1
|
Kaneko H, Kanai M, Saito T, Yanagi Y, Kobayashi H, Kurihara R, Ikeda M, Nemoto O, Baba N, Matsuzaki Y, Sawamura D, Shimoe F, Inaba Y, Kobayashi Y, Kawasaki S, Ueki T, Funatsu S, Shirahama S, Oba M, Hasegawa T, Furukawa H, Miyata T, Isonokami M, Fujita S, Nakaminami H. Significant increase in the prevalence of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus, particularly the USA300 variant ΨUSA300, in the Japanese community. Microbiol Spectr 2023; 11:e0124823. [PMID: 37929951 PMCID: PMC10715091 DOI: 10.1128/spectrum.01248-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
IMPORTANCE USA300 is an MRSA clone producing PVL, a toxin associated with SSTIs. ΨUSA300 is a USA300 variant recently identified in Japan by Takadama et al. (15). Here, we found that the prevalence rate of PVL-positive MRSA in S. aureus was elevated in the Japanese community, and ΨUSA300 accounted for most of them. ΨUSA300 strains have been isolated from several areas in Japan and were associated with deep-seated SSTIs. This study highlighted the emerging threat posed by ΨUSA300 in Japan.
Collapse
Affiliation(s)
- Hiroshi Kaneko
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Miki Kanai
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Takumi Saito
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Yuka Yanagi
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Hana Kobayashi
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Rikuto Kurihara
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Masami Ikeda
- Department of Dermatology, Takamatsu Red Cross Hospital, Kagawa, Japan
| | | | - Naoko Baba
- Department of Dermatology, Kanagawa Children’s Medical Center, Kanagawa, Japan
| | - Yasushi Matsuzaki
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Daisuke Sawamura
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | | | | | | | - Toru Ueki
- Ueki Dermatology Plastic Surgery, Tokyo, Japan
| | | | - Shigeho Shirahama
- Department of Dermatology, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - Misao Oba
- Department of Dermatology, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | | | | | - Toshiko Miyata
- Division of Dermatology, Saitama Citizens Medical Center, Saitama, Japan
| | | | | | - Hidemasa Nakaminami
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| |
Collapse
|
2
|
Hernández-Cuellar E, Tsuchiya K, Valle-Ríos R, Medina-Contreras O. Differences in Biofilm Formation by Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Strains. Diseases 2023; 11:160. [PMID: 37987271 PMCID: PMC10660471 DOI: 10.3390/diseases11040160] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023] Open
Abstract
Staphylococcus aureus (S. aureus) is a common pathogen involved in community- and hospital-acquired infections. Its biofilm formation ability predisposes it to device-related infections. Methicillin-resistant S. aureus (MRSA) strains are associated with more serious infections and higher mortality rates and are more complex in terms of antibiotic resistance. It is still controversial whether MRSA are indeed more virulent than methicillin-susceptible S. aureus (MSSA) strains. A difference in biofilm formation by both types of bacteria has been suggested, but how only the presence of the SCCmec cassette or mecA influences this phenotype remains unclear. In this review, we have searched for literature studying the difference in biofilm formation by MRSA and MSSA. We highlighted the relevance of the icaADBC operon in the PIA-dependent biofilms generated by MSSA under osmotic stress conditions, and the role of extracellular DNA and surface proteins in the PIA-independent biofilms generated by MRSA. We described the prominent role of surface proteins with the LPXTG motif and hydrolases for the release of extracellular DNA in the MRSA biofilm formation. Finally, we explained the main regulatory systems in S. aureus involved in virulence and biofilm formation, such as the SarA and Agr systems. As most of the studies were in vitro using inert surfaces, it will be necessary in the future to focus on biofilm formation on extracellular matrix components and its relevance in the pathogenesis of infection by both types of strains using in vivo animal models.
Collapse
Affiliation(s)
- Eduardo Hernández-Cuellar
- Laboratorio de Biología Celular y Tisular, Departamento de Morfología, Universidad Autónoma de Aguascalientes, Aguascalientes 20100, C.P., México
| | - Kohsuke Tsuchiya
- Division of Immunology and Molecular Biology, Cancer Research Institute, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan;
| | - Ricardo Valle-Ríos
- Research Division, Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City 04360, C.P., México;
- Laboratory of Research in Immunology and Proteomics, Federico Gómez Children’s Hospital of Mexico, Mexico City 06720, C.P., México
| | - Oscar Medina-Contreras
- Epidemiology, Endocrinology & Nutrition Research Unit, Mexico Children’s Hospital (HIMFG), Mexico City 06720, C.P., México;
| |
Collapse
|
3
|
Portilho FVR, Nóbrega J, de Almeida BO, Mota AR, de Paula CL, Listoni FJP, Bosco SMG, Oliveira AL, Cunha MDLRS, Ribeiro MG. Microbial Complexity of Oral Cavity of Healthy Dogs Identified by Mass Spectrometry and Next-Generation Sequencing. Animals (Basel) 2023; 13:2467. [PMID: 37570276 PMCID: PMC10417733 DOI: 10.3390/ani13152467] [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: 03/13/2023] [Revised: 05/10/2023] [Accepted: 05/29/2023] [Indexed: 08/13/2023] Open
Abstract
The high complexity of the oral microbiota of healthy dogs and the close exposure of humans to companion animals represent a risk of the transmission of potential zoonotic microorganisms to humans, especially through dog bites, including multidrug-resistant ones. Nonetheless, a limited number of comprehensive studies have focused on the diversity of the microorganisms that inhabit the oral cavities of healthy dogs, particularly based on modern molecular techniques. We investigated bacterial and fungal organisms in the oral cavities of 100 healthy dogs based on a combination of conventional and selective microbiological culture, mass spectrometry (MALDI-TOF MS), and next-generation sequencing. In addition, in vitro antimicrobial susceptibility patterns of isolates and mecA resistance gene were assessed. A total of 213 bacteria and 20 fungi were isolated. Staphylococcus pseudintermedius (40/100 = 40%), α-hemolytic Streptococcus (37/100 = 37%), and Pasteurella stomatis (22/100 = 22%) were the most prevalent bacteria diagnosed by microbiological culture and MALDI-TOF MS, whereas Aspergillus (10/100 = 10%) was the most common fungi identified. Based on next-generation sequencing of selected 20 sampled dogs, Porphyromonas (32.5%), Moraxella (16.3%), Fusobacterium (12.8%), Conchiformibius (9.5%), Bergeyella (5%), Campylobacter (3.8%), and Capnocytophaga (3.4%) genera were prevalent. A high multidrug resistance rate was observed in Staphylococcus pseudintermedius isolates, particularly to azithromycin (19/19 = 100%), penicillin (15/19 = 78.9%), and sulfamethoxazole/trimethoprim (15/19 = 78.9%). In addition, the mecA resistance gene was detected in 6.1% (3/49) of coagulase-positive staphylococci. Here, we highlight the microbial complexity of the oral mucosa of healthy dogs, including potential zoonotic microorganisms and multidrug-resistant bacteria, contributing with the investigation of the microbiota and antimicrobial resistance patterns of the microorganisms that inhabit the oral cavity of healthy dogs.
Collapse
Affiliation(s)
- Fábio V. R. Portilho
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences, UNESP, Botucatu 18618-681, SP, Brazil; (B.O.d.A.); (A.R.M.); (C.L.d.P.); (F.J.P.L.); (M.G.R.)
| | - Juliano Nóbrega
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine and Animal Sciences, UNESP, Botucatu 18618-681, SP, Brazil;
| | - Beatriz O. de Almeida
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences, UNESP, Botucatu 18618-681, SP, Brazil; (B.O.d.A.); (A.R.M.); (C.L.d.P.); (F.J.P.L.); (M.G.R.)
| | - André R. Mota
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences, UNESP, Botucatu 18618-681, SP, Brazil; (B.O.d.A.); (A.R.M.); (C.L.d.P.); (F.J.P.L.); (M.G.R.)
| | - Carolina L. de Paula
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences, UNESP, Botucatu 18618-681, SP, Brazil; (B.O.d.A.); (A.R.M.); (C.L.d.P.); (F.J.P.L.); (M.G.R.)
| | - Fernando J. P. Listoni
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences, UNESP, Botucatu 18618-681, SP, Brazil; (B.O.d.A.); (A.R.M.); (C.L.d.P.); (F.J.P.L.); (M.G.R.)
| | - Sandra M. G. Bosco
- Department of Chemical and Biological Sciences, Sector of Microbiology and Immunology, Institute of Biosciences, UNESP, Botucatu 18618-689, SP, Brazil (A.L.O.); (M.d.L.R.S.C.)
| | - Alana L. Oliveira
- Department of Chemical and Biological Sciences, Sector of Microbiology and Immunology, Institute of Biosciences, UNESP, Botucatu 18618-689, SP, Brazil (A.L.O.); (M.d.L.R.S.C.)
| | - Maria de Lourdes R. S. Cunha
- Department of Chemical and Biological Sciences, Sector of Microbiology and Immunology, Institute of Biosciences, UNESP, Botucatu 18618-689, SP, Brazil (A.L.O.); (M.d.L.R.S.C.)
| | - Márcio G. Ribeiro
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences, UNESP, Botucatu 18618-681, SP, Brazil; (B.O.d.A.); (A.R.M.); (C.L.d.P.); (F.J.P.L.); (M.G.R.)
| |
Collapse
|
4
|
Gao P, Wei Y, Tai SSC, Halebeedu Prakash P, Iu HTV, Li Y, Yam HCB, Chen JHK, Ho PL, Davies J, Kao RYT. Antivirulence Agent as an Adjuvant of β-Lactam Antibiotics in Treating Staphylococcal Infections. Antibiotics (Basel) 2022; 11:antibiotics11060819. [PMID: 35740225 PMCID: PMC9219823 DOI: 10.3390/antibiotics11060819] [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: 05/13/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/27/2022] Open
Abstract
Staphylococcus aureus can cause a plethora of life-threatening infections. Antibiotics have been extensively used to treat S. aureus infections. However, when antibiotics are used at sub-inhibitory concentrations, especially for β-lactam antibiotics, they may enhance staphylococcal pathogenicity and exacerbate the infection. The combination of antivirulence agents and antibiotics may be a novel approach to controlling antibiotic-induced S. aureus pathogenicity. We have illustrated that under in vitro conditions, antivirulence agent M21, when administered concurrently with ampicillin, suppressed the expression and production of virulence factors induced by ampicillin. In a mouse peritonitis model, M21 reduced bacterial load irrespective of administration of ampicillin. In a bacteremia model, combinatorial treatment consisting of ampicillin or ceftazidime and M21 increased the survival rate of mice and reduced cytokine abundance, suggesting the suppression of antibiotic-induced virulence by M21. Different from traditional antibiotic adjuvants, an antivirulence agent may not synergistically inhibit bacterial growth in vitro, but effectively benefit the host in vivo. Collectively, our findings from this study demonstrated the benefits of antivirulence–antibiotic combinatorial treatment against S. aureus infections and provide a new perspective on the development of antibiotic adjuvants.
Collapse
Affiliation(s)
- Peng Gao
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
- Correspondence: (P.G.); (R.Y.T.K.)
| | - Yuanxin Wei
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
| | - Sherlock Shing Chiu Tai
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
| | - Pradeep Halebeedu Prakash
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
| | - Ho Ting Venice Iu
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
| | - Yongli Li
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
| | - Hin Cheung Bill Yam
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
| | - Jonathan Hon Kwan Chen
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
- Department of Microbiology, Queen Mary Hospital, Hong Kong, China
| | - Pak Leung Ho
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
- Department of Microbiology, Queen Mary Hospital, Hong Kong, China
- State Key Laboratory of Emerging Infectious Diseases and the Research Centre of Infection and Immunology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong, China
| | - Julian Davies
- Department of Microbiology and Immunology, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - Richard Yi Tsun Kao
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (Y.W.); (S.S.C.T.); (P.H.P.); (H.T.V.I.); (Y.L.); (H.C.B.Y.); (J.H.K.C.); (P.L.H.)
- State Key Laboratory of Emerging Infectious Diseases and the Research Centre of Infection and Immunology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Correspondence: (P.G.); (R.Y.T.K.)
| |
Collapse
|
5
|
Stańkowska M, Garbacz K, Korzon-Burakowska A, Bronk M, Skotarczak M, Szymańska-Dubowik A. Microbiological, Clinical and Radiological Aspects of Diabetic Foot Ulcers Infected with Methicillin-Resistant and -Sensitive Staphylococcus aureus. Pathogens 2022; 11:pathogens11060701. [PMID: 35745555 PMCID: PMC9229747 DOI: 10.3390/pathogens11060701] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetic foot ulcer (DFU) is one of the most common chronic complications of diabetes. This study aimed to assess the factors with an impact on the infection of diabetic foot ulcers by methicillin-resistant S. aureus and to evaluate the influence of methicillin resistance on the frequency of osteitis (based on classic X-ray images). A total of 863 patients suffering from DFU were analyzed during the study period. Out of 201 isolated S. aureus cases, 31 (15.4%) were methicillin-resistant (MRSA). MRSA infections were associated with a higher incidence of osteitis compared to MSSA infections (p << 0.0001), both the occurrence of smaller (<50%)) and greater (>50%) inflammatory bone changes (p << 0.0001). Furthermore, MRSA occurred significantly more frequently in men than in women (p < 0.01) and more often among patients with type 2 diabetes than among patients with type 1 diabetes (p < 0.05). MRSA were isolated statistically less often in overweight patients than in patients with normal BMI (p < 0.05). DFUs infected with MRSA were significantly more frequently associated with the presence of Pseudomonas sp. and other non-fermenting bacilli than those infected with MSSA (p < 0.05). To conclude, osteitis incidence is related to MRSA infection in patients with diabetic foot ulcers; thus, patients infected by S. aureus should be closely monitored in the course of using antibiotics and treated with narrow-spectrum antibiotics.
Collapse
Affiliation(s)
- Maria Stańkowska
- Department of Oral Microbiology, Medical Faculty, Medical University of Gdansk, 80-204 Gdansk, Poland;
- 2nd Division of Radiology, Medical Faculty, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.S.); (A.S.-D.)
| | - Katarzyna Garbacz
- Department of Oral Microbiology, Medical Faculty, Medical University of Gdansk, 80-204 Gdansk, Poland;
- Correspondence:
| | - Anna Korzon-Burakowska
- Division of Preventive Medicine & Education, Medical Faculty, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Marek Bronk
- Laboratory of Clinical Microbiology, University Clinical Center, 80-952 Gdansk, Poland;
| | - Monika Skotarczak
- 2nd Division of Radiology, Medical Faculty, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.S.); (A.S.-D.)
| | - Anna Szymańska-Dubowik
- 2nd Division of Radiology, Medical Faculty, Medical University of Gdansk, 80-214 Gdansk, Poland; (M.S.); (A.S.-D.)
| |
Collapse
|
6
|
Muneeb KH, Sudha S, Sivaraman GK, Ojha R, Mendem SK, Murugesan D, Raisen CL, Shome B, Holmes M. Whole-genome sequence analysis of Staphylococcus aureus from retail fish acknowledged the incidence of highly virulent ST672-MRSA-IVa/t1309, an emerging Indian clone, in Assam, India. ENVIRONMENTAL MICROBIOLOGY REPORTS 2022; 14:412-421. [PMID: 34796671 DOI: 10.1111/1758-2229.13024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 11/04/2021] [Indexed: 06/13/2023]
Abstract
The epidemiology and toxigenicity of MRSA in the fishery environment are poorly understood. In this study, methicillin-resistant Staphylococcus aureus (MRSA) (n = 1) and methicillin-susceptible S. aureus (MSSA) (n = 2) from retail fish were subjected to comprehensive genome analysis. Here, we report the occurrence of ST672-MRSA-IV/t1309 and ST5-MSSA/t105 for the first time from India in the fishery environment. The resistome of the isolates was in concordance with their phenotypic resistance pattern. Phenotypically, the resistance profile of MSSA isolates (n = 2) was AMP-CLI-ERY-NOR-PEN. For MRSA (n = 1), it was AMP-CFZ-CLI-ERY-NOR-OXA-PEN. The antibiotic efflux genes and mutations in the antibiotic target accounted for fluoroquinolone resistance whereas methicillin resistance was conferred through possession of a mecA gene. Similarly, all three isolates carried a similar array of virulence factors. The conjugative plasmid inc18 and rep family 10 plasmids were found in two of the three isolates. This study documents the MRSA carrying SCCmec IVa elements which are the markers of community-associated MRSA (CA-MRSA). Through the possession of SCCmec IV elements, which are smaller than other types of SCCmec, MRSA can contribute to the rapid dissemination of antimicrobial resistance and virulence factors. In short, our findings highlighted that the presence of ST672-MRSA in fishery environments may pose a risk to human health.
Collapse
Affiliation(s)
- K H Muneeb
- Microbiology Fermentation and Biotechnology Division, ICAR-Central Institute of Fisheries Technology, Kochi, 682 029, India
- Department of Biotechnology, Faculty of Sciences, Cochin University of Science and Technology, Kochi, India
| | - S Sudha
- Microbiology Fermentation and Biotechnology Division, ICAR-Central Institute of Fisheries Technology, Kochi, 682 029, India
| | - G K Sivaraman
- Microbiology Fermentation and Biotechnology Division, ICAR-Central Institute of Fisheries Technology, Kochi, 682 029, India
| | - Rakshit Ojha
- Department of Disease Investigation, ICAR-National Institute of Veterinary Epidemiology and Disease Informatics, Bangalore, India
| | - Suresh Kumar Mendem
- Department of Disease Investigation, ICAR-National Institute of Veterinary Epidemiology and Disease Informatics, Bangalore, India
| | - Devi Murugesan
- Department of Disease Investigation, ICAR-National Institute of Veterinary Epidemiology and Disease Informatics, Bangalore, India
| | - C L Raisen
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Bibek Shome
- Department of Disease Investigation, ICAR-National Institute of Veterinary Epidemiology and Disease Informatics, Bangalore, India
| | - Mark Holmes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| |
Collapse
|
7
|
Gwenzi W, Shamsizadeh Z, Gholipour S, Nikaeen M. The air-borne antibiotic resistome: Occurrence, health risks, and future directions. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 804:150154. [PMID: 34798728 DOI: 10.1016/j.scitotenv.2021.150154] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
Antibiotic resistance comprising of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) is an emerging problem causing global human health risks. Several reviews exist on antibiotic resistance in various environmental compartments excluding the air-borne resistome. An increasing body of recent evidence exists on the air-borne resistome comprising of antibiotic resistance in air-borne bioaerosols from various environmental compartments. However, a comprehensive review on the sources, dissemination, behavior, fate, and human exposure and health risks of the air-borne resistome is still lacking. Therefore, the current review uses the source-pathway-receptor-impact-mitigation framework to investigate the air-borne resistome. The nature and sources of antibiotic resistance in the air-borne resistome are discussed. The dissemination pathways, and environmental and anthropogenic drivers accounting for the transfer of antibiotic resistance from sources to the receptors are highlighted. The human exposure and health risks posed by air-borne resistome are presented. A health risk assessment and mitigation strategy is discussed. Finally, future research directions including key knowledge gaps are summarized.
Collapse
Affiliation(s)
- Willis Gwenzi
- Biosystems and Environmental Engineering Research Group, Department of Agricultural and Biosystems Engineering, Faculty of Agriculture, University of Zimbabwe, P.O. Box MP 167, Mount Pleasant, Harare, Zimbabwe.
| | - Zahra Shamsizadeh
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sahar Gholipour
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahnaz Nikaeen
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
8
|
Valverde Villar AM, Gutiérrez Del Álamo Oms J, Neira Borrajo I, de Miguel Fernández S, Flox Benítez P, Llopis Miró R. Screening of MRSA colonization in patients undergoing total joint arthroplasty. J Infect Prev 2021; 22:283-288. [PMID: 34880951 DOI: 10.1177/17571774211013410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 04/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Periprosthetic infection is commonly caused by Staphylococcus aureus and, if resistant to methicillin (MRSA), is associated with increase in severity and costs to patient and healthcare systems. MRSA colonizes 1-5% of the population, therefore using a screening and decolonisation protocol the risk of periprosthetic infection could be reduced. The objective of our study is to report the results of a preoperative MRSA screening and management protocol utilised at our hospital. Methods All patients undergoing a total joint arthroplasty at our hospital were preoperatively screened for MRSA colonization with swab samples of five different locations. Exposure to risk factors were investigated in colonised patients and they were treated for 5 days prior surgery with nasal mupirocin, chlorhexidine sponges and oral tablets. Results During the 48 months of the study, MRSA colonisation was identified in 22 (1.01%) of 2188 patients operated. The culture was positive only in the nasal swab in 55 patients. In five patients the nasal culture was negative, but they had another positive swab culture (three in the groin and two perianal). None of the patients reported a history of recent antibiotic treatment or hospitalization. Conclusion At our institution, the prevalence of MRSA colonisation is 1.01% in patients undergoing hip and knee arthroplasty. Interestingly, our screening protocol included samples from five different anatomic locations, and it is important to highlight that we found patients with negative nares culture and positive cultures in other locations. Therefore, the number of carriers may be underdiagnosed if only nasal samples are obtained. Level of evidence IV.
Collapse
Affiliation(s)
- A M Valverde Villar
- Department of Orthopaedic Surgery, Hospital Universitario Santa Cristina, Madrid, Spain
| | | | - I Neira Borrajo
- Department of Orthopaedic Surgery, Hospital Universitario Santa Cristina, Madrid, Spain
| | - S de Miguel Fernández
- Department of Clinical Analysis, Hospital Universitario Santa Cristina, Madrid, Spain
| | - P Flox Benítez
- Department of Pharmacy, Hospital Universitario Santa Cristina, Madrid, Spain
| | - R Llopis Miró
- Department of Orthopaedic Surgery, Hospital Universitario Santa Cristina, Madrid, Spain
| |
Collapse
|
9
|
Cheung GYC, Bae JS, Otto M. Pathogenicity and virulence of Staphylococcus aureus. Virulence 2021; 12:547-569. [PMID: 33522395 PMCID: PMC7872022 DOI: 10.1080/21505594.2021.1878688] [Citation(s) in RCA: 414] [Impact Index Per Article: 138.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 12/15/2022] Open
Abstract
Staphylococcus aureus is one of the most frequent worldwide causes of morbidity and mortality due to an infectious agent. This pathogen can cause a wide variety of diseases, ranging from moderately severe skin infections to fatal pneumonia and sepsis. Treatment of S. aureus infections is complicated by antibiotic resistance and a working vaccine is not available. There has been ongoing and increasing interest in the extraordinarily high number of toxins and other virulence determinants that S. aureus produces and how they impact disease. In this review, we will give an overview of how S. aureus initiates and maintains infection and discuss the main determinants involved. A more in-depth understanding of the function and contribution of S. aureus virulence determinants to S. aureus infection will enable us to develop anti-virulence strategies to counteract the lack of an anti-S. aureus vaccine and the ever-increasing shortage of working antibiotics against this important pathogen.
Collapse
Affiliation(s)
- Gordon Y. C. Cheung
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, U.S. National Institutes of Health, Bethesda, Maryland, USA
| | - Justin S. Bae
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, U.S. National Institutes of Health, Bethesda, Maryland, USA
| | - Michael Otto
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, U.S. National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
10
|
Aratani T, Tsukamoto H, Higashi T, Kodawara T, Yano R, Hida Y, Iwasaki H, Goto N. Association of methicillin resistance with mortality of hospital-acquired Staphylococcus aureus bacteremia. J Int Med Res 2021; 49:3000605211058872. [PMID: 34826374 PMCID: PMC8647257 DOI: 10.1177/03000605211058872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective Methicillin-resistant (MR) Staphylococcus aureus bacteremia (SAB) is associated with higher mortality rates than methicillin-susceptible (MS) SAB. This study assessed potential predictors of mortality and evaluated the association of methicillin resistance with mortality in patients with SAB. Methods We conducted a retrospective cohort study in patients with hospital-acquired SAB, from 2009 to 2018. Clinical features of patients with MR-SAB were compared with those of patients with MS-SAB and predictors of 30-day mortality were determined using Cox regression analysis. Results Among 162 patients, 56.8% had MR-SAB. Overall 30-day mortality was 19.1%; MR-SAB had higher mortality (25.0%) than MS-SAB (11.4%). Univariate analysis highlighted long-term hospitalization, prior antibiotics use, and delayed initiation of appropriate antibiotics as risk factors. Cox regression analysis showed that respiratory tract source, Pitt bacteremia score, Charlson comorbidity index, and appropriate antibiotic therapy within 24 hours were independently and significantly associated with 30-day mortality outcome. Conclusions Methicillin resistance was not an independent risk factor for mortality in patients with SAB. Early, appropriate antibiotic treatment is an important prognostic factor.
Collapse
Affiliation(s)
- Tomonori Aratani
- Department of Pharmacy, University of Fukui Hospital, Fukui, Japan
| | - Hitoshi Tsukamoto
- Department of Pharmacy, University of Fukui Hospital, Fukui, Japan.,Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan
| | - Takashi Higashi
- Department of Pharmacy, University of Fukui Hospital, Fukui, Japan
| | - Takaaki Kodawara
- Department of Pharmacy, University of Fukui Hospital, Fukui, Japan
| | - Ryoichi Yano
- Education and Research Center for Clinical Pharmacy, Osaka University of Pharmaceutical Sciences, Osaka, Japan
| | - Yukio Hida
- Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan.,Clinical Laboratory, University of Fukui Hospital, Fukui, Japan
| | - Hiromichi Iwasaki
- Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan
| | - Nobuyuki Goto
- Department of Pharmacy, University of Fukui Hospital, Fukui, Japan
| |
Collapse
|
11
|
Lalgudi Ganesan S, Mehta A, Lakshmikantha K, Jayashree M, Gautam V, Ray P. Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections in Acutely Ill Children: A Retrospective Case-Control Study. Indian J Pediatr 2021; 88:141-146. [PMID: 32578038 DOI: 10.1007/s12098-020-03391-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 06/05/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To test if admission clinical and laboratory variables could reliably discriminate community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections from methicillin-sensitive Staphylococcus aureus (MSSA) infections in acutely ill children, and to describe the epidemiology, clinical features and outcomes among children with Staphylococcal infections admitted to the hospital. METHODS The authors conducted this retrospective case-control study comparing children with CA-MRSA and MSSA infections admitted to hospital between June 2014 and June 2017. They describe the evolving epidemiology and attempt to identify clinical and laboratory variables that can differentiate MRSA cases from MSSA controls. They used multivariate logistic regression to identify independent predictors of MRSA infection and Cox-proportional hazard analysis to compare survival times. RESULTS Seventy-three children were enrolled, of which 35 had CA-MRSA and 38 had MSSA infections. Children in MRSA group were younger [median (IQR) age in months: 36 (12, 62) vs. 56 (37, 96); p = 0.032]. MRSA and MSSA groups had similar rate of skin and soft tissue involvement (SSTI) [62.9% vs. 54.1%; p = 0.449]. Median duration of illness was lower in MRSA, 6 vs. 8.5 d (p = 0.001). TLC of 8100 or less was 82% sensitive and 94% specific for MRSA sepsis at admission [AUROC = 0.64 (0.51-0.77), p = 0.04]. Mortality (8.6% vs. 10.5% p = 1.0) and length of ICU stay (7.2 vs. 9.3 d, p = 0.24) were similar in both. None of the admission variables were predictive of MRSA culture-positivity on regression analysis. CONCLUSIONS The hospital-based incidence of CA-MRSA infections among children appears to be increasing. None of the admission clinical or laboratory variables could reliably identify CA-MRSA infections. As there seems to be no reliable way to differentiate children with MSSA and MRSA infections, physicians may consider empiric initiation of broad-spectrum antibiotics at admission to cover both MSSA and MRSA, especially in critically ill children with suspected Staphylococcal infections.
Collapse
Affiliation(s)
- Saptharishi Lalgudi Ganesan
- Children's Hospital of Western Ontario, London Health Sciences Center, London, Canada.,Children's Health Research Institute, Western University, London, Canada.,Schulich School of Medicine & Dentistry, Western University, London, Canada.,Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Ankit Mehta
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Keshavmurthy Lakshmikantha
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Muralidharan Jayashree
- Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
| | - Vikas Gautam
- Division of Medical Microbiology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Pallab Ray
- Division of Medical Microbiology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| |
Collapse
|
12
|
Tayebi Z, Fazeli M, Hashemi A, Abdi S, Dadashi M, Nasiri MJ, Goudarzi M. Molecular characterization of invasive Staphylococcus aureus strains isolated from patients with diabetes in Iran: USA300 emerges as the major type. INFECTION GENETICS AND EVOLUTION 2020; 87:104679. [PMID: 33326876 DOI: 10.1016/j.meegid.2020.104679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/29/2020] [Accepted: 12/11/2020] [Indexed: 01/04/2023]
Abstract
There have been few studies focused on the molecular characterization of invasive Staphylococcus aureus strains in patients with diabetes in Iran. In the present study, 20 invasive S. aureus strains recovered from the patients with diabetes characterized by the virulence and resistance analysis, biofilm formation, staphylocoagulase (SC) typing, S. aureus protein A locus (spa) typing staphylococcal cassette chromosome mec (SCCmec) typing, and multilocus sequence typing (MLST). Virulence gene detection indicated a high prevalence of strains encoding the pvl genes (50%), a low prevalence of the tst and seg gene (each of them was 5%) and a markedly high prevalence of fnbB (95%), fnbA (85%), icaD (75%), icaA (65%). A total of 3 coagulase types (III, 85%; II, 10%; V, 5%), 2 agr types (I, 90%; II 10%) and 2 SCCmec types (IV, 65%; III, 35%) and four different clones namely ST8-MRSA-IV/t008 (50%) (USA300), ST239-MRSA-III/t030 (35%), ST5-MRSA-IV/t002 (10%), and ST45-MRSA-IV/t038 (5%) were detected in this study. Eighty-five percent of the isolates were biofilm producers. All the 4 high-level mupirocin resistance (HLMUPR) strains belonged to CC/ST8-MRSA-IV/t008 clone and carried mupA gene. Fusidic acid-resistant isolate belonged to ST239-SCCmec III/t030 clone. One vancomycin-intermediate resistance isolates was detected in our study, which belonged to ST5-MRSA-IVt002. Circulating clone in MRSA strains (USA300) isolated from the patients with diabetes highlighting the possibility of transmission of these microorganisms' clones between hospital, community, and environments. However, further studies require providing critical insights into the importance of continued controlling and treatment of S. aureus infections in patients with diabetes.
Collapse
Affiliation(s)
- Zahra Tayebi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Microbiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Maryam Fazeli
- Department of Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Hashemi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Abdi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Tehran, Iran
| | - Masoud Dadashi
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
13
|
Lu R, Frederiksen MW, Uhrbrand K, Li Y, Østergaard C, Madsen AM. Wastewater treatment plant workers' exposure and methods for risk evaluation of their exposure. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 205:111365. [PMID: 32977286 DOI: 10.1016/j.ecoenv.2020.111365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/14/2020] [Accepted: 09/13/2020] [Indexed: 06/11/2023]
Abstract
Work in wastewater treatment plants (WWTPs) can be associated with respiratory symptoms and diarrhea. The aim of this study was to obtain knowledge about WWTP workers' exposure to airborne bacteria and endotoxin, and the inflammatory potential (TIP) of their exposure, and to evaluate the risk posed by the exposure by 1) calculating a hazard index and relating the exposure to suggested occupational exposure limits (OELs), 2) estimating the potential deposition of bacteria in the airways, 3) relating it to the risk group classification of bacteria by the European Union, and 4) estimating the TIP of the personal exposure. A cohort of 14 workers were followed over one year. Bioaerosols were collected using personal and stationary samplers in a grid chamber house and an aeration tank area. Airborne bacteria were identified using (MALDI-TOF MS), and TIP of exposure was measured using HL-60 cells. A significant effect of season, work task, and person was found on the personal exposure. A hazard index based on exposure levels indicates that the risk caused by inhalation is low. In relation to suggested OELs, 14% and 34% of the personal exposure were exceeded for endotoxin (≥50 EU/m3) and bacteria (≥500 CFU/m3). At least 70% of the airborne bacteria in the grid chamber house and the aeration tank area could potentially deposit in the lower respiratory tract. From the personal samples, three of 131 bacterial species, Enterobacter cloacae, Staphylococcus aureus, and Yersinia enterocolitica are classified within Risk Group 2. Seven additional bacteria from the stationary samples belong to Risk Group 2. The bacterial species composition was affected significantly by season (p = 0.014) and by sampling type/area (p = 0.001). The TIP of WWTP workers' exposure was higher than of a reference sample, and the highest TIP was measured in autumn. TIP of personal exposure correlated with bacterial exposure. Based on the geometric average exposures to endotoxin (9.2 EU/m3) and bacteria (299 CFU/m3) and based on the calculated hazard index, the risk associated with exposure is low. However, since 43 of 106 exposure levels exceed suggested OELs, the TIP of exposure was elevated and associated with bacterial exposure, and WWTP workers were exposed to pathogenic bacteria, a continued focus on preventive measures is important. The identification of bacteria to species level in personal samples was necessary in the risk assessment, and measurement of the microbial composition made the source tracking possible.
Collapse
Affiliation(s)
- Rui Lu
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark; School of Water and Environment, Chang'an University, Xi'an, 710054, China
| | - Margit W Frederiksen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
| | - Katrine Uhrbrand
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
| | - Yanpeng Li
- School of Water and Environment, Chang'an University, Xi'an, 710054, China
| | - Claus Østergaard
- Department of Clinical Microbiology, Lillebaelt Hospital, Denmark
| | - Anne Mette Madsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark.
| |
Collapse
|
14
|
Insufficient repeatability and reproducibility of MALDI-TOF MS-based identification of MRSA. Folia Microbiol (Praha) 2020; 65:895-900. [PMID: 32613406 DOI: 10.1007/s12223-020-00799-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 05/07/2020] [Indexed: 10/23/2022]
Abstract
Rapid identification of methicillin-resistant Staphylococcus aureus (MRSA) is essential for proper initial antibiotic therapy and timely set up of hygienic measures. Recently, detection of MRSA using MALDI-TOF mass spectrometer mediated by the peptide-phenol-soluble modulin (PSM-mec)-linked to the class A mec gene complex present in SCCmec cassettes types II, III, and VIII of MRSA strains, has been commercially available. We present here a multicentre study on MALDI-TOF MS detection of MRSA evincing a poor repeatability and reproducibility of the assay. The sensitivity of the assay varies between 50 and 90% in strains carrying psmMEC and psmδ genes encoding for PSM-mec and δ-toxin (a member of the PSM peptide family), respectively. No false positive results were found. The very major error calculation was 30% and the major error achieved 0%. Interlaboratory repeatability varies between 0 and 100%. No significant difference was observed with the use of different cultivation media. Our data showed a poor sensitivity of the method excluding it from the use in routine laboratory testing.
Collapse
|
15
|
Ahmad A, Teoh KH, Lau L, Cheng N, Evans AR. Can we reduce the number of MRSA screening site swabs in elective orthopedic patients? J Orthop Surg (Hong Kong) 2020; 27:2309499019847068. [PMID: 31068084 DOI: 10.1177/2309499019847068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Deep infection after routine elective orthopedic procedures can be catastrophic, leading to further surgery, loss of limb, disability, and risk of mortality. Ring-fencing elective orthopedic ward has been shown to significantly reduce the incidence of all postoperative infections especially with methicillin-resistant Staphylococcus aureus (MRSA). Our hospital's current MRSA screening is a four-site MRSA swabs. OBJECTIVES This study evaluates the possibility of reducing the number of MRSA swab sites as part of a quality improvement project. STUDY DESIGN AND METHODS Patients on the waiting list for elective orthopedic procedure in our trust who had an MRSA-positive swab from either four sites were analyzed over the time period from January 2012 to December 2014. Those without swabs from all four areas (nose, throat, axilla, and groin) were excluded. Positive swabs of different regions were recorded and compared. RESULTS There were 138 MRSA-positive patients, giving an incidence of 31 per 10,000 screen/year over that time period. Some patients ( n = 31, 22.5%) had a positive swab in more than one site. The positive sites were as follows: nose (69.60%, n = 96), groin (26.10%, n = 36), throat (25.30%, n = 35), and axilla (8.70%, n = 12). In our cohort, we would miss a significant proportion of positive patients if we change it to a two swab screening policy (26.8% for nose and axilla combination; 18.10% for nose and groin combination; and 15.20% for nose and throat). However, we would only miss 2.2% of cases for a nose, groin, and throat three-swab policy. There were also 11 instances, where a previously negative site become positive in the next swab. CONCLUSION A three-swab combination of nasal, throat, and groin swabs improves pickup rate of MRSA significantly compared to a two-swab policy and misses only 2.2% compared to a four-swab policy. Axilla swabbing does not make a significant difference to the results. Based on this study, the policy has now been changed from a four-swab to three-swab screening in our trust. This has now been audited four times and they were all negative. This has helped to reduce cost in terms of staff time and resources. We would not recommend screening only the previous positive site for the next repeat screening swabs as there is an 8% chance of missing MRSA carrier status.
Collapse
Affiliation(s)
- Aziz Ahmad
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, Wales, UK
| | - Kar H Teoh
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, Wales, UK
| | - Lilian Lau
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, Wales, UK
| | - Natalie Cheng
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, Wales, UK
| | - Aled R Evans
- Department of Trauma and Orthopaedics, Royal Gwent Hospital, Newport, Wales, UK
| |
Collapse
|
16
|
Žalnėravičius R, Mikalauskaitė A, Niaura G, Paškevičius A, Jagminas A. Ultra-small methionine-capped Au 0/Au + nanoparticles as efficient drug against the antibiotic-resistant bacteria. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 102:646-652. [PMID: 31147036 DOI: 10.1016/j.msec.2019.04.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/14/2019] [Accepted: 04/20/2019] [Indexed: 12/17/2022]
Abstract
In this study we examined the influence of ultra-small gold and magnetite‑gold nanoparticles (NPs) stabilized with d,l-methionine, Fe3O4@Au@Met, on their antibacterial efficacy against three of twelve the worst bacterial family members included in the World Health Organization (WHO) list. In particular, gram-negative Acinetobacter baumannii, Salmonella enterica and gram-positive methicillin-resistant Staphylococcus aureus and Micrococcus luteus were tested. Apart from the synthesis, gold species reduction and NP stabilization, an excess of methionine has been used herein to detach ultra-small gold NPs from the Fe3O4@Au@Met surface, collect them and investigate. The antimicrobial efficiency of the ultra-small (Ø ~ 1.8 nm) Au@Met NPs and Fe3O4@Au@Met NPs was evaluated through the quantitative analysis by comparing with that of naked magnetite NPs, d,l-Met and BSA. It has been determined that compared with the control sample, 70 mg L-1 probe of Au@Met NPs exhibited the killing efficiency of 84.4-58.5% against gram-negative bacteria and 89.1-75.7% against gram-positive bacteria. The composition, structure, and morphology of the synthesized and tested herein NPs were investigated by inductively coupled plasma optical emission spectrometry, magnetic measurements, FTIR, XRD, XPS, AFM and HRTEM.
Collapse
Affiliation(s)
- Rokas Žalnėravičius
- State Research Institute Centre for Physical Sciences and Technology, Sauletekio av. 3, LT-10257 Vilnius, Lithuania
| | - Agnė Mikalauskaitė
- State Research Institute Centre for Physical Sciences and Technology, Sauletekio av. 3, LT-10257 Vilnius, Lithuania
| | - Gediminas Niaura
- State Research Institute Centre for Physical Sciences and Technology, Sauletekio av. 3, LT-10257 Vilnius, Lithuania
| | - Algimantas Paškevičius
- Laboratory of Biodeterioration Research, Nature Research Centre, Akademijos 2, LT-08412 Vilnius, Lithuania
| | - Arūnas Jagminas
- State Research Institute Centre for Physical Sciences and Technology, Sauletekio av. 3, LT-10257 Vilnius, Lithuania.
| |
Collapse
|
17
|
Soares da Silva J, Machado TR, Martins TA, Assis M, Foggi CC, Macedo NG, Beltrán-Mir H, Cordoncillo E, Andrés J, Longo E. α-AgVO 3 Decorated by Hydroxyapatite (Ca 10(PO 4) 6(OH) 2): Tuning Its Photoluminescence Emissions and Bactericidal Activity. Inorg Chem 2019; 58:5900-5913. [PMID: 31012582 DOI: 10.1021/acs.inorgchem.9b00249] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Defect-related luminescent materials have attracted interest because of their excellent optical properties and are considered as a less expensive and nontoxic alternative to commonly used lanthanide-based optical systems. These materials are fundamentally and technologically important for the next generation of full-color tunable light-emitting diodes as well as in the biomedical field. In this study, we report the preparation of α-silver vanadate (α-AgVO3, AV) decorated by hydroxyapatite (Ca10(PO4)6(OH)2, HA) with intense photoluminescence (PL) emissions at various HA/AV molar ratios (1:1-1:1/32) by a simple route based on chemical precipitation. The well-defined diffraction peaks observed by X-ray diffraction were all indexed to the monoclinic AV and hexagonal HA phases. Analysis of the results obtained by Fourier transform infrared spectroscopy reveals the presence of short-range structural order as deduced by the characteristic vibrational modes assigned to AV and HA systems. Characterization by scanning and transmission electron microscopies confirms the presence of AV and HA micro- and nanorods, respectively. UV-vis spectroscopy renders band gap energies of 5.80 eV for HA and in the range 2.59-2.65 eV for pure AV and HA/AV samples. The PL data reveal the presence of broad-band emission profiles, typical of defect-related optical centers in materials. Depending on the molar ratio, the emission can be completely tunable from the blue to red spectral regions; in addition, pure white color emission was obtained. On the basis of these results, we propose an order-disorder model induced by structural and interface defects to explain the PL emissions in the HA/AV system. Moreover, our results show that HA/AV composites have superior bactericidal activity against Staphylococcus aureus (methicillin-resistant and methicillin-susceptible) and can be used as a novel multifunctional material.
Collapse
Affiliation(s)
- Jussara Soares da Silva
- Departamento de Química , CDMF, Universidade Federal de São Carlos (UFSCar) , 13565-905 São Carlos , São Paulo , Brazil
| | - Thales R Machado
- Departamento de Química , CDMF, Universidade Federal de São Carlos (UFSCar) , 13565-905 São Carlos , São Paulo , Brazil
| | - Tiago A Martins
- Departamento de Química , CDMF, Universidade Federal de São Carlos (UFSCar) , 13565-905 São Carlos , São Paulo , Brazil
| | - Marcelo Assis
- Departamento de Química , CDMF, Universidade Federal de São Carlos (UFSCar) , 13565-905 São Carlos , São Paulo , Brazil
| | - Camila C Foggi
- Departamento de Química , CDMF, Universidade Federal de São Carlos (UFSCar) , 13565-905 São Carlos , São Paulo , Brazil
| | - Nadia G Macedo
- Departamento de Química , CDMF, Universidade Federal de São Carlos (UFSCar) , 13565-905 São Carlos , São Paulo , Brazil
| | - Héctor Beltrán-Mir
- Departament de Química Inorgànica i Orgànica , Universitat Jaume I (UJI) , 12071 Castellón de la Plana , Castelló , Spain
| | - Eloisa Cordoncillo
- Departament de Química Inorgànica i Orgànica , Universitat Jaume I (UJI) , 12071 Castellón de la Plana , Castelló , Spain
| | - Juan Andrés
- Departament de Química Física i Analítica , Universitat Jaume I (UJI) , 12071 Castellón de la Plana , Castelló , Spain
| | - Elson Longo
- Departamento de Química , CDMF, Universidade Federal de São Carlos (UFSCar) , 13565-905 São Carlos , São Paulo , Brazil
| |
Collapse
|
18
|
Subramanian D, Natarajan J. RNA-seq analysis reveals resistome genes and signalling pathway associated with vancomycin-intermediate Staphylococcus aureus. Indian J Med Microbiol 2019; 37:173-185. [PMID: 31745016 DOI: 10.4103/ijmm.ijmm_18_311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Context Vancomycin-intermediate Staphylococcus aureus remains one of the most prevalent multidrug-resistant pathogens causing healthcare infections that are difficult to treat. Aims This study uses a comprehensive computational analysis to systematically investigate various gene expression profiles of resistant and sensitive S. aureus strains on exposure to antibiotics. Settings and Design The transcriptional changes leading to the development of multiple antibiotic resistance were examined by an integrative analysis of nine differential expression experiments under selected conditions of vancomycin-intermediate and -sensitive strains for four different antibiotics using publicly available RNA-Seq datasets. Materials and Methods For each antibiotic, three experimental conditions for expression analysis were selected to identify those genes that are particularly involved in the development of resistance. The results were further scrutinised to generate a resistome that can be analysed for their role in the development or adaptation to antibiotic resistance. Results The 99 genes in the resistome are then compiled to create a multiple drug resistome of 25 known and novel genes identified to play a part in antibiotic resistance. The inclusion of agr genes and associated virulence factors in the identified resistome supports the role of agr quorum sensing system in multiple drug resistance. In addition, enrichment analysis also identified the kyoto encyclopedia of genes and genomes (KEGG) pathways - quorum sensing and two-component system pathways - in the resistome gene set. Conclusion Further studies on understanding the role of the identified molecular targets such as SAA6008_00181, SAA6008_01127, agrA, agrC and coa in adapting to the pressure of antibiotics at sub-inhibitory concentrations can help in learning the molecular mechanisms causing resistance to the pathogens as well as finding other potential therapeutics.
Collapse
Affiliation(s)
- Devika Subramanian
- Department of Bioinformatics, Data Mining and Text Mining Laboratory, Bharathiar University, Coimbatore, Tamil Nadu, India
| | - Jeyakumar Natarajan
- Department of Bioinformatics, Data Mining and Text Mining Laboratory, Bharathiar University, Coimbatore, Tamil Nadu, India
| |
Collapse
|
19
|
Berrevoets MAH, Kouijzer IJE, Slieker K, Aarntzen EHJG, Kullberg BJ, Oever JT, Bleeker-Rovers CP. 18F-FDG PET/CT-Guided Treatment Duration in Patients with High-Risk Staphylococcus Aureus Bacteremia: A Proof of Principle. J Nucl Med 2018; 60:998-1002. [PMID: 30552202 DOI: 10.2967/jnumed.118.221929] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 11/28/2018] [Indexed: 01/05/2023] Open
Abstract
Current guidelines recommend intravenous antibiotic therapy for at least 4 wk in patients with high-risk Staphylococcus aureus bacteremia (SAB), because of the risk for metastatic infection. We evaluated the safety of a shorter duration of treatment in patients with high-risk SAB without signs of metastatic infection at presentation, using standard 18F-FDG PET/CT and echocardiography. Methods: Retrospective analyses were performed of patients with SAB admitted between 2013 and 2017 in 2 medical centers. Patients with risk factors for complicated bacteremia (community acquisition, persistently positive blood cultures, >72 h of fever, or foreign body materials present), a normal echocardiography result, and 18F-FDG PET/CT without signs of metastatic infection were included (cases) and compared with patients with uncomplicated bacteremia (absence of any of the risk factors and no known metastatic disease, controls). Primary outcomes were 3-mo SAB-specific mortality rate and recurrent infection. The secondary outcome was overall mortality. Results: We included 36 cases and 40 controls. Both groups had a similar treatment duration (15.9 vs. 15.4 d). No deaths occurred as a consequence of SAB in the cases, compared with 1 in the control group. One relapse occurred in the case group and 2 in the control group. Overall mortality did not differ between the groups (19.4% vs. 15.0%, P = 0.64). Conclusion: This study suggests that intravenous treatment for 2 wk in high-risk patients with SAB without endocarditis and absence of metastatic infection on 18F-FDG PET/CT is safe. A diagnostic-driven approach using 18F-FDG PET/CT to determine treatment duration in high-risk SAB seems feasible and allows tailoring treatment to individual patients.
Collapse
Affiliation(s)
- Marvin A H Berrevoets
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse J E Kouijzer
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kitty Slieker
- Department of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands; and
| | - Erik H J G Aarntzen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bart Jan Kullberg
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jaap Ten Oever
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chantal P Bleeker-Rovers
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
20
|
Tandon T, Tadros BJ, Akehurst H, Avasthi A, Hill R, Rao M. Risk of Surgical Site Infection in Elective Hip and Knee Replacements After Confirmed Eradication of MRSA in Chronic Carriers. J Arthroplasty 2017; 32:3711-3717. [PMID: 28739308 DOI: 10.1016/j.arth.2017.06.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/31/2017] [Accepted: 06/23/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) is globally endemic and is a leading cause of surgical site infection (SSI). The purpose of this study was to evaluate the incidence of SSI in MRSA carriers undergoing elective hip or knee arthroplasty, who had confirmed eradication and to compare it with incidence of SSI in non-MRSA carriers. METHODS This is a retrospective analysis of 6613 patients who underwent elective total hip arthroplasty (THA; n = 3347) and total knee arthroplasty (TKA; n = 3266) at our institution. A cohort of patients who were preoperatively colonized with MRSA was identified. We compared the infection rates with non-MRSA carriers. RESULTS We had a colonization rate of 1.3% (83 patients). A total of 79 patients had confirmed eradication of carrier status before surgical intervention. Of these, 38 were THAs and 41 were TKAs. Five of 79 patients (6.32%; 95% confidence interval [CI]: 2.35%-14.79%) had "deep SSI" within 1 year of surgery. There were 2 MRSA infections in THAs (relative risk 4.46; 95% CI: 1.12-17.82). There were 2 MRSA and 1 methicillin-sensitive Staphylococcus aureus infections in TKAs (relative risk 5.61; 95% CI: 1.81-17.38). A significant statistical difference in infection rates from MRSA negative control group was noted, which had a deep sepsis rate of 1.17% in THAs and 1.3% in TKAs over the same period. CONCLUSION In spite of a selective treatment program for carriers and confirmed eradication, there is still a significantly increased risk of SSI in MRSA-colonized patients undergoing hip or knee arthroplasties.
Collapse
Affiliation(s)
- Tarang Tandon
- Department of Orthopaedics, St Richards Hospital, Western Sussex Hospitals NHS Trust, Chichester, UK
| | - Baha J Tadros
- Department of Orthopaedics, St Richards Hospital, Western Sussex Hospitals NHS Trust, Chichester, UK
| | - Harold Akehurst
- Department of Orthopaedics, St Richards Hospital, Western Sussex Hospitals NHS Trust, Chichester, UK
| | - Adhish Avasthi
- Department of Orthopaedics, St Richards Hospital, Western Sussex Hospitals NHS Trust, Chichester, UK
| | - Richard Hill
- Department of Orthopaedics, St Richards Hospital, Western Sussex Hospitals NHS Trust, Chichester, UK
| | - Madhu Rao
- Department of Orthopaedics, St Richards Hospital, Western Sussex Hospitals NHS Trust, Chichester, UK
| |
Collapse
|
21
|
Costa EM, Silva S, Vicente S, Neto C, Castro PM, Veiga M, Madureira R, Tavaria F, Pintado MM. Chitosan nanoparticles as alternative anti-staphylococci agents: Bactericidal, antibiofilm and antiadhesive effects. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017. [PMID: 28629011 DOI: 10.1016/j.msec.2017.05.047] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Chitosan is a biocompatible, bioactive, non-toxic polymer that due to these characteristics has been widely used as a carrier for targeted delivery of bioactive molecules. In recent years, and considering that chitosan has a strong antimicrobial potential, the scientific community's focus has shifted onto the possible antimicrobial activity of chitosan nanoparticles. With this in mind, the aim of this work was to produce low molecular weight chitosan nanoparticles, through the ionic gelation method and characterize their potential biological activity against three staphylococci (MSSA, MRSA and MRSE) in planktonic and sessile environments. The chitosan nanoparticles produced had an average size of 244±12nm, an average charge of 17.3±1.4mV and had a MIC of 1.25mg/mL for all tested microorganisms. Bactericidal activity was only registered for MSSA and MRSA with the time-inhibition curves showing bactericidal activity within 1h. Assays regarding chitosan nanoparticles' impact upon sessile populations showed that they were effective in preventing MRSE adhesion and highly effective in reducing MRSA and MSSA biofilm formation.
Collapse
Affiliation(s)
- E M Costa
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal
| | - S Silva
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal
| | - S Vicente
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal
| | - C Neto
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal
| | - P M Castro
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal
| | - M Veiga
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal
| | - R Madureira
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal
| | - F Tavaria
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal
| | - M M Pintado
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal.
| |
Collapse
|
22
|
Spernovasilis N, Demetriou S, Bachlitzanaki M, Gialamas I, Alpantaki K, Hamilos G, Karantanas A, Gikas A. Characteristics and predictors of outcome of spontaneous spinal epidural abscesses treated conservatively: A retrospective cohort study in a referral center. Clin Neurol Neurosurg 2017; 156:11-17. [PMID: 28284111 DOI: 10.1016/j.clineuro.2017.02.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/20/2017] [Accepted: 02/24/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Recent studies have shown that in carefully selected patients, conservative treatment alone can be an option in the management of spinal epidural abscess (SEA). The aim of this study was to identify prognostic factors of outcome in patients with spontaneous SEA treated conservatively. PATIENTS AND METHODS A retrospective cohort study of all patients with spontaneous SEA treated with antibiotics alone from January 2012 to December 2015 was conducted in a 1200-bed tertiary referral center. Demographic, clinical, microbiological, and radiological characteristics were analyzed. Failure of medical treatment was defined as the need for delayed surgical intervention, no neurological improvement or deterioration, death due to the infection, or relapse after hospital discharge. RESULTS We identified 21 patients diagnosed with spontaneous SEA treated conservatively. Median age was 72 years and 10 patients were male. Eleven patients presented with radicular weakness and/or radicular sensory deficit, or incomplete cord injury. Inflammatory markers were markedly elevated in all patients. Thirteen patients were successfully treated with conservative treatment, while among 8 patients with treatment failure, 1 died due to the infection. Presence of serious neurological deficits and infection due to methicillin-resistant S. aureus (MRSA) were associated with failure of conservative treatment. Notably, neither the extension nor the location of the abscess on magnetic resonance imaging (MRI) was associated with failed medical management. CONCLUSIONS A significant proportion of patients with spontaneous SEA can respond to antibiotic treatment alone. However, in patients with infection due to MRSA or with severe neurological impairment, conservative management has an increased risk of failure.
Collapse
Affiliation(s)
- Nikolaos Spernovasilis
- Department of Internal Medicine, Infectious Diseases Unit, University Hospital of Heraklion, Heraklion, Greece
| | - Stelios Demetriou
- Department of Medical Imaging, University Hospital of Heraklion, Heraklion, Greece
| | - Maria Bachlitzanaki
- Department of Internal Medicine, "Venizelion" General Hospital of Heraklion, Heraklion, Greece
| | - Ioannis Gialamas
- Department of Internal Medicine, Infectious Diseases Unit, University Hospital of Heraklion, Heraklion, Greece
| | - Kalliopi Alpantaki
- Department of Orthopaedics and Traumatology, University Hospital of Heraklion, Heraklion, Greece; Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Georgios Hamilos
- Department of Internal Medicine, Infectious Diseases Unit, University Hospital of Heraklion, Heraklion, Greece; Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Apostolos Karantanas
- Department of Medical Imaging, University Hospital of Heraklion, Heraklion, Greece; Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Achilleas Gikas
- Department of Internal Medicine, Infectious Diseases Unit, University Hospital of Heraklion, Heraklion, Greece; Faculty of Medicine, University of Crete, Heraklion, Greece.
| |
Collapse
|
23
|
Ahn JH, Lee SB. Clinical Analysis of Staphylococcus aureus Keratitis according to Methicillin-resistance. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.8.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jang Hwan Ahn
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| | - Sang-Bumm Lee
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| |
Collapse
|
24
|
Ghanwate N, Thakare P, Bhise PR, Gawande S. Colorimetric method for rapid detection of Oxacillin resistance in Staphylococcus aureus and its comparison with PCR for mec A gene. Sci Rep 2016; 6:23013. [PMID: 26960268 PMCID: PMC4785335 DOI: 10.1038/srep23013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 02/17/2016] [Indexed: 11/23/2022] Open
Abstract
Rapid and accurate detection of Methicillin Resistant Staphylococcus aureus (MRSA) is an important role of clinical microbiology laboratories to avoid treatment failure. The detection of MRSA is based on phenotypic assays which require at least 24 h to perform. Detection of the mecA gene or of PBP 2a is the "gold standard", but not always available. The aim of this study was to evaluate a rapid method for detection of MRSA by using 3 (4, 5 dimethyl thiazole -2-yl) -2, 5 diphenyl tetrazolium bromide (MTT). Total 126 isolates of MRSA were collected from tertiary healthcare center and were confirmed by oxacillin screening agar test as per CLSI guidelines. Amplification of mecA gene was performed by using PCR. MTT assay was carried out for all the isolates in 96 well Microtitre plate and compared with standard methods of CLSI. Out of 126 isolates, 98 were found to be mecA positive. MTT method was found to be 98.98% sensitive and 96.43% specific. The MTT based colorimetric method is rapid and simple test for screening of oxacillin resistance in Staphylococcus aureus. It significantly shortens the time to just 7 h required to obtained a drug susceptibility test and could be useful to screen MRSA.
Collapse
Affiliation(s)
- Niraj Ghanwate
- Department of Microbiology, Sant Gadge Baba Amravati University, Amravati, 444602, MS, India
| | - Prashant Thakare
- Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, 444602, MS, India
| | - P. R. Bhise
- Department of Microbiology, DR. P D M Medical College, Amravati, 444603, MS, India
| | - Sonali Gawande
- Department of Microbiology, Sant Gadge Baba Amravati University, Amravati, 444602, MS, India
| |
Collapse
|
25
|
Abstract
A 71-year-old woman presented with painful vision loss in the right eye followed by ophthalmoplegia. Magnetic resonance imaging demonstrated optic nerve sheath enlargement and enhancement. Biopsy of the optic nerve sheath revealed purulent and necrotic material that was positive for methicillin-sensitive Staphylococcus aureus. The patient underwent enucleation of the right eye and was treated with systemic antibiotics with clinical stabilization. Imaging, pathological and treatment aspects of optic nerve sheath abscess are discussed.
Collapse
|
26
|
Qiao Y, Ning X, Chen Q, Zhao R, Song W, Zheng Y, Dong F, Li S, Li J, Wang L, Zeng T, Dong Y, Yao K, Yu S, Yang Y, Shen X. Clinical and molecular characteristics of invasive community-acquired Staphylococcus aureus infections in Chinese children. BMC Infect Dis 2014; 14:582. [PMID: 25377600 PMCID: PMC4225039 DOI: 10.1186/s12879-014-0582-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 10/23/2014] [Indexed: 12/20/2022] Open
Abstract
Background This study aims to investigate the clinical features of invasive community-acquired Staphylococcus aureus (CA-SA) infection in Chinese children and analyze its molecular features. Methods Clinical data and invasive CA-SA isolates were prospectively collected. Pediatric risk of mortality (PRISM) score was used for disease severity measurement. Molecular typing was then performed, followed by expression analysis for virulence genes. Results Among 163 invasive CA-SA infection cases, 71 (43.6%) were methicillin-resistant SA (MRSA) infections and 92 (56.4%) were methicillin-susceptible SA (MSSA). A total of 105 (64.4%) children were younger than 1 year old, and 79.7% (129/163) were under 3 years age. Thirteen kinds of diseases were observed, in which bacteremia and pneumonia accounted for 65.6% (107/163) and 52.8% (86/163), respectively. A total of 112 (68.1%) patients had two or more infective sites simultaneously, and four cases (2.5%) died. CA-MSSA more frequently caused multi-sites infections, bacteremia, and musculoskeletal infection than MRSA. A total of 25 sequence types (STs) were detected. MRSA mainly comprised ST59 (49/71, 69%), whereas the most frequent clonotypes were ST88 (15/92, 16.3%), ST25 (13/92, 14.1%), ST7 (13/92, 14.1%), ST2155 (12/92, 13%), and ST188 (9/92, 9.8%) for MSSA. Seven STs were common to both MSSA and MRSA groups. No differences in clinical presentation or PRISM score were found between the two groups or among different ST. The expression levels of the four known virulence genes varied among the six main ST clones. Conclusions Invasive CA-SA infections were characterized by high incidence and multi-site infections in young children in China. The clinical manifestations of CA-MSSA were more frequently associated with multi-site infections, bacteremia and musculoskeletal infection than those of CA-MRSA. Isolated genotypes may be relevant to the expressions of virulence genes, but not to clinical manifestations. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0582-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xuzhuang Shen
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing, PR China.
| |
Collapse
|
27
|
Thompson T, Brown PD. Comparison of antibiotic resistance, virulence gene profiles, and pathogenicity of methicillin-resistant and methicillin-susceptible Staphylococcus aureus using a Caenorhabditis elegans infection model. Pathog Glob Health 2014; 108:283-91. [PMID: 25319852 DOI: 10.1179/2047773214y.0000000155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This study compared the presence of 35 virulence genes, resistance phenotypes to 11 anti-staphylococcal antibiotics, and pathogenicity in methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA). METHODS Multiplex PCR analysis was used to differentiate Staphylococcus aureus isolates (n = 102) based on characterization of the Staphylococcal Cassette Chromosome mec (SCCmec). Singleplex and multiplex PCR assays targeting 35 virulence determinants were used to analyze the virulence repertoire of S. aureus. In vitro activities of the antibiotics were determined by the disk-diffusion method. The pathogenicity of representative isolates was assessed using Caenorhabditis elegans survival assays. Significance in virulence distribution and antibiotic resistance phenotypes was assessed using the Chi-squared tests. Kaplan-Meier survival estimates were used to analyze nematode survival and significance of survival rates evaluated using the log-rank test. RESULTS Except for sei (staphylococcal enterotoxin I) (P = 0·027), all other virulence genes were not significantly associated with MRSA. Resistance to clindamycin (P = 0·03), tetracycline (P = 0·048), trimethoprim/sulfamethoxazole (P = 0·038), and oxacillin (P = 0·004) was significantly associated with MRSA. Survival assay showed MSSA having a lower median lifespan of 3 days than MRSA that had a median lifespan of 6 days. The difference in the killing time of MRSA and MSSA was significant (P < 0·001). CONCLUSION While antibiotic resistance was significantly associated with MRSA, there was no preferential distribution of the virulence genes. The quicker killing potential of MSSA compared to MRSA suggests that carriage of virulence determinants per se does not determine pathogenicity in S. aureus. Pathogenicity is impacted by other factors, possibly antibiotic resistance.
Collapse
|
28
|
Thakkar V, Ghobrial GM, Maulucci CM, Singhal S, Prasad SK, Harrop JS, Vaccaro AR, Behrend C, Sharan AD, Jallo J. Nasal MRSA colonization: Impact on surgical site infection following spine surgery. Clin Neurol Neurosurg 2014; 125:94-7. [DOI: 10.1016/j.clineuro.2014.07.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/05/2014] [Accepted: 07/13/2014] [Indexed: 10/25/2022]
|
29
|
Al Mohajer M, Musher DM, Minard CG, Darouiche RO. Clinical significance of Staphylococcus aureus bacteriuria at a tertiary care hospital. ACTA ACUST UNITED AC 2013; 45:688-95. [PMID: 23808717 DOI: 10.3109/00365548.2013.803291] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Staphylococcus aureus bacteriuria has been associated with invasive S. aureus disease. The current project describes the clinical significance of S. aureus bacteriuria. METHODS We conducted a retrospective chart review of patients who had S. aureus bacteriuria at the Michael E. DeBakey Veterans Affairs Medical Center, 2008-2010. RESULTS A total of 326 patients were included. Invasive S. aureus disease was documented within 12 months of bacteriuria in 56 patients (22.3% of methicillin-resistant S. aureus (MRSA) cases and 8.4% of methicillin-sensitive S. aureus (MSSA), p = 0.002). Multiple logistic regression indicated that MRSA bacteriuria (odds ratio (OR) 2.91, p = 0.010), absence of symptoms suggestive of a urinary tract infection (UTI) (OR 3.21, p = 0.019), inpatient status (OR 4.72, p = 0.003), and receipt of antibiotics active against S. aureus (OR 6.41, p < 0.001) were significantly associated with the presence of invasive S. aureus disease. Seventy-seven patients (23.6%) died within 12 months of the documented S. aureus bacteriuria. Age (OR 1.02, p = 0.025), absence of pyuria (OR 2.00, p = 0.029), the presence of invasive S. aureus disease (OR 2.05, p = 0.033), and inpatient status (OR 3.62, p < 0.001) were significantly associated with death. CONCLUSIONS S. aureus bacteriuria is associated with significant morbidity and mortality. Patients without UTI symptoms, those with MRSA bacteriuria, and those without pyuria were more to likely to have worse outcomes (invasive S. aureus disease or death). Obtaining blood cultures should be considered in these cases.
Collapse
Affiliation(s)
- Mayar Al Mohajer
- Section of Infectious Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA.
| | | | | | | |
Collapse
|
30
|
Abstract
Staphylococcus aureus is one of the leading causes of surgical site infection (SSI). Over the past decade there has been an increase in methicillin-resistant S. aureus (MRSA). This is a subpopulation of the bacterium with unique resistance and virulence characteristics. Nasal colonisation with either S. aureus or MRSA has been demonstrated to be an important independent risk factor associated with the increasing incidence and severity of SSI after orthopaedic surgery. Furthermore, there is an economic burden related to SSI following orthopaedic surgery, with MRSA-associated SSI leading to longer hospital stays and increased hospital costs. Although there is some controversy about the effectiveness of screening and eradication programmes, the literature suggests that patients should be screened and MRSA-positive patients treated before surgical admission in order to reduce the risk of SSI. Cite this article: Bone Joint J 2013;95-B:4–9.
Collapse
Affiliation(s)
- N. Goyal
- Anderson Orthopaedic Clinic, 2445
Army Navy Drive, Arlington, Virginia
22206, USA
| | - A. Miller
- Thomas Jefferson University, Jefferson
Medical College, Thomas Jefferson University, Walnut
Street, Philadelphia, Pennsylvania 19107, USA
| | - M. Tripathi
- UMDNJ – Robert Wood Johnson Medical School, University
of Medicine and Dentistry of New Jersey, Hoes
Lane, Piscataway, New Jersey
08854, USA
| | - J. Parvizi
- Thomas Jefferson University Hospital, Department
of Orthopaedic Surgery, 111 South 11th Street, Philadelphia, Pennsylvania
19107, USA
| |
Collapse
|
31
|
Wehrhahn MC, Robinson JO, Pascoe EM, Coombs GW, Pearson JC, O'Brien FG, Tan HL, New D, Salvaris P, Salvaris R, Murray RJ. Illness severity in community-onset invasive Staphylococcus aureus infection and the presence of virulence genes. J Infect Dis 2012; 205:1840-8. [PMID: 22492857 DOI: 10.1093/infdis/jis279] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND It is uncertain whether particular clones causing invasive community-onset methicillin-resistant and methicillin-sensitive Staphylococcus aureus (cMRSA/cMSSA) infection differ in virulence. METHODS Invasive cMRSA and cMSSA cases were prospectively identified. Principal component analysis was used to derive an illness severity score (ISS) from clinical data, including 30-day mortality, requirement for intensive hospital support, the presence of bloodstream infection, and hospital length of stay. The mean ISS for each S. aureus clone (based on MLST) was compared with its DNA microarray-based genotype. RESULTS Fifty-seven cMRSA and 50 cMSSA infections were analyzed. Ten clones caused 82 (77%) of these infections and had an ISS calculated. The enterotoxin gene cluster (egc) and the collagen adhesin (cna) gene were found in 4 of the 5 highest-ranked clones (ST47-MSSA, ST30-MRSA-IV[2B], ST45-MSSA, and ST22-MRSA-IV[2B]) compared with none and 1 of the lowest 5 ranked clones, respectively. cMSSA clones caused more severe infection than cMRSA clones. The lukF/lukS Panton-Valentine leukocidin (PVL) genes did not directly correlate with the ISS, being present in the second, fourth, and 10th most virulent clones. CONCLUSIONS The clinical severity of invasive cMRSA and cMSSA infection is likely to be attributable to the isolates' entire genotype rather than a single putative virulence determinant such as PVL.
Collapse
Affiliation(s)
- Michael C Wehrhahn
- Department of Microbiology and Infectious Diseases, Royal Perth Hospital and PathWest Laboratory Medicine, WA. mcwehrhahn@hotmail
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Cameron DR, Howden BP, Peleg AY. The interface between antibiotic resistance and virulence in Staphylococcus aureus and its impact upon clinical outcomes. Clin Infect Dis 2012; 53:576-82. [PMID: 21865195 DOI: 10.1093/cid/cir473] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The ability of Staphylococcus aureus to rapidly acquire antibiotic resistance in the face of antimicrobial challenge has enabled it to remain an ongoing, significant human pathogen. Mechanisms behind the evolution of resistance in S. aureus are well documented, but the effects of these phenotypes upon virulence are less clear. By exploring available clinical and experimental data, we have shown that a number of the major steps in the evolution of antibacterial resistance in S. aureus have been accompanied by alterations in virulence. This review also highlights that further experimentation is required to fully elucidate the mechanisms involved in the interface between virulence and antibiotic resistance, with the intention of identifying novel preventative or therapeutic strategies for this important human pathogen.
Collapse
Affiliation(s)
- David R Cameron
- Department of Microbiology, Monash University, Melbourne, Australia
| | | | | |
Collapse
|
33
|
Eleftheriadou I, Tentolouris N, Argiana V, Jude E, Boulton AJ. Methicillin-resistant Staphylococcus aureus in diabetic foot infections. Drugs 2010; 70:1785-97. [PMID: 20836573 DOI: 10.2165/11538070-000000000-00000] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Diabetic foot ulcers are often complicated by infection. Among pathogens, Staphylococcus aureus predominates. The prevalence of methicillin-resistant S. aureus (MRSA) in infected foot ulcers is 15-30% and there is an alarming trend for increase in many countries. There are also data that recognize new strains of MRSA that are resistant to vancomycin. The risk for MRSA isolation increases in the presence of osteomyelitis, nasal carriage of MRSA, prior use of antibacterials or hospitalization, larger ulcer size and longer duration of the ulcer. The need for amputation and surgical debridement increases in patients infected with MRSA. Infections of mild or moderate severity caused by community-acquired MRSA can be treated with cotrimoxazole (trimethoprim/sulfamethoxazole), doxycycline or clindamycin when susceptibility results are available, while severe community-acquired or hospital-acquired MRSA infections should be managed with glycopeptides, linezolide or daptomycin. Dalbavancin, tigecycline and ceftobiprole are newer promising antimicrobial agents active against MRSA that may also have a role in the treatment of foot infections if more data on their efficacy and safety become available.
Collapse
Affiliation(s)
- Ioanna Eleftheriadou
- Department of Propaedeutic and Internal Medicine, Athens University Medical School, Greece
| | | | | | | | | |
Collapse
|
34
|
Lai CF, Liao CH, Pai MF, Chu FY, Hsu SP, Chen HY, Yang JY, Chiu YL, Peng YS, Chang SC, Hung KY, Tsai TJ, Wu KD. Nasal carriage of methicillin-resistant Staphylococcus aureus is associated with higher all-cause mortality in hemodialysis patients. Clin J Am Soc Nephrol 2010; 6:167-74. [PMID: 20947786 DOI: 10.2215/cjn.06270710] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage is a recognized risk factor for subsequent endogenous infections. However, the association between MRSA carriage and patient survival in hemodialysis patients has not been established. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In March 2007, this prospective cohort study enrolled 306 outpatients under maintenance hemodialysis from a hospital-based dialysis center in Taiwan. They received two consecutive weekly nasal swab cultures at the beginning of the study. Patients having at least one positive culture of MRSA were defined as MRSA carriers. Subjects were followed up until December 31, 2008. The primary outcome was all-cause mortality. Main secondary outcomes were infection-related mortality and morbidity. RESULTS We identified 29 MRSA carriers (9.48%) at study entry. After a median of 613 days of follow-up, Kaplan-Meier analysis showed significant survival differences between MRSA carriers and noncarriers (log-rank P = 0.02). Compared with noncarriers, MRSA carriers had a 2.46-fold increased risk of dying from any cause, after adjusting for covariates at the start of follow-up. The adjusted hazard ratios of infection-related mortality and occurrence of subsequent S. aureus infection in carriers were 4.99 and 4.31, respectively. CONCLUSIONS A major limitation is the relatively small sample size of MRSA carriers. Nevertheless, we demonstrated that there may be an association between MRSA nasal carriage and poor clinical outcomes in an outpatient hemodialysis population. This underscores the need for routine surveillance of MRSA nasal carriage and should alert the physicians of a group at high risk of morbidity and mortality.
Collapse
Affiliation(s)
- Chun-Fu Lai
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Wehrhahn MC, Robinson JO, Pearson JC, O'Brien FG, Tan HL, Coombs GW, Pascoe EM, Lee R, Salvaris P, Salvaris R, New D, Murray RJ. Clinical and laboratory features of invasive community-onset methicillin-resistant Staphylococcus aureus infection: a prospective case-control study. Eur J Clin Microbiol Infect Dis 2010; 29:1025-33. [PMID: 20549534 DOI: 10.1007/s10096-010-0973-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Accepted: 11/16/2009] [Indexed: 01/30/2023]
Abstract
Differences between the features of invasive community-onset methicillin-resistant Staphylococcus aureus (cMRSA) and methicillin-susceptible S. aureus (cMSSA) infections are incompletely understood. Fifty-seven patients with invasive cMRSA infection were prospectively identified at two teaching hospitals; for each cMRSA case, two cases of invasive cMSSA infection acted as controls. The primary outcome was 30-day all-cause mortality. Patients with invasive cMRSA infection were more likely to be Aboriginal (25% vs. 14%, age-adjusted odds ratio [OR] 2.5, p = 0.037), reside in a long-term care facility and/or have been hospitalised in the previous year (51% vs. 34%, p = 0.04) and less likely to have endocarditis (2% vs. 12%, p = 0.02) or require admission to an intensive care unit or high-dependency area (7% vs. 21%, p = 0.02). All-cause mortality at 30 days was similar in the cMRSA and cMSSA groups (9% vs. 7%, p = 0.68). Panton-Valentine leukocidin (PVL) genes were detected in a similar proportion of cMRSA and cMSSA isolates (32% vs. 27%, p = 0.49) and the presence of PVL genes was associated with younger age (35 years vs. 55 years, p < 0.001), Aboriginal ethnicity (38% vs. 10%, p < 0.001), skin and soft-tissue infection (54% vs. 19%, p < 0.001), lower illness severity at presentation (SAPS II score 9 vs. 21, p = 0.001) and shorter hospitalisation (9 days vs. 24 days, p < 0.001). Patients with "PVL-positive" and "PVL-negative" S. aureus infection had similar 30-day all-cause mortality (4% vs. 9%, p = 0.28). Few clinical features differentiated patients with invasive cMRSA infection from those with infection caused by cMSSA. Invasive "PVL-positive" S. aureus infection was associated with less morbidity but similar mortality to "PVL-negative" infection.
Collapse
Affiliation(s)
- M C Wehrhahn
- Department of Microbiology and Infectious Diseases, Royal Perth Hospital and PathWest Laboratory Medicine, Western Australia, Perth, Australia.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Characterization of virulence factors and genetic background of Staphylococcus aureus isolated from Peking University People's Hospital between 2005 and 2009. Curr Microbiol 2010; 61:435-43. [PMID: 20383506 DOI: 10.1007/s00284-010-9635-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2009] [Accepted: 03/19/2010] [Indexed: 10/19/2022]
Abstract
The aim of this study was to investigate both the genetic features of MRSA strains and the occurrence of virulence factors produced by Staphylococcus aureus strains isolated from Peking University People's Hospital in Beijing, China, between 2005 and 2009. A total of 179 S. aureus strains were isolated, 139 of which were MRSA. The MRSA strains were characterized epidemiologically by SCCmec typing, spa typing and agr typing, then were classified into different genetic groups. The prevalence of genes coding for 14 exotoxins and eight adhesion factors among the S. aureus samples was assessed via polymerase chain reaction. Cluster analysis based on virulence factors-encoding gene content was performed to divide the MRSA isolates into valid clusters. Correspondence analysis was done to analyze the correlation between virulence factors clusters and genetic groups. JCSC1716-agrI-t030 (67.6%), SCCmec-IIIA-agrI-t030 (14.4%), SCCmec-IIIA-agrI-t037 (8.6%) and SCCmecII-agrII-t002 (2.2%) were four predominant MRSA clones. PVL was positive only in MSSA strains, there were at least three superantigenic toxins in our HA-MRSA clones, the prevalence of 16 virulence factors genes (sea, seb, sec, sed, seg, sei, sej, pvl, lukE-lukD, eta, bbp, can, ebp, clfA, fib, fnbB) in MRSA and MSSA was found to be significantly different from MSSA (P < 0.05). Results of correspondence analysis among clusters based on virulence factors genes and groups based on genetic typing illustrated not only the correspondence relationship between groups and clusters overall (P < 0.001), but also the genetic diversity of MRSA strains with respect to virulence factors genes.
Collapse
|
37
|
A comparative review on the pathogenicity and virulence factors of meticillin-resistant and meticillin-susceptible Staphylococcus aureus. ACTA ACUST UNITED AC 2010. [DOI: 10.1097/mrm.0b013e3283393cd4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
38
|
Galkowska H, Podbielska A, Olszewski WL, Stelmach E, Luczak M, Rosinski G, Karnafel W. Epidemiology and prevalence of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis in patients with diabetic foot ulcers: focus on the differences between species isolated from individuals with ischemic vs. neuropathic foot ulcers. Diabetes Res Clin Pract 2009; 84:187-93. [PMID: 19269053 DOI: 10.1016/j.diabres.2009.02.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 02/02/2009] [Accepted: 02/09/2009] [Indexed: 11/22/2022]
Abstract
We examined whether foot ischemia or neuropathy with diabetic foot ulcer (DFU) promote selection of staphylococci species, evaluated frequency of MRSA and MRSE among strains yielded from patients with DFU and assessed multidrug resistance of isolates. Patients with DFU and foot osteomyelitis were divided into ischemic foot ulcer (IFU, n=21) and neuropathic foot ulcer (NFU, n=29) groups. Frequency of Staphylococcus epidermidis yielded from curettage of IFU was higher compared with NFU (P<0.05). S. epidermidis was also more frequently isolated from the toe web surface of patients with IFU compared with NFU (55% vs. 17.9%, respectively) and healthy volunteers (HV, n=20) (17.6%, P<0.05). These mostly MRSE strains (83.3-100%) originating from DFU patients were multidrug resistant (88.8%). Also, most of MRSA isolates were multidrug resistant (70.3%). Higher rates of MSSA from DFU patients than HV showed resistance to antimicrobials. This is the first report indicating that diabetic patients with IFU differ with NFU patients in higher frequency of S. epidermidis skin colonization and ulcer infection. We suggest that IFU should be defined as separate disease state of DFU and S. epidermidis should be appreciated as a nosocomial pathogen.
Collapse
Affiliation(s)
- Hanna Galkowska
- Department of Surgical Research & Transplantology, Medical Research Center, Polish Academy of Sciences, 02-106 Warsaw, 5 Pawinskiego str, Poland.
| | | | | | | | | | | | | |
Collapse
|
39
|
Kocsis E, Lagler H, Pesti N, Stich K, Kristóf K, Nagy K, Hermann P, Komka K, Cekovska Z, Graninger W, Rozgonyi F. Comparison of Austrian, Hungarian and Macedonian methicillin-resistant and methicillin-sensitive Staphylococcus aureus strains in relation to prevalence of cytotoxin genes. Microb Pathog 2009; 46:328-36. [PMID: 19366626 DOI: 10.1016/j.micpath.2009.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 12/17/2008] [Accepted: 04/02/2009] [Indexed: 11/18/2022]
Abstract
Cytotoxin genes in 128 Austrian (AT) MSSA, 48 MRSA, 94 Hungarian (HU) MSSA, 110 MRSA and 67 Macedonian (MK) MSSA, 81 MRSA strains were examined. The presence of alfa-haemolysin gene (hla) was more common in HU MSSA strains compared to AT and MK (99%, 86%, 72%: p<0.001). AT and MK MRSA harboured hlb genes more frequently compared to HU (60%, 62%, 33%: p<0.001). HU and MK MRSA strains carried gamma-haemolysin gene (hlg) in higher percentage in contrast to AT (88%, 83%, 69%: p=0.01). Haemolysin gamma-variant gene (hlgv) was more prevalent in HU MSSA compared to AT and MK (84%, 56%, 69%: p<0.001). Panton-Valentine leukocidin genes were found only in AT, HU, MK MSSA and MK MRSA in 2.3%, 4%, 1.5% (p=0.53) and 1% (p=0.38), respectively. The 3-gene combination pattern comprising of hla, hlg and hld genes showed increased prevalence among AT MSSA compared to HU (27%, 11%: p<0.001). The 4-gene pattern composed of hla, hlg, hlgv and hld genes was significantly characteristic for HU MRSA in contrast to AT and MK MRSA (56%, 12.5%, 27%: p<0.001). Frequency of certain cytotoxin genes and combinations differed significantly in Staphylococcus aureus strains according to geographical origin and methicillin-resistance.
Collapse
Affiliation(s)
- Erika Kocsis
- Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Kaito C, Omae Y, Matsumoto Y, Nagata M, Yamaguchi H, Aoto T, Ito T, Hiramatsu K, Sekimizu K. A novel gene, fudoh, in the SCCmec region suppresses the colony spreading ability and virulence of Staphylococcus aureus. PLoS One 2008; 3:e3921. [PMID: 19079549 PMCID: PMC2593785 DOI: 10.1371/journal.pone.0003921] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Accepted: 11/13/2008] [Indexed: 12/20/2022] Open
Abstract
Staphylococcus aureus colonies can spread on soft agar plates. We compared colony spreading of clinically isolated methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA). All MSSA strains showed colony spreading, but most MRSA strains (73%) carrying SCCmec type-II showed little colony spreading. Deletion of the entire SCCmec type-II region from these MRSA strains restored colony spreading. Introduction of a novel gene, fudoh, carried by SCCmec type-II into Newman strain suppressed colony spreading. MRSA strains with high spreading ability (27%) had no fudoh or a point-mutated fudoh that did not suppress colony spreading. The fudoh-transformed Newman strain had decreased exotoxin production and attenuated virulence in mice. Most community-acquired MRSA strains carried SCCmec type-IV, which does not include fudoh, and showed high colony spreading ability. These findings suggest that fudoh in the SCCmec type-II region suppresses colony spreading and exotoxin production, and is involved in S. aureus pathogenesis.
Collapse
Affiliation(s)
- Chikara Kaito
- Laboratory of Microbiology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yosuke Omae
- Laboratory of Microbiology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Yasuhiko Matsumoto
- Laboratory of Microbiology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Makiko Nagata
- Laboratory of Microbiology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hiroki Yamaguchi
- Division of Hematology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Taiji Aoto
- Department of Central Laboratory, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Teruyo Ito
- Department of Infection Control Science, Faculty of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Keiichi Hiramatsu
- Department of Infection Control Science, Faculty of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Kazuhisa Sekimizu
- Laboratory of Microbiology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan
- * E-mail:
| |
Collapse
|
41
|
Sdougkos G, Chini V, Papanastasiou DA, Christodoulou G, Stamatakis E, Vris A, Christodoulidi I, Protopapadakis G, Spiliopoulou I. Community-associated Staphylococcus aureus infections and nasal carriage among children: molecular microbial data and clinical characteristics. Clin Microbiol Infect 2008; 14:995-1001. [PMID: 18808423 DOI: 10.1111/j.1469-0691.2008.02064.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An increasing number of infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) carrying the Panton-Valentine leukocidin (PVL) genes was recently identified in Greece. In the present study, 170 patients with S. aureus infections and 123 uninfected children (<15 years old) who had been tested for nasal carriage were evaluated during a 2-year period. The MecA, PVL and superantigen family genes, and MRSA clones, were investigated by molecular methods. Sites of infection and laboratory findings for patients were recorded. The results were compared and statistically analysed. Among 123 uninfected children 73 (59%) carried S. aureus, including four MRSA strains. Of these, three MRSA and three methicillin-sensitive S. aureus (MSSA) strains were PVL-positive (p <0.0001). Ninety-six patients (96/170) exhibited skin and soft-tissue infections (SSTIs), and 74 exhibited invasive infections. The incidence of staphylococcal infections increased during July to September each year. In total, 110 S. aureus isolates were PVL-positive (81 from SSTIs and 29 from invasive infections, p <0.0001). Ninety-nine out of 106 MRSA (93%) isolates from 170 patients carried the PVL genes (p <0.0001); 97 belonged to the clonal complex CC80. Leukocyte and polymorphonuclear cell counts were higher among children with MRSA infections (p <0.005). MSSA predominated among patients with invasive infections (43/74), and carried mainly genes of the superantigen family. Children <5 years of age showed a higher risk of MRSA infection. The present study demonstrates that infections due to PVL-positive CA-MRSA spread easily among children, and SSTIs can lead to invasive infections. Nasal colonization may be an additional factor contributing to the emergence of CA-MRSA.
Collapse
Affiliation(s)
- G Sdougkos
- Department of Orthopaedics, Karamandaneion Children's Hospital, Patras, Greece
| | | | | | | | | | | | | | | | | |
Collapse
|