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Breed MW, Perez HL, Otto M, Villaruz AE, Weese JS, Alvord GW, Donohue DE, Washington F, Kramer JA. Bacterial Genotype, Carrier Risk Factors, and an Antimicrobial Stewardship Approach Relevant to Methicillin-resistant Staphylococcus aureus Prevalence in a Population of Macaques Housed in a Research Facility. Comp Med 2023; 73:134-144. [PMID: 36941053 PMCID: PMC10162382 DOI: 10.30802/aalas-cm-22-000018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/31/2022] [Accepted: 10/27/2022] [Indexed: 03/22/2023]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant problem for human and animal health and can negatively affect the health status of macaques and other nonhuman primates (NHP) in research colonies. However, few publications provide guidance on the prevalence, genotype, or risk factors for macaques with MRSA and even fewer on how to effectively respond to MRSA once identified in a population. After having a clinical case of MRSA in a rhesus macaque, we sought to determine the MRSA carrier prevalence, risk factors, and genotypes of MRSA in a population of research NHPs. Over a 6-wk period in 2015, we collected nasal swabs from 298 NHPs. MRSA was isolated from 28% (n = 83). We then reviewed each macaque's medical record for a variety of variables including animal housing room, sex, age, number of antibiotic courses, number of surgical interventions, and SIV status. Analysis of these data suggests that MRSA carriage is associated with the room location, age of the animal, SIV status, and the number of antibiotic courses. We used multilocus sequence typing and spa typing on a subset of MRSA and MSSA isolates to determine whether the MRSA present in NHPs was comparable with common human strains. Two MRSA sequence types were predominant: ST188 and a novel MRSA genotype, neither of which is a common human isolate in the United States. We subsequently implemented antimicrobial stewardship practices (significantly reducing antimicrobial use) and then resampled the colony in 2018 and found that MRSA carriage had fallen to 9% (26/285). These data suggest that, as in humans, macaques may have a high carrier status of MRSA despite low clinically apparent disease. Implementing strategic antimicrobial stewardship practices resulted in a marked reduction in MRSA carriage in the NHP colony, highlighting the importance of limiting antimicrobial use when possible.
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Affiliation(s)
- Matthew W Breed
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Bethesda, Maryland
| | | | - Michael Otto
- Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Amer E Villaruz
- Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - J Scott Weese
- Centre for Public Health and Zoonoses, Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
| | - Gregory W Alvord
- Statistical Consulting, Data Management Services, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland; and
| | - Duncan E Donohue
- Statistical Consulting, Data Management Services, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland; and
| | | | - Joshua A Kramer
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Bethesda, Maryland
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2
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Cotter CJ, Ferradas C, Ludwig S, Dalton K, Larsen J, Laucks D, Iverson SA, Baron P, Tolomeo PC, Brazil AM, Ferguson JM, Lautenbach E, Rankin SC, Morris DO, Davis MF. Risk factors for meticillin-resistant Staphylococcus aureus (MRSA) carriage in MRSA-exposed household pets. Vet Dermatol 2023; 34:22-27. [PMID: 36331035 PMCID: PMC11168721 DOI: 10.1111/vde.13135] [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: 12/02/2020] [Revised: 05/03/2022] [Accepted: 08/01/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Household pets can carry meticillin-resistant Staphylococcus aureus (MRSA) introduced to the home by their human companions. Specific factors promoting pet carriage of this pathogen have not been fully elucidated. OBJECTIVE This study evaluated MRSA cultured from pets and the home environment in households where a human infected with MRSA had been identified, and aimed to determine potential risk factors for pet MRSA carriage. MATERIALS AND METHODS Humans diagnosed with community-associated MRSA (CA-MRSA) skin or soft-tissue infection (SSTI) in the mid-Atlantic United States were identified. One hundred forty-two dogs and cats from 57 affected households were identified of which 134 (94.4%) pets and the household environment were sampled for bacterial culture, PCR confirmation and spa-typing for MRSA strain determination. Samples were obtained 3 months later from 86 pets. RESULTS At baseline, 12 (9.0%) pets carried MRSA. Potential risk factors associated with carriage included pet bed (environmental) MRSA contamination, flea infestation and prior antimicrobial use in the pet. Pets tended to carry human-adapted MRSA strains and spa-types of MRSA isolates cultured from pets were concordant with strains cultured from the home environment in seven of eight homes (87.5%) at baseline. CONCLUSIONS AND CLINICAL RELEVANCE Results may inform risk-based veterinary clinical recommendations and provide evidence for selective pet testing as a possible alternative to early removal of pets from the homes of humans infected with MRSA. MRSA contamination of the home environment is likely an important risk factor for pet MRSA carriage, and household interventions should be considered to reduce risk of MRSA carriage in exposed pets.
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Affiliation(s)
- Caitlin J Cotter
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Cusi Ferradas
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia (UPCH), Lima, Peru
- School of Veterinary Medicine, Universidad Peruana Cayetano Heredia (UPCH), Lima, Peru
| | - Shanna Ludwig
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Kathryn Dalton
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jesper Larsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Daniel Laucks
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sally Ann Iverson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patrick Baron
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Health and Human Values, Davidson College, Davidson, North Carolina, USA
| | - Pam C Tolomeo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amy M Brazil
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jacqueline M Ferguson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ebbing Lautenbach
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Shelley C Rankin
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel O Morris
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Meghan F Davis
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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3
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Dalton KR, Fandiño-Del-Rio M, Louis LM, Garza MA, Quirós-Alcalá L, Davis MF. Microbiome alterations associated with phthalate exposures in a US-based sample of Latino workers. ENVIRONMENTAL RESEARCH 2022; 214:114126. [PMID: 36027966 DOI: 10.1016/j.envres.2022.114126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Low-wage service sector jobs are largely occupied by racial/ethnic minority workers who often experience an increased risk of elevated chemical exposures, including chemicals like phthalates, compared to the general public. Phthalates have been linked with adverse health effects, including increased risk of atopy and asthma. An important etiological component in respiratory disease, including asthma, is the role of the upper respiratory microbiota in atopic disease development. However, it is unclear how the upper respiratory microbiome is affected by chemical exposures, and how this may impact respiratory outcomes. As Latino workers are often disproportionately exposed to increased concentrations of chemicals and Hispanics have higher rates of adverse respiratory health conditions such as asthma, the aim of this pilot study was to evaluate the effects of 10 unique phthalate urinary biomarkers on the 16S rRNA nasal microbiome. Nasal and urinary samples were collected from 20 facility workers (plumbers, landscapers, electricians) and 20 custodial workers. Our analysis revealed altered microbial composition and diversity according to phthalate urinary biomarker concentration within the two worker groups. Higher urinary biomarker concentrations of select phthalates (MBP, MBIP, and ∑DEHP) were associated with increased Moraxella relative abundance, which has been positively associated with asthma. Within-sample alpha diversity levels were decreased in facility workers and were generally inversely associated with most phthalate urinary biomarker concentrations. Our research suggests that exposure to chemicals in this vulnerable worker group may impact the respiratory microbiome, which may increase risk of development of adverse health conditions. Further research is warranted to refine the mechanistic pathways that underpin the relationships between phthalate exposures and respiratory microbial communities to provide key insights on respiratory pathologies and, most importantly, to identify modifiable risk factors that can be used to direct mitigation efforts aimed at ameliorating the harmful effects of chemical exposures in this understudied occupational population.
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Affiliation(s)
- Kathryn R Dalton
- Department of Environmental Health & Engineering, Bloomberg School of Public Health Johns Hopkins University, Baltimore, MD, USA
| | - Magdalena Fandiño-Del-Rio
- Department of Environmental Health & Engineering, Bloomberg School of Public Health Johns Hopkins University, Baltimore, MD, USA
| | - Lydia M Louis
- Department of Environmental Health & Engineering, Bloomberg School of Public Health Johns Hopkins University, Baltimore, MD, USA
| | - Mary A Garza
- California State University, Fresno, College of Health and Human Services, Department of Public Health, Fresno, CA, USA
| | - Lesliam Quirós-Alcalá
- Department of Environmental Health & Engineering, Bloomberg School of Public Health Johns Hopkins University, Baltimore, MD, USA.
| | - Meghan F Davis
- Department of Environmental Health & Engineering, Bloomberg School of Public Health Johns Hopkins University, Baltimore, MD, USA; Molecular and Comparative Pathobiology and the Division of Infectious Diseases, Johns Hopkins School of Medicine, USA
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4
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Ferradas C, Cotter C, Shahbazian JH, Iverson SA, Baron P, Misic AM, Brazil AM, Rankin SC, Nachamkin I, Ferguson JM, Peng RD, Bilker WB, Lautenbach E, Morris DO, Lescano AG, Davis MF. Risk factors for antimicrobial resistance among Staphylococcus isolated from pets living with a patient diagnosed with methicillin-resistant Staphylococcus aureus infection. Zoonoses Public Health 2022; 69:550-559. [PMID: 35420715 PMCID: PMC9543542 DOI: 10.1111/zph.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/04/2022] [Accepted: 03/23/2022] [Indexed: 01/26/2023]
Abstract
It has been suggested that pets play a critical role in the maintenance of methicillin-resistant (MR) and multidrug-resistant (MDR) Staphylococcus spp. in the household. We examined risk factors for carriage of antimicrobial-resistant coagulase-positive staphylococci, with particular attention to Staphylococcus aureus and Staphylococcus pseudintermedius isolated from pets living in households of people diagnosed with methicillin-resistant S. aureus (MRSA) skin or soft-tissue infection. We analyzed data collected cross-sectionally from a study conducted in 2012 that evaluated the transmission of MRSA and other staphylococci from humans, their pets and the environment (Pets and Environmental Transmission of Staphylococci [PETS] study). We used unadjusted and adjusted stratified logistic regression analyses with household-clustered standard errors to evaluate the association between demographic, healthcare-related, contact-related and environmental risk factors and MDR Staphylococcus spp. isolated from dogs and cats. Staphylococcal isolates obtained from dogs (n = 63) and cats (n = 47) were included in these analyses. The use of oral or injectable antimicrobials by the pets during the prior year was the main risk factor of interest. Based on our results, 50% (12/24) of S. aureus, 3.3% (1/30) of S. pseudintermedius and 25% (14/56) of other coagulase-positive staphylococci (CPS) were determined to be MDR. S. aureus isolates were more likely to be MDR compared with S. pseudintermedius. We did not find a significant statistical association between the use of oral or injectable antimicrobials in the prior year and the presence of MDR bacteria. The results suggest that drivers of antimicrobial resistance in household staphylococci may vary by bacterial species, which could have implications for one health intervention strategies for staphylococci and inform the investigation of other reverse zoonoses, such as COVID-19.
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Affiliation(s)
- Cusi Ferradas
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA,Emerging Diseases and Climate Change Research UnitSchool of Public Health and AdministrationUniversidad Peruana Cayetano Heredia (UPCH)San Martin de PorresPeru,School of Veterinary MedicineUniversidad Peruana Cayetano Heredia (UPCH)San Martin de PorresPeru
| | - Caitlin Cotter
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | | | - Sally Ann Iverson
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Patrick Baron
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA,Department of Health and Human ValuesDavidson CollegeDavidsonNorth CarolinaUSA
| | - Ana M. Misic
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Amy M. Brazil
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Shelley C. Rankin
- School of Veterinary MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Irving Nachamkin
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Roger D. Peng
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Warren B. Bilker
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Ebbing Lautenbach
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Daniel O. Morris
- School of Veterinary MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Andrés G. Lescano
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA,Emerging Diseases and Climate Change Research UnitSchool of Public Health and AdministrationUniversidad Peruana Cayetano Heredia (UPCH)San Martin de PorresPeru
| | - Meghan F. Davis
- Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMarylandUSA
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5
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Godijk NG, Bootsma MCJ, Bonten MJM. Transmission routes of antibiotic resistant bacteria: a systematic review. BMC Infect Dis 2022; 22:482. [PMID: 35596134 PMCID: PMC9123679 DOI: 10.1186/s12879-022-07360-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background Quantification of acquisition routes of antibiotic resistant bacteria (ARB) is pivotal for understanding transmission dynamics and designing cost-effective interventions. Different methods have been used to quantify the importance of transmission routes, such as relative risks, odds ratios (OR), genomic comparisons and basic reproduction numbers. We systematically reviewed reported estimates on acquisition routes’ contributions of ARB in humans, animals, water and the environment and assessed the methods used to quantify the importance of transmission routes. Methods PubMed and EMBASE were searched, resulting in 6054 articles published up until January 1st, 2019. Full text screening was performed on 525 articles and 277 are included. Results We extracted 718 estimates with S. aureus (n = 273), E. coli (n = 157) and Enterobacteriaceae (n = 99) being studied most frequently. Most estimates were derived from statistical methods (n = 560), mainly expressed as risks (n = 246) and ORs (n = 239), followed by genetic comparisons (n = 85), modelling (n = 62) and dosage of ARB ingested (n = 17). Transmission routes analysed most frequently were occupational exposure (n = 157), travelling (n = 110) and contacts with carriers (n = 83). Studies were mostly performed in the United States (n = 142), the Netherlands (n = 87) and Germany (n = 60). Comparison of methods was not possible as studies using different methods to estimate the same route were lacking. Due to study heterogeneity not all estimates by the same method could be pooled. Conclusion Despite an abundance of published data the relative importance of transmission routes of ARB has not been accurately quantified. Links between exposure and acquisition are often present, but the frequency of exposure is missing, which disables estimation of transmission routes’ importance. To create effective policies reducing ARB, estimates of transmission should be weighed by the frequency of exposure occurrence. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07360-z.
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Affiliation(s)
- Noortje G Godijk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Martin C J Bootsma
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Mathematics, Faculty of Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marc J M Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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6
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Huang Y, Yang N, Teng D, Mao R, Hao Y, Ma X, Wei L, Wang J. Antibacterial peptide NZ2114-loaded hydrogel accelerates Staphylococcus aureus-infected wound healing. Appl Microbiol Biotechnol 2022; 106:3639-3656. [PMID: 35524777 DOI: 10.1007/s00253-022-11943-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/07/2022] [Accepted: 04/23/2022] [Indexed: 12/19/2022]
Abstract
Wound infection caused by Staphylococcus aureus (S. aureus) is a great challenge which has caused significant burden and economic loss to the medical system. NZ2114, a plectasin-derived peptide, is an antibacterial agent for preventing and treating S. aureus infection, especially for methicillin-resistant S. aureus (MRSA) infection. Here, three-dimensional reticulated antimicrobial peptide (AMP) NZ2114 hydrogels were developed based on hydroxypropyl cellulose (HPC) and sodium alginate (SA); they displayed sustained and stable release properties (97.88 ± 1.79% and 91.1 ± 10.52% release rate in 72 h, respectively) and good short-term cytocompatibility and hemocompatibility. But the HPC-NZ2114 hydrogel had a smaller pore size (diameter 0.832 ± 0.420 μm vs. 3.912 ± 2.881 μm) and better mechanical properties than that of the SA-NZ2114 hydrogel. HPC/SA-NZ2114 hydrogels possess efficient antimicrobial activity in vitro and in vivo. In a full-thickness skin defect model, the wound closure of the 1.024 mg/g HPC-NZ2114 hydrogel group was superior to those of the SA-NZ2114 hydrogel and antibiotic groups on day 7. The HPC-NZ2114 hydrogel accelerated wound healing by reducing inflammation and promoting the production of vascular endothelial growth factor (VEGF), endothelial growth factor (EGF) and angiogenesis (CD31) through histological and immunohistochemistry evaluation. These data indicated that the HPC-NZ2114 hydrogel is an excellent candidate for S. aureus infection wound dressing. KEY POINTS: •NZ2114 hydrogels showed potential in vitro bactericidal activity against S. aureus •NZ2114 hydrogels could release continuously for 72 h and had good biocompatibility •NZ2114 hydrogels could effectively promote S. aureus-infected wound healing.
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Affiliation(s)
- Yan Huang
- School of Environmental Ecology and Biological Engineering, Wuhan Institute of Technology - WIT, Wuhan, People's Republic of China.,Innovative Team of Antimicrobial Peptides and Alternatives to Antibiotics, and Gene Engineering Laboratory, Feed Research Institute, Chinese Academy of Agricultural Sciences, Haidian District, 12 Zhongguancun Nandajie St, Beijing, 100081, People's Republic of China.,Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing, 100081, People's Republic of China
| | - Na Yang
- Innovative Team of Antimicrobial Peptides and Alternatives to Antibiotics, and Gene Engineering Laboratory, Feed Research Institute, Chinese Academy of Agricultural Sciences, Haidian District, 12 Zhongguancun Nandajie St, Beijing, 100081, People's Republic of China. .,Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing, 100081, People's Republic of China.
| | - Da Teng
- Innovative Team of Antimicrobial Peptides and Alternatives to Antibiotics, and Gene Engineering Laboratory, Feed Research Institute, Chinese Academy of Agricultural Sciences, Haidian District, 12 Zhongguancun Nandajie St, Beijing, 100081, People's Republic of China.,Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing, 100081, People's Republic of China
| | - Ruoyu Mao
- Innovative Team of Antimicrobial Peptides and Alternatives to Antibiotics, and Gene Engineering Laboratory, Feed Research Institute, Chinese Academy of Agricultural Sciences, Haidian District, 12 Zhongguancun Nandajie St, Beijing, 100081, People's Republic of China.,Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing, 100081, People's Republic of China
| | - Ya Hao
- Innovative Team of Antimicrobial Peptides and Alternatives to Antibiotics, and Gene Engineering Laboratory, Feed Research Institute, Chinese Academy of Agricultural Sciences, Haidian District, 12 Zhongguancun Nandajie St, Beijing, 100081, People's Republic of China.,Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing, 100081, People's Republic of China
| | - Xuanxuan Ma
- Innovative Team of Antimicrobial Peptides and Alternatives to Antibiotics, and Gene Engineering Laboratory, Feed Research Institute, Chinese Academy of Agricultural Sciences, Haidian District, 12 Zhongguancun Nandajie St, Beijing, 100081, People's Republic of China.,Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing, 100081, People's Republic of China
| | - Lingyun Wei
- School of Environmental Ecology and Biological Engineering, Wuhan Institute of Technology - WIT, Wuhan, People's Republic of China.
| | - Jianhua Wang
- Innovative Team of Antimicrobial Peptides and Alternatives to Antibiotics, and Gene Engineering Laboratory, Feed Research Institute, Chinese Academy of Agricultural Sciences, Haidian District, 12 Zhongguancun Nandajie St, Beijing, 100081, People's Republic of China. .,Key Laboratory of Feed Biotechnology, Ministry of Agriculture and Rural Affairs, Beijing, 100081, People's Republic of China.
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7
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Zhu F, Zhuang H, Ji S, Xu E, Di L, Wang Z, Jiang S, Wang H, Sun L, Shen P, Yu Y, Chen Y. Household Transmission of Community-Associated Methicillin-Resistant Staphylococcus Aureus. Front Public Health 2021; 9:658638. [PMID: 34136453 PMCID: PMC8200482 DOI: 10.3389/fpubh.2021.658638] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Currently, the mechanism of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) transmission mechanism is unclear; however, it must be considered in conjunction with asymptomatic S. aureus strains colonization dynamics. This epidemiological study aimed to determine the role of the household in CA-MRSA transmission in China. Five patients with culture-confirmed CA-MRSA infection and five control patients were recruited from the Sir Run Run Shaw Hospital in Zhejiang, China, between December 2019 and January 2020. The household members of the patients, their pets, and environmental surfaces were sampled and screened for MRSA colonization. Mass spectrometry identification and antimicrobial susceptibility testing were performed on the MRSA isolates. Whole-genome sequencing and core genome multilocus sequence typing (cgMLST) were performed to determine the origin and transmission of the MRSA isolates in the households. Overall, 14 S. aureus-positive specimens (14.1%, 14/99) were obtained from the five households of patients with CA-MRSA infections, of which 12 (85.7%) were MRSA. The overall positivity of MRSA was 12.1% (12/99) among the samples from the CA-MRSA households, while no MRSA isolates were detected in the five control households. Most MRSA isolates belonged to epidemic CA-MRSA clones, such as ST59 (15/35, 42.9%) and ST508 (15/35, 42.9%). The cgMLST results confirmed that MRSA was transmitted among patients, contacts, and pets in the households and was present on environmental surfaces in the CA-MRSA patients' households. In conclusion, the study revealed that the home environment was an important MRSA reservoir. Therefore, focusing on MRSA decolonization in patients alone is not sufficient for infection control of CA-MRSA.
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Affiliation(s)
- Feiteng Zhu
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Hemu Zhuang
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Shujuan Ji
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Er Xu
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Lingfang Di
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Zhengan Wang
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Shengnan Jiang
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Haiping Wang
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Lu Sun
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Ping Shen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Medicine School, Zhejiang University, Hangzhou, China
| | - Yunsong Yu
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Yan Chen
- Department of Infectious Diseases, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China.,Department of Hospital Epidemiology and Infection Control, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
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8
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De Maesschalck V, Gutiérrez D, Paeshuyse J, Lavigne R, Briers Y. Advanced engineering of third-generation lysins and formulation strategies for clinical applications. Crit Rev Microbiol 2020; 46:548-564. [PMID: 32886565 DOI: 10.1080/1040841x.2020.1809346] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
One of the possible solutions for the current antibiotic resistance crisis may be found in (often bacteriophage-derived) peptidoglycan hydrolases. The first clinical trials of these natural enzymes, coined here as first-generation lysins, are currently ongoing. Moving beyond natural endolysins with protein engineering established the second generation of lysins. In second-generation lysins, the focus lies on improving antibacterial and biochemical properties such as antimicrobial activity and stability, as well as expanding their activities towards Gram-negative pathogens. However, solutions to particular key challenges regarding clinical applications are only beginning to emerge in the third generation of lysins, in which protein and biochemical engineering efforts focus on improving properties relevant under clinical conditions. In addition, increasingly advanced formulation strategies are developed to increase the bioavailability, antibacterial activity, and half-life, and to reduce pro-inflammatory responses. This review focuses on third-generation and advanced formulation strategies that are developed to treat infections, ranging from topical to systemic applications. Together, these efforts may fully unlock the potential of lysin therapy and will propel it as a true antibiotic alternative or supplement.
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Affiliation(s)
- Vincent De Maesschalck
- Department of Biosystems, KU Leuven, Leuven, Belgium.,Department of Biotechnology, Ghent University, Gent, Belgium
| | - Diana Gutiérrez
- Department of Biotechnology, Ghent University, Gent, Belgium
| | - Jan Paeshuyse
- Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Rob Lavigne
- Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Yves Briers
- Department of Biotechnology, Ghent University, Gent, Belgium
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9
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Hogan PG, Parrish KL, Mork RL, Boyle MG, Muenks CE, Thompson RM, Morelli JJ, Sullivan ML, Hunstad DA, Wardenburg JB, Rzhetsky A, Gehlert SJ, Burnham CAD, Fritz SA. HOME2: Household vs. Personalized Decolonization in Households of Children with Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infection - A Randomized Clinical Trial. Clin Infect Dis 2020; 73:e4568-e4577. [PMID: 32521007 DOI: 10.1093/cid/ciaa752] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/05/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND A household approach to decolonization decreases skin and soft tissue infection (SSTI) incidence, though this is burdensome and costly. As prior SSTI increases risk for SSTI, we hypothesized the effectiveness of decolonization measures to prevent SSTI when targeted to household members with prior year SSTI would be non-inferior to decolonizing all household members. METHODS Upon completion of our 12-month observational HOME study, 102 households were enrolled in HOME2, a 12-month, randomized non-inferiority trial. Pediatric index patients with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) SSTI, their household contacts, and pets were enrolled. Households were randomized 1:1 to the Personalized (decolonization performed only by household members who experienced SSTI during the HOME study) or Household (decolonization performed by all household members) approaches. The 5-day regimen included hygiene education, twice-daily intranasal mupirocin, and daily bleach-water baths. At 5 follow-up visits in participants' homes, swabs to detect S. aureus were collected from participants, environmental surfaces, and pets; incident SSTI were ascertained. RESULTS Non-inferiority of the Personalized Approach was established for the primary outcome 3-month cumulative SSTI: 23 of 212 (10.8%) participants reported SSTI in Household Approach households, while 23 of 236 (9.7%) participants reported SSTI in Personalized Approach households; difference in proportions -1.1% (95% CI -6.7%, 4.5%). In multivariable analyses, prior year SSTI and baseline MRSA colonization were associated with cumulative SSTI. CONCLUSIONS The Personalized Approach was non-inferior to the Household Approach in preventing SSTI. Future studies should interrogate longer durations of decolonization and/or decontamination of the household environment to reduce household MRSA burden.
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Affiliation(s)
- Patrick G Hogan
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Katelyn L Parrish
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ryan L Mork
- Graduate Program in the Biophysical Sciences, University of Chicago, Chicago, Illinois, USA.,Committee of Microbiology, University of Chicago, Chicago, Illinois, USA.,Institute for Genomics and Systems Biology, and University of Chicago, Chicago, Illinois, USA
| | - Mary G Boyle
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carol E Muenks
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ryley M Thompson
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - John J Morelli
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Melanie L Sullivan
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - David A Hunstad
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Andrey Rzhetsky
- Department of Human Genetics, University of Chicago, Chicago, Illinois, USA
| | - Sarah J Gehlert
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carey-Ann D Burnham
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Stephanie A Fritz
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
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10
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Golmohammadi R, Najar-Peerayeh S, Tohidi Moghadam T, Hosseini SMJ. Synergistic Antibacterial Activity and Wound Healing Properties of Selenium-Chitosan-Mupirocin Nanohybrid System: An in Vivo Study on Rat Diabetic Staphylococcus aureus Wound Infection Model. Sci Rep 2020; 10:2854. [PMID: 32071320 PMCID: PMC7028993 DOI: 10.1038/s41598-020-59510-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/27/2020] [Indexed: 11/21/2022] Open
Abstract
The current study aimed to formulate Selenium-Chitosan-Mupirocin (M-SeNPs-CCH) complex. The nanohybrid system was prepared using chitosan-cetyltrimethylammonium bromide (CTAB)-based hydrogel (CCH) that entrapped mupirocin (M) and selenium nanoparticles (SeNPs). The in vitro studies were performed by evaluation of the antibacterial activity and toxicity on L929 mouse fibroblast cell line. The in vivo study was conducted on rat diabetic wound infection model that was infected by mupirocin-methicillin-resistant Staphylococcus aureus (MMRSA). The wounds were treated by M-SeNPs-CCH nanohybrid system with concentrations of M; 20 mg/ml, CCH; 2 mg/ml and SeNPs; 512 μg/ml in two times/day for 21 days. The therapeutic effect of this nanohybrid system was evaluated by monitoring wound contraction and histopathological changes. Evaluation of the average wound healing time showed a significant difference between the treatment and control groups (P≤0.05). The histopathological study indicated that the amount of wound healing was considerable in M-SeNPs-CCH nanohybrid system groups compared to the control and M groups. The M-SeNPs-CCH nanohybrid system formulated in this study was able to reduce 3-fold MIC of mupirocin with synergistic antibacterial activity as well as to play a significant role in wound contraction, angiogenesis, fibroblastosis, collagenesis, proliferation of hair follicle, and epidermis growth compared to the control group (P ≤ 0.05). This research suggests that this nanohybrid system might be a development for the treatment of diabetic wound infection at mild stage.
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Affiliation(s)
- Reza Golmohammadi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shahin Najar-Peerayeh
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Tahereh Tohidi Moghadam
- Department of Nanobiotechnology, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Seyed Mohammad Javad Hosseini
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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11
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Mork RL, Hogan PG, Muenks CE, Boyle MG, Thompson RM, Sullivan ML, Morelli JJ, Seigel J, Orscheln RC, Bubeck Wardenburg J, Gehlert SJ, Burnham CAD, Rzhetsky A, Fritz SA. Longitudinal, strain-specific Staphylococcus aureus introduction and transmission events in households of children with community-associated meticillin-resistant S aureus skin and soft tissue infection: a prospective cohort study. THE LANCET. INFECTIOUS DISEASES 2019; 20:188-198. [PMID: 31784369 DOI: 10.1016/s1473-3099(19)30570-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/01/2019] [Accepted: 08/21/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Devising effective, targeted approaches to prevent recurrent meticillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infection requires an understanding of factors driving MRSA acquisition. We comprehensively defined household longitudinal, strain-level S aureus transmission dynamics in households of children with community-associated MRSA skin and soft tissue infection. METHODS From 2012-15, otherwise healthy paediatric patients with culture-confirmed, community-onset MRSA infections were recruited for the Household Observation of MRSA in the Environment (HOME) prospective cohort study from hospitals and community practices in metropolitan St Louis (MO, USA). Children with health-care-related risk factors were excluded, as determined by evidence of recent hospital admission, an invasive medical device, or residence in a long-term care facility. Household contacts (individuals sleeping in the home ≥four nights per week) and indoor dogs and cats were also enrolled. A baseline visit took place at the index patient's primary home, followed by four quarterly visits over 12 months. At each visit, interviews were done and serial cultures were collected, to detect S aureus from three anatomic sites of household members, two anatomic sites on dogs and cats, and 21 environmental surfaces. Molecular typing was done by repetitive-sequence PCR to define distinct S aureus strains within each household. Longitudinal, multivariable generalised mixed-effects logistic regression models identified factors associated with S aureus acquisition. FINDINGS Across household members, pets, and environmental surfaces, 1267 strain acquisition events were observed. Acquisitions were driven equally by 510 introductions of novel strains into households and 602 transmissions within households, each associated with distinct factors. Frequent handwashing decreased the likelihood of novel strain introduction into the household (odds ratio [OR] 0·86, credible interval [CrI] 0·74-1·01). Transmission recipients were less likely to own their homes (OR 0·77, CrI 0·63-0·94) and were more likely to share bedrooms with strain-colonised individuals (OR 1·33, CrI 1·12-1·58), live in homes with higher environmental S aureus contamination burden (OR 3·97, CrI 1·96-8·20), and report interval skin and soft tissue infection (OR 1·32, CrI 1·07-1·64). Transmission sources were more likely to share bath towels (OR 1·25, CrI 1·01-1·57). Pets were often transmission recipients, but rarely the sole transmission source. INTERPRETATION The household environment plays a key role in transmission, a factor associated with skin and soft tissue infection. Future interventions should inclusively target household members and the environment, focusing on straightforward changes in hand hygiene and household sharing behaviours. FUNDING National Institutes of Health, Agency for Healthcare Research and Quality, Children's Discovery Institute, Burroughs Wellcome Foundation, Defense Advanced Research Projects Agency.
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Affiliation(s)
- Ryan L Mork
- Institute for Genomics and Systems Biology, University of Chicago, Chicago, IL, USA
| | - Patrick G Hogan
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Carol E Muenks
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Mary G Boyle
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Ryley M Thompson
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Melanie L Sullivan
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - John J Morelli
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Jennifer Seigel
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Rachel C Orscheln
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | | | - Sarah J Gehlert
- Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Carey-Ann D Burnham
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA; Department of Pathology & Immunology, Washington University School of Medicine, St Louis, MO, USA
| | - Andrey Rzhetsky
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Stephanie A Fritz
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA.
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12
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Hogan PG, Mork RL, Boyle MG, Muenks CE, Morelli JJ, Thompson RM, Sullivan ML, Gehlert SJ, Merlo JR, McKenzie MG, Wardenburg JB, Rzhetsky A, Burnham CAD, Fritz SA. Interplay of personal, pet, and environmental colonization in households affected by community-associated methicillin-resistant Staphylococcus aureus. J Infect 2018; 78:200-207. [PMID: 30503843 DOI: 10.1016/j.jinf.2018.11.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/21/2018] [Accepted: 11/28/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVE We sought to determine the prevalence, molecular epidemiology, and factors associated with Staphylococcus aureus environmental surface and pet colonization in households of children with community-associated methicillin-resistant S. aureus (CA-MRSA) infection. METHODS Between 2012 and 2015, 150 children with CA-MRSA infections and their household contacts and pets were enrolled in this cross-sectional study in metropolitan Saint Louis, MO. Cultures to detect S. aureus were collected from 3 anatomic sites of household members, 2 dog/cat sites, and 21 environmental surfaces in each household. Molecular epidemiology of S. aureus isolates was determined via repetitive-sequence PCR. Generalized linear models were developed to identify factors associated with S. aureus/MRSA household contamination. RESULTS MRSA was recovered from environmental surfaces in 69 (46%) households (median 2 surfaces [range 1-18]). The enrollment infecting strain type was the most common strain recovered from the environment in most (64%) households. In generalized linear models, factors associated with a higher proportion of MRSA-contaminated environmental surfaces were household member MRSA colonization burden, MRSA as the dominant S. aureus strain colonizing household members, more strain types per household member, index case African-American race, and renting (vs. owning) the home. Of 132 pets, 14% were colonized with MRSA. Pets whose primary caretaker was MRSA-colonized were more likely to be MRSA-colonized than pets whose primary caretaker was not MRSA-colonized (50% vs. 4%, p < 0.001). CONCLUSIONS Household environments and pet dogs and cats serve as reservoirs of MRSA. Household member MRSA colonization burden predicts environmental MRSA contamination. Longitudinal studies will inform the directionality of household transmission.
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Affiliation(s)
- Patrick G Hogan
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ryan L Mork
- Graduate Program in the Biophysical Sciences, University of Chicago, Chicago, IL, USA; Committee of Microbiology, University of Chicago, Chicago, IL, USA; Institute for Genomics and Systems Biology, University of Chicago, Chicago, IL, USA
| | - Mary G Boyle
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Carol E Muenks
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - John J Morelli
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ryley M Thompson
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Melanie L Sullivan
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah J Gehlert
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Jessica R Merlo
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Matt G McKenzie
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Andrey Rzhetsky
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Carey-Ann D Burnham
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA; Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephanie A Fritz
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
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13
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A Phage Lysin Fused to a Cell-Penetrating Peptide Kills Intracellular Methicillin-Resistant Staphylococcus aureus in Keratinocytes and Has Potential as a Treatment for Skin Infections in Mice. Appl Environ Microbiol 2018; 84:AEM.00380-18. [PMID: 29625989 DOI: 10.1128/aem.00380-18] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/03/2018] [Indexed: 12/21/2022] Open
Abstract
Staphylococcus aureus is the main pathogen that causes skin and skin structure infections and is able to survive and persist in keratinocytes of the epidermis. Since the evolution of multidrug-resistant bacteria, the use of phages and their lysins has presented a promising alternative approach to treatment. In this study, a cell wall hydrolase (also called lysin) derived from Staphylococcus phage JD007 (JDlys) was identified. JDlys showed strong lytic activity against methicillin-resistant Staphylococcus aureus (MRSA) strains from different sources and of different multilocus sequence typing (MLST) types. Furthermore, a fusion protein consisting of a cell-penetrating peptide derived from the trans-activating transcription (Tat) factor fused to JDlys (CPPTat-JDlys) was used to kill MRSA bacteria causing intracellular infections. CPPTat-JDlys, in which the fusion of CPPTat to JDlys had almost no effect on the bacteriolytic activity of JDlys, was able to effectively eliminate intracellular MRSA bacteria and alleviate the inflammatory response and cell damage caused by MRSA. Specifically, CPPTat-JDlys was able to combat MRSA-induced murine skin infections and, consequently, expedite the healing of cutaneous abscesses. These data suggest that the novel antimicrobial CPP-JDlys may be a worthwhile candidate as a treatment for skin and skin structure infections caused by MRSA.IMPORTANCES. aureus is the main cause of skin and skin structure infections due to its ability to invade and survive in the epithelial barrier. Due to the overuse of antibiotics in humans and animals, S. aureus has shown a high capacity for acquiring and accumulating mechanisms of resistance to antibiotics. Moreover, most antibiotics are usually limited in their ability to overcome the intracellular persistence of bacteria causing skin and skin structure infections. So, it is critical to seek a novel antimicrobial agent to eradicate intracellular S. aureus In this study, a cell-penetrating peptide fused to lysin (CPP-JDlys) was engineered. Our results show that CPP-JDlys can enter keratinocytes and effectively eliminate intracellular MRSA. Meanwhile, experiments with mice revealed that CPP-JDlys efficiently inhibits the proliferation of MRSA in murine skin and thus shortens the course of wound healing. Our results indicate that the CPP-fused lysin has potential for use for the treatment of skin infections caused by MRSA.
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14
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Schmidt VM, Pinchbeck G, Nuttall T, Shaw S, McIntyre KM, McEwan N, Dawson S, Williams NJ. Impact of systemic antimicrobial therapy on mucosal staphylococci in a population of dogs in Northwest England. Vet Dermatol 2018; 29:192-e70. [PMID: 29664197 DOI: 10.1111/vde.12538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Antimicrobial-resistant bacteria are increasingly isolated from veterinary patients. OBJECTIVES To determine risk factors for antimicrobial resistance (AMR) among canine mucosal staphylococci following routine antimicrobial treatment with cefalexin (CFX), clavulanate-amoxicillin (AC), cefovecin (CVN), clindamycin (CD) or a fluoroquinolone (FQ). ANIMALS Mucosal swab samples (n = 463) were collected from 127 dogs pre-treatment, immediately, and at one- and three-months post-treatment. METHODS Staphylococci were identified phenotypically and biochemically as coagulase negative (CoNS) or coagulase positive (CoPS); CoPS were speciated by nuc gene PCR. Antimicrobial susceptibility was determined using disc diffusion and mecA gene carriage by PCR. Multilevel, multivariable models examined associations between risk factors and presence/absence of CoPS, meticillin resistance (MR), multidrug-resistance (MDR) and fluoroquinolone resistance (FQR). RESULTS The percentage of samples with CoNS increased and with CoPS (including S. pseudintermedius) decreased immediately post-treatment with CFX, CVN and CD (P ≤ 0.001) and one month post-treatment with CD (P = 0.003). By three months post-treatment, there was no significant difference compared to pre-treatment samples. Immediately post-treatment with FQs there was significantly increased risk of isolating MRS (P = 0.002), MDR (P = 0.002) or FQR (P = 0.013) staphylococci and of MDR following CFX treatment (P = 0.019). The percentage of samples with AMR staphylococci declined from immediately to three months post-treatment and there was no significant difference between resistance prevalence at one or three months post-treatment for most AMR traits and treatment groups. Exceptions include increased MDR following FQ (P = 0.048) or CFX (P = 0.021), at one and three months post-treatment, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE Systemic antimicrobials impact on mucosal staphylococci. Immediately after therapy, the mucosa may be a reservoir for AMR staphylococci that are a source of mobile genetic elements carrying AMR genes.
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Affiliation(s)
- Vanessa M Schmidt
- Institute of Veterinary Science, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK.,Department of Epidemiology and Population Health, Institute of Infection and Global Health, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK
| | - Gina Pinchbeck
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK
| | - Tim Nuttall
- Institute of Veterinary Science, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK.,The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Bush Farm Road Easter Bush Campus, Roslin, Midlothian, UK
| | - Steve Shaw
- UK Vet Derm, 16 Talbot Street Whitwick, Coalville, LE67 5AW, Leicestershire, UK
| | - K Marie McIntyre
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK.,NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, West Derby Street, Liverpool, L69 7BE, UK
| | - Neil McEwan
- Institute of Veterinary Science, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK
| | - Susan Dawson
- Institute of Veterinary Science, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK
| | - Nicola J Williams
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, The University of Liverpool, Leahurst Campus Chester High Road, Neston, CH64 7TE, UK.,NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, West Derby Street, Liverpool, L69 7BE, UK
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15
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Shahbazian JH, Hahn PD, Ludwig S, Ferguson J, Baron P, Christ A, Spicer K, Tolomeo P, Torrie AM, Bilker WB, Cluzet VC, Hu B, Julian K, Nachamkin I, Rankin SC, Morris DO, Lautenbach E, Davis MF. Multidrug and Mupirocin Resistance in Environmental Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Homes of People Diagnosed with Community-Onset MRSA Infection. Appl Environ Microbiol 2017; 83:e01369-17. [PMID: 28939607 PMCID: PMC5666133 DOI: 10.1128/aem.01369-17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/02/2017] [Indexed: 01/11/2023] Open
Abstract
Patients with community-onset (CO) methicillin-resistant Staphylococcus aureus (MRSA) infections contribute to MRSA contamination of the home environment and may be reexposed to MRSA strains from this reservoir. This study evaluates One Health risk factors, which focus on the relationship between humans, animals, and the environment, for the increased prevalence of multiple antimicrobial-resistant MRSA isolates in the home environment. During a trial of patients with CO-MRSA infection, MRSA was isolated from the household environment at the baseline and 3 months later, following randomization of patients and household members to mupirocin-based decolonization therapy or an education control group. Up to two environmental MRSA isolates collected at each visit were tested. MRSA isolates were identified in 68% (65/95) of homes at the baseline (n = 104 isolates) and 51% (33/65) of homes 3 months later (n = 56 isolates). The rates of multidrug resistance (MDR) were 61% among isolates collected at the baseline and 55% among isolates collected at the visit 3 months later. At the baseline, 100% (14/14) of MRSA isolates from rural homes were MDR. While antimicrobial use by humans or pets was associated with an increased risk for the isolation of MDR MRSA from the environment, clindamycin use was not associated with an increased risk for the isolation of MDR MRSA. Incident low-level mupirocin-resistant MRSA strains were isolated at 3 months from 2 (5%) of 39 homes that were randomized to mupirocin treatment but none of the control homes. Among patients recently treated for a CO-MRSA infection, MRSA and MDR MRSA were common contaminants in the home environment. This study contributes to evidence that occupant use of antimicrobial drugs, except for clindamycin, is associated with MDR MRSA in the home environmental reservoir. (This study has been registered at ClinicalTrials.gov under registration no. NCT00966446.)IMPORTANCE MRSA is a common bacterial agent implicated in skin and soft tissue infections (SSTIs) in both community and health care settings. Patients with CO-MRSA infections contribute to environmental MRSA contamination in these settings and may be reexposed to MRSA strains from these reservoirs. People interact with natural and built environments; therefore, understanding the relationships between humans and animals as well as the characteristics of environmental reservoirs is important to advance strategies to combat antimicrobial resistance. Household interactions may influence the frequency and duration of exposure, which in turn may impact the duration of MRSA colonization or the probability for recurrent colonization and infection. Therefore, MRSA contamination of the home environment may contribute to human and animal recolonization and decolonization treatment failure. The aim of this study was to evaluate One Health risk factors that may be amenable to intervention and may influence the recovery of MDR and mupirocin resistance in CO-MRSA isolates.
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Affiliation(s)
- J H Shahbazian
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - P D Hahn
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - S Ludwig
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - J Ferguson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - P Baron
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - A Christ
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - K Spicer
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - P Tolomeo
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - A M Torrie
- Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - W B Bilker
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - V C Cluzet
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - B Hu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - K Julian
- Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - I Nachamkin
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - S C Rankin
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - D O Morris
- University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - E Lautenbach
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - M F Davis
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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