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Tran KQ, Nguyen TTD, Pham VH, Pham QM, Tran HD. Pathogenic Role and Antibiotic Resistance of Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Causing Severe Community-Acquired Pneumonia in Vietnamese Children. Adv Respir Med 2023; 91:135-145. [PMID: 37102779 PMCID: PMC10135923 DOI: 10.3390/arm91020012] [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: 02/05/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023]
Abstract
In recent years, the pathogenic role and antibiotic resistance of methicillin-resistant Staphylococcus aureus (MRSA) strains causing severe community-acquired pneumonia (CAP) have received increasing attention in clinical practice. The aim of this study was to determine the rate of isolates of MRSA strains causing severe CAP in children and to assess their level of antibiotic resistance. The study design was cross-sectional. Children with severe CAP were sampled by nasopharyngeal aspiration for the culture, isolation, and identification of MRSA. Antimicrobial susceptibility testing was performed using the gradient diffusion method to determine the minimum inhibitory concentration (MIC) of antibiotics. Results: MRSA was identified as the second leading cause of severe CAP in Vietnamese children. The rate of isolates of S. aureus was 41/239 (17.5%), of which most were MRSA, at 32/41 (78.0%). MRSA strains were completely non-susceptible to penicillin (100%), more resistant to clindamycin and erythromycin, less sensitive to ciprofloxacin and levofloxacin, and fully susceptible to vancomycin and linezolid, with a 32-fold decreased MIC90 for vancomycin (0.5 mg/L) and a 2-fold decreased MIC90 for linezolid (4 mg/L). Therefore, vancomycin and linezolid may be appropriate options for severe CAP identified by MRSA.
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Affiliation(s)
- Khai Quang Tran
- Department of Pediatrics, Can Tho University of Medicine and Pharmacy, Can Tho City 90000, Vietnam
| | | | - Van Hung Pham
- Laboratory of Nam Khoa Biotek Company, International Research of Gene and Immunology Institute, Ho Chi Minh City 700000, Vietnam
| | - Quan Minh Pham
- Department of Pediatrics, Can Tho University of Medicine and Pharmacy, Can Tho City 90000, Vietnam
| | - Hung Do Tran
- Department of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy, Can Tho City 90000, Vietnam
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Knox J, Uhlemann AC, Lowy FD. Stopping household MRSA transmission and recurrent infections: an unmet challenge. Clin Infect Dis 2020; 73:e4578-e4580. [PMID: 32520349 DOI: 10.1093/cid/ciaa745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/05/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Justin Knox
- Department of Epidemiology, Columbia University, New York, New York, USA
| | - Anne-Catrin Uhlemann
- Division of Infectious Diseases, Department of Medicine, Columbia University, College of Physicians and Surgeons, New York, New York, USA
| | - Franklin D Lowy
- Division of Infectious Diseases, Department of Medicine, Columbia University, College of Physicians and Surgeons, New York, New York, USA
- Department of Pathology and Cell Biology, Columbia University, College of Physicians and Surgeons, New York, New York, USA
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Grinberg A, Biggs PJ, Zhang J, Ritchie S, Oneroa Z, O'Neill C, Karkaba A, Velathanthiri NS, Coombs GW. Genomic epidemiology of methicillin-susceptible Staphylococcus aureus across colonisation and skin and soft tissue infection. J Infect 2017; 75:326-335. [PMID: 28782565 DOI: 10.1016/j.jinf.2017.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 07/29/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Staphylococcus aureus skin and soft tissue infection (Sa-SSTI) places a significant burden on healthcare systems. New Zealand has a high incidence of Sa-SSTI, and here most morbidity is caused by a polyclonal methicillin-susceptible (MSSA) bacterial population. However, MSSA also colonise asymptomatically the cornified epithelia of approximately 20% of the population, and their divide between commensalism and pathogenicity is poorly understood. We aimed to see whether MSSA are genetically differentiated across colonisation and SSTI; and given the close interactions between people and pets, whether strains isolated from pets differ from human strains. METHODS We compared the genomes of contemporaneous colonisation and clinical MSSA isolates obtained in New Zealand from humans and pets. RESULTS Core and accessory genome comparisons revealed a homogeneous bacterial population across colonisation, disease, humans, and pets. The rate of MSSA colonisation in dogs was comparatively low (5.4%). CONCLUSIONS In New Zealand, most Sa-SSTI morbidity is caused by a random sample of the colonising MSSA population, consistent with the opportunistic infection model rather than the paradigm distinguishing strains according to their pathogenicity. Thus, studies of the factors determining colonisation and immune-escape may be more beneficial than comparative virulence studies. Contact with house-hold pets may pose low zoonotic risk.
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Affiliation(s)
- Alex Grinberg
- Massey University, Institute of Veterinary, Animal and Biomedical Sciences, Private Bag 11,222, Palmerston North, 4442, New Zealand.
| | - Patrick J Biggs
- Massey University, Institute of Veterinary, Animal and Biomedical Sciences, Private Bag 11,222, Palmerston North, 4442, New Zealand
| | - Ji Zhang
- Massey University, Institute of Veterinary, Animal and Biomedical Sciences, Private Bag 11,222, Palmerston North, 4442, New Zealand
| | - Stephen Ritchie
- University of Auckland, Faculty of Medical and Health Sciences, Molecular Medicine and Pathology, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Zachary Oneroa
- Massey University, Institute of Veterinary, Animal and Biomedical Sciences, Private Bag 11,222, Palmerston North, 4442, New Zealand
| | - Charlotte O'Neill
- Massey University, Institute of Veterinary, Animal and Biomedical Sciences, Private Bag 11,222, Palmerston North, 4442, New Zealand
| | - Ali Karkaba
- Massey University, Institute of Veterinary, Animal and Biomedical Sciences, Private Bag 11,222, Palmerston North, 4442, New Zealand
| | - Niluka S Velathanthiri
- Massey University, Institute of Veterinary, Animal and Biomedical Sciences, Private Bag 11,222, Palmerston North, 4442, New Zealand
| | - Geoffrey W Coombs
- School of Veterinary and Life Sciences, Murdoch University, 90 South Street, Murdoch, WA, Australia
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May LS, Zocchi M, Zatorski C, Jordan JA, Rothman RE, Ware CE, Eells S, Miller L. Treatment Failure Outcomes for Emergency Department Patients with Skin and Soft Tissue Infections. West J Emerg Med 2015; 16:642-52. [PMID: 26587085 PMCID: PMC4644029 DOI: 10.5811/westjem.2015.7.26213] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/07/2015] [Accepted: 07/23/2015] [Indexed: 11/14/2022] Open
Abstract
Introduction Skin and soft tissue infections (SSTIs) are commonly evaluated in the emergency department (ED). Our objectives were to identify predictors of SSTI treatment failure within one week post-discharge in patients with cutaneous abscesses, as well as to identify predictors of recurrence within three months in that proportion of participants. Methods This was a sub-analysis of a parent study, conducted at two EDs, evaluating a new, nucleic acid amplification test (NAAT) for Staphylococcus aureus in ED patients. Patients ≥18 years receiving incision and drainage (I&D) were eligible. Patient-reported outcome data on improvement of fever, swelling, erythema, drainage, and pain were collected using a structured abstraction form at one week, one month, and three months post ED visit. Results We enrolled 272 participants (20 from a feasibility study and 252 in this trial), of which 198 (72.8%) completed one-week follow up. Twenty-seven additional one-week outcomes were obtained through medical record review rather than by the one-week follow-up phone call. One hundred ninety-three (73%) patients completed either the one- or three-month follow up. Most patients recovered from their initial infection within one week, with 10.2% of patients reporting one-week treatment failure. The odds of treatment failure were 66% lower for patients who received antibiotics following I&D at their initial visit. Overall SSTI recurrence rate was 28.0% (95% CI [21.6%–34.4%]) and associated with contact with someone infected with methicillin resistant S. aureus (MRSA), previous SSTI history, or clinician use of wound packing. Conclusion Treatment failure was reduced by antibiotic use, whereas SSTI recurrence was associated with prior contact, SSTI, or use of packing.
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Affiliation(s)
- Larissa S May
- University of California, Davis, Department of Emergency Medicine, Davis, California
| | - Mark Zocchi
- The George Washington University, Office for Clinical Practice Innovation, Washington, District of Columbia
| | - Catherine Zatorski
- The George Washington University, Department of Emergency Medicine, Washington, District of Columbia
| | - Jeanne A Jordan
- The George Washington University, Department of Epidemiology and Biostatistics, Washington, District of Columbia
| | - Richard E Rothman
- Johns Hopkins University, Department of Emergency Medicine, Baltimore, Maryland
| | - Chelsea E Ware
- The George Washington University, Department of Emergency Medicine, Washington, District of Columbia
| | - Samantha Eells
- Los Angeles BioMedical Research Center at Harbor - UCLA Medical Center, Torrance, California
| | - Loren Miller
- Los Angeles BioMedical Research Center at Harbor - UCLA Medical Center, Torrance, California
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Singer AJ, Talan DA. Management of skin abscesses in the era of methicillin-resistant Staphylococcus aureus. N Engl J Med 2014; 370:1039-47. [PMID: 24620867 DOI: 10.1056/nejmra1212788] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Adam J Singer
- From the Department of Emergency Medicine, Stony Brook University, Stony Brook, NY (A.J.S.); the Departments of Emergency Medicine and Medicine, Division of Infectious Diseases, Olive View-UCLA Medical Center, Sylmar, CA (D.A.T.); and the David Geffen School of Medicine at UCLA, Los Angeles (D.A.T.)
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