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Bwanga F, Mukashyaka C, Kateete DP, Tumuhamye J, Okeng A, Aboce E, Namugga O, Kwizera R, Sommerfelt H, Nankabirwa V. Vaginal colonization with virulent and methicillin resistant Staphylococcus aureus among Ugandan women in Labour. BMC Microbiol 2024; 24:307. [PMID: 39155368 PMCID: PMC11331675 DOI: 10.1186/s12866-024-03460-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/12/2024] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND Staphylococcus aureus (S. aureus) often colonizes the human skin, upper respiratory and genital tracts. In the female genital tract, it can be passed on to the newborn during vaginal delivery leading to either ordinary colonization, or neonatal infections notably umbilical stump sepsis, scalded skin syndrome, arthritis, or bacteraemia/sepsis. These infections are mediated by staphylococcal virulence factors such as (i) Staphylococcal Enterotoxins A, B, C, D, and E encoded by the sea, seb, sec, sed, see genes, (ii) Exfoliative Toxins A and B encoded by the eta and etb genes, (iii) Toxic Shock Syndrome Toxin 1 (TSST-1) encoded by the tst gene, (iv) Panton-Valentine Leukocidin (PVL) encoded by the pvl gene, and (v) Hemolysins alpha and delta encoded by the hla and hld genes, respectively. We determined the prevalence of S. aureus possessing one or more virulence factor genes and of methicillin resistant Staphylococcus aureus (MRSA) in this population. METHODS This was a cross-sectional study, which used 85 S. aureus isolates from the Chlorohexidine (CHX) clinical trial study in Uganda. The isolates had been obtained by culturing vaginal swabs (VS) from 1472 women in labour, frozen at minus 80oC, then thawed, sub-cultured, and tested for the selected virulence genes sea, seb, sec, sed, see eta, etb, tst, pvl, hla and hld, and for the methicillin resistance determining gene (mecA). Data were analyzed using SPSS version 20. RESULTS Of the 85 S. aureus isolates 13 (15.3%) were positive for one or more virulence factor genes, as follows: pvl 9/85 (10.6%), hld 5/85 (5.9%), sea 1/85 (1.2%) and seb genes 1/85 (1.2%). The other virulence genes (sec, sed, see, eta, etb, hla and tst) were not detected in any of the isolates. MRSA was detected in 55.3% (47/85) of the isolates, but only two of these carried the pvl virulence gene. CONCLUSION This study demonstrated that 15% of the S. aureus colonizing the female lower genital tract of mothers in labour in central Uganda carried one or more virulence genes, mostly pvl, indicating potential for newborn infection with S. aureus acquired in the maternal birth canal. More than half of the isolates were MRSA.
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Affiliation(s)
- Freddie Bwanga
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, P. O Box 7072, Kampala, Uganda
| | - Claudine Mukashyaka
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, P. O Box 7072, Kampala, Uganda.
| | - David Patrick Kateete
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, P. O Box 7072, Kampala, Uganda
| | - Josephine Tumuhamye
- Centre for Intervention Science in Maternal and Child Health, University of Bergen, Bergen, Norway
| | | | | | - Olive Namugga
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Richard Kwizera
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Halvor Sommerfelt
- Centre for Intervention Science in Maternal and Child Health, University of Bergen, Bergen, Norway
| | - Victoria Nankabirwa
- Centre for Intervention Science in Maternal and Child Health, University of Bergen, Bergen, Norway
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
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White RT, Bakker S, Burton M, Castro ML, Couldrey C, Dyet K, Eustace A, Harland C, Hutton S, Macartney-Coxson D, Tarring C, Velasco C, Voss EM, Williamson J, Bloomfield M. Rapid identification and subsequent contextualization of an outbreak of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit using nanopore sequencing. Microb Genom 2024; 10:001273. [PMID: 38967541 PMCID: PMC11316549 DOI: 10.1099/mgen.0.001273] [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: 04/04/2024] [Accepted: 06/26/2024] [Indexed: 07/06/2024] Open
Abstract
Outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) are well described in the neonatal intensive care unit (NICU) setting. Genomics has revolutionized the investigation of such outbreaks; however, to date, this has largely been completed retrospectively and has typically relied on short-read platforms. In 2022, our laboratory established a prospective genomic surveillance system using Oxford Nanopore Technologies sequencing for rapid outbreak detection. Herein, using this system, we describe the detection and control of an outbreak of sequence-type (ST)97 MRSA in our NICU. The outbreak was identified 13 days after the first MRSA-positive culture and at a point where there were only two known cases. Ward screening rapidly defined the extent of the outbreak, with six other infants found to be colonized. There was minimal transmission once the outbreak had been detected and appropriate infection control measures had been instituted; only two further ST97 cases were detected, along with three unrelated non-ST97 MRSA cases. To contextualize the outbreak, core-genome single-nucleotide variants were identified for phylogenetic analysis after de novo assembly of nanopore data. Comparisons with global (n=45) and national surveillance (n=35) ST97 genomes revealed the stepwise evolution of methicillin resistance within this ST97 subset. A distinct cluster comprising nine of the ten ST97-IVa genomes from the NICU was identified, with strains from 2020 to 2022 national surveillance serving as outgroups to this cluster. One ST97-IVa genome presumed to be part of the outbreak formed an outgroup and was retrospectively excluded. A second phylogeny was created using Illumina sequencing, which considerably reduced the branch lengths of the NICU isolates on the phylogenetic tree. However, the overall tree topology and conclusions were unchanged, with the exception of the NICU outbreak cluster, where differences in branch lengths were observed. This analysis demonstrated the ability of a nanopore-only prospective genomic surveillance system to rapidly identify and contextualize an outbreak of MRSA in a NICU.
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Affiliation(s)
- Rhys T. White
- Institute of Environmental Science and Research, Health Group, Porirua 5022, New Zealand
| | - Sarah Bakker
- Institute of Environmental Science and Research, Health Group, Porirua 5022, New Zealand
| | - Megan Burton
- Awanui Labs Wellington, Department of Microbiology and Molecular Pathology, Wellington 6021, New Zealand
| | - M. Leticia Castro
- Institute of Environmental Science and Research, Health Group, Porirua 5022, New Zealand
| | - Christine Couldrey
- Livestock Improvement Corporation, Research and Development, Newstead 3286, New Zealand
| | - Kristin Dyet
- Institute of Environmental Science and Research, Health Group, Porirua 5022, New Zealand
| | - Alexandra Eustace
- Institute of Environmental Science and Research, Health Group, Porirua 5022, New Zealand
| | - Chad Harland
- Livestock Improvement Corporation, Research and Development, Newstead 3286, New Zealand
| | - Samantha Hutton
- Awanui Labs Wellington, Department of Microbiology and Molecular Pathology, Wellington 6021, New Zealand
| | - Donia Macartney-Coxson
- Institute of Environmental Science and Research, Health Group, Porirua 5022, New Zealand
| | - Claire Tarring
- Awanui Labs Wellington, Department of Microbiology and Molecular Pathology, Wellington 6021, New Zealand
| | - Charles Velasco
- Awanui Labs Wellington, Department of Microbiology and Molecular Pathology, Wellington 6021, New Zealand
| | - Emma M. Voss
- Livestock Improvement Corporation, Research and Development, Newstead 3286, New Zealand
- University of Otago, Department of Microbiology and Immunology, Dunedin 9016, New Zealand
| | - John Williamson
- University of Otago, Department of Microbiology and Immunology, Dunedin 9016, New Zealand
| | - Max Bloomfield
- Awanui Labs Wellington, Department of Microbiology and Molecular Pathology, Wellington 6021, New Zealand
- Te Whatu Ora/Health New Zealand, Infection Prevention and Control, Capital, Coast & Hutt Valley, Wellington 6021, New Zealand
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Zampatti N, Bonato I, Calandrino A, Saffioti C, Parodi A, Brigati G, Minghetti D, Ramenghi LA. Severe cellulitis from methicillin-resistant Staphylococcus aureus (MRSA) in a couple of preterm twins: a case report. Ital J Pediatr 2024; 50:78. [PMID: 38641615 PMCID: PMC11027535 DOI: 10.1186/s13052-024-01659-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 04/16/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Preterms are at risk of systemic infections as the barrier function of their immature skin is insufficient. The long period of hospitalization and the huge number of invasive procedures represent a risk factor for complications. Among the nosocomial infections of the skin, methicillin-resistant Staphylococcus aureus (MRSA) is associated with significant morbidity and mortality. We report a clinical case of cellulitis and abscess in two preterm twins caused by MRSA in a tertiary level Neonatal Intensive Care Unit (NICU). CASE PRESENTATION Two preterm female babies developed cellulitis from MRSA within the first month of extrauterine life. The first one (BW 990 g) showed signs of clinical instability 4 days before the detection of a hyperaemic and painful mass on the thorax. The second one (BW 1240 g) showed signs of clinical instability contextually to the detection of an erythematous, oedematous and painful area in the right submandibular space. In both cases the diagnosis of cellulitis was confirmed by ultrasound. A broad spectrum, multidrug antimicrobial therapy was administered till complete resolution. CONCLUSIONS Due to the characteristic antibiotic resistance of MRSA and the potential complications of those infections in such delicate patients, basic prevention measures still represent the key to avoid the spreading of neonatal MRSA infections in NICUs, which include hand hygiene and strict precautions, as well as screening of patients for MRSA on admission and during hospital stay, routine prophylactic topical antibiotic of patients, enhanced environmental cleaning, cohorting and isolation of positive patients, barrier precautions, avoidance of ward crowding, and, in some units, surveillance, education and decolonization of healthcare workers and visiting parents.
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Affiliation(s)
- Noemi Zampatti
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, 16132, Italy
| | - Irene Bonato
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, 16132, Italy
- Department of Maternal and Neonatal Health, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, 16147, Italy
| | - Andrea Calandrino
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, 16132, Italy
- Department of Maternal and Neonatal Health, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, 16147, Italy
| | - Carolina Saffioti
- Department of Pediatrics, Infectious Disease Unit, IRCCS Istituto Giannina Gaslini, Genoa, 16147, Italy
| | - Alessandro Parodi
- Department of Maternal and Neonatal Health, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, 16147, Italy
| | - Giorgia Brigati
- Department of Maternal and Neonatal Health, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, 16147, Italy
| | - Diego Minghetti
- Department of Maternal and Neonatal Health, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, 16147, Italy.
| | - Luca Antonio Ramenghi
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, 16132, Italy
- Department of Maternal and Neonatal Health, Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, 16147, Italy
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Malik S, Afzal MF, Hamid MH. Comparison of risk factors for Methicillin Resistant Staphylococcus aureus (MRSA) colonization in healthy newborns, born to mothers with and without MRSA colonization. Pak J Med Sci 2024; 40:84-88. [PMID: 38196494 PMCID: PMC10772440 DOI: 10.12669/pjms.40.1.7703] [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: 02/13/2023] [Revised: 07/31/2023] [Accepted: 08/30/2023] [Indexed: 01/11/2024] Open
Abstract
Objective To compare the risk factors for MRSA colonization in healthy newborns, born of mothers with and without MRSA colonization. Methods This case control study was conducted in post-natal unit of Lady Willingdon Hospital, affiliated with King Edward Medical University/Mayo Hospital, Lahore from January to June 2017. The vaginal and anterior nares swabs for MRSA culture were collected from mothers within six hours before planned delivery and the neonatal anterior nares swabs for MRSA culture were taken within one hour of birth. All the samples were cultured in Paediatric Microbiology laboratory in Mayo Hospital. Data were analyzed through SPSS 20.0 and logistic regression was applied for risk factors analysis. Results Out of total 80 mothers and their newborns, 15 (18.75%) mothers and 16 neonates (20%) were MRSA colonized. The frequency of MRSA colonization in mothers' anterior nares and vaginal swab was 17.5% and 1.25% respectively. The significant risk factors were prolonged rupture of membranes for >18 hours (p-value 0.02, odds ratio 11.85, 95% CI 1.41-99.3), birth weight <2500 grams (p-value 0.01, odds ratio 5.39, 95% CI 1.35-21.4), history of presence of meconium (p-value 0.006, odds ratio 7.30, 95% CI 1.78-29.8). The non-significant factors were age of mother (p-value 0.682, odds ratio 0.765, 95% CI 1.0.212-2.76), parity (p-value 0.185, odds ratio 3.82, 95% CI 0.46-31.66) , gestation (p-value 0.615, odds ratio 0.797, 95% CI 0.714-0.89) , mode of delivery (p-value 0.576, odds ratio 0.543, 95% CI 0.062-4.76), sex of baby (p-value 0.546, odds ratio 0.683, 95% CI 0.196-2.37) and presentation of baby at birth (p-value 0.47, odds ratio 0.795, 95% CI 0.71-0.89). Conclusion The presence of meconium, prolonged rupture of membranes and low birth weight were the significant risk factors for MRSA colonization in healthy new-borns, born to mothers with and without MRSA colonization.
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Affiliation(s)
- Sara Malik
- Sara Malik, MD Senior Registrar, University of Child Health and Sciences, Children Hospital, Lahore, Pakistan
| | - Muhammad Faheem Afzal
- Muhammad Faheem Afzal, FCPS, FCPS (Pediatric Infectious Disease), MHPE Professor Pediatric Medicine, Ameer ud Din Medical College PGMI / Lahore General Hospital, Lahore, Pakistan
| | - Muhammad Haroon Hamid
- Muhammad Haroon Hamid, FCPS (Pediatrics) MRCP, FRCP Chairman/Professor Pediatric Medicine, Chief executive Officer, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
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Zhang Y, Liu Q, Sun Q, Li H, Shen J, Liu H, Chen W, Zhang Y, Chen Y. Metalloporphyrin-Based Metal-Organic Frameworks for the Ultrasensitive Chemiresistive Detection of NO 2: Effect of the Central Metal on Tuning the Sensing Performance. ACS Sens 2023; 8:4353-4363. [PMID: 37899610 DOI: 10.1021/acssensors.3c01740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
The highly sensitive and selective detection of trace hazardous gases at room temperature is very promising for health protection and environmental safety. Herein, chemiresistive sensors for NO2 were fabricated based on self-assembled films of the four metalloporphyrin (MPor)-based metal-organic frameworks PCN-222-M (M = Cu, Ni, Co, Fe) by the quasi-Langmuir-Shäfer method. It is found that the relative responses of the four PCN-222-M films are linearly related to the NO2 concentration, and the PCN-222-Cu possessed an unprecedented high response to NO2 with a sensitivity of 2209% ppm-1 in the 4-20 ppb range and a low limit of detection (LOD) of 0.93 ppb, achieving the best performance reported so far for NO2 detection at room temperature. Meanwhile, PCN-222-Ni showed the fastest recovery among the four PCN-222-M films, which can be used for the rapid detection of NO2. Excellent reproducibility, stability, selectivity, and moisture resistance are shown for both PCN-222-Cu and PCN-222-Ni. Combining the experimental study and density functional theory (DFT) calculation, the essential roles of MPor units and the MPor/Zr6 cluster hybrid material in tuning the Fermi level and the electron transfer between PCN-222-M and NO2 were further proved. These were less considered topics in previous studies on MOFs. This work explores the application of MPor-based MOFs in gas sensing by selecting appropriate MPor units, thus providing guidance for the development of MOF-based chemiresistive sensors.
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Affiliation(s)
- Yuming Zhang
- School of Materials Science and Engineering, China University of Petroleum (East China), Qingdao 266580, China
| | - Qi Liu
- School of Materials Science and Engineering, China University of Petroleum (East China), Qingdao 266580, China
| | - Qiqi Sun
- School of Materials Science and Engineering, China University of Petroleum (East China), Qingdao 266580, China
| | - Hao Li
- School of Materials Science and Engineering, China University of Petroleum (East China), Qingdao 266580, China
| | - Jingshun Shen
- School of Materials Science and Engineering, China University of Petroleum (East China), Qingdao 266580, China
| | - Heyuan Liu
- School of Materials Science and Engineering, China University of Petroleum (East China), Qingdao 266580, China
| | - Wenmiao Chen
- School of Materials Science and Engineering, China University of Petroleum (East China), Qingdao 266580, China
- Department of Science, Texas A&M University at Qatar, Education City, P.O. Box, Doha 23874, Qatar
| | - Yuexing Zhang
- College of Chemistry and Chemical Engineering, Dezhou University, Dezhou 253023, P. R. China
| | - Yanli Chen
- School of Materials Science and Engineering, China University of Petroleum (East China), Qingdao 266580, China
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Worley JN, Crothers JW, Wolfgang WJ, Venkata SLG, Hoffmann M, Jayeola V, Klompas M, Allard M, Bry L. Prospective Genomic Surveillance Reveals Cryptic MRSA Outbreaks with Local to International Origins among NICU Patients. J Clin Microbiol 2023; 61:e0001423. [PMID: 37022157 PMCID: PMC10204624 DOI: 10.1128/jcm.00014-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/19/2023] [Indexed: 04/07/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infections cause substantive morbidity and mortality in neonates. Using publicly available resources from the National Center of Biotechnology Information (NCBI) and Food and Drug Administration's (FDA) GalaxyTrakr pipeline, we illustrate the dynamics of MRSA colonization and infection in neonates. Over 217 days of prospective surveillance, analyses revealed concurrent MRSA transmission chains affecting 11 of 17 MRSA-colonized patients (65%), with two clusters that demonstrated intervals of more than a month among the appearance of isolates. All MRSA infected neonates (n = 3) showed previous colonization with the infecting strain. GalaxyTrakr clustering of the NICU strains, in the context of 21,521 international isolates deposited in NCBI's Pathogen Detection Resource, revealed NICU isolates to be distinct from adult MRSA strains seen locally and internationally. Clustering of the NICU strains within an international context enhanced the resolution of strain clusters and supported the rule-out of suspected, local transmission events within the NICU. Analyses also identified sequence type 1535 isolates, emergent in the Middle East, carrying a unique SCCmec with fusC and aac(6')-Ie/aph(2'')-1a that provided a multidrug-resistant phenotype. NICU genomic pathogen surveillance, leveraging public repositories and outbreak detection tools, supports rapid identification of cryptic MRSA clusters, and can inform infection prevention interventions for this vulnerable patient population. Results demonstrate that sporadic infections in the NICU may be indicative of hidden chains of asymptomatic transmission best identified with sequenced-based approaches.
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Affiliation(s)
- Jay N. Worley
- Massachusetts Host-Microbiome Center, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, Maryland, USA
| | - Jessica W. Crothers
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, Vermont, USA
- Translational Global Infectious Disease Research Center, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - William J. Wolfgang
- Wadsworth Center, Division of Infectious Diseases, New York State Department of Health, Albany, New York, USA
| | - Sai Laxmi Gubbala Venkata
- Wadsworth Center, Division of Infectious Diseases, New York State Department of Health, Albany, New York, USA
| | - Maria Hoffmann
- Center for Food Safety and Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Victor Jayeola
- Center for Food Safety and Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Michael Klompas
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Marc Allard
- Center for Food Safety and Nutrition, U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Lynn Bry
- Massachusetts Host-Microbiome Center, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Clinical Microbiology Laboratory, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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De Rose DU, Pugnaloni F, Martini L, Bersani I, Ronchetti MP, Diociaiuti A, El Hachem M, Dotta A, Auriti C. Staphylococcal Infections and Neonatal Skin: Data from Literature and Suggestions for the Clinical Management from Four Challenging Patients. Antibiotics (Basel) 2023; 12:632. [PMID: 37106994 PMCID: PMC10135205 DOI: 10.3390/antibiotics12040632] [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: 02/22/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Staphylococcal infections in neonates might be associated with skin blistering since early antibiotic therapy has been shown to limit infection spread and positively influence outcomes; therefore, neonatologists should be aware of these conditions. This review examines the recent literature on the management of Staphylococcal infections that involve neonatal skin, discussing the most appropriate clinical approach to four cases of neonatal blistering diseases with Staphylococcal infections: a case of Staphylococcal bullous impetigo, a case of Staphylococcal scalded skin syndrome (SSSS), a case of epidermolysis bullosa with overlapping Staphylococcal infection, and a case of burns with overlapping Staphylococcal infection. In treating Staphylococcal infections involving skin in neonates, the presence or absence of systemic symptoms should be considered. In the lack of evidence-based guidelines in this age category, treatment should be individualized according to several factors including the extension of the disease or further skin comorbidities (such as skin fragility), with a multidisciplinary approach.
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Affiliation(s)
| | - Flaminia Pugnaloni
- Neonatal Intensive Care Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Ludovica Martini
- Neonatal Intensive Care Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Iliana Bersani
- Neonatal Intensive Care Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Maria Paola Ronchetti
- Neonatal Intensive Care Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Andrea Diociaiuti
- Dermatology Unit and Genodermatosis Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
| | - May El Hachem
- Dermatology Unit and Genodermatosis Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Andrea Dotta
- Neonatal Intensive Care Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Cinzia Auriti
- Neonatal Intensive Care Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
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8
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Multidrug-Resistant Methicillin-Resistant Staphylococcus aureus Associated with Hospitalized Newborn Infants. Diagnostics (Basel) 2023; 13:diagnostics13061050. [PMID: 36980357 PMCID: PMC10047632 DOI: 10.3390/diagnostics13061050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Multidrug resistance (MDR) is a significant challenge in healthcare management, and addressing it requires a comprehensive approach. In this study, we employed a combination of phenotypic and genotypic approaches, along with whole genome sequencing (WGS) to investigate five hospital-associated MDR methicillin-resistant Staphylococcus aureus (MRSA) strains that were isolated from newborn infants. Our analysis revealed the following for the MDR-MRSA strains: SauR31 was resistant to three antimicrobial classes; SauR12, SauR91 and SauR110 were resistant to four antimicrobial classes; and SauR23 exhibited resistance to seven classes. All the MDR-MRSA strains were capable of producing slime and biofilms, harbored SCCmec type IV, and belonged to different spa types (t022, t032, and t548), with varying profiles for microbial surface components recognizing adhesive matrix molecules (MSCRAMMs) and virulence genes. The WGS data for the MDR SauR23 and SauR91 strains revealed that most of the antimicrobial resistance genes were present in the chromosomes, including blaZ, mecA, norA, lmrS, and sdrM, with only the ermC gene found in a small (<3 kb) plasmid. The presence of MDR-MRSA strains among neonates raises public concern, hence implementation of multifaceted interventions is recommended to address this issue. In addition, metadata is needed to improve the investigation of antimicrobial resistance genes in MDR isolates.
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Zahoor Z, Mumtaz A, Farooqi ZUR, Rehman N, Batool N, Noreen Z, Sattar S, Bostan N, Javed S. High prevalence of Panton-Valentine Leucocidin (PVL) toxin carrying MRSA and multidrug resistant gram negative bacteria in late onset neonatal sepsis indicate nosocomial spread in a Pakistani tertiary care hospital. J Infect Public Health 2023; 16:266-271. [PMID: 36621204 DOI: 10.1016/j.jiph.2022.12.017] [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: 10/19/2022] [Revised: 12/15/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Neonatal sepsis has high incidence with significant mortality and morbidity rates in Pakistan. We investigated common etiological patterns of neonatal sepsis at a tertiary care setup. METHODS 90 pus and blood, gram negative and gram positive bacterial isolates were analyzed for virulence and antibiotic resistance gene profiling using PCR and disc diffusion methods. RESULTS Staphylococcus aureus showed strong association with neonatal sepsis (43 %) followed by Citrobacter freundii (21 %), Pseudomonas aeruginosa (13 %), Escherichia coli (15 %) and Salmonella enterica (8 %). Molecular typing of E. coli isolates depicted high prevalence of the virulent F and B2 phylogroups, with 4 hypervirulent phylogroup G isolates. 76.9 % S. aureus isolates showed presence of Luk-PV, encoding for Panton-valentine leucocidin (PVL) toxin with majority also carrying MecA gene and classified as methicillin resistant S. aureus (MRSA). ecpA, papC, fimH and traT virulence genes were detected in E. coli and Salmonella isolates. 47 % Citrobacter freundii isolates carried the shiga like toxin SltII B. Antimicrobial resistance profiling depicted common resistance to cephalosporins, beta lactams and fluoroquinolones. CONCLUSION Presence of PVL carrying MRSA and multidrug resistant gram negative bacteria, all isolated from late onset sepsis neonates indicate a predominant nosocomial transmission pattern which may complicate management of the disease in NICU setups.
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Affiliation(s)
- Zainab Zahoor
- Microbiology and Public Health Laboratory, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan; Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Amna Mumtaz
- Microbiology and Public Health Laboratory, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan
| | | | - Noor Rehman
- Department of Pathology, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Nighat Batool
- Microbiology and Public Health Laboratory, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan
| | - Zobia Noreen
- Microbiology and Public Health Laboratory, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan
| | - Sadia Sattar
- Molecular Virology Lab, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan
| | - Nazish Bostan
- Molecular Virology Lab, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan
| | - Sundus Javed
- Microbiology and Public Health Laboratory, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan.
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10
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Wang C, Lu Y, Hu J, Yang Y, Cheng J, Jiang S, Guo M. Comparative proteomics of human milk casein fraction collected from women of Korean and Han ethnic groups in China. Front Nutr 2023; 10:1078355. [PMID: 36755990 PMCID: PMC9901581 DOI: 10.3389/fnut.2023.1078355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023] Open
Abstract
Introduction Human breast milk provides neonates with indispensable nutrition and function. Milk protein is one of the main constituents of breast milk. Human milk profiles can be influenced by many factors. Methods The present study aimed to investigate the difference in casein isolated from mature milk of healthy mothers of Korean and Han ethnic groups in China using data-independent acquisition (DIA) proteomics. Results A total of 535 proteins were identified and quantified in casein fraction samples from both groups. A total of 528 proteins were annotated to 52 Gene Ontology (GO) terms, the majority (94.13%) of which were distributed in the cell and cell parts of the cellular component. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed that 106 proteins were involved in 23 pathways, the greatest (36.79%) in carbohydrate metabolism. There were 39 differentially expressed proteins (DEPs)-10 upregulated and 29 downregulated-between Korean and Han milk. The GO function of blood microparticles and KEGG pathway of Staphylococcus aureus infection for DEPs were the most significantly enriched (p < 0.05). Protein-protein interaction analysis revealed a network with 23 DEPs in 47 interactions, and the fibrinogen alpha chain ranked first as the hub protein. Discussion These data may provide useful technical guidance for the development of specific infant foods for certain populations.
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Affiliation(s)
- Cuina Wang
- Department of Food Science, Jilin University, Changchun, China
| | - Yingcong Lu
- Department of Food Science, Jilin University, Changchun, China
| | - Jia Hu
- Department of Food Science, Jilin University, Changchun, China
| | - Yang Yang
- Department of Food Science, Jilin University, Changchun, China
| | - Jianjun Cheng
- Department of Food Science, Northeast Agricultural University, Harbin, China
| | - Shilong Jiang
- R&D Center, Heilongjiang Feihe Dairy Co., Ltd., Beijing, China
| | - Mingruo Guo
- Department of Nutrition and Food Sciences, College of Agriculture and Life Sciences, The University of Vermont, Burlington, VT, United States,*Correspondence: Mingruo Guo,
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11
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Reducing Staphylococcus aureus infections in the neonatal intensive care unit. J Perinatol 2022; 42:1540-1545. [PMID: 35487977 DOI: 10.1038/s41372-022-01407-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/07/2022] [Accepted: 04/22/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Our neonatal intensive care unit (NICU) saw an increase in Staphylococcus aureus (SA) infections-methicillin-resistant SA (MRSA) infections increased from 2.1/10,000 patient days (PD) to 5.1/10,000 PD, and methicillin-sensitive SA (MSSA) infections from 1.2/10,000 PD to 3.9/10,000 PD. This quality improvement project aimed to decrease the rates of SA infections to less than 2.0/10,000 PD, and to determine the rate of SA decolonization. METHODS Infection prevention interventions targeted patient factors (SA surveillance, patient cohorting, decolonization protocol), provider factors (provider cohorting, enhanced hand hygiene) and environmental factors (room structure, equipment optimization). RESULTS The rates of MRSA and MSSA infections decreased to 0.6/10,000 PD and 0.7 infections/10,000 PD respectively. Persistent decolonization of SA was successful in 67% of colonized patients. CONCLUSIONS Specific interventions targeting patient, provider, and environmental factors, including the implementation of a SA decolonization protocol, were successful in decreasing the incidence of SA infections in neonates.
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12
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Mptx2 defends against peritoneal infection by methicillin-resistant staphylococcus aureus. Int Immunopharmacol 2022; 108:108856. [DOI: 10.1016/j.intimp.2022.108856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 11/15/2022]
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13
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Shadbolt R, We MLS, Kohan R, Porter M, Athalye-Jape G, Nathan E, Shrestha D, Strunk T. Neonatal Staphylococcus Aureus Sepsis: a 20-year Western Australian experience. J Perinatol 2022; 42:1440-1445. [PMID: 35752689 PMCID: PMC9616716 DOI: 10.1038/s41372-022-01440-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to characterise neonatal Staphylococcus aureus (SA) sepsis in Western Australia (WA) between 2001 and 2020 at the sole tertiary neonatal intensive care unit (NICU), examine risk factors for sepsis in the cohort, and compare short- and long-term outcomes to control infants without any sepsis. METHODS Retrospective cohort study at the Neonatal Directorate at King Edward Memorial Hospital (KEMH) and Perth Children's Hospital, using electronic databases and patient medical records. RESULTS The overall incidence of SA sepsis was 0.10 per 1000 live births (62/614207). From 2001 to 2010 the incidence was 0.13/1000 live births, reducing to 0.07/1000 live births from 2011 to 2020. SA was most frequently isolated from endotracheal aspirates, and infants with SA sepsis had longer median duration of ventilatory support than those without any sepsis (31 days vs 18 days respectively, p < 0.001). In our cohort, SA sepsis was associated with worse neurodevelopmental outcomes compared to infants without any sepsis. CONCLUSIONS The incidence of neonatal SA sepsis has reduced over the last 20 years, suggesting potential effectiveness of the preventative interventions implemented. Endotracheal tube (ETT) colonisation and prolonged ventilation may be under-recognised as potential sources of SA infection. Our study suggests SA sepsis may negatively impact neurodevelopmental outcomes.
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Affiliation(s)
- Rachel Shadbolt
- grid.1012.20000 0004 1936 7910Medical School, University of Western Australia, Perth, WA Australia
| | - Michael Lee Shee We
- grid.1012.20000 0004 1936 7910Medical School, University of Western Australia, Perth, WA Australia
| | - Rolland Kohan
- Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, WA, Australia. .,Telethon Kids Institute, Perth, WA, Australia. .,Neonatal Directorate, Child and Adolescent Health Service, Perth, WA, Australia.
| | - Michelle Porter
- grid.2824.c0000 0004 0589 6117Microbiology Department, PathWest Laboratories, Perth, WA Australia
| | - Gayatri Athalye-Jape
- grid.1012.20000 0004 1936 7910Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, WA Australia ,grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, WA Australia ,Neonatal Directorate, Child and Adolescent Health Service, Perth, WA Australia
| | - Elizabeth Nathan
- grid.415259.e0000 0004 0625 8678Division of Obstetrics and Gynaecology, University of Western Australia and the Women and Infants Research Foundation, King Edward Memorial Hospital, Perth, WA Australia
| | - Damber Shrestha
- Neonatal Directorate, Child and Adolescent Health Service, Perth, WA Australia
| | - Tobias Strunk
- grid.1012.20000 0004 1936 7910Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, WA Australia ,grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, WA Australia ,Neonatal Directorate, Child and Adolescent Health Service, Perth, WA Australia
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14
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Doudoulakakis A, Spiliopoulou I, Giormezis N, Syridou G, Nika A, Bozavoutoglou E, Militsopoulou M, Kalogeras G, Tsolia M, Lebessi E. Methicillin-resistant Staphylococcus aureus transmission and hospital-acquired bacteremia in a neonatal intensive care unit in Greece. J Infect Chemother 2021; 28:176-180. [PMID: 34785117 DOI: 10.1016/j.jiac.2021.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Staphylococcus aureus is a common pathogen causing hospital acquired infections (HAIs) in neonates. In this study, the epidemiology of methicillin-resistant S. aureus (MRSA) colonization and infections in a 30-bed, level III university-affiliated neonatal intensive care unit (NICU) located in a children's hospital was retrospectively investigated for the period 2014-2018. METHODS Genes encoding Panton-Valentine Leukocidin (lukS/lukF-PV, PVL), toxic shock syndrome toxin (tst), exfoliative toxins (eta, etb), and the resistance genes mecA, mecC and fusB, were defined in 46 representative strains by PCRs. Relatedness of strains was assessed by MLST. RESULTS Of 1538 neonates, 77 (5%) had a positive culture for MRSA (23/77 were NICU-acquired and 54/77 imported cases). Four MRSA bacteremias occurred. Most isolates were multi-resistant. One major clone was identified, ST225, among 40 tested neonatal strains (23/40, 58%). Of these, 14/23 were imported from the same maternity hospital (MH). Another clone, ST217, was predominant (4/6) among health care workers (HCWs), found colonized. Four isolates classified as ST80 were PVL-positive. Additional four strains carried tst (10%), belonging to ST30 and ST225 (two strains each), and two etb. The implicated MH was notified for the problem, decolonization treatment was successfully performed in HCWs and neonates. Strengthening of infection control measures with emphasis on hand hygiene was applied. CONCLUSIONS Uncovering reservoirs for on-going MRSA transmission in NICUs has proved challenging. Well known nosocomial MRSA clones are being constantly introduced and transmitted via MHs and HCWs. Effective infection prevention and control requires constant vigilance.
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Affiliation(s)
| | - Iris Spiliopoulou
- National Staphylococcal Reference Laboratory, Department of Microbiology, School of Medicine, University of Patras, Patras, Greece
| | - Nikolaos Giormezis
- National Staphylococcal Reference Laboratory, Department of Microbiology, School of Medicine, University of Patras, Patras, Greece
| | | | - Angeliki Nika
- Neonatal Intensive Care Unit, 2nd Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | | | | | - Georgios Kalogeras
- Department of Microbiology P. & A. Kyriakou Children's Hospital, Athens, Greece
| | - Maria Tsolia
- Neonatal Intensive Care Unit, 2nd Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Evangelia Lebessi
- Department of Microbiology P. & A. Kyriakou Children's Hospital, Athens, Greece
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Microbial Contamination in Hospital Environment Has the Potential to Colonize Preterm Newborns' Nasal Cavities. Pathogens 2021; 10:pathogens10050615. [PMID: 34067889 PMCID: PMC8156200 DOI: 10.3390/pathogens10050615] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/29/2021] [Accepted: 05/14/2021] [Indexed: 12/13/2022] Open
Abstract
Infants born before 28 weeks are at risk of contracting healthcare-associated infections (HAIs), which could be caused by pathogens residing on contaminated hospital surfaces. In this longitudinal study, we characterized by NGS the bacterial composition of nasal swabs of preterm newborns, at the time of birth and after admission to the Neonatal Intensive Care Unit (NICU), comparing it with that of the environmental wards at the time of delivery and during the hospitalization. We characterized the resistome on the samples too. The results showed that environmental microorganisms responsible for HAIs, in particular Staphylococcus spp., Streptococcus spp., Escherichia-Shigella spp., and K. pneumoniae, were detected in higher percentages in the noses of the babies after 13 days of hospitalization, in terms of the number of colonized patients, microorganism amount, and relative abundance. The analysis of nasal bacteria resistome evidenced the absence of resistance genes at the time of birth, some of which appeared and increased after the admission in the NICU. These data suggest that hospital surface microbiota might be transported to respiratory mucosae or other profound tissues. Our study highlights the importance of a screening that allows characterizing the microbial profile of the environment to assess the risk of colonization of the newborn.
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16
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Whole-genome sequencing for neonatal intensive care unit outbreak investigations: Insights and lessons learned. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY 2021; 1:e2. [PMID: 36168459 PMCID: PMC9495531 DOI: 10.1017/ash.2021.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/20/2022]
Abstract
Abstract
Infectious diseases outbreaks are a cause of significant morbidity and mortality among hospitalized patients. Infants admitted to the neonatal intensive care unit (NICU) are particularly vulnerable to infectious complications during hospitalization. Thus, rapid recognition of and response to outbreaks in the NICU is essential. At Rush University Medical Center, whole-genome sequencing (WGS) has been utilized since early 2016 as an adjunctive method for outbreak investigations. The use of WGS and potential lessons learned are illustrated for 3 different NICU outbreak investigations involving methicillin-resistant Staphylococcus aureus (MRSA), group B Streptococcus (GBS), and Serratia marcescens. WGS has contributed to the understanding of the epidemiology of outbreaks in our NICU, and it has also provided further insight in settings of unusual diseases or when lower-resolution typing methods have been inadequate. WGS has emerged as the new gold standard for evaluating strain relatedness. As barriers to implementation are overcome, WGS has the potential to transform outbreak investigation in healthcare settings.
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Molecular epidemiology of methicillin-susceptible Staphylococcus aureus in infants in a neonatal intensive care unit. Infect Control Hosp Epidemiol 2020; 41:1402-1408. [PMID: 32935655 DOI: 10.1017/ice.2020.355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To investigate the molecular epidemiology of methicillin-susceptible Staphylococcus aureus (MSSA) in infants in a neonatal intensive care unit (NICU) using whole-genome sequencing. DESIGN Investigation of MSSA epidemiology in a NICU. SETTING Single-center, level IV NICU. METHODS Universal S. aureus screening was done using a single swab obtained from the anterior nares, axilla, and groin area of infants in the NICU on a weekly basis. Core genome multilocus sequence type (cgMLST) analysis was performed on MSSA isolates detected over 1 year (2018-2019). RESULTS In total, 68 MSSA-colonized infants were identified, and cgMLSTs of 67 MSSA isolates were analyzed. Overall, we identified 11 cgMLST isolate groups comprising 39 isolates (58%), with group sizes ranging from 2 to 10 isolates, and 28 isolates (42%) were unrelated to each other or any of the isolate groups. Cases of infants colonized by MSSA were scattered throughout the 1-year study period, and isolates belonging to the same cgMLST group were typically detected contemporaneously, over a few weeks or a few months. Overall, 13 infants (19.7%) developed MSSA infections: bacteremia (n = 3), wound infection (n = 5), conjunctivitis (n = 4), and cellulitis (n = 1). We detected no association between these clinically manifest infections and specific cgMLST groups. CONCLUSIONS Although MSSA isolates in infants in a NICU showed high diversity, most were related to other isolates, albeit within small groups. cgMLST facilitates an understanding of the complex transmission dynamics of MSSA in NICUs, and these data can be used to inform better control strategies.
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18
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Comparison of Stir Bar Sorptive Extraction and Solid Phase Microextraction of Volatile and Semi-Volatile Metabolite Profile of Staphylococcus Aureus. MOLECULES (BASEL, SWITZERLAND) 2019; 25:molecules25010055. [PMID: 31877955 PMCID: PMC6982899 DOI: 10.3390/molecules25010055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/14/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022]
Abstract
For the analysis of volatile bacterial compounds, solid phase microextraction (SPME) is currently the most widely used metabolite concentration technique. Recently, the potential of stir bar sorptive extraction (SBSE) for this use has been demonstrated. These two approaches were therefore used in combination with gas-chromatography coupled with mass-spectrometry (GC–MS) for the analysis of volatile and semi-volatile bacterial compounds produced by Staphylococcus aureus. In both cases, SPME and SBSE/headspace sorptive extraction (HSSE) enrichment was carried out in two coating phases. A whole analytical and statistical process was developed to differentiate the metabolites produced from the metabolites consumed. The results obtained with SBSE/HSSE and SPME were compared and showed the recovery of 90% of the compounds by SBSE/HSSE. In addition, we were able to detect the production of 12 volatile/semi-volatile compounds by S. aureus, six of which had never been reported before. The extraction by SBSE/HSSE showed higher concentration capacities and greater sensitivity than SPME concerning bacterial compounds, suggesting that this technique may therefore become the new preferred option for bacterial volatile and semi-volatile compound analysis.
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19
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Gideskog M, Melhus Å. Outbreak of Methicillin‐resistant Staphylococcus aureus in a Hospital Center for Children's and Women's Health in a Swedish County. APMIS 2019; 127:181-186. [DOI: 10.1111/apm.12929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 01/02/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Gideskog
- Department of Infection Control and Hygiene Linköping University Hospital Linköping Sweden
| | - Åsa Melhus
- Department of Infection Control and Hygiene Linköping University Hospital Linköping Sweden
- Department of Medical Sciences/Section of Clinical Microbiology Uppsala University Hospital Uppsala Sweden
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20
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Sundaramoorthy NS, Mitra K, Ganesh JS, Makala H, Lotha R, Bhanuvalli SR, Ulaganathan V, Tiru V, Sivasubramanian A, Nagarajan S. Ferulic acid derivative inhibits NorA efflux and in combination with ciprofloxacin curtails growth of MRSA in vitro and in vivo. Microb Pathog 2018; 124:54-62. [PMID: 30118803 DOI: 10.1016/j.micpath.2018.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/11/2018] [Accepted: 08/13/2018] [Indexed: 11/15/2022]
Abstract
A series of ferulic acid (FA) derivatives were synthesized and evaluated for its ability to inhibit NorA efflux in methicillin resistant Staphylococcus aureus (MRSA), by in silico docking analysis. Based on prediction from glide scores and ability to reduce EtBr MIC, two of the ten derivatives S3- [4-((E)-2-(diethylcarbamoyl)vinyl)-2-methoxyphenyl acetate] and S6- [(E)-methyl 3-(4-((p-tolylcarbamoyl)methoxy)-3-methoxyphenyl)acrylate] were chosen as putative efflux pump inhibitors (EPI's). Time dependent accumulation studies revealed that S6 caused enhanced EtBr accumulation relative to standard NorA efflux inhibitor reserpine, in clinical isolate of MRSA (CIMRSA) and in NorA overexpressed strain of S. aureus (SA1199B). S6 also exhibited synergy with Ciprofloxacin (CPX) against NorA overexpressed strain (SA1199B) of S. aureus but not in NorA knock out strain (K1758). MIC reversal studies showed that S3 in CIMRSA and S6 in NorA overexpressed strain of S. aureus (SA1199B), caused a 4 fold reduction in CPX MIC. In vitro time kill studies revealed that both S3 and S6 with sub MIC of CPX caused a significant 4 log CFU decline in CIMRSA. A decline of >3 log fold CFU by time kill assay implies synergy between FA derivatives and CPX. When tested in vivo in infected muscle tissue of zebrafish both S3 and S6 with CPX caused >3.2 log decline in CIMRSA cell counts relative to CPX treatment alone. Of the two potent derivatives, S6 probably acts through NorA whereas S3 might exert its effect through pump other than NorA. Greater in vitro and in vivo efficiency of FA derivatives implies its potential to be used as an adjuvant along with CPX to curtail MRSA infection in higher animal models.
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Affiliation(s)
- Niranjana Sri Sundaramoorthy
- Center for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India
| | - Kartik Mitra
- Center for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India
| | - Jayasankari Senthil Ganesh
- Center for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India
| | - Himesh Makala
- Department of Biotechnology, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India
| | - Robert Lotha
- Department of Chemistry, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India
| | - Shamprasad R Bhanuvalli
- Department of Chemistry, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India
| | - Venkatasubramanian Ulaganathan
- Department of Biotechnology, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India
| | - Vaidehi Tiru
- Department of Microbiology, Dr. Rangarajan Memorial Hospital, Sundaram Medical Foundation, Annanagar, Chennai, 600 040, India
| | - Aravind Sivasubramanian
- Department of Chemistry, School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India.
| | - Saisubramanian Nagarajan
- Center for Research in Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu, India.
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