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Jiang JH, Cameron DR, Nethercott C, Aires-de-Sousa M, Peleg AY. Virulence attributes of successful methicillin-resistant Staphylococcus aureus lineages. Clin Microbiol Rev 2023; 36:e0014822. [PMID: 37982596 PMCID: PMC10732075 DOI: 10.1128/cmr.00148-22] [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] [Indexed: 11/21/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of severe and often fatal infections. MRSA epidemics have occurred in waves, whereby a previously successful lineage has been replaced by a more fit and better adapted lineage. Selection pressures in both hospital and community settings are not uniform across the globe, which has resulted in geographically distinct epidemiology. This review focuses on the mechanisms that trigger the establishment and maintenance of current, dominant MRSA lineages across the globe. While the important role of antibiotic resistance will be mentioned throughout, factors which influence the capacity of S. aureus to colonize and cause disease within a host will be the primary focus of this review. We show that while MRSA possesses a diverse arsenal of toxins including alpha-toxin, the success of a lineage involves more than just producing toxins that damage the host. Success is often attributed to the acquisition or loss of genetic elements involved in colonization and niche adaptation such as the arginine catabolic mobile element, as well as the activity of regulatory systems, and shift metabolism accordingly (e.g., the accessory genome regulator, agr). Understanding exactly how specific MRSA clones cause prolonged epidemics may reveal targets for therapies, whereby both core (e.g., the alpha toxin) and acquired virulence factors (e.g., the Panton-Valentine leukocidin) may be nullified using anti-virulence strategies.
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Affiliation(s)
- Jhih-Hang Jiang
- Department of Microbiology, Infection Program, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - David R. Cameron
- Department of Biomedical Research, University of Bern, Bern, Switzerland
| | - Cara Nethercott
- Department of Microbiology, Infection Program, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Marta Aires-de-Sousa
- Laboratory of Molecular Genetics, Institutode Tecnologia Químicae Biológica António Xavier (ITQB-NOVA), Universidade Nova de Lisboa, Oeiras, Portugal
- Escola Superior de Saúde da Cruz Vermelha Portuguesa-Lisboa (ESSCVP-Lisboa), Lisbon, Portugal
| | - Anton Y. Peleg
- Department of Microbiology, Infection Program, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Centre to Impact Antimicrobial Resistance, Monash University, Clayton, Melbourne, Victoria, Australia
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2
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Koh AJJ, Thombare V, Hussein M, Rao GG, Li J, Velkov T. Bifunctional antibiotic hybrids: A review of clinical candidates. Front Pharmacol 2023; 14:1158152. [PMID: 37397488 PMCID: PMC10313405 DOI: 10.3389/fphar.2023.1158152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/02/2023] [Indexed: 07/04/2023] Open
Abstract
Antibiotic resistance is a top threat to human health and a priority across the globe. This problematic issue is accompanied by the decline of new antibiotics in the pipeline over the past 30 years. In this context, an urgent need to develop new strategies to combat antimicrobial resistance is in great demand. Lately, among the possible approaches used to deal with antimicrobial resistance is the covalent ligation of two antibiotic pharmacophores that target the bacterial cells through a dissimilar mode of action into a single hybrid molecule, namely hybrid antibiotics. This strategy exhibits several advantages, including better antibacterial activity, overcoming the existing resistance towards individual antibiotics, and may ultimately delay the onset of bacterial resistance. This review sheds light on the latest development of the dual antibiotic hybrids pipeline, their potential mechanisms of action, and challenges in their use.
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Affiliation(s)
- Augustine Jing Jie Koh
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIP, Australia
| | - Varsha Thombare
- Monash Biomedicine Discovery Institute, Department of Pharmacology, Monash University, Parkville, VIP, Australia
| | - Maytham Hussein
- Monash Biomedicine Discovery Institute, Department of Pharmacology, Monash University, Parkville, VIP, Australia
| | - Gauri G. Rao
- Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Jian Li
- Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University, Parkville, VIP, Australia
| | - Tony Velkov
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIP, Australia
- Monash Biomedicine Discovery Institute, Department of Pharmacology, Monash University, Parkville, VIP, Australia
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3
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Madrazo M, López-Cruz I, Piles L, Viñola S, Alberola J, Eiros JM, Artero A. Risk Factors and the Impact of Multidrug-Resistant Bacteria on Community-Acquired Urinary Sepsis. Microorganisms 2023; 11:1278. [PMID: 37317252 DOI: 10.3390/microorganisms11051278] [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: 04/01/2023] [Revised: 04/28/2023] [Accepted: 05/11/2023] [Indexed: 06/16/2023] Open
Abstract
Risk factors for multidrug-resistant bacteria (MDRB) in nosocomial urinary tract infection (UTI) have been widely studied. However, these risk factors have not been analyzed in community-acquired urinary sepsis (US), nor have its outcomes been studied. The aim of our study is to determine risk factors for MDRB in community-acquired US and its influence on outcomes. Prospective observational study of patients with community-acquired US admitted to a university hospital. We compared epidemiological and clinical variables and outcomes of US due to MDRB and non-MDRB. Independent risk factors for MDRB were analyzed using logistic regression. A total of 193 patients were included, 33.7% of them with US due to MDRB. The median age of patients was 82 years. Hospital mortality was 17.6%, with no difference between the MDRB and non-MDRB groups. The length of hospital stay was 5 (4-8) days, with a non-significant tendency to longer hospital stays in the MDRB group (6 (4-10) vs. 5 (4-8) days, p = 0.051). Healthcare-associated US was found to be an independent risk factor for MDR bacteria by multivariate analysis. In conclusion, the impact of MDR bacteria on the outcomes of community-acquired urinary sepsis was mild. Healthcare-associated US was an independent risk factor for MDR bacteria.
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Affiliation(s)
- Manuel Madrazo
- Hospital Universitario Doctor Peset, 46017 Valencia, Spain
| | - Ian López-Cruz
- Hospital Universitario Doctor Peset, 46017 Valencia, Spain
| | - Laura Piles
- Hospital Universitario Doctor Peset, 46017 Valencia, Spain
| | - Sofía Viñola
- Hospital Universitario Doctor Peset, 46017 Valencia, Spain
| | - Juan Alberola
- Hospital Universitario Doctor Peset, 46017 Valencia, Spain
| | | | - Arturo Artero
- Hospital Universitario Doctor Peset, 46017 Valencia, Spain
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4
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Zhang B, Phetsang W, Stone MRL, Kc S, Butler MS, Cooper MA, Elliott AG, Łapińska U, Voliotis M, Tsaneva-Atanasova K, Pagliara S, Blaskovich MAT. Synthesis of vancomycin fluorescent probes that retain antimicrobial activity, identify Gram-positive bacteria, and detect Gram-negative outer membrane damage. Commun Biol 2023; 6:409. [PMID: 37055536 PMCID: PMC10102067 DOI: 10.1038/s42003-023-04745-x] [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: 06/22/2022] [Accepted: 03/22/2023] [Indexed: 04/15/2023] Open
Abstract
Antimicrobial resistance is an urgent threat to human health, and new antibacterial drugs are desperately needed, as are research tools to aid in their discovery and development. Vancomycin is a glycopeptide antibiotic that is widely used for the treatment of Gram-positive infections, such as life-threatening systemic diseases caused by methicillin-resistant Staphylococcus aureus (MRSA). Here we demonstrate that modification of vancomycin by introduction of an azide substituent provides a versatile intermediate that can undergo copper-catalysed azide-alkyne cycloaddition (CuAAC) reaction with various alkynes to readily prepare vancomycin fluorescent probes. We describe the facile synthesis of three probes that retain similar antibacterial profiles to the parent vancomycin antibiotic. We demonstrate the versatility of these probes for the detection and visualisation of Gram-positive bacteria by a range of methods, including plate reader quantification, flow cytometry analysis, high-resolution microscopy imaging, and single cell microfluidics analysis. In parallel, we demonstrate their utility in measuring outer-membrane permeabilisation of Gram-negative bacteria. The probes are useful tools that may facilitate detection of infections and development of new antibiotics.
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Affiliation(s)
- Bing Zhang
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Wanida Phetsang
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - M Rhia L Stone
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Sanjaya Kc
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Mark S Butler
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Matthew A Cooper
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Alysha G Elliott
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Urszula Łapińska
- Living Systems Institute, University of Exeter, Stocker Road, Exeter, EX4 4QD, UK
- Biosciences, University of Exeter, Stocker Road, Exeter, EX4 4Q, UK
| | - Margaritis Voliotis
- Living Systems Institute, University of Exeter, Stocker Road, Exeter, EX4 4QD, UK
- Department of Mathematics, University of Exeter, Stocker Road, Exeter, UK
| | - Krasimira Tsaneva-Atanasova
- Living Systems Institute, University of Exeter, Stocker Road, Exeter, EX4 4QD, UK
- Department of Mathematics, University of Exeter, Stocker Road, Exeter, UK
- EPSRC Hub for Quantitative Modelling in Healthcare, University of Exeter, Exeter, EX4 4QJ, UK
- Department of Bioinformatics and Mathematical Modelling, Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, 105 Acad. G. Bonchev Street, 1113, Sofia, Bulgaria
| | - Stefano Pagliara
- Living Systems Institute, University of Exeter, Stocker Road, Exeter, EX4 4QD, UK
- Biosciences, University of Exeter, Stocker Road, Exeter, EX4 4Q, UK
| | - Mark A T Blaskovich
- Centre for Superbug Solutions, Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia.
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Bharadwaj A, Rastogi A, Pandey S, Gupta S, Sohal JS. Multidrug-Resistant Bacteria: Their Mechanism of Action and Prophylaxis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5419874. [PMID: 36105930 PMCID: PMC9467707 DOI: 10.1155/2022/5419874] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/11/2022] [Accepted: 08/20/2022] [Indexed: 11/18/2022]
Abstract
In the present scenario, resistance to antibiotics is one of the crucial issues related to public health. Earlier, such resistance to antibiotics was limited to nosocomial infections, but it has now become a common phenomenon. Several factors, like extensive development, overexploitation of antibiotics, excessive application of broad-spectrum drugs, and a shortage of target-oriented antimicrobial drugs, could be attributed to this condition. Nowadays, there is a rise in the occurrence of these drug-resistant pathogens due to the availability of a small number of effective antimicrobial agents. It has been estimated that if new novel drugs are not discovered or formulated, there would be no effective antibiotic available to treat these deadly resistant pathogens by 2050. For this reason, we have to look for the formulation of some new novel drugs or other options or substitutes to treat such multidrug-resistant microorganisms (MDR). The current review focuses on the evolution of the most common multidrug-resistant bacteria and discusses how these bacteria escape the effects of targeted antibiotics and become multidrug resistant. In addition, we also discuss some alternative mechanisms to prevent their infection as well.
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Affiliation(s)
- Alok Bharadwaj
- Department of Biotechnology, GLA University, Mathura (U.P.)-281 406, India
| | - Amisha Rastogi
- Department of Biotechnology, GLA University, Mathura (U.P.)-281 406, India
| | - Swadha Pandey
- Department of Biotechnology, GLA University, Mathura (U.P.)-281 406, India
| | - Saurabh Gupta
- Department of Biotechnology, GLA University, Mathura (U.P.)-281 406, India
| | - Jagdip Singh Sohal
- Department of Biotechnology, GLA University, Mathura (U.P.)-281 406, India
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OKUYAN Ö, AKSARAY N, KIZILYILDIRIM S, ÖNLEN GÜNERİ C, KÖKSAL F. Detection of Vancomycin-Resistant Enterococci and Vancomycin Resistance Genes in Patients Hospitalized in the Pediatric Intensive Care Unit. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.1113953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: Vancomycin-resistant enterococci (VRE) infection and colonization are seen increasingly frequently, especially among intensive care unit (ICU) patients. In this study, the aim was to detect VRE in swab samples taken from patients hospitalized in the Pediatric ICU (PICU), colonization, and to investigate the clonal relationship between isolates.
Materials and Methods: In the present study, swab samples were taken from the external auditory canal (EAC), umbilical region, and rectal region from 82 patients hospitalized in the Çukurova University Balcalı Hospital PICU. The 246 swab samples from patients were inoculated on Kanamycin-Esculin-Azide agar. Isolates were identified with the help of the BBL Crystal Gram-Positive identification system. The susceptibility of the isolates to vancomycin (30 µg) was investigated by Kirby-Bauer disk diffusion method according to CLSI criteria. VanA-VanB genes in phenotypically defined vancomycin-resistant enterococci were investigated by Polymerase Chain Reaction (PCR) method. The clonal relationship between vancomycin-susceptible (VSE) and -resistant enterococci was determined by the SmaI-PFGE method.
Results: A total of 49 (20.3%) enterococcal strains were isolated from 246 swab samples from the patients, of which 14 (28.5%) were VRE. Of the enterococci isolates, 27 (55.10%) were E. faecium and 13 (26.53%) were E. feacalis. While VanA type resistance was detected in 11 of the vancomycin-resistant E. faecium and E. feacalis isolates, VanB type resistance was not detected in any sample. There was no significant clonal relationship between the isolates.
Conclusion: Although the prevalence of VRE in the PICU was high throughout the study, no enterococcal infection was observed.
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Costa M, Meirinhos C, Cunha E, Gomes D, Pereira M, Dias R, Tavares L, Oliveira M. Nisin Mutant Prevention Concentration and the Role of Subinhibitory Concentrations on Resistance Development by Diabetic Foot Staphylococci. Antibiotics (Basel) 2022; 11:antibiotics11070972. [PMID: 35884226 PMCID: PMC9311964 DOI: 10.3390/antibiotics11070972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 12/10/2022] Open
Abstract
The most prevalent microorganism in diabetic foot infections (DFI) is Staphylococcus aureus, an important multidrug-resistant pathogen. The antimicrobial peptide nisin is a promising compound for DFI treatment, being effective against S. aureus. However, to avoid the selection of resistant mutants, correct drug therapeutic doses must be established, being also important to understand if nisin subinhibitory concentrations (subMIC) can potentiate resistant genes transfer between clinical isolates or mutations in genes associated with nisin resistance. The mutant selection window (MSW) of nisin was determined for 23 DFI S. aureus isolates; a protocol aiming to prompt vanA horizontal transfer between enterococci to clinical S. aureus was performed; and nisin subMIC effect on resistance evolution was assessed through whole-genome sequencing (WGS) applied to isolates subjected to a MEGA-plate assay. MSW ranged from 5–360 μg/mL for two isolates, from 5–540 μg/mL for three isolates, and from 5–720 μg/mL for one isolate. In the presence of nisin subMIC values, no transconjugants were obtained, indicating that nisin does not seem to promote vanA transfer. Finally, WGS analysis showed that incubation in the presence of nisin subMIC did not promote the occurrence of significant mutations in genes related to nisin resistance, supporting nisin application to DFI treatment.
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Affiliation(s)
- Margarida Costa
- CIISA—Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Av. da Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal; (M.C.); (C.M.); (D.G.); (L.T.); (M.O.)
- Laboratório Associado para Ciência Animal e Veterinária (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Cláudia Meirinhos
- CIISA—Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Av. da Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal; (M.C.); (C.M.); (D.G.); (L.T.); (M.O.)
- Laboratório Associado para Ciência Animal e Veterinária (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Eva Cunha
- CIISA—Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Av. da Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal; (M.C.); (C.M.); (D.G.); (L.T.); (M.O.)
- Laboratório Associado para Ciência Animal e Veterinária (AL4AnimalS), 1300-477 Lisbon, Portugal
- Correspondence:
| | - Diana Gomes
- CIISA—Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Av. da Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal; (M.C.); (C.M.); (D.G.); (L.T.); (M.O.)
- Laboratório Associado para Ciência Animal e Veterinária (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Marcelo Pereira
- Biosystems and Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal; (M.P.); (R.D.)
| | - Ricardo Dias
- Biosystems and Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal; (M.P.); (R.D.)
| | - Luís Tavares
- CIISA—Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Av. da Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal; (M.C.); (C.M.); (D.G.); (L.T.); (M.O.)
- Laboratório Associado para Ciência Animal e Veterinária (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Manuela Oliveira
- CIISA—Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Av. da Universidade Técnica de Lisboa, 1300-477 Lisboa, Portugal; (M.C.); (C.M.); (D.G.); (L.T.); (M.O.)
- Laboratório Associado para Ciência Animal e Veterinária (AL4AnimalS), 1300-477 Lisbon, Portugal
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NMR and MD Analysis of the Bonding Interaction of Vancomycin with Muramyl Pentapeptide. Int J Mol Sci 2022; 23:ijms23031146. [PMID: 35163070 PMCID: PMC8835396 DOI: 10.3390/ijms23031146] [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: 12/14/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/05/2023] Open
Abstract
The article describes an NMR spectroscopy study of interactions between vancomycin and a muramyl pentapeptide in two complexes: vancomycin and a native muramyl pentapeptide ended with D-alanine (MPP-D-Ala), and vancomycin and a modified muramyl pentapeptide ended with D-serine (MPP-D-Ser). The measurements were made in a 9:1 mixture of H2O and D2O. The obtained results confirmed the presence of hydrogen bonds previously described in the literature. At the same time, thanks to the pentapeptide model used, we were able to prove the presence of two more hydrogen bonds formed by the side chain amino group of L-lysine and oxygen atoms from the vancomycin carboxyl and amide groups. This type of interaction has not been described before. The existence of these hydrogen bonds was confirmed by the 1H NMR and molecular modeling. The formation of these bonds incurs additional through-space interactions, visible in the NOESY spectrum, between the protons of the L-lysine amino group and a vancomycin-facing hydrogen atom in the benzylic position. The presence of such interactions was also confirmed by molecular dynamics trajectory analysis.
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Das AK, Dudeja M, Kohli S, Ray P, Nandy S. High-level gentamicin resistance mediated by Aac(6')-Ie-aph(2")-Ia gene in Enterococcus species isolated from clinical samples in Northern India. Indian J Pharmacol 2022; 54:171-176. [PMID: 35848687 PMCID: PMC9396691 DOI: 10.4103/ijp.ijp_41_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
CONTEXT Enterococci are known to cause life-threatening infections which are difficult to treat as the organism harbors innate resistance to many antibiotics and can amass resistance toward many others through plasmid-mediated genetic exchange. AIMS The study evaluates the drug susceptibility profile of various Enterococcus species isolated from various patient specimens submitted for bacteriological analysis and check the incidence of aac(6') Ie-aph(2") Ia gene. SETTING AND DESIGN This in vitro cross-sectional study was executed at bacteriology laboratory of a 470 bedded hospital in New Delhi. MATERIALS AND METHODS Drug susceptibility testing was carried out on enterococcal isolates. High-level gentamicin-resistant (HLGR) isolates detected by micro broth dilution assay were then subjected to molecular detection of aac(6') Ie-aph(2") Ia gene. STATISTICAL ANALYSIS USED The level of significance was established by Chi-square test. RESULTS Among the 182 enterococcal stains detected, 76.9% were Enterococcus faecalis and 20.3% were Enterococcus faecium. 12.08% strains were vancomycin resistant. 39% expressed resistance toward high-level gentamicin (HLG) and this finding was significantly higher in E. faecium than E. faecalis. HLGR strains expressed a higher degree of resistance to other drugs in contrast to non-HLGR isolates. In 67 out of 71 HLGR isolates the bifunctional gene was detected. CONCLUSION Considerable presence of HLG and vancomycin resistance in the clinical isolates is alarming and should be taken seriously. The study shows high dissemination of aac(6')-Ie-aph(2")-Ia gene among Enterococci isolated from the region.
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Affiliation(s)
- Ayan Kumar Das
- Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India,Address for correspondence: Dr. Ayan Kumar Das, Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi - 110 062, India. E-mail:
| | - Mridu Dudeja
- Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India
| | - Sunil Kohli
- Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India
| | - Pratima Ray
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard University, New Delhi, India
| | - Shyamasree Nandy
- Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India
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Riccobono E, Giani T, Baldi G, Arcangeli S, Antonelli A, Tellone V, Vecchio AD, De Joannon AC, Rossolini GM. Update on activity of dalbavancin and comparators against clinical isolates of Gram-positive pathogens from Europe and Russia (2017-2018), and on clonal distribution of MRSA. Int J Antimicrob Agents 2021; 59:106503. [PMID: 34929289 DOI: 10.1016/j.ijantimicag.2021.106503] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/03/2021] [Accepted: 12/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Gram-positive pathogens remain a major cause of healthcare- and community-associated infections. In particular, the dissemination of methicillin-resistant staphylococci, as methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE), have significantly reduced the therapeutic options, making the management of these infections even more challenging. Dalbavancin is a second-generation lipoglycopeptide approved for the treatment of moderate to severe acute bacterial skin and skin structure infections (ABSSSIs) caused by Gram-positive organisms, showing a bactericidal effect and a low propensity towards the selection of resistance over time. AIM This study aimed to evaluate the antimicrobial activity of dalbavancin and other comparators against recent clinical isolates of Gram-positive pathogens obtained from different sources and from several European countries, including countries of southern and eastern Europe and Russia, where resistance rates are typically high. This study also aimed to describe the clonal relationship of MRSA strains circulating in southern and eastern Europe and Russia. RESULTS A total of 1478 isolates were collected. Study results demonstrated the excellent and stable activity of dalbavancin against Gram-positive microorganisms, including MRSA. Interestingly, dalbavancin has retained unaltered MIC50 and MIC90 values over the years and seemed to have a low propensity in selecting resistance mechanisms. CONCLUSIONS Our data supported the potential efficacy of dalbavancin against Gram-positive bacteria and uncommon Gram-positive pathogens in patients with ABSSSIs. Of note, few CoNS isolates were resistant to dalbavancin and susceptible to vancomycin, pointing out the importance of testing the susceptibility to dalbavancin before its administration for CoNS infections.
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Affiliation(s)
- Eleonora Riccobono
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Tommaso Giani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | - Giulia Baldi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sophie Arcangeli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy
| | | | | | | | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.
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11
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Jun I, Rich SN, Chen Z, Bian J, Prosperi M. Challenges in replicating secondary analysis of electronic health records data with multiple computable phenotypes: A case study on methicillin-resistant Staphylococcus aureus bacteremia infections. Int J Med Inform 2021; 153:104531. [PMID: 34332468 PMCID: PMC8451470 DOI: 10.1016/j.ijmedinf.2021.104531] [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: 12/29/2020] [Revised: 06/03/2021] [Accepted: 06/24/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Replication of prediction modeling using electronic health records (EHR) is challenging because of the necessity to compute phenotypes including study cohort, outcomes, and covariates. However, some phenotypes may not be easily replicated across EHR data sources due to a variety of reasons such as the lack of gold standard definitions and documentation variations across systems, which may lead to measurement error and potential bias. Methicillin-resistant Staphylococcus aureus (MRSA) infections are responsible for high mortality worldwide. With limited treatment options for the infection, the ability to predict MRSA outcome is of interest. However, replicating these MRSA outcome prediction models using EHR data is problematic due to the lack of well-defined computable phenotypes for many of the predictors as well as study inclusion and outcome criteria. OBJECTIVE In this study, we aimed to evaluate a prediction model for 30-day mortality after MRSA bacteremia infection diagnosis with reduced vancomycin susceptibility (MRSA-RVS) considering multiple computable phenotypes using EHR data. METHODS We used EHR data from a large academic health center in the United States to replicate the original study conducted in Taiwan. We derived multiple computable phenotypes of risk factors and predictors used in the original study, reported stratified descriptive statistics, and assessed the performance of the prediction model. RESULTS In our replication study, it was possible to (re)compute most of the original variables. Nevertheless, for certain variables, their computable phenotypes can only be approximated by proxy with structured EHR data items, especially the composite clinical indices such as the Pitt bacteremia score. Even computable phenotype for the outcome variable was subject to variation on the basis of the admission/discharge windows. The replicated prediction model exhibited only a mild discriminatory ability. CONCLUSION Despite the rich information in EHR data, replication of prediction models involving complex predictors is still challenging, often due to the limited availability of validated computable phenotypes. On the other hand, it is often possible to derive proxy computable phenotypes that can be further validated and calibrated.
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Affiliation(s)
- Inyoung Jun
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Shannan N Rich
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Zhaoyi Chen
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Mattia Prosperi
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
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Hernández-Aristizábal I, Ocampo-Ibáñez ID. Antimicrobial Peptides with Antibacterial Activity against Vancomycin-Resistant Staphylococcus aureus Strains: Classification, Structures, and Mechanisms of Action. Int J Mol Sci 2021; 22:7927. [PMID: 34360692 PMCID: PMC8347216 DOI: 10.3390/ijms22157927] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 12/27/2022] Open
Abstract
The emergence of bacteria resistant to conventional antibiotics is of great concern in modern medicine because it renders ineffectiveness of the current empirical antibiotic therapies. Infections caused by vancomycin-resistant Staphylococcus aureus (VRSA) and vancomycin-intermediate S. aureus (VISA) strains represent a serious threat to global health due to their considerable morbidity and mortality rates. Therefore, there is an urgent need of research and development of new antimicrobial alternatives against these bacteria. In this context, the use of antimicrobial peptides (AMPs) is considered a promising alternative therapeutic strategy to control resistant strains. Therefore, a wide number of natural, artificial, and synthetic AMPs have been evaluated against VRSA and VISA strains, with great potential for clinical application. In this regard, we aimed to present a comprehensive and systematic review of research findings on AMPs that have shown antibacterial activity against vancomycin-resistant and vancomycin-intermediate resistant strains and clinical isolates of S. aureus, discussing their classification and origin, physicochemical and structural characteristics, and possible action mechanisms. This is the first review that includes all peptides that have shown antibacterial activity against VRSA and VISA strains exclusively.
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Affiliation(s)
| | - Iván Darío Ocampo-Ibáñez
- Research Group of Microbiology, Industry and Environment, Faculty of Basic Sciences, Universidad Santiago de Cali, Cali 760035, Colombia;
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Pinholt M, Mollerup S, Boye K, Worning P, Holzknecht BJ, Nygaard S, Nielsen KL, Hasman H, Roer L, Hammerum AM, Westh H, Schønning K. Investigation of the introduction and dissemination of vanB Enterococcus faecium in the Capital Region of Denmark and development of a rapid and accurate clone-specific vanB E. faecium PCR. J Antimicrob Chemother 2021; 76:2260-2267. [PMID: 34151364 DOI: 10.1093/jac/dkab198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/17/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND During 2018-19, an increase of vanB vancomycin-resistant Enterococcus faecium (VREfm) was observed in the Capital Region of Denmark. vanA/vanB PCR performed directly on rectal swabs is accurate in detection of vanA; however, the positive predictive value for vanB-positive samples is low because of the presence of vanB in non-enterococcal gut commensals. OBJECTIVES We investigated the epidemiology and clonal relatedness of vanB VREfm from the period 2015-19 and describe the application of a clone-specific vanB VREfm PCR assay for rapid and accurate detection of vanB VREfm in rectal screening samples. METHODS vanB VREfm were investigated using epidemiological data and WGS data. The SeqSphere+ software was used to analyse MLST and cgMLST, and de novo assemblies were annotated to determine insertion sites for the vanB transposon (Tn1549). A clone-specific vanB VREfm PCR assay was designed to detect the sequence bridging Tn1549 and the E. faecium chromosome (araA2) in the dominant cluster. RESULTS Two hundred and seventy-five vanB VREfm isolates were identified, of which 76% were identified in 2019. A dominant cluster (Cluster 1, n = 204, 74%), six minor clusters and 15 singletons were identified. All Cluster 1 isolates and six non-Cluster 1 isolates had Tn1549 integrated into araA2. In 2019, the PCR assay would have detected 92% of all rectal screening samples containing vanB VREfm. CONCLUSIONS vanB VREfm increased due to the introduction and nosocomial transmission of the successful Cluster 1. The clone-specific PCR assay detected vanB VREfm outbreak isolates in rectal screening samples rapidly and accurately.
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Affiliation(s)
- Mette Pinholt
- Department of Clinical Microbiology, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
| | - Sarah Mollerup
- Department of Clinical Microbiology, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
| | - Kit Boye
- Department of Clinical Microbiology, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
| | - Peder Worning
- Department of Clinical Microbiology, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
| | - Barbara Juliane Holzknecht
- Department of Clinical Microbiology, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sanne Nygaard
- Department of Clinical Microbiology, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | - Karen Leth Nielsen
- Department of Clinical Microbiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Henrik Hasman
- Department for Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Louise Roer
- Department for Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Anette M Hammerum
- Department for Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Henrik Westh
- Department of Clinical Microbiology, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Schønning
- Department of Clinical Microbiology, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Microbiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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Stagliano DR, Susi A, Adams DJ, Nylund CM. Epidemiology and Outcomes of Vancomycin-Resistant Enterococcus Infections in the U.S. Military Health System. Mil Med 2021; 186:100-107. [PMID: 33499465 DOI: 10.1093/milmed/usaa229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/02/2020] [Accepted: 08/10/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Vancomycin-resistant enterococci (VRE) are classified by the Centers for Diseases Control and Prevention as a serious antibiotic resistance threat. Our study aims to characterize the epidemiology, associated conditions, and outcomes of VRE infections among hospitalized patients in the U.S. military health system (MHS). MATERIALS AND METHODS We performed a retrospective cohort study of patients with VRE infection using the MHS database. Cases included all patients admitted to a military treatment facility for ≥2 days from October 2008 to September 2015 with a clinical culture growing Enterococcus faecalis, Enterococcus faecium, or Enterococcus species (unspecified), reported as resistant to vancomycin. Co-morbid conditions and procedures associated with VRE infection were identified by multivariable conditional logistic regression. Patient case-mix adjusted outcomes including in-hospital mortality, length of stay, and hospitalization cost were evaluated by high-dimensional propensity score adjustment. RESULTS During the seven-year study period and among 1,161,335 hospitalized patients within the MHS, we identified 577 (0.05%) patients with VRE infection. A majority of VRE infections were urinary tract infections (57.7%), followed by bloodstream (24.7%), other site/device-related (12.9%), respiratory (2.9%), and wound infections (1.8%). Risk factors for VRE infection included invasive gastrointestinal, pulmonary, and urologic procedures, indwelling devices, and exposure to 4th generation cephalosporins, but not to glycopeptides. Patients hospitalized with VRE infection had significantly higher hospitalization costs (attributable difference [AD] $135,534, P<0.001), prolonged hospital stays (AD 20.44 days, P<0.001, and higher in-hospital mortality (case-mix adjusted odds ratio 5.77; 95% confidence interval 4.59-7.25). CONCLUSIONS VRE infections carry a considerable burden for hospitalized patients given their impact on length of stay, hospitalization costs, and in-hospital mortality. Active surveillance and infection control efforts should target those identified as high-risk for VRE infection. Antimicrobial stewardship programs should focus on limiting exposure to 4th generation cephalosporins.
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Affiliation(s)
- David R Stagliano
- Department of Pediatrics, Uniformed Services University, Bethesda, MD 20814, USA
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University, Bethesda, MD 20814, USA
| | - Daniel J Adams
- Department of Pediatrics, Uniformed Services University, Bethesda, MD 20814, USA.,Department of Pediatrics, Uniformed Services University, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
| | - Cade M Nylund
- Department of Pediatrics, Uniformed Services University, Bethesda, MD 20814, USA
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Bidu NS, Fernandes BJD, Filho JNC, Bastos REA, Pedreira JNR, Couto RD. Should the Vancomycin Minimal Inhibitory Concentration be used as an Infant Critical Care Regular Criteria? Curr Pharm Biotechnol 2020; 21:1052-1058. [PMID: 32216735 DOI: 10.2174/1389201021666200327162402] [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: 10/25/2019] [Revised: 01/20/2020] [Accepted: 02/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Vancomycin is the first-line antibiotic used for the treatment of staphylococcal infections. Because of its narrow therapeutic window and the pharmacokinetics variability, vancomycin trough serum concentration should be monitored. However, due to the increased cases of staphylococcus' commensal species infections and the case of vancomycin resistance, the minimal inhibitory concentration should be considered on antimicrobial therapy. OBJECTIVE This article aimed to show the importance of the minimal inhibitory concentration to infants on vancomycin therapy as regular criteria. MATERIALS AND METHODS Three infants in the use of vancomycin, hospitalized in the same maternity hospital, and that had at least one blood culture performed during the intensive-care-unit hospitalization were included in the study. Vancomycin serum concentrations were determined by particleenhanced- turbidimetric inhibition-immunoassay. The vancomycin minimal inhibitory concentration data were interpreted by following the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST). The trough serum concentration range of 10 to 20 mg.L-1 was considered therapeutic. RESULTS All three patients had at least one infection by S. epidermidis, being one patient exhibit vancomycin- resistant S. epidermidis infection. All patients had stoppages in the vancomycin treatment, and the minimal inhibitory concentration was performed for only one patient. CONCLUSION The data obtained from these patients also showed the need to perform therapeutic monitoring by using minimal inhibitory concentration values, because, although the serum concentrations were within the reference range, they are insufficient to guarantee patient therapeutic success.
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Affiliation(s)
- Nadielle S Bidu
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | - Bruno J D Fernandes
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | - Jucelino N C Filho
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | - Regina E A Bastos
- Department of Pediatrics, Hospital Roberto Santos, Salvador, Bahia, Brazil
| | - Joice N R Pedreira
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | - Ricardo D Couto
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
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Zalewska A, Wilson J, Kennedy S, Lockhart M, MacLeod M, Malcolm W. Epidemiological Analysis of Antimicrobial Resistance in Staphylococcus epidermidis in Scotland, 2014-2018. Microb Drug Resist 2020; 27:485-491. [PMID: 32799636 DOI: 10.1089/mdr.2019.0502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aims: This study aimed to investigate recent national surveillance trends in Staphylococcus epidermidis antibiotic resistance in Scotland and to draw conclusions on the potential clinical and public health impact of multidrug-resistant isolates. Results: Resistance in S. epidermidis isolates to individual agents was broadly stable over the past 5 years. Isolates from sterile sites, and therefore those most likely to be associated with clinical infection, were found to be more resistant to the majority of reported agents, than isolates from nonsterile sites. Increased resistance to a number of important antibiotics was observed in rifampicin-, vancomycin-, and daptomycin-resistant isolates, suggesting limited treatment options for infections caused by these isolates. Conclusions: Although S. epidermidis resistance to individual agents has been broadly stable over the past 5 years nationally, of particular concern is the association of multidrug resistance in rifampicin-resistant isolates, which has been reported elsewhere. This has the potential to result in treatment failures in significant device-related infections.
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Affiliation(s)
| | | | | | | | - Mairi MacLeod
- NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
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17
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Jubeh B, Breijyeh Z, Karaman R. Resistance of Gram-Positive Bacteria to Current Antibacterial Agents and Overcoming Approaches. Molecules 2020; 25:E2888. [PMID: 32586045 PMCID: PMC7356343 DOI: 10.3390/molecules25122888] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/22/2022] Open
Abstract
The discovery of antibiotics has created a turning point in medical interventions to pathogenic infections, but unfortunately, each discovery was consistently followed by the emergence of resistance. The rise of multidrug-resistant bacteria has generated a great challenge to treat infections caused by bacteria with the available antibiotics. Today, research is active in finding new treatments for multidrug-resistant pathogens. In a step to guide the efforts, the WHO has published a list of the most dangerous bacteria that are resistant to current treatments and requires the development of new antibiotics for combating the resistance. Among the list are various Gram-positive bacteria that are responsible for serious healthcare and community-associated infections. Methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, and drug-resistant Streptococcus pneumoniae are of particular concern. The resistance of bacteria is an evolving phenomenon that arises from genetic mutations and/or acquired genomes. Thus, antimicrobial resistance demands continuous efforts to create strategies to combat this problem and optimize the use of antibiotics. This article aims to provide a review of the most critical resistant Gram-positive bacterial pathogens, their mechanisms of resistance, and the new treatments and approaches reported to circumvent this problem.
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Affiliation(s)
| | | | - Rafik Karaman
- Pharmaceutical Sciences Department, Faculty of Pharmacy, Al-Quds University, Jerusalem P.O. Box 20002, Palestine; (B.J.); (Z.B.)
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18
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Das AK, Dudeja M, Kohli S, Ray P, Singh M, Kaur PS. Biofilm synthesis and other virulence factors in multidrug-resistant uropathogenic enterococci isolated in Northern India. Indian J Med Microbiol 2020; 38:200-209. [PMID: 32883934 DOI: 10.4103/ijmm.ijmm_19_355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose Enterococci express high degree of resistance towards wide range of antibiotics. Production of biofilm and many virulence factors along with drug resistance makes it difficult to eradicate the infection from urinary tract. The present study detected the expression of such factors including biofilm production by multidrug-resistant (MDR) enterococci. Materials and Methods Drug susceptibility of 103 uropathogenic enterococci was performed followed by estimation of minimum inhibitory concentration of high-level gentamicin and vancomycin by microbroth dilution method. Vancomycin-resistant genes were detected by multiplex polymerase chain reaction. Production of virulence factors such as haemagglutination, caseinase, lipase, gelatinase, haemolysin and β-lactamase was detected by phenotypic methods in MDR strains. Biofilm production was detected by calcofluor-white fluorescence staining and semi-quantitative adherence assay. Results 45% and 18.4% of the isolates were high-level gentamicin-resistant and vancomycin-resistant enterococci (VRE), respectively. vanA gene was detected in 14 and vanB gene in 5 strains. Biofilm, caseinase and gelatinase were the most expressed virulence factor. Expression of caseinase, gelatinase and lipase was significantly higher in Enterococcus faecalis (P < 0.05). Expression of haemagglutination, gelatinase and haemolysin among the vancomycin-resistant isolates was significantly higher (P < 0.05). Conclusion VanA and vanB are the prevalent genotypes responsible for vancomycin resistance. The high prevalence of MDR enterococcal strains producing biofilm and virulence determinants raises concern. asa1, hyl, esp, gelE, cyl and other genes are known to express these factors and contribute to biofilm formation. Most uropathogenic enterococci expressed biofilm at moderate level and can be detected effectively by calcofluor-white staining. No correlation was noted between vancomycin resistance and biofilm production.
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Affiliation(s)
- Ayan Kumar Das
- Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Mridu Dudeja
- Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Sunil Kohli
- Department of Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
| | - Pratima Ray
- Department of Biotechnology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| | - Manvi Singh
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Preet Simran Kaur
- Department of Microbiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
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Guven gokmen T, Nagiyev T, Akcimen B, Kayar B, Meral M, Köksal F. Kolonize ve infekte hastalardan izole edilen vankomisin dirençli enterococcus spp.’nin virülans genleri ve klonal ilişkilerinin belirlenmesi. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.552522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sheikh AF, Hamidi H, Shahin M, Shahmohammadi S. The prevalence of phenotypic and genotypic glycopeptides resistance among clinical isolates of enterococci in Ahvaz, southwestern Iran. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Szemraj M, Czekaj T, Kalisz J, Szewczyk EM. Differences in distribution of MLS antibiotics resistance genes in clinical isolates of staphylococci belonging to species: S. epidermidis, S. hominis, S. haemolyticus, S. simulans and S. warneri. BMC Microbiol 2019; 19:124. [PMID: 31182020 PMCID: PMC6558908 DOI: 10.1186/s12866-019-1496-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 05/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Macrolides and lincosamides are two leading types of antibiotics commonly used in therapies. The study examines the differences in resistance to these antibiotics and their molecular bases in S. epidermidis as well as in rarely isolated species of coagulase-negative staphylococci such as S. hominis, S. haemolyticus, S. warneri and S. simulans. The isolates were tested for the presence of the erm(A), erm(B), erm(C), lnu(A), msr(A), msr(B), mph(C), ere(A) and ere(B) genes. Phenotypic resistance to methicillin and mecA presence were also determined. Results The MLSB resistance mechanism was phenotypically found in isolates of species included in the study. The most prevalent MLSB resistance mechanism was observed in S. hominis, S. haemolyticus and S. epidermidis isolates mainly of the MLSB resistance constitutive type. Macrolide, lincosamide and streptogramin B resistance genes were rarely detected in isolates individually. The erm(B), ere(A) and ere(B) genes were not found in any of the strains. The erm(A) gene was determined only in four strains of S. epidermidis and S. hominis while lnu(A) was seen in eight strains (mainly in S. hominis). The erm(C) gene was present in most of S. epidermidis strains and predominant in S. hominis and S. simulans isolates. The examined species clearly differed between one another in the repertoire of accumulated genes. Conclusions The presence of genes encoding the MLSB resistance among CoNS strains demonstrates these genes’ widespread prevalence and accumulation in opportunistic pathogens that might become gene reservoir for bacteria with superior pathogenic potential.
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Affiliation(s)
- Magdalena Szemraj
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Łódź, Pomorska 137, 90-235, Łódź, Poland.
| | - Tomasz Czekaj
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Łódź, Pomorska 137, 90-235, Łódź, Poland
| | - Jacek Kalisz
- Synevo Sp. z o. o., Microbiological Laboratory of Łódź, Sokola 14, 93-519, Łódź, Poland
| | - Eligia M Szewczyk
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Łódź, Pomorska 137, 90-235, Łódź, Poland
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Persistence of vancomycin resistance genes and transposable elements in Enterococcus faecalis isolated from groundwater intended for human consumption: A public health implication. GENE REPORTS 2018. [DOI: 10.1016/j.genrep.2018.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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23
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Adaptive Metabolism in Staphylococci: Survival and Persistence in Environmental and Clinical Settings. J Pathog 2018; 2018:1092632. [PMID: 30327733 PMCID: PMC6171259 DOI: 10.1155/2018/1092632] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/28/2018] [Accepted: 08/12/2018] [Indexed: 01/04/2023] Open
Abstract
Staphylococci are highly successful at colonizing a variety of dynamic environments, both nonpathogenic and those of clinical importance, and comprise the list of pathogens of global public health significance. Their remarkable survival and persistence can be attributed to a host of strategies, one of which is metabolic versatility—their ability to rapidly alter their metabolism in the presence of transient or long-term bacteriostatic and bactericidal conditions and facilitate cellular homeostasis. These attributes contribute to their widespread dissemination and challenging eradication particularly from clinical settings. The study of microbial behaviour at the metabolite level provides insight into mechanisms of survival and persistence under defined environmental and clinical conditions. This paper reviews the range of metabolic modulations that facilitate staphylococcal acclimatization and persistence in varying terrestrial and host conditions, and their public health ramifications in these settings.
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Streptococcus pneumoniae two-component regulatory systems: The interplay of the pneumococcus with its environment. Int J Med Microbiol 2018; 308:722-737. [DOI: 10.1016/j.ijmm.2017.11.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 11/21/2017] [Accepted: 11/24/2017] [Indexed: 02/06/2023] Open
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Guan D, Chen F, Liu J, Li J, Lan L, Huang W. Design and Synthesis of Pyrophosphate-Targeting Vancomycin Derivatives for Combating Vancomycin-Resistant Enterococci. ChemMedChem 2018; 13:1644-1657. [PMID: 29920964 DOI: 10.1002/cmdc.201800252] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/13/2018] [Indexed: 12/12/2022]
Abstract
As the last resort for intractable Gram-positive bacterial infections, vancomycin is losing efficacy with the emergence of vancomycin-resistant bacteria, especially vancomycin-resistant Enterococci (VRE). To combat this threat, we rationally designed and synthesized 39 novel vancomycin derivatives by respective or combined modifications using metal-chelating, lipophilic, and galactose-attachment strategies for extensive structure-activity relationship (SAR) analysis. In a proposed mechanism, the conjugation of dipicolylamine on the seventh amino acid resorcinol position or C-terminus endowed the vancomycin backbone with binding capacity for the pyrophosphate moiety in lipid II while maintaining the intrinsic binding affinity for the dipeptide terminus of the bacterial cell wall peptidoglycan precursor. The in vitro antibacterial activities were evaluated, and the optimal compounds indicated 16- to 1024-fold higher activity against VRE than that of vancomycin. Compound 11 b (3',5'-bis(dipicolylaminomethyl)tyrosine [1,2,3]triazolylmethoxylethyoxyl ethylaminomethyl-N-decylvancomycin) was found to have particularly potent activity against VRE through synergistic effects brought about by combining two peripheral modifications.
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Affiliation(s)
- Dongliang Guan
- CAS Key Laboratory of Receptor Research, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Pudong, Shanghai, 201203, P.R. China
- University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing, 100049, P.R. China
| | - Feifei Chen
- CAS Key Laboratory of Receptor Research, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Pudong, Shanghai, 201203, P.R. China
| | - Junjie Liu
- CAS Key Laboratory of Receptor Research, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Pudong, Shanghai, 201203, P.R. China
- Department of Chemistry, Nanchang University, 999 Xuefu Avenue, Nanchang, 330031, P.R. China
| | - Jian Li
- CAS Key Laboratory of Receptor Research, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Pudong, Shanghai, 201203, P.R. China
- University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing, 100049, P.R. China
| | - Lefu Lan
- CAS Key Laboratory of Receptor Research, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Pudong, Shanghai, 201203, P.R. China
- University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing, 100049, P.R. China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, P.R. China
| | - Wei Huang
- CAS Key Laboratory of Receptor Research, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Pudong, Shanghai, 201203, P.R. China
- University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing, 100049, P.R. China
- Center for Biotherapeutics Discovery Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, P.R. China
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Dunaway S, Orwig KW, Arbogast ZQ, Myers ZL, Sizemore JA, Giancola SE. Evaluation of a pharmacy-driven methicillin-resistant Staphylococcus aureus surveillance protocol in pneumonia. Int J Clin Pharm 2018; 40:526-532. [DOI: 10.1007/s11096-018-0647-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/26/2018] [Indexed: 01/31/2023]
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Ozbak HA. A novel high-resolution melting analysis approach for rapid detection of vancomycin-resistant enterococci. Ann Saudi Med 2018; 38:200-207. [PMID: 29848938 PMCID: PMC6074308 DOI: 10.5144/0256-4947.2018.200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Vancomycin-resistant enterococci (VRE) are resistant to most classes of antibiotics. Diagnosis of VRE using standard methods takes 2 to 5 days. Development of a rapid PCR-assay that detects and identifies resistant genes in bacteria would provide time-critical information on the presence of VRE in clinical samples allowing early treatment and management of infected patients. OBJECTIVES Investigate the use of high resolution melting analysis (HRMA) and 16S-rRNA-PCR approach for rapid and cost-effective identification of VRE. DESIGN Descriptive antibiotic susceptibility studies. SETTING Manchester Academic Health Sciences Centre and School of Translational Medicine, University of Manchester, UK, and Department of Clinical Laboratory Sciences, Taibah University, Saudi Arabia. MATERIALS AND METHODS PCR-HRMA using 16S-rRNA V1-primers was used to detect and identify VRE. DNA from different strains of vancomycin-resistant and -sensitive Enterococcus faecalis (VSE) and Enterococcus faecium were amplified using V1-primer followed by HRMA in a single run. Differentiation of VRE from VSE was based on curve shapes generated against reference organisms (Bacteroides fragilis). MAIN OUTCOMES MEASURES Amplification curves and difference plots for VRE and VSE. RESULTS Difference plots were generated for all vancomycin-resistant and -sensitive E faecalis and E faecium strains by subtracting their fluo.rescence melting profile from that of a reference-species B fragilis. A characteristic curve shape was produced by vancomycin-sensitive E faecalis and E faecium. However, vancomycin-resistant strains of these bacteria were associated with a markedly different curve shape facilitating a clear differentiation. CONCLUSION The 16S-PCR-HRMA approach has the potential for detecting vancomycin-resistant E faecium and E faecalis. Data with VRE provide the basis for combining VRE identification with pathogens speciation in a rapid, cheap assay able to identify a pathogen as an Enterococcus and whether it is vancomycin-sensitive or -resistant E faecium or E faecalis in a single PCR and HRMA run. LIMITATIONS Tested on specific, but not all, reference Enterococcus species and clinical isolates. CONFLICT OF INTEREST None.
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Affiliation(s)
- Hani Adnan Ozbak
- Dr. Hani Adnan Ozbak, Department of Clinical Laboratory Sciences,, Faculty of Applied Medical Sciences,, Taibah University,, PO Box 344, Madinah, Saudi Arabia T: +966-44-8618888 ext. 3622, Hani.ozbak@gmail. com, http://orcid.org/0000-0002.2651-9017
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ARSHADI M, MAHMOUDI M, MOTAHAR MS, SOLTANI S, POURMAND MR. Virulence Determinants and Antimicrobial Resistance Patterns of Vancomycin-resistant Enterococcus faecium Isolated from Different Sources in Southwest Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:264-272. [PMID: 29445637 PMCID: PMC5810390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study aimed to investigate the incidence of antibiotic-resistance and virulence genes in vancomycin-resistant Enterococcus faecium isolated from different sources in southwest Iran from Mar to Sep 2015. METHODS Overall, 120 E. faecium isolates (80 VRE and 40 vancomycin-susceptible enterococci [VSE] isolates) were obtained from four hospitals. The resistance of the VRE isolates was determined by disk diffusion method. Multiplex PCR was performed to detect the virulence genes carried by the E. faecium isolates, namely, enterococcal surface protein (esp), hyaluronidase (hyl), and collagen-binding adhesin (acm). RESULTS All the VRE isolates exhibited multidrug resistance, with the rates of resistance to ampicillin, erythromycin, and ciprofloxacin reaching high levels. The isolates were least resistant to chloramphenicol and nitrofurantoin, but all of them were susceptible to linezolid. 46.6%, 20.8%, and 86.6% of the E.faecium isolates carried the esp, hyl, and acm genes, respectively. CONCLUSION There is a significant difference between the prevalence of esp and hyl genes in the VRE and VSE isolates. In the VRE isolates, the high prevalence of multidrug resistance were found and the difference in the prevalence of esp among various sources was significant. The findings reflected a relationship between the prevalence of esp and hyl and resistance to certain antibiotics.
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Affiliation(s)
- Maniya ARSHADI
- Dept. of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood MAHMOUDI
- Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Sadat MOTAHAR
- Dept. of Microbiology, School of Medicine, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran
| | - Saber SOLTANI
- Dept. of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza POURMAND
- Dept. of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
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Amberpet R, Sistla S, Parija SC, Rameshkumar R. Risk factors for intestinal colonization with vancomycin resistant enterococci' A prospective study in a level III pediatric intensive care unit. J Lab Physicians 2018; 10:89-94. [PMID: 29403213 PMCID: PMC5784302 DOI: 10.4103/jlp.jlp_32_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/07/2017] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Vancomycin-resistant enterococci (VRE) emerged as one of the major nosocomial pathogens across the globe. Gut colonization rate with VRE is higher in patients admitted to intensive care units (ICUs) due to the higher antibiotic pressure. VRE colonization increases the risk of developing infection up to 5-10 folds. The aim of this study was to determine the rates of VRE colonization among the patients admitted to pediatric ICU (PICU) and risk factors associated with it. MATERIALS AND METHODS Rectal swabs were collected after 48 h of admission to PICU from 198 patients. The samples were inoculated onto bile esculin sodium azide agar with 6 mg/ml of vancomycin. Growth on this medium was identified by the standard biochemical test, and minimum inhibitory concentration of vancomycin and teicoplanin was detected by agar dilution method. Resistance genes for vancomycin were detected by polymerase chain reaction. Risk factors were assessed by logistic regression analysis. RESULTS The rates of VRE colonization in patients admitted to PICU was 18.6%. The majority of the isolates were Enterococcus faecium (75.6%) followed by Enterococcus faecalis (24.4%). One patient acquired a VRE bloodstream infection (2.6%) among colonized patients, and none of the noncolonized patients acquired the infection. Consumption of vancomycin was found to be the only risk factor significantly associated with VRE colonization. CONCLUSION Routine surveillance and isolation of patients found to be VRE colonized may not be possible in tertiary care hospitals; however, educating health-care workers, promoting handwashing with antiseptic soaps or solutions, and antibiotic Stewardship policy may help in the reduction of vancomycin resistance and VRE colonization.
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Affiliation(s)
- Rajesh Amberpet
- Department of Microbiology, Division of Pediatric Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sujatha Sistla
- Department of Microbiology, Division of Pediatric Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Subhash Chandra Parija
- Department of Microbiology, Division of Pediatric Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ramachandran Rameshkumar
- Department of Pediatrics, Division of Pediatric Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Ahmed MO, Baptiste KE. Vancomycin-Resistant Enterococci: A Review of Antimicrobial Resistance Mechanisms and Perspectives of Human and Animal Health. Microb Drug Resist 2017; 24:590-606. [PMID: 29058560 DOI: 10.1089/mdr.2017.0147] [Citation(s) in RCA: 230] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Vancomycin-resistant enterococci (VRE) are both of medical and public health importance associated with serious multidrug-resistant infections and persistent colonization. Enterococci are opportunistic environmental inhabitants with a remarkable adaptive capacity to evolve and transmit antimicrobial-resistant determinants. The VRE gene operons show distinct genetic variability and apparently continued evolution leading to a variety of antimicrobial resistance phenotypes and various environmental and livestock reservoirs for the most common van genes. Such complex diversity renders a number of important therapeutic options including "last resort antibiotics" ineffective and poses a particular challenge for clinical management. Enterococci resistance to glycopeptides and multidrug resistance warrants attention and continuous monitoring.
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Affiliation(s)
- Mohamed O Ahmed
- 1 Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli , Tripoli, Libya
| | - Keith E Baptiste
- 2 Department of Veterinary Medicine, Danish Medicines Agency , Copenhagen South, Denmark
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Purohit G, Gaind R, Dawar R, Verma PK, Aggarwal KC, Sardana R, Deb M. Characterization of Vancomycin Resistant Enterococci in Hospitalized Patients and Role of Gut Colonization. J Clin Diagn Res 2017; 11:DC01-DC05. [PMID: 29207701 DOI: 10.7860/jcdr/2017/25988.10548] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 06/06/2017] [Indexed: 11/24/2022]
Abstract
Introduction Enterococci are part of the normal intestinal flora and have been recognized as important human pathogens. Vancomycin Resistant Enterococci (VRE) are global threat as this resistance is transmissible and also poses a challenge for infection control. Aim This study was undertaken to study phenotypic and genotypic characteristics of VRE from clinically significant infections among hospitalized patients and their association with gut colonization. Materials and Methods Clinically significant isolates of enterococci (n=250) were studied. Species confirmation was done by Polymerase Chain Reaction (PCR). Minimum Inhibitory Concentration (MIC) for vancomycin was determined by E-test. PCR for VanA, VanB and VanC1 gene was done for genotypic characterization. MIC for teicoplanin, linezolid, tigecycline, daptomycin and quinupristin-dalfopristin was determined by E test. Patients with VRE infection were screened for gut colonization using vancomycin screen agar (6 μg/mL). Continuous data was analysed using the Student's t-test. Categorical data was assessed using Pearson's Chi-square test. A value of p ≤ 0.05 was considered statistically significant. Results There was good correlation between the phenotypic and genotypic methods used for species identification and detection of vancomycin resistance. E. faecium (162, 64.8%) was most common followed by E. faecalis (82, 32.84%) and E. gallinarum (6, 2.4%). Overall higher resistance was observed among E. faecium. Vancomycin MIC ≥ 2 μg/mL was noted in 63 (25.2%) isolates. Fifty seven isolates showed presence of vanA and vanC1 was detected in six isolates of E. gallinarum. Isolates with VanB genotype was not detected in the present study. MIC50 (μg/mL) for teicoplanin, linezolid, tigecycline, daptomycin and quinupristin-dalfopristrin was 24, 0.75, 0.064, 2 and 0.064 respectively. Resistance to linezolid (1, 1.6%) and tigecycline (2, 3.2%) was rare. Majority (33/47, 70.2%) patients with clinically significant VRE infection showed gut colonization. Conclusion Vancomycin resistance among enterococci is emerging. Emergence of tigecycline and linezolid resistance is also posing a challenge for clinicians. Thus, further investigations are warranted to control vancomycin resistance among pathogens.
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Affiliation(s)
- Geetarani Purohit
- Senior Resident, Department of Microbiology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Rajni Gaind
- Professor and Head, Department of Microbiology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Reetika Dawar
- Senior Consultant, Department of Microbiology, Apollo Hospital, New Delhi, India
| | - P K Verma
- Professor, Department of Anaesthesia, VMMC and Safdarjung Hospital, New Delhi, India
| | - K C Aggarwal
- Professor and Head, Department of Paediatrics, VMMC and Safdarjung Hospital, New Delhi, India
| | - Raman Sardana
- Senior Consultant, Department of Microbiology, Apollo Hospital, New Delhi, India
| | - Monorama Deb
- Director Professor, Department of Microbiology, VMMC and Safdarjung Hospital, New Delhi, India
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Matsuda K, Koya J, Toyama K, Ikeda M, Arai S, Nakamura F, Okugawa S, Moriya K, Kurokawa M. A therapeutic benefit of daptomycin against glycopeptide-resistant gram-positive cocci bloodstream infections under neutropenia. J Infect Chemother 2017; 23:788-790. [PMID: 28743428 DOI: 10.1016/j.jiac.2017.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/20/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Abstract
Antibiotic-resistant infections remain to be a major issue for all over the world. Although appropriate diagnosis and rapid treatment initiation are crucially important particularly in immunocompromised patients, selection of antibiotics without identification of causative bacteria is often challenging. A 44-year-old woman with acute myeloid leukemia (AML) under myelosuppression suffered from teicoplanin-resistant gram-positive cocci bacteremia. Taking severe neutropenia due to chemotherapy and glycopeptide-resistance into account, teicoplanin was empirically substituted with daptomycin, which led to prompt defervescence. This microorganism later turned out to be Leuconostoc lactis (L. Lactis), and daptmycin was continued to use based on antimicrobial susceptibility tests. As a result, empiric use of daptomycin successfully controlled glycopeptide-resistant gram-positive cocci bacteremia under neutropenia. This is the first report of daptomycin treatment for L. lactis bacteremia in a patient with AML under neutropenia. Our findings suggest that daptomycin would be a suitable treatment option for glycopeptide-resistant gram-positive cocci bloodstream infections, especially in myelosuppressive patients.
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Affiliation(s)
- Kensuke Matsuda
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Junji Koya
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazuhiro Toyama
- Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mahoko Ikeda
- Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shunya Arai
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Fumihiko Nakamura
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shu Okugawa
- Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kyoji Moriya
- Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan; Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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Review of MRSA screening and antibiotics prophylaxis in orthopaedic trauma patients; The risk of surgical site infection with inadequate antibiotic prophylaxis in patients colonized with MRSA. Injury 2017; 48:1382-1387. [PMID: 28473167 DOI: 10.1016/j.injury.2017.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 04/09/2017] [Indexed: 02/02/2023]
Abstract
AIMS The primary aim of this study was to determine whether orthopaedic trauma patients receive appropriate antibiotic prophylaxis keeping in view the results of their MRSA screening. The secondary aim was to analyse the risk of developing MRSA surgical site infection with and without appropriate antibiotic prophylaxis in those colonized with MRSA. PATIENTS AND METHODS We reviewed 400 consecutive orthopaedic trauma patient episodes. Preoperative MRSA screening results, operative procedures, prophylactic antibiotics and postoperative course were explored. In addition to these consecutive patients, the hospital MRSA database over the previous 5 years identified 27 MRSA colonized acute trauma patients requiring surgery. RESULTS Of the 400 consecutive patient episodes, 395(98.7%) had MRSA screening performed on admission. However, in 236 (59.0%) cases, the results were not available before the surgery. Seven patient episodes (1.8%) had positive MRSA colonization. Analysis of 27 MRSA colonized patients revealed that 20(74%) patients did not have the screening results available before the surgery. Only 5(18.5%) received Teicoplanin and 22(81.4%) received cefuroxime for antibiotic prophylaxis before their surgery. Of those receiving cefuroxime, five (22.73%) patients developed postoperative MRSA surgical site infection (SSI) but none of those (0%) receiving Teicoplanin had MRSA SSI. The absolute risk reduction for SSI with Teicoplanin as antibiotic prophylaxis was 22.73% (CI=5.22%-40.24%) and NNT (Number Needed to Treat) was 5 (CI=2.5-19.2) CONCLUSION: Lack of available screening results before the surgery may lead to inadequate antibiotic prophylaxis increasing the risk of MRSA surgical site infection. Glycopeptide (e.g.Teicoplanin) prophylaxis should be considered when there is history of MRSA colonization or MRSA screening results are not available before the surgery.
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Virulence factors associated with Coagulase Negative Staphylococci isolated from human infections. 3 Biotech 2017; 7:140. [PMID: 28593524 DOI: 10.1007/s13205-017-0753-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 01/23/2017] [Indexed: 10/19/2022] Open
Abstract
Infections caused by commensal organisms by changing to infectious life style generate much challenge to the current treatment strategies. Coagulase Negative Staphylococci (CoNS) are one of them, with their coexisting biofilm forming and multiple antibiotic resistance properties form important agents of nosocomial infection. To evaluate species distribution, biofilm formation, and antibiogram, CoNS isolates from various clinical samples were isolated. The presence of biofilm and associated genes icaAB, aap, atlE, embp, bhp, and fbe in CoNS was screened by PCR. The biofilm chemical composition and its correlation with the genotypes were also analysed. Staphylococcus epidermidis (59%) was found to be the most prevalent CoNS species. Most of the CoNS isolates harboring biofilm gene showed carbohydrate-protein-eDNA biofilm, whereas carbohydrate-protein biofilms were also observed. High percentage of multiple drug resistance, and biofilm gene frequency among these CoNS isolates point towards the need of periodic surveillance as CoNS are recently identified to cause difficult to treat infections.
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WU X, HOU S, ZHANG Q, MA Y, ZHANG Y, KAN W, ZHAO X. Prevalence of virulence and resistance to antibiotics in pathogenic enterococci isolated from mastitic cows. J Vet Med Sci 2016; 78:1663-1668. [PMID: 27476730 PMCID: PMC5138418 DOI: 10.1292/jvms.15-0718] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Accepted: 07/12/2016] [Indexed: 11/22/2022] Open
Abstract
The prevalence of enterococci was examined in 280 milk samples collected from dairy cattle diagnosed with mastitis in three provinces of western China. Sixty strains of enterococci were isolated, and the species were determined based on their biochemical characters and 16S rRNA sequences. Resistance to seven antibiotic agents, frequency of seven virulence genes and pathogenicity in Kunming mice were tested to evaluate biological risks. The correlation between the number of virulence genes and pathogenicity in Kunming mice was also evaluated. The 60 isolates were allocated to Enterococcus hirae (68.3%), E. faecium (25.0%), E. mundtii (3.3%) and E. durans (3.3%). A total of 83.3% of the isolates were resistant to penicillin, whereas 15.0% were resistant to ampicillin, 15.0% to vancomycin, 6.7% to tetracycline and 25.0% to ciprofloxacin. Moreover, isolates exhibited 50.0% and 21.7% resistance to high levels of gentamycin and streptomycin, respectively. The gene asa1 was detected in all enterococcal isolates, whereas 66.7% of strains harbored three or more virulence factors and 56.7% were asa1-ccf-gelE-positive. In pathogenicity tests, isolates harboring numerous virulence factors did not show greater invasiveness than isolates harboring fewer virulence traits against Kunming mice. In conclusion, the number of virulence factors does not appear to predict the risk of enterococcal infection. Isolates were commonly resistant to penicillin and sporadically to ampicillin and vancomycin. These results suggest that the use of gentamycin, streptomycin and ciprofloxacin against enterococci should be avoided in mastitic cows. Additionally, the results demonstrate that the majority of isolates are sensitive to tetracycline.
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Affiliation(s)
- Xiaohu WU
- College of Veterinary Medicine, Gansu Agricultural
University, No. 1, Yingmen county, Anning district, Lanzhou 730070, China
| | - Shubao HOU
- College of Veterinary Medicine, Gansu Agricultural
University, No. 1, Yingmen county, Anning district, Lanzhou 730070, China
| | - Quanwei ZHANG
- College of Life Science & Technology, Gansu Agricultural
University, No. 1, Yingmen county, Anning district, Lanzhou 730070, China
| | - Youji MA
- College of Animal Science & Technology, Gansu
Agricultural University, No. 1, Yingmen county, Anning district, Lanzhou 730070,
China
| | - Yong ZHANG
- College of Veterinary Medicine, Gansu Agricultural
University, No. 1, Yingmen county, Anning district, Lanzhou 730070, China
| | - Wei KAN
- No. 498, Helanshanxilu, Department of Agriculture and
Husbandry, Ningxia Hui Autonomous Region, Yinchuan 750021, China
| | - Xingxu ZHAO
- College of Veterinary Medicine, Gansu Agricultural
University, No. 1, Yingmen county, Anning district, Lanzhou 730070, China
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Clinical utility of a nasal swab methicillin-resistant Staphylococcus aureus polymerase chain reaction test in intensive and intermediate care unit patients with pneumonia. Diagn Microbiol Infect Dis 2016; 86:307-310. [DOI: 10.1016/j.diagmicrobio.2016.08.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/26/2016] [Accepted: 08/10/2016] [Indexed: 11/21/2022]
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Amberpet R, Sistla S, Parija SC, Thabah MM. Screening for Intestinal Colonization with Vancomycin Resistant Enterococci and Associated Risk Factors among Patients Admitted to an Adult Intensive Care Unit of a Large Teaching Hospital. J Clin Diagn Res 2016; 10:DC06-DC09. [PMID: 27790430 DOI: 10.7860/jcdr/2016/20562.8418] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/02/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Gut colonization with Vancomycin Resistant Enterococci (VRE) increases the risk of acquiring infection during hospital stay. Patients admitted in the ICU's are the major reservoirs for VRE colonization due to higher antibiotic pressure. AIM To determine the rate of VRE colonization among patients admitted in the Medical Intensive Care Unit (MICU) and to assess the various risk factors which are associated with VRE colonization. MATERIALS AND METHODS This was a prospective study carried out over a period of 18 months from September 2013 to February 2015 in the Jawaharlal Institute of Post graduate Medical Education and Research (JIPMER), Pondicherry, South India. After 48 hours of ICU admission rectal swabs were collected from a total of 302 patients, admitted in MICU. The samples were inoculated on to Bile Esculin Sodium Azide agar with 6mg/L of vancomycin. Vancomycin resistance was confirmed by determination of Minimum Inhibitory Concentration (MIC) by agar dilution method. Isolates were identified up to species level by standard biochemical tests. Vancomycin resistance genes such as van A, van B and van C, were detected by Polymerase Chain Reaction (PCR). Risk factors were assessed by multivariate logistic regression analysis. RESULTS The rates of VRE colonization in patients admitted to MICU was 29%. Majority of the isolates were Enterococcus faecium (77.2 %) followed by Enterococcus faecalis (23.8%). All the VRE isolates were positive for van A gene. Increased duration of hospital stay, younger age, consumption of ceftriaxone and vancomycin were found to be significantly associated with VRE colonization in MICU. Among VRE colonized patients, six (4.5%) acquired VRE infection. CONCLUSION The rates of VRE colonization in our ICU were similar to other hospitals worldwide. Educating health care workers on the importance of adherence to hand hygiene is essential to bring down VRE colonization rates.
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Affiliation(s)
- Rajesh Amberpet
- PhD Scholar, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry, India
| | - Sujatha Sistla
- Professor and Head, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry, India
| | - Subhash Chandra Parija
- Director and Senior Professor, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry, India
| | - Molly Mary Thabah
- Associate Professor, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry, India
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Iweriebor BC, Obi LC, Okoh AI. Macrolide, glycopeptide resistance and virulence genes in Enterococcus species isolates from dairy cattle. J Med Microbiol 2016; 65:641-648. [DOI: 10.1099/jmm.0.000275] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Benson C. Iweriebor
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice 5700, South Africa
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice 5700, South Africa
| | - Larry C. Obi
- Academic and Research Division, University of Fort Hare, Alice, Eastern Cape, South Africa
| | - Anthony I. Okoh
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice 5700, South Africa
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice 5700, South Africa
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Synthesis and biological evaluation of lipophilic teicoplanin pseudoaglycon derivatives containing a substituted triazole function. J Antibiot (Tokyo) 2016; 70:152-157. [PMID: 27353163 DOI: 10.1038/ja.2016.80] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/24/2016] [Accepted: 06/05/2016] [Indexed: 12/18/2022]
Abstract
A series of lipophilic teicoplanin pseudoaglycon derivatives, including alkyl-, aryl-, calixarene- and protected sugar-containing conjugates, were prepared using azide-alkyne click chemistry. Out of the conditions applied, the CuSO4-ascorbate reagent system proved to be more efficient than the Cu(I)I-Et3N-mediated reaction. Some of the new compounds have high in vitro activity against glycopeptide-resistant Gram-positive bacteria, including vanA-positive Enterococcus faecalis. A few of them also display promising in vitro anti-influenza activity.
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Cycoń M, Borymski S, Orlewska K, Wąsik TJ, Piotrowska-Seget Z. An Analysis of the Effects of Vancomycin and/or Vancomycin-Resistant Citrobacter freundii Exposure on the Microbial Community Structure in Soil. Front Microbiol 2016; 7:1015. [PMID: 27446053 PMCID: PMC4923127 DOI: 10.3389/fmicb.2016.01015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/15/2016] [Indexed: 01/03/2023] Open
Abstract
The occurrence of antibiotics and antibiotic resistance genes in the environment has become a subject of growing concern. The extensive use of vancomycin and other pharmaceuticals may alter the biodiversity of soil microbial communities and select antibiotic-resistant bacteria. Therefore, the purpose of the study was to evaluate the impact of vancomycin and/or vancomycin-resistant Citrobacter freundii on soil microbial communities using the denaturing gradient gel electrophoresis (DGGE) and the phospholipid fatty acid (PLFA) approaches. The experiment had a completely randomized block design with the following treatments: control soil (C), soil with vancomycin (1 mg/kg soil-VA1), soil with vancomycin (10 mg/kg soil-VA10), soil with C. freundii (Cit), soil with vancomycin (1 mg/kg soil) and C. freundii (VA1+Cit), and soil with vancomycin (10 mg/kg soil) and C. freundii (VA10+Cit). A bacterial strain resistant to vancomycin was isolated from raw sewage collected from the municipal sewage treatment plant. The obtained results indicated that the antibiotic and/or the bacterial strain exerted a selective pressure that resulted in qualitative and quantitative changes in the population of soil microorganisms. However, a multivariate analysis showed that the genetic and structural diversity of the soil microbial community was primarily affected by the incubation time and to a lesser extent by the antibiotic and introduced bacteria. DGGE analysis clearly showed that certain species within the bacterial community were sensitive to vancomycin as was evidenced by a decrease in the values of S (richness) and H (Shannon-Wiener) indices. Moreover, a PLFA method-based analysis revealed alterations in the structure of the soil microbial community as indicated by changes in the biomass of the PLFA biomarkers specific for Gram-positive and Gram-negative bacteria as well as fungi. The changes observed in the community of soil microorganisms may decrease the rate of microbial-mediated processes, which can lead to a disturbance in the ecological balance of the soil ecosystem.
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Affiliation(s)
- Mariusz Cycoń
- Department of Microbiology and Virology, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia Sosnowiec, Poland
| | | | - Kamila Orlewska
- Department of Microbiology and Virology, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia Sosnowiec, Poland
| | - Tomasz J Wąsik
- Department of Microbiology and Virology, School of Pharmacy with the Division of Laboratory Medicine, Medical University of Silesia Sosnowiec, Poland
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Guerrero-Ramos E, Molina-González D, Blanco-Morán S, Igrejas G, Poeta P, Alonso-Calleja C, Capita R. Prevalence, Antimicrobial Resistance, and Genotypic Characterization of Vancomycin-Resistant Enterococci in Meat Preparations. J Food Prot 2016; 79:748-56. [PMID: 27296421 DOI: 10.4315/0362-028x.jfp-15-390] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A total of 160 samples of poultry (80), pork (40), and beef (40) preparations (red sausages, white sausages, hamburgers, meatballs, nuggets, minced meat, escalope, and crepes) were tested in northwestern Spain to determine the prevalence of vancomycin-resistant enterococci (VRE). VRE were detected in 38 (23.8%) samples (37.5% of poultry, 15.0% of pork, and 5.0% of beef samples). One strain per food sample was further characterized. Isolates were identified as Enterococcus faecium (14 strains), E. durans (10), E. hirae (7), E. gallinarum (5), and E. casseliflavus-E. flavescens (2). All strains showed resistance or intermediate susceptibility to three or more antimicrobials of clinical significance, in addition to vancomycin. High rates of resistance or intermediate susceptibility were observed for teicoplanin (81.6% of isolates), chloramphenicol (81.6%), erythromycin (100%), quinupristin-dalfopristin (89.5%), and ciprofloxacin (81.6%). A moderate rate of resistance or intermediate susceptibility emerged for ampicillin (34.2%) and tetracycline (36.8%). Genes encoding antimicrobial resistance and virulence were studied by PCR. The vanA, vanB, vanC-1, and vanC-2/3 genes were identified in 27, 1, 5, and 2 isolates, respectively. Other resistance genes or transposon sequences found were tet(L), tet(M), Tn5397 (tetracycline), erm(A), erm(B) (erythromycin), vat(D), and vat(E) (quinupristin-dalfopristin). Most isolates were free of virulence determinants (agg, hyl, and efaAfm genes were detected in one, one, and five strains, respectively). Strains were classified as not biofilm producers (crystal violet assay; 4 isolates) or weak biofilm producers (34 isolates). Cluster analysis (EcoRI ribotyping) suggested a strong genetic relationship among isolates from different types of meat preparations, animal species, and retail outlets. Meat preparations might play a role in the spread through the food chain of VRE with several resistance and virulence genes.
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Affiliation(s)
- Emilia Guerrero-Ramos
- Department of Food Hygiene and Food Technology, Veterinary Faculty, University of Léon, E-24071 Léon, Spain; Ministry of Health, Regional Government of Castilla y Léon, E-47071 Valladolid, Spain
| | | | - Sonia Blanco-Morán
- Department of Food Hygiene and Food Technology, Veterinary Faculty, University of Léon, E-24071 Léon, Spain
| | - Gilberto Igrejas
- Department of Genetics and Biotechnology, Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, 5000-801, Vila Real, Portugal; BIOSCOPE Group, REQUIMTE-CQFB Chemistry Department, Faculty of Science and Technology, University NOVA of Lisbon, 2829-516, Monte de Caparica, Portugal
| | - Patrícia Poeta
- Department of Veterinary Science, University of Trás-os-Montes and Alto Douro, 5001-911 Vila Real, Portugal; Centre for Animal and Veterinary Science, University of Trás-os-Montes and Alto Douro, 5001-911 Vila Real, Portugal
| | - Carlos Alonso-Calleja
- Department of Food Hygiene and Food Technology, Veterinary Faculty, University of Léon, E-24071 Léon, Spain; Institute of Food Science and Technology, University of Léon, E-24007 Léon, Spain
| | - Rosa Capita
- Department of Food Hygiene and Food Technology, Veterinary Faculty, University of Léon, E-24071 Léon, Spain; Institute of Food Science and Technology, University of Léon, E-24007 Léon, Spain.
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Bender JK, Kalmbach A, Fleige C, Klare I, Fuchs S, Werner G. Population structure and acquisition of the vanB resistance determinant in German clinical isolates of Enterococcus faecium ST192. Sci Rep 2016; 6:21847. [PMID: 26902259 PMCID: PMC4763178 DOI: 10.1038/srep21847] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/29/2016] [Indexed: 12/28/2022] Open
Abstract
In the context of the global action plan to reduce the dissemination of antibiotic resistances it is of utmost importance to understand the population structure of resistant endemic bacterial lineages and to elucidate how bacteria acquire certain resistance determinants. Vancomycin resistant enterococci represent one such example of a prominent nosocomial pathogen on which nation-wide population analyses on prevalent lineages are scarce and data on how the bacteria acquire resistance, especially of the vanB genotype, are still under debate. With respect to Germany, an increased prevalence of VRE was noted in recent years. Here, invasive infections caused by sequence type ST192 VRE are often associated with the vanB-type resistance determinant. Hence, we analyzed 49 vanB-positive and vanB-negative E. faecium isolates by means of whole genome sequencing. Our studies revealed a distinct population structure and that spread of the Tn1549-vanB-type resistance involves exchange of large chromosomal fragments between vanB-positive and vanB-negative enterococci rather than independent acquisition events. In vitro filter-mating experiments support the hypothesis and suggest the presence of certain target sequences as a limiting factor for dissemination of the vanB element. Thus, the present study provides a better understanding of how enterococci emerge into successful multidrug-resistant nosocomial pathogens.
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Affiliation(s)
- Jennifer K Bender
- National Reference Centre for Staphylococci and Enterococci, Robert Koch Institute, Department of Infectious Diseases, Wernigerode, 38855, Germany
| | - Alexander Kalmbach
- National Reference Centre for Staphylococci and Enterococci, Robert Koch Institute, Department of Infectious Diseases, Wernigerode, 38855, Germany
| | - Carola Fleige
- National Reference Centre for Staphylococci and Enterococci, Robert Koch Institute, Department of Infectious Diseases, Wernigerode, 38855, Germany
| | - Ingo Klare
- National Reference Centre for Staphylococci and Enterococci, Robert Koch Institute, Department of Infectious Diseases, Wernigerode, 38855, Germany
| | - Stephan Fuchs
- National Reference Centre for Staphylococci and Enterococci, Robert Koch Institute, Department of Infectious Diseases, Wernigerode, 38855, Germany
| | - Guido Werner
- National Reference Centre for Staphylococci and Enterococci, Robert Koch Institute, Department of Infectious Diseases, Wernigerode, 38855, Germany
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Rengaraj R, Mariappan S, Sekar U, Kamalanadhan A. Detection of Vancomycin Resistance among Enterococcus faecalis and Staphylococcus aureus. J Clin Diagn Res 2016; 10:DC04-6. [PMID: 27042459 DOI: 10.7860/jcdr/2016/17552.7201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/04/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Vancomycin remains the drug of choice for resistant gram positive infections caused by Enterococcus spp and Methicillin resistant Staphylococcus aureus (MRSA). Increased use of vancomycin has led to frank resistance and increase in MIC (MIC creep). Vancomycin intermediate Staphylococcus aureus (VISA), Vancomycin resistant Staphylococcus aureus (VRSA) & Vancomycin resistant Enterococci (VRE) are important emerging nosocomial pathogens resulting in treatment failures. AIM This study was undertaken to detect vancomycin resistance among clinical isolates of Staphylococcus aureus and Enterococcus faecalis by phenotypic and genotypic methods. MATERIALS AND METHODS The study was conducted in a 1850 bedded university teaching hospital from November 2013 to April 2014. Non-repetitive, consecutive clinically significant Staphylococcus aureus (109) and Enterococcus faecalis (124) were included in this study. They were identified up to species level by conventional and automated methods. Susceptibility to various antibiotics was tested by disc diffusion method. MIC of vancomycin was determined by agar dilution method. Inducible resistance to clindamycin was detected by the D test. Methicillin resistance in Staphylococcus aureus (MRSA) was screened using cefoxitin disc. All isolates were subjected to polymerase chain reaction (PCR) to detect van A and van B genes. RESULTS Out of 109 Staphylococcus aureus isolates, 54 were MRSA. By MIC there was no resistance observed to vancomycin.MIC50 was 1μg/ml. None of the isolates harboured van A and van B. Among Enterococcus faecalis, sixteen isolates (12.9%) and four isolates (3.2%) exhibited resistance to vancomycin and teicoplanin by disc diffusion respectively. All isolates were susceptible to linezolid. Van A was detected in 2, van B in 7 and one had both van A and van B. CONCLUSION PCR remains the gold standard for diagnosis of vancomycin resistance. There was no resistance observed to vancomycin among Staphylococci though the MIC creep detected is a cause for concern. Eight percent of Enterococci were vancomycin resistant.
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Affiliation(s)
- Ramya Rengaraj
- Postgraduate, Department of Microbiology, SRMC , Chennai, Tamil nadu, India
| | - Shanthi Mariappan
- Associate Professor, Department of Microbiology, SRMC , Chennai, Tamil nadu, India
| | - Uma Sekar
- Head of the Department, Department of Microbiology, SRMC , Chennai, Tamil nadu, India
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Mirza HC, Sancak B, Gür D. The Prevalence of Vancomycin-Intermediate Staphylococcus aureus and Heterogeneous VISA Among Methicillin-Resistant Strains Isolated from Pediatric Population in a Turkish University Hospital. Microb Drug Resist 2015; 21:537-44. [PMID: 25919019 DOI: 10.1089/mdr.2015.0048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
There are limited data regarding the prevalence of vancomycin-intermediate Staphylococcus aureus (VISA)/heterogeneous VISA (hVISA) among pediatric population. Our objective was to determine the distribution of vancomycin and daptomycin minimum inhibitory concentrations (MICs) and explore the phenomenon of vancomycin MIC creep and the VISA/hVISA prevalence among the methicillin-resistant Staphylococcus aureus (MRSA) strains belonging to pediatric population by population analysis profile-area under the curve (PAP-AUC) and Etest macromethod. Vancomycin and daptomycin susceptibilities of 94 pediatric isolates of MRSA were tested by broth microdilution (BMD) and Etest methods. To determine the prevalence of VISA/hVISA, Etest macromethod and PAP-AUC was performed on all isolates. All isolates were susceptible to vancomycin and daptomycin by both BMD and Etest methods. Twenty-eight (29.8%) isolates had vancomycin MICs of 2 μg/ml by BMD. No increase in vancomycin MICs was observed over time. There were no VISA among 94 MRSA tested but 20 (21.3%) hVISA isolates were identified by PAP-AUC. Results of Etest macromethod were compared to PAP-AUC. Etest macromethod was 60.0% sensitive and 90.5% specific. The hVISA isolates represented 53.6% of isolates with vancomycin MICs of 2 μg/ml. Also, 75% of hVISA isolates had vancomycin MICs of 2 μg/ml. To our knowledge, this is the first study investigating the prevalence of VISA/hVISA among MRSA isolated from pediatric patients by PAP-AUC method. Based on our findings, MRSA isolates, which have vancomycin MIC of 2 μg/ml can be investigated for the presence of hVISA. In this study, daptomycin showed potent activity against all isolates and may represent a therapeutic option for MRSA infections.
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Affiliation(s)
- Hasan Cenk Mirza
- 1 Department of Medical Microbiology, Merzifon State Hospital , Amasya, Turkey
| | - Banu Sancak
- 2 Department of Medical Microbiology, Hacettepe University Medical School , Ankara, Turkey
| | - Deniz Gür
- 2 Department of Medical Microbiology, Hacettepe University Medical School , Ankara, Turkey
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Iweriebor BC, Gaqavu S, Obi LC, Nwodo UU, Okoh AI. Antibiotic susceptibilities of enterococcus species isolated from hospital and domestic wastewater effluents in alice, eastern cape province of South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4231-46. [PMID: 25893999 PMCID: PMC4410244 DOI: 10.3390/ijerph120404231] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/24/2015] [Accepted: 04/08/2015] [Indexed: 01/12/2023]
Abstract
Background: Antimicrobial resistance in microorganisms are on the increase worldwide and are responsible for substantial cases of therapeutic failures. Resistance of species of Enterococcus to antibiotics is linked to their ability to acquire and disseminate antimicrobial resistance determinants in nature, and wastewater treatment plants (WWTPs) are considered to be one of the main reservoirs of such antibiotic resistant bacteria. We therefore determined the antimicrobial resistance and virulence profiles of some common Enterococcus spp that are known to be associated with human infections that were recovered from hospital wastewater and final effluent of the receiving wastewater treatment plant in Alice, Eastern Cape. Methods: Wastewater samples were simultaneously collected from two sites (Victoria hospital and final effluents of a municipal WWTP) in Alice at about one to two weeks interval during the months of July and August 2014. Samples were screened for the isolation of enterococci using standard microbiological methods. The isolates were profiled molecularly after targeted generic identification and speciation for the presence of virulence and antibiotic resistance genes. Results: Out of 66 presumptive isolates, 62 were confirmed to belong to the Enterococcus genusof which 30 were identified to be E. faecalis and 15 E. durans. The remaining isolates were not identified by the primers used in the screening procedure. Out of the six virulence genes that were targeted only three of them; ace, efaA, and gelE were detected. There was a very high phenotypic multiple resistance among the isolates and these were confirmed by genetic analyses. Conclusions: Analyses of the results obtained indicated that hospital wastewater may be one of the sources of antibiotic resistant bacteria to the receiving WWTP. Also, findings revealed that the final effluent discharged into the environment was contaminated with multi-resistant enterococci species thus posing a health hazard to the receiving aquatic environment as these could eventually be transmitted to humans and animals that are exposed to it.
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Affiliation(s)
- Benson Chuks Iweriebor
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare,1 King Williams Town Road, Alice 5700, South Africa.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, 1 King Williams Town Road, Alice 5700, South Africa.
| | - Sisipho Gaqavu
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare,1 King Williams Town Road, Alice 5700, South Africa.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, 1 King Williams Town Road, Alice 5700, South Africa.
| | - Larry Chikwelu Obi
- Academic and Research Division, University of Fort Hare, King Williams Road, Alice 5700 Eastern Cape, South Africa.
| | - Uchechukwu U Nwodo
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare,1 King Williams Town Road, Alice 5700, South Africa.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, 1 King Williams Town Road, Alice 5700, South Africa.
| | - Anthony I Okoh
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare,1 King Williams Town Road, Alice 5700, South Africa.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, 1 King Williams Town Road, Alice 5700, South Africa.
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Cázares-Domínguez V, Cruz-Córdova A, Ochoa SA, Escalona G, Arellano-Galindo J, Rodríguez-Leviz A, Hernández-Castro R, López-Villegas EO, Xicohtencatl-Cortes J. Vancomycin tolerant, methicillin-resistant Staphylococcus aureus reveals the effects of vancomycin on cell wall thickening. PLoS One 2015; 10:e0118791. [PMID: 25793280 PMCID: PMC4368777 DOI: 10.1371/journal.pone.0118791] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/06/2015] [Indexed: 11/18/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is an important opportunistic pathogen that causes both healthcare- and community-acquired infections. An increase in the incidence of these infections may lead to a substantial change in the rate of vancomycin usage. Incidence of reduced susceptibility to vancomycin has been increasing worldwide for the last few years, conferring different levels of resistance to vancomycin as well as producing changes in the cell wall structure. The aim of the present study was to determine the effect of vancomycin on cell wall thickening in clinical isolates of vancomycin-tolerant (VT) MRSA obtained from pediatric patients. From a collection of 100 MRSA clinical isolates from pediatric patients, 12% (12/100) were characterized as VT-MRSA, and from them, 41.66% (5/12) exhibited the heterogeneous vancomycin-intermediate S. aureus (hVISA) phenotype. Multiplex-PCR assays revealed 66.66% (8/12), 25% (3/12), and 8.33% (1/12) of the VT-MRSA isolates were associated with agr group II, I, and III polymorphisms, respectively; the II-mec gene was amplified from 83.3% (10/12) of the isolates, and the mecIVa gene was amplified from 16.66% (2/12) of the isolates. Pulsed field electrophoresis (PFGE) fingerprint analysis showed 62% similarity among the VT-MRSA isolates. Thin transverse sections analyzed by transmission electron microscopy (TEM) revealed an average increase of 24 nm (105.55%) in the cell wall thickness of VT-MRSA compared with untreated VT-MRSA isolates. In summary, these data revealed that the thickened cell walls of VT-MRSA clinical isolates with agr type II and SCCmec group II polymorphisms are associated with an adaptive resistance to vancomycin.
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Affiliation(s)
- Vicenta Cázares-Domínguez
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Delegación Cuauhtémoc, México D.F., México
| | - Ariadnna Cruz-Córdova
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Delegación Cuauhtémoc, México D.F., México
| | - Sara A. Ochoa
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Delegación Cuauhtémoc, México D.F., México
| | - Gerardo Escalona
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Delegación Cuauhtémoc, México D.F., México
| | - José Arellano-Galindo
- Departamento de Infectología, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Delegación Cuauhtémoc, México D.F., México
| | - Alejandra Rodríguez-Leviz
- Laboratorio de Patología, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Delegación Cuauhtémoc, México D.F., México
| | - Rigoberto Hernández-Castro
- Departamento de Ecología de Agentes Patógenos. Hospital General “Dr. Manuel Gea González”, Delegación Tlalpan, México D.F., México
| | - Edgar O. López-Villegas
- Laboratorio Central de Microscopia. Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional. Prol. De Carpio y Plan de Ayala S/N Col. Santo Tomás, Delegación Miguel Hidalgo, México D.F., México
| | - Juan Xicohtencatl-Cortes
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Delegación Cuauhtémoc, México D.F., México
- * E-mail:
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Affiliation(s)
- Hee-Kyoung Kang
- Department of Biomedical Sciences, Chosun University, Gwangju, Korea
| | - Yoonkyung Park
- Department of Biomedical Sciences, Chosun University, Gwangju, Korea
- Research Center for Proteinaceous Materials, Chosun University, Gwangju, Korea
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Cheng M, Ziora ZM, Hansford KA, Blaskovich MA, Butler MS, Cooper MA. Anti-cooperative ligand binding and dimerisation in the glycopeptide antibiotic dalbavancin. Org Biomol Chem 2014; 12:2568-75. [PMID: 24608916 PMCID: PMC4082399 DOI: 10.1039/c3ob42428f] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 01/22/2014] [Indexed: 12/22/2022]
Abstract
Dalbavancin, a semi-synthetic glycopeptide with enhanced antibiotic activity compared to vancomycin and teicoplanin, binds to the C-terminal lysyl-d-alanyl-d-alanine subunit of Lipid II, inhibiting peptidoglycan biosynthesis. In this study, micro-calorimetry and electrospray ionization (ESI)-MS have been used to investigate the relationship between oligomerisation of dalbavancin and binding of a Lipid II peptide mimic, diacetyl-Lys-d-Ala-d-Ala (Ac2-Kaa). Dalbavancin dimerised strongly in an anti-cooperative manner with ligand-binding, as was the case for ristocetin A, but not for vancomycin and teicoplanin. Dalbavancin and ristocetin A both adopt an 'closed' conformation upon ligand binding, suggesting anti-cooperative dimerisation with ligand-binding may be a general feature of dalbavancin/ristocetin A-like glycopeptides. Understanding these effects may provide insight into design of novel dalbavancin derivatives with cooperative ligand-binding and dimerisation characteristics that could enhance antibiotic activity.
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Affiliation(s)
- Mu Cheng
- Division of Chemistry and Structural Biology , Institute for Molecular Bioscience , The University of Queensland , Brisbane , Queensland 4072 , Australia . ; Tel: +61-7-3346-2044
| | - Zyta M. Ziora
- Division of Chemistry and Structural Biology , Institute for Molecular Bioscience , The University of Queensland , Brisbane , Queensland 4072 , Australia . ; Tel: +61-7-3346-2044
| | - Karl A. Hansford
- Division of Chemistry and Structural Biology , Institute for Molecular Bioscience , The University of Queensland , Brisbane , Queensland 4072 , Australia . ; Tel: +61-7-3346-2044
| | - Mark A. Blaskovich
- Division of Chemistry and Structural Biology , Institute for Molecular Bioscience , The University of Queensland , Brisbane , Queensland 4072 , Australia . ; Tel: +61-7-3346-2044
| | - Mark S. Butler
- Division of Chemistry and Structural Biology , Institute for Molecular Bioscience , The University of Queensland , Brisbane , Queensland 4072 , Australia . ; Tel: +61-7-3346-2044
| | - Matthew A. Cooper
- Division of Chemistry and Structural Biology , Institute for Molecular Bioscience , The University of Queensland , Brisbane , Queensland 4072 , Australia . ; Tel: +61-7-3346-2044
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Varney KM, Bonvin AMJJ, Pazgier M, Malin J, Yu W, Ateh E, Oashi T, Lu W, Huang J, Diepeveen-de Buin M, Bryant J, Breukink E, MacKerell AD, de Leeuw EPH. Turning defense into offense: defensin mimetics as novel antibiotics targeting lipid II. PLoS Pathog 2013; 9:e1003732. [PMID: 24244161 PMCID: PMC3820767 DOI: 10.1371/journal.ppat.1003732] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 09/12/2013] [Indexed: 01/09/2023] Open
Abstract
We have previously reported on the functional interaction of Lipid II with human alpha-defensins, a class of antimicrobial peptides. Lipid II is an essential precursor for bacterial cell wall biosynthesis and an ideal and validated target for natural antibiotic compounds. Using a combination of structural, functional and in silico analyses, we present here the molecular basis for defensin-Lipid II binding. Based on the complex of Lipid II with Human Neutrophil peptide-1, we could identify and characterize chemically diverse low-molecular weight compounds that mimic the interactions between HNP-1 and Lipid II. Lead compound BAS00127538 was further characterized structurally and functionally; it specifically interacts with the N-acetyl muramic acid moiety and isoprenyl tail of Lipid II, targets cell wall synthesis and was protective in an in vivo model for sepsis. For the first time, we have identified and characterized low molecular weight synthetic compounds that target Lipid II with high specificity and affinity. Optimization of these compounds may allow for their development as novel, next generation therapeutic agents for the treatment of Gram-positive pathogenic infections. Every year, an increasing number of people are at risk for bacterial infections that cannot be effectively treated. This is because many bacteria are becoming more resistant to antibiotics. Of particular concern is the rise in hospital-acquired infections. Infection caused by the methicillin-resistant Staphylococcus aureus bacterium or MRSA is the cause of many fatalities and puts a burden on health care systems in many countries. The antibiotic of choice for treatment of S. aureus infections is vancomycin, an antimicrobial peptide that kills bacteria by binding to the bacterial cell wall component Lipid II. Here, we have identified for the first time, small synthetic compounds that also bind Lipid II with the aim to develop new antibiotic drugs to fight against bacterial infections.
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Affiliation(s)
- Kristen M. Varney
- NMR Facility, University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States of America
| | - Alexandre M. J. J. Bonvin
- Utrecht University, Bijvoet Center for Biomolecular Research, Faculty of Science-Chemistry, Utrecht, The Netherlands
| | - Marzena Pazgier
- Institute of Human Virology & Department of Biochemistry and Molecular Biology of the University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States of America
| | - Jakob Malin
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - Wenbo Yu
- Department of Pharmaceutical Sciences and Computer-Aided Drug Design Center, University of Maryland, School of Pharmacy, Baltimore, Maryland, United States of America
| | - Eugene Ateh
- Institute of Human Virology & Department of Biochemistry and Molecular Biology of the University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States of America
| | - Taiji Oashi
- Department of Pharmaceutical Sciences and Computer-Aided Drug Design Center, University of Maryland, School of Pharmacy, Baltimore, Maryland, United States of America
| | - Wuyuan Lu
- Institute of Human Virology & Department of Biochemistry and Molecular Biology of the University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States of America
| | - Jing Huang
- Department of Pharmaceutical Sciences and Computer-Aided Drug Design Center, University of Maryland, School of Pharmacy, Baltimore, Maryland, United States of America
| | - Marlies Diepeveen-de Buin
- Utrecht University, Bijvoet Center for Biomolecular Research, Faculty of Science-Chemistry, Utrecht, The Netherlands
| | - Joseph Bryant
- Institute of Human Virology & Department of Biochemistry and Molecular Biology of the University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States of America
| | - Eefjan Breukink
- Utrecht University, Bijvoet Center for Biomolecular Research, Faculty of Science-Chemistry, Utrecht, The Netherlands
| | - Alexander D. MacKerell
- Department of Pharmaceutical Sciences and Computer-Aided Drug Design Center, University of Maryland, School of Pharmacy, Baltimore, Maryland, United States of America
| | - Erik P. H. de Leeuw
- Institute of Human Virology & Department of Biochemistry and Molecular Biology of the University of Maryland Baltimore School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
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50
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POURAKBARI B, MAHMOUDI S, KAMALI AGHDAM M, SABOUNI F, ESHAGHI H, ALIZADEH S, MAMISHI S. Clonal spread of vancomycin resistance Enterococcus faecalis in an Iranian referral pediatrics center. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2013; 54:87-9. [PMID: 24396988 PMCID: PMC4718390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Vancomycin-resistant enterococci (VRE) represent as an immediate threat to public health. Since few active compounds are available for VRE infections, rapid identification of these isolates are essential. In the absence of any report on the genetic relatedness of Enterococcus faecalis especially Vancomycin-resistant E. faecalis (VREF) isolates in Iran, we undertook this study to characterize these isolates using random amplification of polymorphic DNA (RAPD-PCR) genotyping method. In this study, E. faecalis strains isolated from various samples collected from different wards of Children Medical Hospital (Tehran, Iran). These isolates were identified by standard laboratory procedures and tested for antimicrobial resistance to vancomycin and teicoplanin. The genetic similarity of the strains was investigated by amplification of the RAPD-PCR. In our study among 91 E. faecalis isolates, 15 (16%) were identified as VREF. The similarity pattern built for E. faecalis isolates by RAPD-PCR, demonstrated the presence of four distinct clusters (A, B, C, D). It is of interest to note that 100% of VREF isolates belonged to Clusters A, indicating that there may have occurred horizontal transmission of the same strain between patients. In conclusion, rapid spread of VREF from a clonal origin calls for implementation of careful isolation and infection control measures. Therefore, environmental control by routine disinfection of patient area as well as screening of high risk patients and isolation of colonized patients should be imposed in order to diminish risk of acquiring nosocomial VRE.
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Affiliation(s)
- B. POURAKBARI
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - S. MAHMOUDI
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - M. KAMALI AGHDAM
- Department of Pediatric Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - F. SABOUNI
- Department of Pediatric Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - H. ESHAGHI
- Department of Pediatric Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - S. ALIZADEH
- Department of Pathobiology, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - S. MAMISHI
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran;, Department of Pediatric Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;,Correspondence: Setareh Mamishi, Department of Pediatric Infectious Diseases, Children Medical Center Hospital School of Medicine, Tehran University of Medical Sciences, No. 62, Gharib St., Keshavarz Blvd., Tehran, Iran - Tel. +98 21 66428996 - Fax +98 21 66428996 - E-mail:
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