai Ruijin hospital, Shanghai, 200025, China
| | - Qingtian Li
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ke Dong
- Department of Immunology and Microbiology, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Yan Zhang
- Department of Immunology and Microbiology, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Yongzhang Zhu
- Department of Immunology and Microbiology, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Lizhong Han
- Department of Clinical Microbiology, Shanghai Ruijin hospital, Shanghai, 200025, China
| | - Jinhong Qin
- Department of Immunology and Microbiology, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Xiaokui Guo
- Department of Immunology and Microbiology, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China.
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14
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Gu FF, Zhang J, Zhao SY, Yang ZR, Zhang YL, Xiao SZ, Wang S, Guo XK, Qu JM, Ni YX, Han LZ. Risk factors for methicillin-resistant Staphylococcus aureus carriage among residents in 7 nursing homes in Shanghai, China. Am J Infect Control 2016; 44:805-8. [PMID: 26996267 DOI: 10.1016/j.ajic.2016.01.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 01/11/2016] [Accepted: 01/15/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Nursing home residents are a population at risk for methicillin-resistant Staphylococcus aureus (MRSA) carriage, but few data about MRSA in this setting in Shanghai are available. The aim of this study is to determine the prevalence and risk factors for MRSA carriage in nursing home residents in Shanghai, China. METHODS Four hundred forty-three residents from 7 nursing homes in Shanghai, China, participated in this study; nasal and axillary swabs were obtained from these residents. Laboratory identification for S aureus and antimicrobial susceptibility testing were performed when isolated. Data, including individual resident characteristics and nursing home characteristics, were collected and analyzed. RESULTS Of the 443 participating residents, 99 (22.3%) and 45 (10.2%) residents were colonized by S aureus and MRSA, respectively. Previous hospitalization (odds ratio [OR], 2.564; 95% confidence interval [CI], 1.214-5.415; P = .014), presence of an invasive device (OR, 3.455; 95% CI, 1.678-7.113; P = .001), chloramphenicol therapy (OR, 7.672; 95% CI, 1.807-32.580; P = .006), and macrolides therapy (OR, 2.796; 95% CI, 1.056-7.403; P = .038) were independent risk factors for MRSA colonization. Low expenditure per month and less good sanitary condition also increased the risk for MRSA colonization. CONCLUSIONS Our study suggests that nursing homes are significant reservoirs for MRSA. Implementation of infection control strategies must be given high priority in nursing homes to fight the high prevalence of MRSA, and increased convenience and feasibility should also be realized with these control strategies for MRSA colonization.
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Affiliation(s)
- Fei-Fei Gu
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ji Zhang
- Department of Clinical Laboratory, Shanghai People's Hospital of Putuo District, Shanghai, China
| | - Sheng-Yuan Zhao
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Zhi-Rong Yang
- Center of Post-Marketing Safety Evaluation, Peking University Health Science Center, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yue-Lun Zhang
- Division of Epidemiology, School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Shu-Zhen Xiao
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Su Wang
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Kui Guo
- Department of Microbiology and Parasitology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie-Ming Qu
- Department of Pulmonary Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Xing Ni
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li-Zhong Han
- Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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15
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Prevalence and Molecular Epidemiology of Staphylococcus aureus among Residents of Seven Nursing Homes in Shanghai. PLoS One 2015; 10:e0137593. [PMID: 26340648 PMCID: PMC4560451 DOI: 10.1371/journal.pone.0137593] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/18/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Residents in nursing homes (NHs) always represent potential reservoirs for Staphylococcus aureus and methicillin-resistant S. aureus (MRSA). To our knowledge, there is no epidemiological information up till now that describes the prevalence and molecular characteristics of S. aureus in nursing home residents in Shanghai, China. METHODS Four hundred and ninety-one unique residents from 7 NHs were enrolled in this study. Specimens were collected among these residents including 491 nasal swabs, 487 axillary swabs and 119 skin swabs. S. aureus isolated and identified from the swabs was characterized according to antimicrobial susceptibility profiling, toxin gene prevalence, and multilocus sequence typing (MLST), spa and SCCmec typing. RESULTS Among the 491 residents screened, S. aureus was isolated in 109 residents from 90 nasal swabs (90/491, 18.3%), 29 axillary swabs (29/487, 6.0%), and 22 skin swabs (22/119, 18.5%). Sixty-eight MRSA isolates were detected in 52 residents from 41 nasal carriers, 15 axillary carriers and 12 skin carriers. The overall prevalence rate of S. aureus and MRSA colonization was 22.2% and 10.6% respectively. Ten residents presented S. aureus in all three sample types and 12 residents presented S. aureus in two of the three sample types collected. Molecular analysis revealed CC1 (29.1%) to be the dominant clone in this study, followed by CC398 (19.9%), CC188 (13.5%) and CC5 (12.8%). The most common spa type was t127 (22.0%), followed by t14383 (12.8%) and t002 (10.6%). CONCLUSIONS A high prevalence of S. aureus and MRSA colonization was revealed in nursing home residents in Shanghai. CC1 was the most common clonal complex and t127 was the most common spa type among NH residents. The data provides an important baseline for future surveillance of S. aureus in NHs in Shanghai and other highly urbanized regions in China. Implementation of infection control strategies must be given high priority in NHs to fight such high prevalence of both MRSA and methicillin-susceptible S. aureus (MSSA).
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