1
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Hwang YJ. Comparing the Phylogenetic Distribution of Multilocus Sequence Typing, Staphylococcal Protein A, and Staphylococcal Cassette Chromosome Mec Types in Methicillin-Resistant Staphylococcus Aureus (MRSA) in Korea from 1994 to 2020. Antibiotics (Basel) 2023; 12:1397. [PMID: 37760694 PMCID: PMC10525390 DOI: 10.3390/antibiotics12091397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Staphylococcus aureus (S. aureus) bacteremia is one of the most frequent and severe bacterial infections worldwide. Methicillin-resistant Staphylococcus aureus (MRSA) is a serious human pathogen that can cause a wide variety of infections. Comparative genetic analyses have shown that despite the existence of a vast number of genotypes, genotypes are restricted to certain geographical locations. By comparing multilocus sequence typing (MLST) and SCCmec types from 1994 to 2020, the present study intended to discover which genotype genes were related to MRSA infections. MLST, Staphylococcus aureus protein A (spa), and SCCmec typings were performed to determine their relationship during those years. Results revealed that MRSA isolates in the Republic of Korea were distributed among all major staphylococcal cassette chromosome mec (SCCmec) types. The majority of SCCmec isolates belonged to SCCmec type II and type IV. The majority of MLST had the sequence type (ST) 72, 239, 8, or 188. By contrast, minorities belonged to ST22 (SCCmec IV), ST772 (SCCmec V), and ST672 (SCCmec V) genotypes. The SCCmec type was determined for various types. The spa type was dispersed, seemingly regardless of its multidrug resistance property. The MLST type was found to be similar to the existing typical type. These results showed some correlations between resistance characteristics and types according to the characteristics of the MLST types distributed, compared to previous papers. Reports on genotype distribution of MLST and SCCmec types in MRSA are rare. These results show a clear distribution of MLST and SCCmec types of MRSA from 1994 to 2020 in the Republic of Korea.
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Affiliation(s)
- You-Jin Hwang
- Department of Biomedical Engineering, Gachon University, Incheon 21936, Republic of Korea; or ; Tel.: +82-032-820-4545; Fax: +82-032-820-4449
- Department of Health Sciences and Technology (GAIHST), Gachon University, Incheon 21999, Republic of Korea
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2
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Yuan Z, Wang J, Qu Q, Zhu Z, Xu M, Zhao M, Sun C, Peng H, Huang X, Dong Y, Dong C, Zheng Y, Yuan S, Li Y. Celastrol Combats Methicillin-Resistant Staphylococcus aureus by Targeting Δ 1 -Pyrroline-5-Carboxylate Dehydrogenase. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2302459. [PMID: 37381655 PMCID: PMC10477891 DOI: 10.1002/advs.202302459] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/22/2023] [Indexed: 06/30/2023]
Abstract
The emergence and rapid spread of methicillin-resistant Staphylococcus aureus (MRSA) raise a critical need for alternative therapeutic options. New antibacterial drugs and targets are required to combat MRSA-associated infections. Based on this study, celastrol, a natural product from the roots of Tripterygium wilfordii Hook. f., effectively combats MRSA in vitro and in vivo. Multi-omics analysis suggests that the molecular mechanism of action of celastrol may be related to Δ1 -pyrroline-5-carboxylate dehydrogenase (P5CDH). By comparing the properties of wild-type and rocA-deficient MRSA strains, it is demonstrated that P5CDH, the second enzyme of the proline catabolism pathway, is a tentative new target for antibacterial agents. Using molecular docking, bio-layer interferometry, and enzyme activity assays, it is confirmed that celastrol can affect the function of P5CDH. Furthermore, it is found through site-directed protein mutagenesis that the Lys205 and Glu208 residues are key for celastrol binding to P5CDH. Finally, mechanistic studies show that celastrol induces oxidative stress and inhibits DNA synthesis by binding to P5CDH. The findings of this study indicate that celastrol is a promising lead compound and validate P5CDH as a potential target for the development of novel drugs against MRSA.
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Affiliation(s)
- Zhongwei Yuan
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Jun Wang
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Qianwei Qu
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Zhenxin Zhu
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Marc Xu
- Shenzhen Institutes of Advanced TechnologyChinese Academy of SciencesShenzhen518055China
| | - Mengmeng Zhao
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Chongxiang Sun
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Haixin Peng
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Xingyu Huang
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Yue Dong
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Chunliu Dong
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Yadan Zheng
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
| | - Shuguang Yuan
- Shenzhen Institutes of Advanced TechnologyChinese Academy of SciencesShenzhen518055China
| | - Yanhua Li
- Heilongjiang Key Laboratory for Animal Disease Control and Pharmaceutical DevelopmentCollege of Veterinary MedicineNortheast Agricultural UniversityHarbin150030China
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3
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Yan J, Lyu X, Jiang Y, Ng KR, Yang R, Zhang F, Zhao W. Precise Photothermal Treatment of Methicillin-Resistant S. aureus Infection via Phage Lysin-Cell Binding Domain-Modified Gold Nanosheets. ACS APPLIED MATERIALS & INTERFACES 2023; 15:6514-6525. [PMID: 36695173 DOI: 10.1021/acsami.2c20102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The increasing spread of antibiotic resistance in bacterial pathogens poses a huge threat to global human health. Precise targeting of bacterial pathogens while avoiding collateral damage to healthy tissues has become the overriding goal for bacterial infection treatment. Inspired by the host specificity of bacteriophages, a biomimetic intelligent platform was designed for highly precise photothermal treatment herein. As proof-of-concept, the lysin cell-binding domain (CBD) from a newly discovered virulent methicillin-resistant S. aureus (MRSA) phage Z was applied to the functionalization of gold nanosheets. Our results demonstrated that the bionanocomposite gold particles (Au@PEG-CBDz) could be effectively delivered directly to MRSA and kill them effectively under near infrared irradiation in vitro, while displaying good in vivo biocompatibility. This work is the first to report the combination of phage lysin navigatory function with photothermal effect-induced bactericidal activity from Au nanosheets, providing a novel therapeutic mode for the precision treatment of antibiotic-resistant bacterial infections.
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Affiliation(s)
- Jiai Yan
- School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi, Jiangsu 214122, P. R. China
- Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, Jiangsu 214122, P. R. China
| | - Xiaomei Lyu
- School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi, Jiangsu 214122, P. R. China
| | - Yiming Jiang
- School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi, Jiangsu 214122, P. R. China
| | - Kuan Rei Ng
- Food Science and Technology Programme, Nanyang Technological University, Singapore 637459, Singapore
| | - Ruijin Yang
- School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi, Jiangsu 214122, P. R. China
| | - Feng Zhang
- Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, Wuxi, Jiangsu 214122, P. R. China
| | - Wei Zhao
- School of Food Science and Technology, Jiangnan University, 1800 Lihu Avenue, Wuxi, Jiangsu 214122, P. R. China
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4
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Huang S, He J, Zhang Y, Su L, Tong L, Sun Y, Zhou M, Chen Z. The Correlation Between Biofilm-Forming Ability of Community-Acquired Methicillin-Resistant Staphylococcus aureus Isolated from the Respiratory Tract and Clinical Characteristics in Children. Infect Drug Resist 2022; 15:3657-3668. [PMID: 35855760 PMCID: PMC9288189 DOI: 10.2147/idr.s370755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/17/2022] [Indexed: 01/09/2023] Open
Abstract
Objective This study aimed to investigate the biofilm-forming ability, molecular typing, and antimicrobial resistance of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) strains isolated from the respiratory tract of children and their correlation with clinical characteristics. Methods All CA-MRSA strains were isolated from hospitalized children, and their presentation, molecular typing, antimicrobial susceptibility, and biofilm formation were investigated. The clinical characteristics were compared between the strong and weak biofilm producer groups. Results Fifty-three CA-MRSA strains were isolated from the respiratory samples of 53 children, with nearly half of them being young infants (0-12 months). Approximately, 88.7% (47/53) of the isolates were resistant to four or more antibiotics, mainly β-lactam antibiotics, lincosamides, and macrolides. Twelve sequence types (STs) and 20 subtypes of staphylococcal protein A (spa) typing were identified, with ST59-t437 (39.6%, 21/53) as the predominant subtype. All strains showed the ability to form biofilms. When compared to children with weak biofilm-forming CA-MRSA strains, those with strong biofilm-forming strains had higher proportions of lower respiratory tract infections (LRTI) (88.5% vs 59.3%), obvious cough symptoms (84.6% vs 51.9%), and severe chest imaging manifestations (76.9% vs 37.0%). Furthermore, a strong biofilm-forming ability significantly increased the risk of prolonged cough in children with LRTI (44.4% vs 14.3%), and a positive correlation between the duration of cough and the extent of biofilm formation was observed. Medical history investigation revealed that the strong biofilm-forming group had a much higher percentage of macrolides intake than the weak biofilm-forming group in the last month before admission (61.5% vs 14.8%). Conclusion ST59-t437 was the most prevalent clone in CA-MRSA respiratory isolates among the hospitalized children. All CA-MRSA strains formed biofilms. The stronger the biofilm-forming ability, the more serious and prolonged were the respiratory symptoms.
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Affiliation(s)
- Shumin Huang
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People’s Republic of China,National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, 310052, People’s Republic of China
| | - Jing He
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People’s Republic of China,National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, 310052, People’s Republic of China
| | - Yiting Zhang
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People’s Republic of China,National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, 310052, People’s Republic of China
| | - Lin Su
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People’s Republic of China,National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, 310052, People’s Republic of China
| | - Lin Tong
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People’s Republic of China,National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, 310052, People’s Republic of China
| | - Ying Sun
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People’s Republic of China,National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, 310052, People’s Republic of China
| | - Mingming Zhou
- National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, 310052, People’s Republic of China,Department of Clinical Laboratory, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People’s Republic of China
| | - Zhimin Chen
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, People’s Republic of China,National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, 310052, People’s Republic of China,Correspondence: Zhimin Chen, Email
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5
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Tai CH, Liu WL, Pan SC, Ku SC, Lin FJ, Wu CC. Evaluation of the Negative Predictive Value of Methicillin-Resistant Staphylococcus aureus Nasal Swab Screening in the Medical Intensive Care Units and Its Effect on Antibiotic Duration. Infect Drug Resist 2022; 15:1259-1266. [PMID: 35355623 PMCID: PMC8959872 DOI: 10.2147/idr.s351832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background In addition to active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) carrier, MRSA nasal screening can be valuable for antibiotic de-escalation. This study aimed to assess the correlations between the MRSA nasal swab and subsequent culture results in patients admitted to medical intensive care units (MICU). The impact of MRSA nasal swab on the antibiotic duration was also evaluated. Materials and Methods This retrospective study enrolled patients who received glycopeptides in the MICU of a medical center in 2019. Patients treated with glycopeptides for over 2 days before MICU admission were excluded. The associated data were collected through the electronic medical record system. The negative predictive value (NPV) of MRSA nasal swabs for MRSA infection was calculated, and their influence on empirical glycopeptide treatment duration was analyzed. Results Of the 338 patients who met the inclusion criteria, 277 underwent MRSA nasal screening. The NPV of MRSA-negative nasal swab for subsequent MRSA infection was 98.4%. The glycopeptide treatment duration of the patients with and without nasal screening was not significantly different (4.2 ± 2.8 vs 4.4 ± 3.0 days, p = 0.577). Of the 120 patients with MRSA-negative nasal swab and no subsequent MRSA infection, 75 continued empirical glycopeptides therapy. The additional treatment time was 3 days (interquartile range: 2–6 days). Conclusion The MRSA nasal swabs have high NPV for MRSA infection in critically ill patients. However, it has no impact on the empirical glycopeptide treatment duration. The value of MRSA nasal swabs should be advocated to optimize antibiotic therapy.
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Affiliation(s)
- Chih-Hsun Tai
- Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wei-Ling Liu
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sung-Ching Pan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Chi Ku
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Fang-Ju Lin
- Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chih Wu
- Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
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6
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Bastos LR, Almeida MM, Marques EA, Leão RS. Colonização pré-operatória por Staphylococcus aureus e as bactérias não suscetíveis à cefalosporina, em pacientes com fratura proximal do fêmur. Rev Bras Ortop 2022; 57:726-733. [PMID: 36226207 PMCID: PMC9550373 DOI: 10.1055/s-0041-1735546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/07/2021] [Indexed: 11/30/2022] Open
Abstract
Objective
To estimate the frequency of
Staphylococcus aureus
and cephalosporin nonsusceptible bacteria colonization in patients with proximal femoral fracture during preoperative hospitalization.
Methods
Prevalence and incidence assessment in 63 hospitalized patients over 1 year. The median time of pretreatment hospitalization was 12 days. Samples were collected from the nostrils, groin skin and anal mucosa during the pretreatment hospitalization and were tested by the disc-diffusion technique.
Results
The hospital colonization incidence and the prevalence of positive results were 14.3 and 44.4% for
S. aureus
; 3.2 and 6.4% for meticillin-resistant
S. aureus
; 28.6 and 85.7% for meticillin-resistant coagulase-negative
Staphylococcus
; 28.6 and 61.9% for cefazolin nonsusceptible
Enterobacteriaceae
(KFNSE); and 20.6 and 28.6% for cefuroxime nonsusceptible
Enterobacteriaceae
(CXNSE). In addition, factors such as to the duration of the pretreatment hospitalization period, being non-walker before fracture, antimicrobial use, American Society of Anesthesiologists (ASA) 4 surgical risk, and previous hospitalization, were related to an increase in the incidence of hospital acquisition and prevalence of colonization by the evaluated strains. The prevalence of colonization by KFNSE was three times higher than by CXNSE on admission, and twice as high at the time of fracture treatment.
Conclusion
There was a high incidence of hospital colonization and prevalence of colonization by all strains studied, which may guide the indication of prophylactic measures for infection.
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Affiliation(s)
- Leonardo R. Bastos
- Seção de Ortopedia e Traumatologia, Hospital Geral de Fortaleza/Exército Brasileiro, Fortaleza, CE, Brasil
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
| | - Mila M. Almeida
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
| | - Elizabeth A. Marques
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
| | - Robson Souza Leão
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
- Laboratórios de Bacteriologia e Micobactérias, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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7
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Gutiérrez D, Rodríguez-Rubio L, Ruas-Madiedo P, Fernández L, Campelo AB, Briers Y, Nielsen MW, Pedersen K, Lavigne R, García P, Rodríguez A. Design and Selection of Engineered Lytic Proteins With Staphylococcus aureus Decolonizing Activity. Front Microbiol 2021; 12:723834. [PMID: 34594314 PMCID: PMC8477017 DOI: 10.3389/fmicb.2021.723834] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/10/2021] [Indexed: 12/15/2022] Open
Abstract
Staphylococcus aureus causes various infections in humans and animals, the skin being the principal reservoir of this pathogen. The widespread occurrence of methicillin-resistant S. aureus (MRSA) limits the elimination and treatment of this pathogen. Phage lytic proteins have been proven as efficient antimicrobials against S. aureus. Here, a set of 12 engineered proteins based on endolysins were conceptualized to select the most optimal following a stepwise funnel approach assessing parameters including turbidity reduction, minimum inhibitory concentration (MIC), time-kill curves, and antibiofilm assays, as well as testing their stability in a broad range of storage conditions (pH, temperature, and ionic strength). The engineered phage lysins LysRODIΔAmi and ClyRODI-H5 showed the highest specific lytic activity (5 to 50 times higher than the rest), exhibited a shelf-life up to 6 months and remained stable at temperatures up to 50°C and in a pH range from 3 to 9. LysRODIΔAmi showed the lower MIC values against all staphylococcal strains tested. Both proteins were able to kill 6 log units of the strain S. aureus Sa9 within 5 min and could remove preformed biofilms (76 and 65%, respectively). Moreover, LysRODIΔAmi could prevent biofilm formation at low protein concentrations (0.15–0.6 μM). Due to its enhanced antibiofilm properties, LysRODIΔAmi was selected to effectively remove S. aureus contamination in both intact and disrupted keratinocyte monolayers. Notably, this protein did not demonstrate any toxicity toward human keratinocytes, even at high concentrations (22.1 μM). Finally, a pig skin ex vivo model was used to evaluate treatment of artificially contaminated pig skin using LysRODIΔAmi (16.5 μg/cm2). Following an early reduction of S. aureus, a second dose of protein completely eradicated S. aureus. Overall, our results suggest that LysRODIΔAmi is a suitable candidate as antimicrobial agent to prevent and treat staphylococcal skin infections.
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Affiliation(s)
- Diana Gutiérrez
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Asturias, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.,Laboratory of Applied Biotechnology, Department of Biotechnology, Ghent University, Ghent, Belgium
| | - Lorena Rodríguez-Rubio
- Laboratory of Gene Technology, Department of Biosystems, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Patricia Ruas-Madiedo
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Asturias, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Lucía Fernández
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Asturias, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Ana Belén Campelo
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Asturias, Spain
| | - Yves Briers
- Laboratory of Applied Biotechnology, Department of Biotechnology, Ghent University, Ghent, Belgium
| | - Martin Weiss Nielsen
- Department of Microbiology and Production, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Karl Pedersen
- Department of Microbiology and Production, National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Rob Lavigne
- Laboratory of Gene Technology, Department of Biosystems, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Pilar García
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Asturias, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Ana Rodríguez
- Instituto de Productos Lácteos de Asturias (IPLA-CSIC), Asturias, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
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8
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Wu C, Wu P, Li P, Cheng F, Du Y, He S, Lang H. Construction of an index system of core competence assessment for infectious disease specialist nurse in China: a Delphi study. BMC Infect Dis 2021; 21:791. [PMID: 34376141 PMCID: PMC8353424 DOI: 10.1186/s12879-021-06402-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/18/2021] [Indexed: 12/25/2022] Open
Abstract
Aim and objective This study was to establish an index system for the evaluation of Chinese infectious disease specialist nurses’ core competence. Background The index system for the evaluation of infectious disease specialist nurses’ core competence has not been established. Design A two-round Delphi survey was conducted to seek opinions from experts about the index system for the evaluation of infectious disease specialist nurses’ core competence. Methods The study adopted several research methods, including literature retrieval, theoretical analysis and qualitative research. Based on the above method, the draft of core competence evaluation index system of infectious disease specialist nurses was constructed. A Delphi survey was used for the study of 30 infectious disease experts from 8 provinces and cities around China. A modified recommendation for the Conducting and Reporting of Delphi studies (CREDES) was also used to guide this study. A STROBE checklist was used. Results The Core Competence Evaluation Index System of Infectious Disease Nurses is composed of 6 primary indicators, namely, Nursing Abilities for Infectious Diseases, Infection Prevention and Control Abilities, Responsiveness to Infectious Diseases, Professional Development Abilities, Communication and Management Abilities, and Professionalism and Humanistic Accomplishment, 16 secondary indicators and 47 tertiary indicators. The authority coefficient, judgment coefficient and familiarity degree of Delphi experts were 0.923, 0.933 and 0.913 respectively. Conclusions The evaluation index system of core competence of diseases specialist nurses is scientific and reliable. It can be reference for future training and assessment of Chinese infectious disease specialist nurses. Relevance to clinical practice Infectious disease specialist nurses are the main force for infectious disease nursing. Their core competence is related to the quality of infectious disease nursing and treatment. The core competence of the nurses is important for identification of training strategies and can be regarded as reference for nurse assessment and promotion. The construction of the index system is based on the consensus of infectious disease experts, which is not only helpful to standardize the training strategies and selection standards of infectious disease specialist nurses in the future, but also meet the society’s needs in clinical infectious disease nursing.
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Affiliation(s)
- Chao Wu
- Air Force Medical University, Shaanxi, Xian, 710032, China
| | - Ping Wu
- Tongji Hospital, Affiliated Hospital of Tongji Medical School of Huazhong University of Science and Technology, Hubei, Wuhan, 430000, China
| | - Pei Li
- Tangdu Hospital, the Second Affiliated Hospital of Air Force Military Medical University Shaanxi, Shaanxi, Xian, 710032, China
| | - Feixia Cheng
- Naval University of Engineering, Hubei, Wuhan, 430000, China
| | - Yanling Du
- Air Force Medical University, Shaanxi, Xian, 710032, China
| | - Shizhe He
- Air Force Medical University, Shaanxi, Xian, 710032, China
| | - Hongjuan Lang
- Air Force Medical University, Shaanxi, Xian, 710032, China.
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9
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Wang P, Yuan Y, Xu K, Zhong H, Yang Y, Jin S, Yang K, Qi X. Biological applications of copper-containing materials. Bioact Mater 2021; 6:916-927. [PMID: 33210018 PMCID: PMC7647998 DOI: 10.1016/j.bioactmat.2020.09.017] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
Copper is an indispensable trace metal element in the human body, which is mainly absorbed in the stomach and small intestine and excreted into the bile. Copper is an important component and catalytic agent of many enzymes and proteins in the body, so it can influence human health through multiple mechanisms. Based on the biological functions and benefits of copper, an increasing number of researchers in the field of biomaterials have focused on developing novel copper-containing biomaterials, which exhibit unique properties in protecting the cardiovascular system, promoting bone fracture healing, and exerting antibacterial effects. Copper can also be used in promoting incisional wounds healing, killing cancer cells, Positron Emission Tomography (PET) imaging, radioimmunological tracing and radiotherapy of cancer. In the present review, the biological functions of copper in the human body are presented, along with an overview of recent progress in our understanding of the biological applications and development of copper-containing materials. Furthermore, this review also provides the prospective on the challenges of those novel biomaterials for future clinical applications.
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Affiliation(s)
- Peng Wang
- Key Laboratory of Diagnostic Imaging and Interventional Radiology of Liaoning Province, Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China
| | - Yonghui Yuan
- Clinical Research Center for Malignant Tumor of Liaoning Province, Cancer Hospital of China Medical University Liaoning Cancer Hospital & Institute, Shenyang, Liaoning, 110042, China
| | - Ke Xu
- Key Laboratory of Diagnostic Imaging and Interventional Radiology of Liaoning Province, Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China
| | - Hongshan Zhong
- Key Laboratory of Diagnostic Imaging and Interventional Radiology of Liaoning Province, Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China
| | - Yinghui Yang
- Suzhou Silvan Medical Co., Ltd, Suzhou 215006, China
| | - Shiyu Jin
- Key Laboratory of Diagnostic Imaging and Interventional Radiology of Liaoning Province, Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China
| | - Ke Yang
- Institute of Metal Research, Chinese Academy of Science, Shenyang 110016, China
| | - Xun Qi
- Key Laboratory of Diagnostic Imaging and Interventional Radiology of Liaoning Province, Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China
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10
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Longitudinal whole-genome based comparison of carriage and infection associated Staphylococcus aureus in northern Australian dialysis clinics. PLoS One 2021; 16:e0245790. [PMID: 33544742 PMCID: PMC7864423 DOI: 10.1371/journal.pone.0245790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022] Open
Abstract
Background The study objective was to reveal reservoirs potentially leading to Staphylococcus aureus infections in haemodialysis clinic clients in the tropical north of the Australian Northern Territory (NT). This client population are primarily Aboriginal Australians who have a greater burden of ill health than other Australians. Reservoir identification will enhance infection control in this client group, including informing potential S. aureus decolonisation strategies. Methods and findings The study participants were 83 clients of four haemodialysis clinics in the Darwin region of the NT, and 46 clinical staff and researchers who had contact with the clinic clients. The study design was longitudinal, encompassing swabbing of anatomical sites at two month intervals to yield carriage isolates, and also progressive collection of infection isolates. Swab sampling was performed for all participants, and infection isolates collected for dialysis clients only. Analysis was based on the comparison of 139 carriage isolates and 27 infection isolates using whole genome sequencing. Genome comparisons were based on of 20,651 genome-wide orthologous SNPs, presence/absence of the mecA and pvl genes, and inferred multilocus sequence type and clonal complex. Pairs of genomes meeting the definition of “not discriminated” were classed as defining potential transmission events. The primary outcome was instances of potential transmission between a carriage site other than a skin lesion and an infection site, in the same individual. Three such instances were identified. Two involved ST762 (CC1) PVL- MRSA, and one instance ST121 PVL+ MSSA. Three additional instances were identified where the carriage strains were derived from skin lesions. Also identified were six instances of potential transmission of a carriage strains between participants, including transmission of strains between dialysis clients and staff/researchers, and one potential transmission of a clinical strain between participants. There were frequent occurrences of longitudinal persistence of carriage strains in individual participants, and two examples of the same strain causing infection in the same participants at different times. Strains associated with infections and skin lesions were enriched for PVL and mecA in comparison to strains associated with long term carriage. Conclusions This study indicated that strains differ with respect to propensity to stably colonise sites such as the nose, and cause skin infections. PVL+ strains were associated with infection and skin lesions and were almost absent from the carriage sites. PVL- MRSA (mainly CC1) strains were associated with infection and also with potential transmission events involving carriage sites, while PVL- MSSA were frequently observed to stably colonise individuals without causing infection, and to be rarely transmitted. Current clinical guidelines for dialysis patients suggest MRSA decolonisation. Implementation in this client group may impact infections by PVL- MRSA, but may have little effect on infection by PVL+ strains. In this study, the PVL+ strains were predominant causes of infection but rarely colonised typical carriage sites such as the nose, and in the case of ST121, were MSSA. The important reservoirs for infection by PVL+ strains appeared to be prior infections.
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11
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Sasaki H, Ishikawa H, Itoh T, Arano M, Hirata K, Ueshiba H. Penicillin-Binding Proteins and Associated Protein Mutations Confer Oxacillin/Cefoxitin Tolerance in Borderline Oxacillin-Resistant Staphylococcus aureus. Microb Drug Resist 2020; 27:590-595. [DOI: 10.1089/mdr.2020.0191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Hiraku Sasaki
- Department of Health Science, Faculty of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Hiroki Ishikawa
- Department of Microbiology and Immunology, Showa University School of Medicine, Shinagawa-ku, Japan
| | - Taisuke Itoh
- Department of Health Science, Faculty of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Makoto Arano
- Department of Health Science, Faculty of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Koya Hirata
- Department of Health Science, Faculty of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Hidehiro Ueshiba
- Department of Microbiology and Immunology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Japan
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12
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Yuan Z, Ouyang P, Gu K, Rehman T, Zhang T, Yin Z, Fu H, Lin J, He C, Shu G, Liang X, Yuan Z, Song X, Li L, Zou Y, Yin L. The antibacterial mechanism of oridonin against methicillin-resistant Staphylococcus aureus (MRSA). PHARMACEUTICAL BIOLOGY 2019; 57:710-716. [PMID: 31622118 PMCID: PMC8871620 DOI: 10.1080/13880209.2019.1674342] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 08/22/2019] [Accepted: 09/22/2019] [Indexed: 05/29/2023]
Abstract
Context: Methicillin-resistant Staphylococcus aureus (MRSA) is a very harmful bacterium. Oridonin, a component in Rabdosia rubescens (Hemsl.) Hara (Lamiaceae), is widely used against bacterial infections in China. Objective: We evaluated oridonin effects on MRSA cell membrane and wall, protein metabolism, lactate dehydrogenase (LDH), DNA and microscopic structure. Materials and methods: Broth microdilution and flat colony counting methods were used to measure oridonin minimal inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against USA300 strain. Electrical conductivity and DNA exosmosis were analysed to study oridonin effects (128 μg/mL) on cell membrane and wall for 0, 1, 2, 4 and 6 h. Sodium dodecyl sulphate polyacrylamide gel electrophoresis was used to detect effects on soluble protein synthesis after 6, 10 and 16 h. LDH activity was examined with an enzyme-linked immunosorbent assay. Effects of oridonin on USA300 DNA were investigated with DAPI staining. Morphological changes in MRSA following oridonin treatment were determined with scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Results: Oridonin MIC and MBC values against USA300 were 64 and 512 μg/mL, respectively. The conductivity and DNA exosmosis level of oridonin-treated USA300 improved by 3.20±0.84% and increased by 58.63 ± 1.78 μg/mL, respectively. LDH and soluble protein levels decreased by 30.85±7.69% and 27.51 ± 1.39%, respectively. A decrease in fluorescence intensity was reported with time. Oridonin affected the morphology of USA300. Conclusions: Oridonin antibacterial mechanism was related to changes in cell membrane and cell wall permeability, disturbance in protein and DNA metabolism, and influence on bacterial morphology. Thus, oridonin may help in treating MRSA infection.
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Affiliation(s)
- Zhongwei Yuan
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Ping Ouyang
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Kexin Gu
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Tayyab Rehman
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Tianyi Zhang
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Zhongqiong Yin
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Hualin Fu
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Juchun Lin
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Changliang He
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Gang Shu
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Xiaoxia Liang
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Zhixiang Yuan
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Xu Song
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Lixia Li
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Yuanfeng Zou
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
| | - Lizi Yin
- College of Veterinary Medicine, Sichuan Agriculture University, Chengdu, China
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13
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Mun YS, Hwang YJ. Novel spa and Multi-Locus Sequence Types (MLST) of Staphylococcus Aureus Samples Isolated from Clinical Specimens in Korean. Antibiotics (Basel) 2019; 8:antibiotics8040202. [PMID: 31671880 PMCID: PMC6963223 DOI: 10.3390/antibiotics8040202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 12/24/2022] Open
Abstract
Staphylococcus aureus bacteremia is one of the most frequent and severe bacterial infections worldwide. The increased incidence of S. aureus infections with a diverse pattern of S. aureus protein A (spa) types across different geographic regions is a global challenge. This study investigated a novel spa type of methicillin-resistant S. aureus in a clinically isolated specimen. A total of 109 clinical S. aureus samples were subjected to 19 sets of antimicrobial susceptibility testing using the Kirby-Bauer disk diffusion method. Molecular typing was performed with S. aureus protein A (spa) and multi-locus sequence types (MLST) via polymerase chain reaction and sequencing. The methicillin-resistant S. aureus samples in our study accounted for 55.05% (60/109) of the total. A novel spa type was detected in five (5/60) strains. This gh22 isolate was identified in antimicrobial susceptibility tests of 15 kinds of antibiotics. Antibiotic resistance genes included mecA, TEM, aac(6')-aph(2"), ermA, and tetM. Eleven S. aureus samples were classified as t2460, t338, t324, t693, five unknown spa types (new spa types), and undefined MLST (novel MLST). We report a high prevalence rate of t2460 methicillin-resistant S. aureus samples in our country. Additionally, novel spa gh22, MLST ST4613, and clonal compact CC5-type strains (T1:M1:B1:B1:M1:E1:K1, r26:r17:r34:r34:r17:r13:r16, mlst;1:4:1:4:559:495:10) showing multidrug resistance were identified among S. aureus samples.
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Affiliation(s)
- Yae Sung Mun
- Department of Life science, College of Bio-nano technology, Gachon University, 191, Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Korea.
| | - You Jin Hwang
- Department of Life science, College of Bio-nano technology, Gachon University, 191, Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Korea.
- Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon 21999, Korea.
- Department of Biomedical Engineering, College of Health Science, Gachon University, 191, Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Korea.
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14
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Kim MH, Lee SG, Kim KS, Heo YJ, Oh JE, Jeong SJ. Environmental disinfection with photocatalyst as an adjunctive measure to control transmission of methicillin-resistant Staphylococcus aureus: a prospective cohort study in a high-incidence setting. BMC Infect Dis 2018; 18:610. [PMID: 30509196 PMCID: PMC6276245 DOI: 10.1186/s12879-018-3555-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background Environmental disinfection with continuously antimicrobial surfaces could offer superior control of surface bioburden. We sought to decide the efficacy of photocatalyst antimicrobial coating in reducing methicillin-resistant Staphylococcus aureus (MRSA) acquisition in high incidence setting. Methods We performed prospective cohort study involving patients hospitalized in medical intensive care unit. A titanium dioxide-based photocatalyst was coated on high touch surfaces and walls. Five months of pre-intervention data were compared with five months of post-intervention data. The incidence rates of multidrug-resistant organism acquisition and the rates of hospital-acquired blood stream infection, pneumonia, urinary tract infection, and Clostridium difficile–associated diseases were compared using Cox proportional hazards regression analysis. Results In total, 621 patients were included. There was significant decrease in MRSA acquisition rate after photocatalyst coating (hazard ratio, 0.37; 95% confidence interval, 0.14–0.99; p = 0.04). However, clinical identification of vancomycin-resistant Enterococcus spp. and multidrug-resistant Acinetobacter baumannii did not decrease significantly. The hazard of contracting hospital-acquired pneumonia during the intervention period compared to baseline period was 0.46 (95% confidence interval, 0.23–0.94; p = 0.03). Conclusions In conclusion, MRSA rate was significantly reduced after photocatalyst coating. We provide evidence that photocatalyst disinfection can be an adjunctive measure to control MRSA acquisition in high-incidence settings. Trial registration ISRCTN Registry (ISRCTN31972004). Registered retrospectively on November 19, 2018. Electronic supplementary material The online version of this article (10.1186/s12879-018-3555-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Min Hyung Kim
- Department of Internal Medicine, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Seong Gyu Lee
- Department of Laboratory Medicine, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Ki Sook Kim
- Department of Infection Control Office, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Yoon Ji Heo
- Department of Infection Control Office, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Ji Eun Oh
- Department of Nursing, Bundang Jesaeng Hospital, 180-2Seohyeon-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-774, South Korea
| | - Su Jin Jeong
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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15
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A new carbapenem drug dosage metric for carbapenem usage and correlation with carbapenem resistance of Pseudomonas aeruginosa. J Infect Chemother 2018; 24:949-953. [PMID: 30268412 DOI: 10.1016/j.jiac.2018.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/24/2018] [Accepted: 08/03/2018] [Indexed: 12/24/2022]
Abstract
The emergence and dissemination of antimicrobial resistance is a worldwide problem. Inappropriate antimicrobial use contributes to this resistance, and several metrics of drug usage have been used to monitor their consumption and rational use. We examined several existing drug metrics, and developed a new one, dose/duration-density (D/d2), for a the best correlation between carbapenem usage and carbapenem resistance of Pseudomonas aeruginosa. The annual changes of antimicrobial use density (AUD), days of therapy (DOT), daily dose (DD) and D/d2 for meropenem, imipenem and total carbapenems was analyzed for a correlation with carbapenem susceptibility of P. aeruginosa from 2006 through 2015 at a university hospital. The substitution of meropenem for imipenem usage, and an approximate 10% increase in carbapenem susceptibility of P. aeruginosa occurred over the study period. There were significant correlations of the meropenem susceptibility of P. aeruginosa and meropenem usage as measured by the meropenem DD, of imipenem susceptibility and imipenem AUD and DOT, and overall carbapenem susceptibility and imipenem DOT. The D/d2 for meropenem, imipenem and total carbapenems had significant correlations with individual and all carbapenem susceptibility of P. aeruginosa. These D/d2 is the best single carbapenem use metric for correlating carbapenem usage with P. aeruginosa resistance. Further studies are warranted to consider the value of D/d2 for other antimicrobials and bacteria.
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16
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Rubin IM, Hansen TA, Klingenberg AM, Petersen AM, Worning P, Westh H, Bartels MD. A Sporadic Four-Year Hospital Outbreak of a ST97-IVa MRSA With Half of the Patients First Identified in the Community. Front Microbiol 2018; 9:1494. [PMID: 30042745 PMCID: PMC6048196 DOI: 10.3389/fmicb.2018.01494] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/18/2018] [Indexed: 02/01/2023] Open
Abstract
This study describes a sporadically occurring 4-year outbreak of methicillin-resistant Staphylococcus aureus (MRSA) originating from a surgical ward. Whole-genome sequencing (WGS) identified the outbreak clone as spa type t267, sequence type ST97, and SCCmec IVa. Prompted by the finding of four patients within 6 months in the same ward with this unusual MRSA type, an outbreak was suspected. Subsequent MRSA screening in the ward in February 2017 identified three-additional patients and two health care workers (HCWs) with t267/ST97-IVa. WGS linked these 9 isolates to 16 previous isolates in our WGS database and the outbreak thus included 23 patients and two HCWs. Twenty-one patients had a connection to the surgery ward during the period 2013-2017, but half of them had MRSA diagnosed in the community long after discharge. The community debut of several patients MRSA infections weeks to months after hospital discharge made the identification of a hospital source difficult and it was the SNP relatedness of the isolates that led us to identify the common denominator of hospitalization. An index patient was not identified, but our hypothesis is that HCWs with unrecognized long-term MRSA colonization could have caused sporadic nosocomial transmission due to intermittent breaches in infection prevention and control practice.
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Affiliation(s)
- Ingrid M Rubin
- Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark
| | - Thomas A Hansen
- Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark
| | | | - Andreas M Petersen
- Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark.,Department of Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peder Worning
- Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark
| | - Henrik Westh
- Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mette D Bartels
- Department of Clinical Microbiology, Hvidovre Hospital, Hvidovre, Denmark
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17
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Clinical predictors of methicillin-resistance and their impact on mortality associated with Staphylococcus aureus bacteraemia. Epidemiol Infect 2018; 146:1326-1336. [PMID: 29781425 DOI: 10.1017/s0950268818001255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We investigated the clinical predictors of methicillin-resistance and their impact on mortality in 371 patients with Staphylococcus aureus bacteraemia identified from two prospective multi-centre studies. Methicillin resistant S. aureus (MRSA) accounted for 42.2% of community-onset and 74.5% of hospital-onset cases. No significant clinical difference was found between patients infected with MRSA vs. methicillin-sensitive S. aureus (MSSA), except that the former were more likely to have had hospital-onset bacteraemia and received antibiotics in the preceding 90 days. After stratifying according to the acquisition site, prior antibiotic use was the only independent predictor of having MRSA in both community-onset and hospital-onset cases. The frequency of inappropriate empirical antibiotic therapy was higher in patients with MRSA than in those with MSSA bacteraemia. However, methicillin resistance was not a predictor of mortality in patients and the clinical characteristics and outcomes of both MRSA and MSSA bacteraemia were similar. This study indicates that there are no definitive clinical or epidemiological risk factors which could distinguish MRSA from MSSA cases with the exception of the previous use of antibiotics for having MRSA bacteraemia, which emphasises the prudent use of glycopeptide treatment of patients at risk for invasive MRSA infections.
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18
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Hamdan-Partida A, González-García S, de la Rosa García E, Bustos-Martínez J. Community-acquired methicillin-resistant Staphylococcus aureus can persist in the throat. Int J Med Microbiol 2018; 308:469-475. [PMID: 29661650 DOI: 10.1016/j.ijmm.2018.04.002] [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] [Received: 12/08/2017] [Revised: 03/27/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022] Open
Abstract
Colonization by Staphylococcus aureus is an important factor in infections caused by this microorganism. Among the colonization niches of staphylococci are the nose, skin, intestinal tract, and, recently, the throat has been given relevance. Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) can be fatal. Persistence of S. aureus is an important process in the pathogenesis of this microorganism and must be studied. The aim of this study was to determine the persistence of S. aureus in the throat, and characterized the strains. We studied the persistence of S. aureus for 6 years in the throat of apparently healthy people. The isolated strains from the persistent carriers were characterized through PFGE, spa-typing, SCCmec typing, resistance to methicillin, presence of virulence genes (adhesins and toxins), and the formation of biofilm. We found persistent and intermittent carriers of S. aureus in the throat, with methicillin-sensitive (MSSA), methicillin-resistant (MRSA) strains, and confirmed for the first time that CA-MRSA colonizes this niche. These strains can colonize persistently the throat for four years or more. Typification of strains through PFGE and spa-typing revealed that some carriers present the same strain, whereas others present different strains along the period of persistence. Almost all strains induced a strong biofilm formation. All strains presented adhesin and toxin genes, but no shared genotype was found. We conclude that S. aureus, including CA-MRSA strains, can remain persistently in the throat, finding a wide variability among the persistent strains.
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Affiliation(s)
- Aida Hamdan-Partida
- Depto. de Atención a la Salud. Universidad Autónoma Metropolitana-Xochimilco, Calzada del Hueso 1100. Mexico City, 04960, Mexico
| | - Samuel González-García
- Depto. de Atención a la Salud. Universidad Autónoma Metropolitana-Xochimilco, Calzada del Hueso 1100. Mexico City, 04960, Mexico
| | - Estela de la Rosa García
- Depto. de Atención a la Salud. Universidad Autónoma Metropolitana-Xochimilco, Calzada del Hueso 1100. Mexico City, 04960, Mexico
| | - Jaime Bustos-Martínez
- Depto. de Atención a la Salud. Universidad Autónoma Metropolitana-Xochimilco, Calzada del Hueso 1100. Mexico City, 04960, Mexico.
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19
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Wang W, Baloch Z, Jiang T, Zhang C, Peng Z, Li F, Fanning S, Ma A, Xu J. Enterotoxigenicity and Antimicrobial Resistance of Staphylococcus aureus Isolated from Retail Food in China. Front Microbiol 2017; 8:2256. [PMID: 29209290 PMCID: PMC5702451 DOI: 10.3389/fmicb.2017.02256] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/31/2017] [Indexed: 11/17/2022] Open
Abstract
Staphylococcus aureus is one of the most common causes of zoonotic agent in the world, which are attributable to the contamination of food with enterotoxins. In this study, a total of 1,150 S. aureus isolates were cultured from 27,000 retail foods items from 203 cities of 24 provinces in China in 2015 and were test for antimicrobial susceptibility. Additionally, the role of the genes responsible for the staphylococcal enterotoxins (SEA to SEE), methicillin resistance (mecA) and the toxigenic capabilities were also assessed. The results showed that 4.3% retail foods were contaminated with S. aureus, and 7.9% retail foods isolates were mecA positive. Some 97.6% of S. aureus isolates were resistant to at least one antimicrobial compound, and 57.5% of these were multi drug resistant (MDR). Resistance to penicillin (83.7%, 963/1,150), was common, followed by linezolid (67.7%, 778/1,150) and erythromycin (52.1%, 599/1,150). The isolates cultured from raw meats showed high levels of resistant to tetracycline (42.8%), ciprofloxacin (17.4%), and chloramphenicol (12.0%) and expressed a MDR phenotype (62.4%). A total of 29.7% S. aureus isolates harbored the classical SEs genes (sea, seb, sec, and sed). The sea and seb genes were the most frequent SEs genes detected. Of note, 22% of the SEs genes positive S. aureus harbored two or three SEs genes, and 16 isolates were confirmed with the capacity to simultaneously produce two or three enterotoxin types. Moreover, nearly 50% of the MRSA isolates were positive for at least one SE gene in this study. Therefore, it is important to monitor the antimicrobial susceptibility and enterotoxigenicity of MDR S. aureus and MRSA in the food chain and to use these data to develop food safety measures, designed to reduce the contamination and transmission of this bacterium.
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Affiliation(s)
- Wei Wang
- School of Public Health, Qingdao University, Qingdao, China.,Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zulqarnain Baloch
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Tao Jiang
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Cunshan Zhang
- Kuiwen District Center for Disease Control and Prevention, Weifang, China
| | - Zixin Peng
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Fengqin Li
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Séamus Fanning
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China.,UCD-Centre for Food Safety, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Aiguo Ma
- School of Public Health, Qingdao University, Qingdao, China
| | - Jin Xu
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
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