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Morin-Le Bihan A, Le Neindre K, Dejoies L, Piau C, Donnio PY, Ménard G. Use of the quantitative antibiogram method for assessing nosocomial transmission of ESBL-producing Enterobacteriaceae in a French hospital. J Hosp Infect 2023; 135:132-138. [PMID: 36918068 DOI: 10.1016/j.jhin.2023.01.023] [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: 12/16/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND ESBL-producing Enterobacteriaceae (eESBL) have a high prevalence in hospitals but real-time monitoring of nosocomial acquisition through conventional typing methods is challenging. Moreover, patient-to-patient transmission varies between the main species, namely Escherichia coli, and Klebsiella pneumoniae, then questioning the relevance of applying identical preventive measures. AIM To detect eESBL cross-transmission events (CTE) using combination of quantitative antibiogram with epidemiological data (combined-QA), and to rule on the effectiveness of standard or contact precautions for eESBL species. METHODS First, a validation set was used to confirm the relevance of the combined-QA by comparison to a combination of pulsed-field gel electrophoresis and epidemiological data (combined-PFGE). Secondly, a four-year retrospective analysis was conducted to detect eESBL-CTE in hospitalized patients. Two species were screened i.e. ESBL-E. coli (ESBL-Ec), and ESBL-K. pneumoniae (ESBL-Kp). During the study, only standard precautions were applied to ESBL-Ec patients whereas contact precautions were retained for ESBL-Kp. FINDINGS As a proof of concept, results between the two combined methods for the detection of CTE were identical for E. coli, and similar to at least 75% for K. pneumoniae. During the retrospective analysis, 722 patients with ESBL-Ec isolates and 280 with ESBL-Kp isolates were included. Nine CTE were identified for E. coli and 23 for K. pneumoniae, implying 20 (2.7%) and 36 (12.8%) patients, respectively. CONCLUSION The QA-combined method constitutes a rapid tool for epidemiological surveillance to detect CTE. In our hospital, standard precautions are sufficient to prevent acquisition of ESBL-Ec whereas contact precautions must be implemented to prevent acquisition of ESBL-Kp.
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Affiliation(s)
- Amélie Morin-Le Bihan
- CHU Rennes, SB2H (Service de Bactériologie-Hygiène Hospitalière), F-35000 Rennes, France
| | - Killian Le Neindre
- CHU Rennes, SB2H (Service de Bactériologie-Hygiène Hospitalière), F-35000 Rennes, France; INSERM, BRM (Bacterial RNAs and Medicine), University Rennes, UMR_S 1230, F-35000 Rennes, France
| | - Loren Dejoies
- CHU Rennes, SB2H (Service de Bactériologie-Hygiène Hospitalière), F-35000 Rennes, France; INSERM, BRM (Bacterial RNAs and Medicine), University Rennes, UMR_S 1230, F-35000 Rennes, France
| | - Caroline Piau
- CHU Rennes, SB2H (Service de Bactériologie-Hygiène Hospitalière), F-35000 Rennes, France
| | - Pierre-Yves Donnio
- CHU Rennes, SB2H (Service de Bactériologie-Hygiène Hospitalière), F-35000 Rennes, France; INSERM, BRM (Bacterial RNAs and Medicine), University Rennes, UMR_S 1230, F-35000 Rennes, France
| | - Guillaume Ménard
- CHU Rennes, SB2H (Service de Bactériologie-Hygiène Hospitalière), F-35000 Rennes, France; INSERM, BRM (Bacterial RNAs and Medicine), University Rennes, UMR_S 1230, F-35000 Rennes, France.
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Ramadan AA. Bacterial typing methods from past to present: A comprehensive overview. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Potential Applications of an Exopolysaccharide Produced by Bacillus xiamenensis RT6 Isolated from an Acidic Environment. Polymers (Basel) 2022; 14:polym14183918. [PMID: 36146061 PMCID: PMC9505781 DOI: 10.3390/polym14183918] [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: 08/09/2022] [Revised: 09/09/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
The Bacillus xiamenensis RT6 strain was isolated and identified by morphological, biochemical and molecular tests from an extreme acidic environment, Rio Tinto (Huelva). Optimisation tests for exopolysaccharide (EPS) production in different culture media determined that the best medium was a minimal medium with glucose as the only carbon source. The exopolymer (EPSt) produced by the strain was isolated and characterised using different techniques (GC-MS, HPLC/MSMS, ATR-FTIR, TGA, DSC). The molecular weight of EPSt was estimated. The results showed that the average molecular weight of EPSt was approximately 2.71 × 104 Da and was made up of a heteropolysaccharide composed of glucose (60%), mannose (20%) and galactose (20%). The EPSt showed antioxidant capabilities that significantly improved cell viability. Metal chelation determined that EPSt could reduce the concentration of transition metals such as iron at the highest concentrations tested. Finally, the emulsification study showed that EPSt was able to emulsify different natural polysaccharide oils, reaching up to an 80% efficiency (olive and sesame oil), and was a good candidate for the substitution of the most polluting emulsifiers. The EPSt was found to be suitable for pharmaceutical and industrial applications.
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Liu C, Feng J, Zhang D, Xie Y, Li A, Wang J, Su Y. Clustering Analysis of Antibiograms and Antibiogram Types ofStreptococcus agalactiaeStrains from Tilapia in China. Microb Drug Resist 2018; 24:1431-1439. [DOI: 10.1089/mdr.2017.0350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Chan Liu
- Key Laboratory of South China Sea Fishery Resources Exploitation & Utilization, Ministry of Agriculture, South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, People's Republic of China
- College of Fisheries, Tianjin Agricultural University, Tianjin, People's Republic of China
| | - Juan Feng
- Key Laboratory of South China Sea Fishery Resources Exploitation & Utilization, Ministry of Agriculture, South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, People's Republic of China
| | - Defeng Zhang
- Key Laboratory of Tropical & Subtropical Fishery Resource Application & Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, People's Republic of China
| | - Yundan Xie
- Key Laboratory of South China Sea Fishery Resources Exploitation & Utilization, Ministry of Agriculture, South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, People's Republic of China
- College of Fisheries, Tianjin Agricultural University, Tianjin, People's Republic of China
| | - Anxing Li
- Key Laboratory for Aquatic Products Safety of Ministry of Education/State Key Laboratory of Biocontrol, The School of Life Sciences, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jiangyong Wang
- Key Laboratory of South China Sea Fishery Resources Exploitation & Utilization, Ministry of Agriculture, South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, People's Republic of China
| | - Youlu Su
- Key Laboratory of South China Sea Fishery Resources Exploitation & Utilization, Ministry of Agriculture, South China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, People's Republic of China
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Kasela M, Malm A. Overview of phenotypic methods used for differentiation of Staphylococcus aureus. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2018. [DOI: 10.1515/cipms-2018-0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Choosing the appropriate method for differentiation of Staphylococcus aureus strains is important for effective diagnostics and epidemiological investigations. Despite the fact that the results of phenotypic methods are strongly dependent on environmental conditions, they can still be useful in the investigation of epidemic strains of S. aureus. In this article, the potential application of commonly used phenotypic methods in epidemiological studies of S. aureus was analysed. Advantages and disadvantages of methods such as biotyping, serotyping, phage typing, AST (Antimicrobial Susceptibility Testing), SDS-PAGE (Sodium Dodecyl Sulphate Polyacryl Gel Electrophoresis), MLEE (Multilocus Enzyme Electrophoresis) and MALDI-TOF MS (Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectroscopy) were also discussed. Finally, phenotypic techniques were compared in terms of their discriminatory potential, typeability of isolates, time of analysis, reproducibility, ease of performance and ease of results interpretation.
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Affiliation(s)
- Martyna Kasela
- Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics , Medical University of Lublin , Chodzki 1, 20-093 , Lublin , Poland
| | - Anna Malm
- Department of Pharmaceutical Microbiology with Laboratory for Microbiological Diagnostics , Medical University of Lublin , Chodzki 1, 20-093 , Lublin , Poland
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Leiva Peláez O, Stojanov M, Zayas Tamayo AM, Barreras García G, González Aleman M, Martínez Ceballos L, Muñoz del Campo JL, Bello Rodríguez O, Gonzalez Mesa L, Blanc DS. Molecular epidemiology of methicillin-resistant Staphylococcus aureus from 4 Cuban hospitals. Diagn Microbiol Infect Dis 2014; 81:1-3. [PMID: 25467174 DOI: 10.1016/j.diagmicrobio.2014.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/23/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
Abstract
During a 1-year period, 87 methicillin-resistant Staphylococcus aureus isolates were collected from 4 major Cuban hospitals for epidemiological analysis. The majority (86%) were related to the community-associated USA300 clone, whereas the remaining belonged to a new clone ST72-V. Interestingly, no hospital-associated clone was found in these Cuban hospitals.
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Affiliation(s)
- Osney Leiva Peláez
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Switzerland; Microbiology Department, National Center for Scientific Investigation (CNIC), Havana, Cuba
| | - Miloš Stojanov
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Switzerland
| | | | | | | | | | | | - Olga Bello Rodríguez
- Microbiology Department, Center for Medical Surgical Investigations (CIMEQ), Havana, Cuba
| | | | - Dominique S Blanc
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Switzerland; Institute of Microbiology, Lausanne University Hospital, Switzerland.
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Joseph NM, Sistla S, Dutta TK, Badhe AS, Parija SC. Ventilator-associated pneumonia: role of colonizers and value of routine endotracheal aspirate cultures. Int J Infect Dis 2010; 14:e723-9. [DOI: 10.1016/j.ijid.2010.02.2248] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 01/25/2010] [Accepted: 02/24/2010] [Indexed: 10/19/2022] Open
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Stepán J, Pantůcek R, Doskar J. Molecular diagnostics of clinically important staphylococci. Folia Microbiol (Praha) 2008; 49:353-86. [PMID: 15530002 DOI: 10.1007/bf03354664] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Bacterial species of the genus Staphylococcus known as important human and animal pathogens are the cause of a number of severe infectious diseases. Apart from the major pathogen Staphylococcus aureus, other species until recently considered to be nonpathogenic may also be involved in serious infections. Rapid and accurate identification of the disease-causing agent is therefore prerequisite for disease control and epidemiological surveillance. Modern methods for identification and typing of bacterial species are based on genome analysis and have many advantages compared to phenotypic methods. The genotypic methods currently used in molecular diagnostics of staphylococcal species, particularly of S. aureus, are reviewed. Attention is also paid to new molecular methods with the highest discriminatory power. Efforts made to achieve interlaboratory reproducibility of diagnostic methods are presented.
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Affiliation(s)
- J Stepán
- Department of Genetics and Molecular Biology, Faculty of Science, Masaryk University, 611 37 Brno, Czechia
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Boyce JM. Community-Associated Methicillin-Resistant Staphylococcus aureus as a Cause of Health Care--Associated Infection. Clin Infect Dis 2008; 46:795-8. [DOI: 10.1086/528717] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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10
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Blanc DS, Petignat C, Wenger A, Kuhn G, Vallet Y, Fracheboud D, Trachsel S, Reymond M, Troillet N, Siegrist HH, Oeuvray S, Bes M, Etienne J, Bille J, Francioli P, Zanetti G. Changing molecular epidemiology of methicillin-resistant Staphylococcus aureus in a small geographic area over an eight-year period. J Clin Microbiol 2007; 45:3729-36. [PMID: 17881551 PMCID: PMC2168490 DOI: 10.1128/jcm.00511-07] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) at an international level shows that most MRSA strains belong to a few pandemic clones. At the local level, a predominance of one or two clones was generally reported. However, the situation is evolving and new clones are emerging worldwide, some of them with specific biological characteristics, such as the presence of Panton-Valentine leucocidin (PVL). Understanding these changes at the local and international levels is of great importance. Our objective was to analyze the evolution of MRSA epidemiology at multiple sites on a local level (Western Switzerland) over a period of 8 years. Data were based on MRSA reports from seven sentinel laboratories and infection control programs covering different areas. Pulsed-field gel electrophoresis was used to type MRSA isolates. From 1997 to 2004, a total of 2,256 patients with MRSA were reported. Results showed the presence of four predominant clones (accounting for 86% of patients), which could be related to known international clones (Berlin, New York/Japan, Southern Germany, and Iberian clones). Within the small geographic region, the 8-year follow-up period in the different areas showed spacio-temporal differences in the relative proportions of the four clones. Other international MRSA clones, as well as clones showing genetic characteristics identical to those of community-acquired MRSA (SCCmec type IV and the presence of PVL genes), were also identified but presumably did not disseminate. Despite the worldwide predominance of a few MRSA clones, our data showed that at a local level, the epidemiology of MRSA might be different from one hospital to another. Moreover, MRSA clones were replaced by other emerging clones, suggesting a rapid change.
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Affiliation(s)
- D S Blanc
- Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
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11
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van Belkum A, Tassios PT, Dijkshoorn L, Haeggman S, Cookson B, Fry NK, Fussing V, Green J, Feil E, Gerner-Smidt P, Brisse S, Struelens M. Guidelines for the validation and application of typing methods for use in bacterial epidemiology. Clin Microbiol Infect 2007; 13 Suppl 3:1-46. [PMID: 17716294 DOI: 10.1111/j.1469-0691.2007.01786.x] [Citation(s) in RCA: 530] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
For bacterial typing to be useful, the development, validation and appropriate application of typing methods must follow unified criteria. Over a decade ago, ESGEM, the ESCMID (Europen Society for Clinical Microbiology and Infectious Diseases) Study Group on Epidemiological Markers, produced guidelines for optimal use and quality assessment of the then most frequently used typing procedures. We present here an update of these guidelines, taking into account the spectacular increase in the number and quality of typing methods made available over the past decade. Newer and older, phenotypic and genotypic methods for typing of all clinically relevant bacterial species are described according to their principles, advantages and disadvantages. Criteria for their evaluation and application and the interpretation of their results are proposed. Finally, the issues of reporting, standardisation, quality assessment and international networks are discussed. It must be emphasised that typing results can never stand alone and need to be interpreted in the context of all available epidemiological, clinical and demographical data relating to the infectious disease under investigation. A strategic effort on the part of all workers in the field is thus mandatory to combat emerging infectious diseases, as is financial support from national and international granting bodies and health authorities.
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Affiliation(s)
- A van Belkum
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands.
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Alexandre A, Laranjo M, Oliveira S. Natural populations of chickpea rhizobia evaluated by antibiotic resistance profiles and molecular methods. MICROBIAL ECOLOGY 2006; 51:128-36. [PMID: 16389465 DOI: 10.1007/s00248-005-0085-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2005] [Accepted: 08/11/2005] [Indexed: 05/06/2023]
Abstract
The aims of this study were to investigate the hypothesis that intrinsic antibiotic resistance (IAR) profiles of chickpea rhizobia are correlated with the isolates site of origin, and to compare the discriminating power of IAR profiles with molecular approaches in rhizobial strain identification and differentiation. Rhizobial diversity from five Portuguese soils was assessed by IAR profiles and molecular methods [16S rDNA restriction fragment length polymorphism (RFLP) analysis, direct amplified polymorphic DNA (DAPD) fingerprinting, and SDS-PAGE analysis of protein profiles]. For each analysis, a dendrogram was generated using the software BioNumerics. All three molecular methods generated analogous clustering of the isolates, supporting previous results on 16S rDNA sequence-based phylogeny. Clusters obtained with IAR profile are similar to the species groups generated with the molecular methods used. IAR groups do not correlate significantly with the geographic origin of the isolates. These results may indicate a chromosomal location of antibiotic resistance genes, and suggest that IAR is species related. DAPD and IAR profiles proved to be the most discriminating approaches in strain differentiation and can be used as fast methods to screen diversity in new isolates.
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Affiliation(s)
- Ana Alexandre
- Departamento de Biologia, Universidade de Evora, Apartado 94, 7002-554 Evora, Portugal
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Montesinos I, Salido E, Delgado T, Cuervo M, Sierra A. Epidemiologic genotyping of methicillin-resistant Staphylococcus aureus by pulsed-field gel electrophoresis at a university hospital and comparison with antibiotyping and protein A and coagulase gene polymorphisms. J Clin Microbiol 2002; 40:2119-25. [PMID: 12037075 PMCID: PMC130756 DOI: 10.1128/jcm.40.6.2119-2125.2002] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A total of 124 methicillin-resistant Staphylococcus aureus (MRSA) isolates were ascertained at the University Hospital of the Canary Islands between January 1997 and April 2000. Genotyping included pulsed-field gel electrophoresis (PFGE) (SmaI digestion) and PCR-restriction fragment length polymorphism (PCR-RFLP) analysis for the coagulase (coa) and protein A (spa) genes. Antibiotic resistance was the main phenotypic marker correlated with genotyping results. Three main PFGE types were detected: A (with 12 subtypes), B (with 2 subtypes), and C. PFGE type A1 was the most commonly found (61% of isolates) and the one responsible for all the epidemic outbreaks. Other genetics markers used (coa and spa RFLPs) were significantly correlated with the PFGE types detected (P < 0.001). These PCR-RFLP assays were useful as molecular markers for a quick, preliminary study of MRSA outbreaks.
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Affiliation(s)
- I Montesinos
- Microbiology Laboratory, Hospital Universitario de Canarias, Tenerife, Canary Islands, Spain.
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Donnio PY, Louvet L, Preney L, Nicolas D, Avril JL, Desbordes L. Nine-year surveillance of methicillin-resistant Staphylococcus aureus in a hospital suggests instability of mecA DNA region in an epidemic strain. J Clin Microbiol 2002; 40:1048-52. [PMID: 11880436 PMCID: PMC120266 DOI: 10.1128/jcm.40.3.1048-1052.2002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The distributions of the antibiotic resistance patterns in a population of Staphylococcus aureus isolates from a teaching hospital were studied over a 9-year period. The results indicate the existence of successive major epidemic methicillin-resistant strains and the emergence of a methicillin-susceptible strain with an unusual resistance pattern. Our findings suggest that this methicillin-susceptible S. aureus strain could be derived from the dominant gentamicin-susceptible methicillin-resistant S. aureus strain with the loss of a 40-kb DNA fragment.
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Affiliation(s)
- Pierre-Yves Donnio
- Laboratoire de Bactériologie-Virologie, Centre Hospitalier Universitaire. UPRES 12-54 Microbiologie, Université de Rennes 1, 35033 Rennes Cedex 9, France.
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van Belkum A. Molecular epidemiology of methicillin-resistant Staphylococcus aureus strains: state of affairs and tomorrow' s possibilities. Microb Drug Resist 2001; 6:173-88. [PMID: 11144418 DOI: 10.1089/mdr.2000.6.173] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Methicillin-resistant strains of Staphylococcus aureus (MRSA) have posed a clinical threat for nearly 40 years. During these years, an array of additional technologies suited for identification of MRSA below the species level has become available. The technologies, whether they assess phenotype or genotype, provide data that can be used for elucidation of the routes of dissemination of individual MRSA types. This review summarizes the current state of affairs with respect to the quality of the various laboratory techniques and includes descriptions of novel strategies such as binary typing and multilocus sequence typing (MLST). Drawbacks of procedures will be compared, and the value of molecular typing in the elucidation of complex biological phenomena, such as epidemicity, carriage, and reduced vancomycin susceptibility, will be indicated. Means for integrated assessment of bacterial biology, epidemiology, and population structure will be discussed.
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Affiliation(s)
- A van Belkum
- Erasmus University Medical Center Rotterdam, Department of Medical Microbiology & Infectious Diseases, The Netherlands.
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Lee YL, Thrupp L. Genotyping by restriction endonuclease analysis compared to phenotyping by antibiogram for typing methicillin-resistant Staphylococcus aureus strains colonizing patients in a nursing home. Infect Control Hosp Epidemiol 2000; 21:218-21. [PMID: 10738994 DOI: 10.1086/501748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assist in defining patterns of methicillin-resistant Staphylococcus aureus (MRSA) colonization in a skilled nursing facility (SNF), we compared genotyping by field-inversion gel electrophoresis (FIGE) restriction endonuclease digestion analysis (REA) with phenotyping by antibiogram for defining strain relatedness among MRSA isolates from SNF patients. DESIGN Prospective screening culture surveillance for MRSA among patients in a community SNF. METHODS Nares and stool swab cultures were obtained from newly admitted patients and from all patients quarterly. MRSA were isolated by oxacillin screening agar. Antibiograms were determined by the disk-diffusion method, and genotyping was by FIGE REA. RESULTS It was shown that, among isolates with the same genotypes, many had different antibiograms; among isolates with the same antibiograms, many had different genotypes; and the discriminatory indices for isolates of MRSA by FIGE REA and by antibiogram were 0.56 and 0.78, respectively. CONCLUSION Our study demonstrated that, in patients from one SNF, genotyping by FIGE REA identified two prevalent REA DNA types, but with variability of antibiogram patterns within each DNA type; the antibiogram also identified prevalent patterns with variability of REA DNA type within each antibiogram pattern. The discriminatory index of antibiograms alone, or of genotypes alone as determined by FIGE REA, was poor for strains of MRSA isolated from the SNF patients in our study.
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Affiliation(s)
- Y L Lee
- Infectious Disease Division, Department of Medicine, University of California Irvine, USA
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Blanc DS, Petignat C, Moreillon P, Entenza JM, Eisenring M, Kleiber H, Wenger A, Troillet N, Blanc C, Francioli P. Unusual spread of a penicillin-susceptible methicillin-resistant Staphylococcus aureus clone in a geographic area of low incidence. Clin Infect Dis 1999; 29:1512-8. [PMID: 10585805 DOI: 10.1086/313522] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We describe the unusual spread of a penicillin-susceptible methicillin-resistant Staphylococcus aureus (MRSA) clone in hospitals in western Switzerland, where the incidence of MRSA is usually low. During a 2-year period, this clone had been responsible for several outbreaks and had been isolated from >156 persons in 21 institutions. Molecular typing by pulsed-field gel electrophoresis (PFGE) demonstrated that all of these isolates belonged to the same clone. In 1 of the outbreaks, involving 30 cases, the clone was responsible for at least 17 secondary cases. In contrast, during the period of the latter outbreak, 9 other patients harboring different MRSA strains, as assessed by PFGE, were hospitalized in the same wards, but no secondary cases occurred. These observations suggest that this clone, compared with other MRSA strains, had some intrinsic factor(s) that contributed to its ability to disseminate and could thus be considered epidemic.
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Affiliation(s)
- D S Blanc
- Division Autonome de Médecine Préventive Hospitalière, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
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Melter O, Santos Sanches I, Schindler J, Aires de Sousa M, Mato R, Kovárova V, Zemlicková H, de Lencastre H. Methicillin-resistant Staphylococcus aureus clonal types in the Czech Republic. J Clin Microbiol 1999; 37:2798-803. [PMID: 10449455 PMCID: PMC85383 DOI: 10.1128/jcm.37.9.2798-2803.1999] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Molecular surveillance studies have documented the extensive spread of methicillin-resistant Staphylococcus aureus (MRSA) clones. Studies carried out by Centro de Epidemiologia Molecular-Network for Tracking Gram-Positive Pathogenic Bacteria (CEM/NET) led to the identification of two international multidrug-resistant strains, which were designated as the Iberian and Brazilian MRSA clones and which were defined by multiple genomic typing methods; these included ClaI restriction digests hybridized with mecA- and Tn554-specific DNA probes and pulsed-field gel electrophoresis (PFGE). The genotypic characteristics of these clones are distinct: the Iberian clone is defined as mecA type I, Tn554 type E (or its variants), and PFGE pattern A (I:E:A), whereas the Brazilian clone is defined as mecA type XI (or its variants), Tn554 type B, and PFGE pattern B (XI:B:B). In this study, we characterized 59 single-patient isolates of MRSA collected during 1996 and 1997 at seven hospitals located in Prague and five other cities in the Czech Republic by using the methodologies mentioned above and by using ribotyping of EcoRI and HindIII digests hybridized with a 16S-23S DNA probe. The Brazilian MRSA clone (XI:B:B) was the major clone (80%) spread in two hospitals located in Prague and one located in Brno; the Iberian MRSA clone (I:E:A or its variant I:DD:A), although less representative (12%), was detected in two hospitals, one in Prague and the other in Plzen. Almost all the strains belonging to clone XI:B:B (45 of 47) corresponded to a unique ribotype, E1H1, whereas most strains of the I:E:A and I:DD:A clonal types (6 of 7) corresponded to ribotype E2H2.
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Affiliation(s)
- O Melter
- Unidade de Genética Molecular, Instituto de Tecnologia Química e Biológica da Universidade Nova de Lisboa (ITQB/UNL), Oeiras, Portugal
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Leflon-Guibout V, Métral-Bétina V, Heym B, Lortat-Jacob A, Nicolas-Chanoine MH. Acinetobacter baumannii outbreak in an orthopedic ward: analysis of strain relatedness by RAPD and quantitative antibiogram techniques. Clin Microbiol Infect 1998. [DOI: 10.1111/j.1469-0691.1998.tb00398.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tambic A, Power EG, Talsania H, Anthony RM, French GL. Analysis of an outbreak of non-phage-typeable methicillin-resistant Staphylococcus aureus by using a randomly amplified polymorphic DNA assay. J Clin Microbiol 1997; 35:3092-7. [PMID: 9399500 PMCID: PMC230128 DOI: 10.1128/jcm.35.12.3092-3097.1997] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A cluster of methicillin-resistant Staphylococcus aureus (MRSA) infections among patients on an intensive care unit (ICU) was detected by routine infection control surveillance. In the period from 5 January to 22 June 1995, 10 patients on the ICU and a further 6 patients (5 on one ward that had received colonized patients transferred from the ICU) were affected by MRSA strains with the same antibiotic susceptibility patterns. Seven (44%) of these 16 colonized patients developed MRSA bacteremia. MRSA isolates with the same characteristics were also found on the hands of one member of the ICU staff. The isolates were untypeable by phage typing, but 15 of 17 outbreak strains analyzed genetically had identical randomly amplified polymorphic DNA (RAPD) and pulsed-field gel electrophoresis (PFGE) profiles. A single strain of MRSA that was nontypeable by phage typing and that was isolated on the ICU on 1 January and six nontypeable and epidemiologically unrelated MRSA isolates all had RAPD profiles distinct from that of the outbreak strain. Implementation of strict infection control measures stopped the further spread of MRSA on the ICU, the affected general ward, and seven other wards that received MRSA carriers from the ICU. Although nontypeable by phage typing and not previously recognized as an epidemic strain, this strain of MRSA was readily transmissible and highly virulent. RAPD typing was found to be a simple, rapid, and effective method for the epidemiological investigation of this outbreak, and performance of typing by this method was simpler and less time-consuming than that of typing by PFGE. RAPD typing may have more general application for the study of S. aureus infections in hospitals.
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Affiliation(s)
- A Tambic
- Department of Microbiology, UMDS of Guy's and St. Thomas's Hospitals, London, United Kingdom
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21
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Kinoshita M, Sawabe E, Okamura N. Concept of segmentation in nosocomial epidemiology: epidemiological relation among antimicrobial-resistant isolates of Pseudomonas aeruginosa. J Infect 1997; 35:269-76. [PMID: 9459401 DOI: 10.1016/s0163-4453(97)93118-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Typing studies on 271 clinical strains of Pseudomonas aeruginosa isolated from the University Teaching Hospital were conducted to obtain their serotypes, antimicrobial susceptibility patterns and plasmid profiles. These strain typing data were arranged through multivariate statistical analysis by computation to classify individual strains. Plots in the scatter diagrams obtained from both principal component analysis and quantification theory type III expressed the clinical strains of P. aeruginosa with various degrees of antimicrobial resistance. Epidemiological relation among these clinical strains was analysed in those scatter diagrams by segmentation, in combination with their epidemiological information (date and place of isolation, type of specimen, etc.). The results showed that the serotype E strains both with high-level resistance to gentamicin and with a plasmid of 3.9 x 10(6) dalton, and the strains resistant to more than five antimicrobial agents, were colonized and localized each in certain clinical wards for inpatients. It was suggested that segmentation analysis could be of practical use in the management of nosocomial infection control against P. aeruginosa with antimicrobial resistance.
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Affiliation(s)
- M Kinoshita
- Department of Clinical Microbiology and Immunology, School of Allied Health Sciences, Faculty of Medicine, University Hospital, Tokyo Medical and Dental University, Japan
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Abstract
Abstract
Over the past several years, the development and application of molecular diagnostic techniques has initiated a revolution in the diagnosis and monitoring of infectious diseases. Microbial phenotypic characteristics, such as protein, bacteriophage, and chromatographic profiles, as well as biotyping and susceptibility testing, are used in most routine laboratories for identification and differentiation. Nucleic acid techniques, such as plasmid profiling, various methods for generating restriction fragment length polymorphisms, and the polymerase chain reaction (PCR), are making increasing inroads into clinical laboratories. PCR-based systems to detect the etiologic agents of disease directly from clinical samples, without the need for culture, have been useful in rapid detection of unculturable or fastidious microorganisms. Additionally, sequence analysis of amplified microbial DNA allows for identification and better characterization of the pathogen. Subspecies variation, identified by various techniques, has been shown to be important in the prognosis of certain diseases. Other important advances include the determination of viral load and the direct detection of genes or gene mutations responsible for drug resistance. Increased use of automation and user-friendly software makes these technologies more widely available. In all, the detection of infectious agents at the nucleic acid level represents a true synthesis of clinical chemistry and clinical microbiology techniques.
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Affiliation(s)
| | | | - David H Persing
- Division of Clinical Microbiology, Department of Pathology and Laboratory Medicine, Hilton Bldg. 470, Mayo Clinic, 200 First St., SW, Rochester, MN 55905
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Nicolas-Chanoine MH, Espinasse-Maes F. Evaluation of clonal relatedness of extended-spectrum beta-lactamase-producing Proteus mirabilis isolates by quantitative antibiogram and RAPD typing. Clin Microbiol Infect 1997; 3:45-52. [PMID: 11864075 DOI: 10.1111/j.1469-0691.1997.tb00250.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE: To delineate, using two different typing systems, the clonal relatedness of 40 isolates of extended-spectrum beta-lactamase (ESbetaIa)-producing Proteus mirabilis obtained over a period of 7 years in six hospitals in the Paris area and two in Pas-de-Calais. METHODS: Random amplified polymorphic DNA (RAPD) polymerase chain reaction typing was applied by using three random primers on the ESbetaIa-producing P. mirabilis isolates and on isogenic Escherichia coli strains with or without plasmids encoding the representative resistance pattern transferred from P. mirabilis. Quantitative antibiogram typing, which was also applied to the P. mirabilis isolates, was used to define the euclidean distance between these strains. RESULTS: After having demonstrated that P. mirabilis plasmids did not influence chromosomal DNA amplification, we could classify the ESbetaIa-producing P. mirabilis isolates into 12 groups based on RAPD fingerprints. The same isolates were classified into 19 groups by quantitative antibiogram typing. Despite this difference in group numbers, general concordance between the typing systems was observed. This allowed us to show that the greater number of isolates in some hospitals belonged to a single strain and that single isolates obtained in different hospitals generally represented unique strains. CONCLUSIONS: A small number of ESbetaIa-producing P. mirabilis strains was isolated during 7 years in the eight medical centers studied, and the number of different strains identified suggested that inter-hospital transfer had not occurred.
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GARCÍA-ARATA MISABEL, GERNER-SMIDT PETER, LÓPEZ-BREA MANUEL. Epidemiological study ofAcinetobacterspecies isolated from an intensive care unit. APMIS 1997. [DOI: 10.1111/j.1699-0463.1997.tb00551.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Quantitative Antibiogram as a Typing Method for the Prospective Epidemiological Surveillance and Control of MRSA Comparison with Molecular Typing. Infect Control Hosp Epidemiol 1996. [DOI: 10.1017/s0195941700002940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:Evaluation of the quantitative antibiogram as an epidemiological tool for the prospective typing of methicillin-resistantStaphylococcus aureus(MRSA), and comparison with ribotyping.Methods:The method is based on the multivariate analysis of inhibition zone diameters of antibiotics in disk diffusion tests. Five antibiotics were used (erythromycin, clindamycin, cotrimoxazole, gentamicin, and ciprofloxacin). Ribotyping was performed using seven restriction enzymes (EcoRV,HindIII,KpnI,PstI,EcoRI,SfuI, andBamHI).Setting:1,000-bed tertiary university medical center.Results:During a 1-year period, 31 patients were found to be infected or colonized with MRSA. Cluster analysis of antibiogram data showed nine distinct antibiotypes. Four antibiotypes were isolated from multiple patients (2, 4, 7, and 13, respectively). Five additional antibiotypes were isolated from the remaining five patients. When analyzed with respect to the epidemiological data, the method was found to be equivalent to ribotyping.Among 206 staff members who were screened, six were carriers of MRSA. Both typing methods identified concordant of MRSA types in staff members and in the patients under their care.Conclusions:The quantitative antibiogram was found to be equivalent to ribotyping as an epidemiological tool for typing of MRSA in our setting. Thus, this simple, rapid, and readily available method appears to be suitable for the prospective surveillance and control of MRSA for hospitals that do not have molecular typing facilities and in which MRSA isolates are not uniformly resistant or susceptible to the antibiotics tested.
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Blanc DS, Petignat C, Moreillon P, Wenger A, Bille J, Francioli P. Quantitative Antibiogram as a Typing Method for the Prospective Epidemiological Surveillance and Control of MRSA: Comparison with Molecular Typing. Infect Control Hosp Epidemiol 1996. [DOI: 10.2307/30141299] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Struelens MJ. Consensus guidelines for appropriate use and evaluation of microbial epidemiologic typing systems. Clin Microbiol Infect 1996; 2:2-11. [PMID: 11866804 DOI: 10.1111/j.1469-0691.1996.tb00193.x] [Citation(s) in RCA: 363] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wiedmann M, Bruce JL, Knorr R, Bodis M, Cole EM, McDowell CI, McDonough PL, Batt CA. Ribotype diversity of Listeria monocytogenes strains associated with outbreaks of listeriosis in ruminants. J Clin Microbiol 1996; 34:1086-90. [PMID: 8727881 PMCID: PMC228960 DOI: 10.1128/jcm.34.5.1086-1090.1996] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Ribotyping is a molecular method for the characterization, identification, and typing of bacterial isolates that has value in epidemiological studies. To demonstrate the utility of this technique for typing of Listeria monocytogenes, four outbreaks of epizootic listeriosis in ruminants were investigated through coordinated detection and characterization methods utilizing classical microbiology and nucleic acid-based techniques. L. monocytogenes strains isolated from clinical samples and the silage consumed by the affected animals were ribotyped to establish the causal relationship between feed and the disease outbreak. For all but one outbreak, we were able to isolate L. monocytogenes strains represented by the same ribotype from both clinical and silage samples. Additional L. monocytogenes strains with ribotypes different from those of the respective clinical samples were isolated from all silage samples. This indicates that a diverse population of L. monocytogenes strains exists in farm environments, of which some may be more likely than others to cause disease.
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Affiliation(s)
- M Wiedmann
- Department of Food Science, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA
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Lugeon C, Blanc DS, Wenger A, Francioli P. Molecular Epidemiology of Methicillin-Resistant Staphyloccocus aureus at a Low-Incidence Hospital over a 4-Year Period. Infect Control Hosp Epidemiol 1995. [DOI: 10.2307/30143091] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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