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Pedretti N, Iseppi R, Condò C, Ghazanfar S, Messi P, Di Cerbo A, Sabia C. Characterization of virulence factors and antimicrobial resistance in Staphylococcus spp. isolated from clinical samples. Folia Microbiol (Praha) 2024:10.1007/s12223-024-01148-1. [PMID: 38367164 DOI: 10.1007/s12223-024-01148-1] [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: 11/27/2023] [Accepted: 02/01/2024] [Indexed: 02/19/2024]
Abstract
The virulence factors, antibiotic resistance patterns, and the associated genetic elements have been investigated in Staphylococcus species. A total of 100 strains has been isolated from clinical samples in the Microbiology Laboratory of Hesperia Hospital, Modena, Italy, and identified as Staphylococcus aureus (65), Staphylococcus epidermidis (24), Staphylococcus hominis (3), Staphylococcus saprophyticus (3), and Staphylococcus warneri (5). All the strains were analyzed to determine phenotypic and genotypic characters, notably the virulence factors, the antibiotics susceptibility, and the genetic determinants. The highest percentage of resistance in Staphylococcus spp. was found for erythromycin and benzylpenicillin (87% and 85%, respectively). All S. aureus, two S. epidermidis (8.3%), and one S. saprophyticus (33.3%) strains were resistant to oxacillin. The methicillin resistance gene (mecA) was detected by polymerase chain reaction (PCR) amplification in 65 S. aureus strains and in 3 coagulase-negative staphylococci (CoNS) (8.6%). With regard to the virulence characteristics, all the S. aureus were positive to all virulence tests, except for slime test. Among the CoNS isolates, 19 (79.1%) S. epidermidis and one (33.3%) S. saprophyticus strains resulted positive for the slime test only. The results obtained are useful for a more in-depth understanding of the function and contribution of S. aureus and CoNS antibiotic resistance and virulence factors to staphylococcal infections. In particular, the production of slime is very important for CoNS, a virulence factor frequently found in infections caused by these strains. Further investigations on the genetic relatedness among strains of different sources will be useful for epidemiological and monitoring purposes and will enable us to develop new strategies to counteract the diffusion of methicillin-resistant S. aureus (MRSA) and CoNS strains not only in clinical field, but also in other related environments.
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Affiliation(s)
- Natalia Pedretti
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Ramona Iseppi
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy
| | - Carla Condò
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy
| | - Shakira Ghazanfar
- National Institute for Genomics Advanced and Biotechnology (NIGAB), National Agricultural Research Centre, Park Road, 45500, Islamabad, Pakistan
| | - Patrizia Messi
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy
| | - Alessandro Di Cerbo
- School of Biosciences and Veterinary Medicine, University of Camerino, 62024, Matelica, Italy
| | - Carla Sabia
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy.
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Wolska-Gębarzewska M, Międzobrodzki J, Kosecka-Strojek M. Current types of staphylococcal cassette chromosome mec (SCC mec) in clinically relevant coagulase-negative staphylococcal (CoNS) species. Crit Rev Microbiol 2023:1-17. [PMID: 37882662 DOI: 10.1080/1040841x.2023.2274841] [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: 08/04/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
Coagulase-negative staphylococci (CoNS) colonize human skin and mucosal membranes, which is why they are considered harmless commensal bacteria. Two species, Staphylococcus epidermidis and Staphylococcus haemolyticus belong to the group of CoNS species and are most frequently isolated from nosocomial infections, including device-associated healthcare-associated infections (DA-HAIs) and local or systemic body-related infections (FBRIs). Methicillin resistance, initially described in Staphylococcus aureus, has also been reported in CoNS species. It is mediated by the mecA gene within the staphylococcal cassette chromosome (SCCmec). SCCmec typing, primarily using PCR-based methods, has been employed as a molecular epidemiological tool. However, the introduction of whole genome sequencing (WGS) and next-generation sequencing (NGS) has enabled the identification and verification of new SCCmec types. This review describes the current distribution of SCCmec types, subtypes, and variants among CoNS species, including S. epidermidis, S. haemolyticus, and S. capitis. The literature review focuses on recent research articles from the past decade that discuss new combinations of SCCmec in coagulase-negative Staphylococcus. The high genetic diversity and gaps in CoNS SCCmec annotation rules underscore the need for an efficient typing system. Typing SCCmec cassettes in CoNS strains is crucial to continuously updating databases and developing a unified classification system.
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Affiliation(s)
- Mariola Wolska-Gębarzewska
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
- Doctoral School of Exact and Natural Sciences, Jagiellonian University, Krakow, Poland
| | - Jacek Międzobrodzki
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Maja Kosecka-Strojek
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
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Siciliano V, Passerotto RA, Chiuchiarelli M, Leanza GM, Ojetti V. Difficult-to-Treat Pathogens: A Review on the Management of Multidrug-Resistant Staphylococcus epidermidis. Life (Basel) 2023; 13:life13051126. [PMID: 37240771 DOI: 10.3390/life13051126] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/23/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
Multidrug-resistant Staphylococcus epidermidis (MDRSE) is responsible for difficult-to-treat infections in humans and hospital-acquired-infections. This review discusses the epidemiology, microbiology, diagnosis, and treatment of MDRSE infection and identifies knowledge gaps. By using the search term "pan resistant Staphylococcus epidermidis" OR "multi-drug resistant Staphylococcus epidermidis" OR "multidrug-resistant lineages of Staphylococcus epidermidis", a total of 64 records have been identified from various previously published studies. The proportion of methicillin resistance in S. epidermidis has been reported to be as high as 92%. Several studies across the world have aimed to detect the main phylogenetic lineages and antibiotically resistant genes through culture, mass spectrometry, and genomic analysis. Molecular biology tools are now available for the identification of S. epidermidis and its drug resistance mechanisms, especially in blood cultures. However, understanding the distinction between a simple colonization and a bloodstream infection (BSI) caused by S. epidermidis is still a challenge for clinicians. Some important parameters to keep in mind are the number of positive samples, the symptoms and signs of the patient, the comorbidities of the patient, the presence of central venous catheter (CVC) or other medical device, and the resistance phenotype of the organism. The agent of choice for empiric parenteral therapy is vancomycin. Other treatment options, depending on different clinical settings, may include teicoplanin, daptomycin, oxazolidinones, long-acting lipoglycopeptides, and ceftaroline. For patients with S. epidermidis infections associated with the presence of an indwelling device, assessment regarding whether the device warrants removal is an important component of management. This study provides an overview of the MDRSE infection. Further studies are needed to explore and establish the most correct form of management of this infection.
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Affiliation(s)
- Valentina Siciliano
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Rosa Anna Passerotto
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del S. Cuore, 00168 Rome, Italy
| | - Marta Chiuchiarelli
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del S. Cuore, 00168 Rome, Italy
| | - Gabriele Maria Leanza
- Dipartimento di Sicurezza e Bioetica, Università Cattolica del S. Cuore, 00168 Rome, Italy
| | - Veronica Ojetti
- Dipartimento di Emergenza e Accettazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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Short Peripheral Venous Catheters Contamination and the Dangers of Bloodstream Infection in Portugal: An Analytic Study. Microorganisms 2023; 11:microorganisms11030709. [PMID: 36985281 PMCID: PMC10056756 DOI: 10.3390/microorganisms11030709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023] Open
Abstract
Peripheral venous catheters (PVCs) are the most used vascular access devices in the world. However, failure rates remain considerably high, with complications such as PVC-related infections posing significant threats to patients’ well-being. In Portugal, studies evaluating the contamination of these vascular medical devices and characterizing the associated microorganisms are scarce and lack insight into potential virulence factors. To address this gap, we analyzed 110 PVC tips collected in a large tertiary hospital in Portugal. Experiments followed Maki et al.’s semi-quantitative method for microbiological diagnosis. Staphylococcus spp. were subsequently studied for the antimicrobial susceptibility profile by disc diffusion method and based on the cefoxitin phenotype, were further classified into strains resistant to methicillin. Screening for the mecA gene was also done by a polymerase chain reaction and minimum inhibitory concentration (MIC)-vancomycin as determined by E-test, proteolytic and hemolytic activity on skimmed milk 1% plate and blood agar, respectively. The biofilm formation was evaluated on microplate reading through iodonitrotetrazolium chloride 95% (INT). Overall, 30% of PVCs were contaminated, and the most prevalent genus was Staphylococcus spp., 48.8%. This genus presented resistance to penicillin (91%), erythromycin (82%), ciprofloxacin (64%), and cefoxitin (59%). Thus, 59% of strains were considered resistant to methicillin; however, we detected the mecA gene in 82% of the isolates tested. Regarding the virulence factors, 36.4% presented α-hemolysis and 22.7% β-hemolysis, 63.6% presented a positive result for the production of proteases, and 63.6% presented a biofilm formation capacity. Nearly 36.4% were simultaneously resistant to methicillin and showed expression of proteases and/or hemolysins, biofilm formation, and the MIC to vancomycin were greater than 2 µg/mL. Conclusion: PVCs were mainly contaminated with Staphylococcus spp., with high pathogenicity and resistance to antibiotics. The production of virulence factors strengthens the attachment and the permanence to the catheter’s lumen. Quality improvement initiatives are needed to mitigate such results and enhance the quality and safety of the care provided in this field.
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Admane N, Kothandan R, Syed S, Biswas S. A quinoline alkaloid potentially modulates the amyloidogenic structural transitions of the biofilm scaffolding small basic protein. J Biomol Struct Dyn 2023; 41:1366-1377. [PMID: 34963419 DOI: 10.1080/07391102.2021.2020165] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Bacterial biofilm formation by communities of opportunistic bacterial pathogens like Staphylococcus epidermidis is regarded as the primary virulence mechanism facilitating the spread of detrimental nosocomial and implant-associated infections. An 18-kDa small basic protein (Sbp) and its amyloid fibrils account for strengthening the biofilm architecture and scaffolding the S. epidermidis biofilm matrix. Our study reports systematic analysis of the amyloidogenic structural transitions of Sbp and predicts the amyloid core of the protein which may trigger misfolding and aggregation. Herein, we report the novel amyloid inhibitory potential of Camptothecin, a quinoline alkaloid which binds stably to Sbp monomers and redirects the formation of unstructured regions further destabilizing the protein. Molecular dynamics simulations reveal that Camptothecin averts β-sheet transitions, interrupts with electrostatic interactions and disrupts the intermolecular hydrophobic associations between the exposed hydrophobic amyloidogenic regions of Sbp. Collectively, our study puts forward the first report detailing the heteromolecular associations and amyloid modulatory effects of Camptothecin which may serve as a structural scaffold for the tailored designing of novel drugs targeting the S. epidermidis biofilm matrix.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Nikita Admane
- ViStA Lab, Department of Biological Sciences, BITS, Goa, India
| | - Ram Kothandan
- Bioinformatics Laboratory, Department of Biotechnology, Kumaraguru College of Technology, Coimbatore, India
| | - Sowfia Syed
- Bioinformatics Laboratory, Department of Biotechnology, Kumaraguru College of Technology, Coimbatore, India
| | - Sumit Biswas
- ViStA Lab, Department of Biological Sciences, BITS, Goa, India
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Molecular Detection and Characterization of the Staphylococcus epidermidis and Staphylococcus haemolyticus Isolated from Hospitalized Patients and Healthcare Workers in Iran. BIOMED RESEARCH INTERNATIONAL 2023; 2023:3775142. [PMID: 36644166 PMCID: PMC9839402 DOI: 10.1155/2023/3775142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/27/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023]
Abstract
Background The present study is aimed at surveying the antibiotics resistance profile, biofilm formation ability, staphylococcal cassette chromosome mec (SCCmec) types, and molecular epidemiology of Staphylococcus epidermidis and Staphylococcus haemolyticus isolated from hospitalized patients and healthcare workers in four teaching hospitals in Iran. Methods In total, 43 Staphylococcus epidermidis and 12 Staphylococcus haemolyticus were isolated from hospitalized patients, and 19 Staphylococcus epidermidis and 7 Staphylococcus haemolyticus isolated from healthcare workers were included in the present study. The antimicrobial resistance profile of isolates was determined using the disk diffusion method. Moreover, the resistance of isolates to methicillin was identified using the cefoxitin disk diffusion test. The microtiter-plate test was used for quantifying biofilm formation. Moreover, the frequency of icaA and icaD genes was determined using PCR assay. The molecular epidemiology of methicillin-resistant isolates was determined using SCCmec typing and pulsed-field gel electrophoresis methods. Results Among all coagulase-negative staphylococci isolates, the highest resistance rate (81.5%) was seen for cefoxitin and cotrimoxazole. All of the isolates were susceptible to linezolid. Out of the 66 mecA-positive isolates, the most common SCCmec type was the type I (n = 23; 34.8%) followed by type IV (n = 13; 19.7%). Using pulsed-field gel electrophoresis (PFGE) assay, 27 PFGE types including 14 common types and 13 singletons were obtained among 51 methicillin-resistant S. epidermidis (MRSE) isolates. Moreover, among 12 methicillin-resistant S. haemolyticus (MRSH) isolates, 8 PFGE types were detected, of which 5 PFGE types were singletons. Conclusion The high rate of resistance to antibiotics as well as the possibility of cross-infection shows the importance of a pattern shift in the management and controlling programs of coagulase-negative staphylococci, especially in healthcare centers. Clinical trial registration. The present study is not a clinical trial study. Thus, a registration number is not required.
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Cangui-Panchi SP, Lizbeth Ñacato-Toapanta A, Enríquez-Martínez LJ, Reyes J, Garzon-Chavez D, Machado A. Biofilm-forming microorganisms causing hospital-acquired infections from intravenous catheter: a systematic review. CURRENT RESEARCH IN MICROBIAL SCIENCES 2022; 3:100175. [DOI: 10.1016/j.crmicr.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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El-Deeb W, Cave R, Fayez M, Alhumam N, Quadri S, Mkrtchyan HV. Methicillin Resistant Staphylococci Isolated from Goats and Their Farm Environments in Saudi Arabia Genotypically Linked to Known Human Clinical Isolates: a Pilot Study. Microbiol Spectr 2022; 10:e0038722. [PMID: 35913203 PMCID: PMC9431424 DOI: 10.1128/spectrum.00387-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/09/2022] [Indexed: 11/20/2022] Open
Abstract
We conducted a pilot whole genome sequencing (WGS) study to characterize the genotypes of nine methicillin resistant staphylococci (MRS) isolates recovered from goats and their farm environments in Eastern Province, Saudi Arabia, between November 2019 to August 2020. Seven out of nine isolates were methicillin resistant Staphylococcus aureus (MRSA), and two were methicillin resistant Staphylococcus epidermidis (MRSE). All MRSA isolates possessed genotypes previously identified to infect humans, including isolates harboring ST6-SCCmec IV-t304 (n = 4), ST5-SCCmec VI- t688 (n = 2) and ST5-SCCmec V-t311 (n = 1). 2 MRSA isolates possessed plasmids that were genetically similar to those identified in S. aureus isolates recovered from humans and poultry. In contrast, plasmids found in three MRSA isolates and one MRSE isolate were genetically similar to those recovered from humans. All MRSA isolates harbored the host innate modulate genes sak and scn previously associated with human infections. The genotypes of MRSE isolates were determined as ST35, a well-known zoonotic sequence type and ST153, which has been associated with humans. However, the MRSE isolates were untypeable due to extra ccr complexes identified in their SCCmec elements. Moreover, we identified in ST153 isolate SCCmec element also harbored the Arginine Catabolic Mobile Element (ACME) IV. All MRS isolates were phenotypically resistant to trimethoprim-sulfamethoxazole, an antibiotic for the decolonization of MRS. Three isolates carried antibiotic resistance genes in their SCCmec elements that were not previously described, including those encoding fusidic acid resistance (fusC) and trimethoprim resistance (dfrC) incorporated in the MRSA SCCmec VI. IMPORTANCE Our findings demonstrate a possible cross-transmission of methicillin resistant staphylococci between goats and their local environments and between goats and humans. Due to ever increasing resistance to multiple antibiotics, the burden of MRS has a significant impact on livestock farming, public health, and the economy worldwide. This study highlights that implementing a holistic approach to whole genome sequencing surveillance in livestock and farm environments would aid our understanding of the transmission of methicillin resistant staphylococci and, most importantly, allow us to implement appropriate infection control and hygiene practices.
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Affiliation(s)
- Wael El-Deeb
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Hofuf, Al-Ahsa, Saudi Arabia
- Department of Internal Medicine, Infectious Diseases and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Rory Cave
- School of Biomedical Sciences, University of West London, London, United Kingdom
| | - Mahmoud Fayez
- Al Ahsa Veterinary Diagnostic Laboratory, Ministry of Environment, Water and Agriculture, Al-Hofuf, Al-Ahsa, Saudi Arabia
- Veterinary Serum and Vaccine Research Institute, Ministry of Agriculture, Cairo, Egypt
| | - Naser Alhumam
- Department of Microbiology and parasitology, College of Veterinary Medicine, King Faisal University, Al-Hofuf, Al-Ahsa, Saudi Arabia
| | - Sayed Quadri
- Division of Microbiology and Immunology, Department of Biomedical Sciences, College of Medicine, King Faisal University, Al-Hofuf, Al-Ahsa, Kingdom of Saudi Arabia
| | - Hermine V. Mkrtchyan
- School of Biomedical Sciences, University of West London, London, United Kingdom
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Thomson P, García P, Miles J, Isla D, Yáñez C, Santibáñez R, Núñez A, Flores-Yáñez C, del Río C, Cuadra F. Isolation and Identification of Staphylococcus Species Obtained from Healthy Companion Animals and Humans. Vet Sci 2022; 9:vetsci9020079. [PMID: 35202332 PMCID: PMC8879518 DOI: 10.3390/vetsci9020079] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 01/20/2023] Open
Abstract
The close contact between people and their pets has generated the exchange of skin microbiota, accompanied by bacteria that present resistance to antibiotics. Staphylococcus spp., opportunistic pathogens present in the skin and mucosa of mammals, have had their importance recognized in human and veterinary medicine. The objectives of this study were to identify Staphylococcus spp. present in isolates from the nostrils of healthy humans, dogs and cats as well as to determine their phenotype of resistance to methicillin. Strain identification was performed by MALDI-TOF mass spectrometry and antimicrobial susceptibility was determined using a disk diffusion assay for 12 antibiotics. Sixty humans (veterinary and technicians), sixty dogs and sixty cats were sampled; of them, 61.6%, 56.6% and 46.6%, respectively, carried Staphylococcus spp. in their nostrils, and only two people carried two different species of Staphylococcus in the only anatomical site sampled. A methicillin-resistant phenotype was present in 48.7% of the humans, 26.5% of the dogs and 57.1% of the cats, and sampled. These results demonstrate the presence of Staphylococcus spp. strains resistant to methicillin in personnel who work in contact with animals, as well as in dogs and cats that entered the same hospital or veterinary clinic, which alerts us to the potential transfer of these strains to or between people, dogs and/or cats.
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Affiliation(s)
- Pamela Thomson
- Laboratorio de Microbiología Clínica y Microbioma, Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago 8370134, Chile; (C.d.R.); (F.C.)
- Correspondence: ; Tel.: +56-227-703-688
| | - Patricia García
- Departamento de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica, Santiago 8940000, Chile; (P.G.); (J.M.); (D.I.); (C.Y.)
| | - Jorge Miles
- Departamento de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica, Santiago 8940000, Chile; (P.G.); (J.M.); (D.I.); (C.Y.)
| | - David Isla
- Departamento de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica, Santiago 8940000, Chile; (P.G.); (J.M.); (D.I.); (C.Y.)
| | - Camilo Yáñez
- Departamento de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica, Santiago 8940000, Chile; (P.G.); (J.M.); (D.I.); (C.Y.)
| | - Rodrigo Santibáñez
- Departamento de Ingeniería Química y Bioprocesos, Facultad de Ingeniería, Pontificia Universidad Católica, Santiago 8940000, Chile;
| | - Andrea Núñez
- Facultad de Medicina Veterinaria y Agronomía, Universidad de las Américas, Santiago 7500975, Chile;
| | | | - Camila del Río
- Laboratorio de Microbiología Clínica y Microbioma, Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago 8370134, Chile; (C.d.R.); (F.C.)
| | - Françoise Cuadra
- Laboratorio de Microbiología Clínica y Microbioma, Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago 8370134, Chile; (C.d.R.); (F.C.)
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Li T, Lu Y, Zhang H, Wang L, Beier RC, Jin Y, Wang W, Li H, Hou X. Antibacterial Activity and Membrane-Targeting Mechanism of Aloe-Emodin Against Staphylococcus epidermidis. Front Microbiol 2021; 12:621866. [PMID: 34484130 PMCID: PMC8415635 DOI: 10.3389/fmicb.2021.621866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
The emergence of multidrug-resistant Staphylococcus epidermidis (S. epidermidis) dwarfs the current antibiotic development and calls for the discovery of new antibacterial agents. Aloe-emodin is a plant-derived compound that holds promise to battle against these strains. This work reports the antimicrobial activity of aloe-emodin against S. epidermidis and other Gram-positive pathogenic species, manifesting minimum inhibitory concentrations (MICs) and minimum bactericidal concentration (MBCs) around 4–32 and 32–128 μg/mL, respectively. For Gram-negative bacteria tested, the MICs and MBCs of aloe-emodin were 128–256 and above 1024 μg/mL, respectively. Aloe-emodin at the MBC for 4 h eradicated 96.9% of S. epidermidis cells. Aloe-emodin treatment led to deformities in the morphology of S. epidermidis cells and the destroy of the selective permeability of the cell membranes. Analysis of the transcriptional profiles of aloe-emodin-treated cells revealed changes of genes involved in sulfur metabolism, L-lysine and peptidoglycan biosynthesis, and biofilm formation. Aloe-emodin therefore can safely control Gram-positive bacterial infections and proves to target the bacterial outer membrane.
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Affiliation(s)
- Tao Li
- Shanghai Veterinary Research Institute, CAAS, Shanghai, China
| | - Yan Lu
- Beijing Key Laboratory of Chinese Veterinary Medicine, Department of Veterinary Medicine, National Demonstration Center for Experimental Animal Education, Beijing University of Agriculture, Beijing, China
| | - Hua Zhang
- Beijing Key Laboratory of Chinese Veterinary Medicine, Department of Veterinary Medicine, National Demonstration Center for Experimental Animal Education, Beijing University of Agriculture, Beijing, China
| | - Lei Wang
- Beijing Huafukang Bioscience Co., Ltd., Beijing, China
| | - Ross C Beier
- Food and Feed Safety Research Unit, Southern Plains Agricultural Research Center, Agricultural Research Service, United States Department of Agriculture, College Station, TX, United States
| | - Yajie Jin
- Shanghai Veterinary Research Institute, CAAS, Shanghai, China
| | - Wenjing Wang
- Shanghai Veterinary Research Institute, CAAS, Shanghai, China
| | - Huanrong Li
- Beijing Key Laboratory of Chinese Veterinary Medicine, Department of Veterinary Medicine, National Demonstration Center for Experimental Animal Education, Beijing University of Agriculture, Beijing, China
| | - Xiaolin Hou
- Beijing Key Laboratory of Chinese Veterinary Medicine, Department of Veterinary Medicine, National Demonstration Center for Experimental Animal Education, Beijing University of Agriculture, Beijing, China
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Suepaul S, Georges K, Unakal C, Boyen F, Sookhoo J, Ashraph K, Yusuf A, Butaye P. Determination of the frequency, species distribution and antimicrobial resistance of staphylococci isolated from dogs and their owners in Trinidad. PLoS One 2021; 16:e0254048. [PMID: 34214140 PMCID: PMC8253405 DOI: 10.1371/journal.pone.0254048] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 06/21/2021] [Indexed: 11/25/2022] Open
Abstract
The close contact between humans and their dogs can lead to the commingling of staphylococci and the exchange of mobile genetic elements encoding antimicrobial resistance. The objectives of this study were to determine the species distribution and antimicrobial resistance patterns of staphylococci colonizing canine pets and their owners in Trinidad. Staphylococci were isolated from canine pets and their owners and identified using MALDI-TOF mass spectrometry. Antimicrobial susceptibilities were determined using the Kirby-Bauer disc diffusion method against seven classes of antimicrobial agents. A total of 440 staphylococci were isolated from 112 canine pets and their owners, 53.4% were from canine pets and 46.6% were from owners. Twenty-four species were detected, of which, most isolates (32.5%) belonged to the Staphylococcus intermedius group (SIG). S. sciuri was the most common species of coagulase-negative staphylococci (CoNS) comprising 22.3% of all isolates. Antimicrobial resistance was highest against commonly used antimicrobials, such as penicillin (51.4%), tetracycline (26.1%) and trimethoprim/sulfamethoxazole (18.6%). These antimicrobials also comprised the most common multidrug resistance (MDR) combination. Overall, 19.1% of isolates displayed multidrug resistance. No methicillin-resistant Staphylococcus aureus (MRSA) isolates were detected. However, methicillin resistance was detected in 13.3% and 15.1% of coagulase-positive staphylococci (CoPS) and the CoNS+CoVS (combined CoNS and coagulase-variable staphylococci) group respectively. The presence of methicillin-resistant staphylococci is worrisome because there is the potential for the transfer of these strains between dogs and humans. These strains may act as a reservoir of resistance genes.
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Affiliation(s)
- Sharianne Suepaul
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
- * E-mail:
| | - Karla Georges
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Chandrashekhar Unakal
- Department of Paraclinical Sciences, School of Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Filip Boyen
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Jamie Sookhoo
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Khalil Ashraph
- Department of Paraclinical Sciences, School of Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Anisah Yusuf
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Patrick Butaye
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
- School of Veterinary Medicine, Ross University, Basseterre, St. Kitts and Nevis
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12
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Antimicrobial susceptibility of bacterial pathogens isolated from healthcare workers' cellphones. Infect Dis Now 2021; 51:596-602. [PMID: 34091094 DOI: 10.1016/j.idnow.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/07/2021] [Accepted: 05/27/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate bacterial isolates, antibiotic susceptibility, and disease transmission risk in healthcare workers using cellphones. METHODS A total of 70 cellphones were received from the hospital staff. Samples were collected from the phones with a sterile cotton swab moistened with physiological saline solution. Samples were inoculated in a bacteriological culture medium and incubated at 37.5°C for 24-48hours. Identification of microorganisms was performed by traditional methods and VITEK 2 device. Kirby-Bauer disk diffusion method was used to determine antibiotic susceptibility. RESULTS A total of 26 species and 170 microorganisms were isolated from 66 cellphones from which bacterial growths were obtained: coagulase-negative staphylococci (n=63, 37%) (most commonly Staphylococcus epidermidis: 25/63), Micrococcus luteus (n=25, 14.7%), Tetracoccus (n=24, 14.1%), Kocuria spp. (n=24, 14.1%), Corynebacterium diphtheriae (n=7, 4.1%), Leuconostoc mesenteroides (n=5, 3.0%), S. aureus (n=4, 2.3%), Enterococcus spp. (n=5, 2.9%), Acinetobacter spp. (n=7, 4.1%), Klebsiella pneumoniae (n=2, 1.2%), Actinomyces spp. (n=1, 0.6%), Pseudomonas aeruginosa (n=1, 0.6%), Morganella morganii (n=1, 0.6%), and Alcaligenes faecalis (n=1, 0.6%). Gram-positive isolates were all susceptible to the antibiotics used, whereas Gram-negative isolates were all resistant to ceftazidime. CONCLUSION Hands and/or cellphones of healthcare staff can be contaminated with various types of microorganisms. We recommend proper hand washing and disinfection to prevent bacterial pathogens spread within the hospital.
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Berezhna AV, Tertyshnyi VO, Makarova VI, Chumachenko TO. Staphylococcus aureus and S. epidermidis in biological systems of hospital environment: Antibiotic resistance patterns in regions of Ukraine. REGULATORY MECHANISMS IN BIOSYSTEMS 2021. [DOI: 10.15421/022124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Staphylococcus bacteria are ubiquitous and often circulate in the biological systems of the hospital environment. Staphylococci have developed antibiotic resistance mechanisms resulting in a significant medical and economic burden to the healthcare system. The goal of our research was to conduct a comparative analysis of resistance to antibiotics in S. aureus and S. epidermidis isolates found in surgical hospitals in Kharkiv and Poltava regions. In 2013 through 2019, 151,015 and 98,754 tests were made by disc-diffusion method to identify the sensitivity in the S. aureus strains to antibiotics in Kharkiv and Poltava regions respectively. In 2013–2015, 15,589 tests were made in Kharkiv region to identify antibiotics sensitivity in S. epidermidis strains. Comparison of antibiotic resistance of the S. aureus strains in Kharkiv and Poltava regions was performed using the Pearson Chi-square test (χ2) and Fisher’s exact test. The proportion of S. aureus strains resistant to penicillins, cephalosporins, carbapenems, aminoglycosides, and macrolides was higher in Kharkiv region in terms of statistical validity than in Poltava region. Overall, the proportion of S. aureus strains resistant to lincozamids, tetracycline antibiotics, and fluoroquinolones in Poltava region was higher in terms of statistical validity than in Kharkiv region. An analysis of resistance of S. aureus strains to linezolid demonstrated that in Poltava region the proportion of resistant microorganisms was higher in terms of statistical validity in 2013–2014 and in 2016–2018. In Kharkiv region, in 2013 and in 2014, 96.3% and 89.1% of isolated strains of S. aureus respectively, were resistant to vancomycin. In 2019, more than a quarter of the located isolates (26.6%) in Poltava region were resistant to this antibiotic. The analysis of the dynamic of resistance in S. epidermidis isolates demonstrated that in 2015 nearly half of the isolates located in Kharkiv region were insensitive to penicillin antibiotics. Between 2013 and 2015, the spread of resistance to cephalosporins, aminoglycosides, macrolides, and fluoroquinolones among the S. epidermidis isolates noticeably increased. When S. epidermidis resistance to vancomycin was analyzed, a decrease in the proportion of resistant strains from 88.0% in 2013 to 8.7% in 2015 was noted. A promising direction for further research is the creation of passports of microorganism resistance in the regions and various health-care settings, as well as the creation of a unified national database network on microorganism resistance using modern methodologies for determining the phenotypes and genotypes of microorganisms.
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14
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Cole K, Atkins B, Llewelyn M, Paul J. Genomic investigation of clinically significant coagulase-negative staphylococci. J Med Microbiol 2021; 70. [PMID: 33704043 DOI: 10.1099/jmm.0.001337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction. Coagulase-negative staphylococci have been recognized both as emerging pathogens and contaminants of clinical samples. High-resolution genomic investigation may provide insights into their clinical significance.Aims. To review the literature regarding coagulase-negative staphylococcal infection and the utility of genomic methods to aid diagnosis and management, and to identify promising areas for future research.Methodology. We searched Google Scholar with the terms (Staphylococcus) AND (sequencing OR (infection)). We prioritized papers that addressed coagulase-negative staphylococci, genomic analysis, or infection.Results. A number of studies have investigated specimen-related, phenotypic and genetic factors associated with colonization, infection and virulence, but diagnosis remains problematic.Conclusion. Genomic investigation provides insights into the genetic diversity and natural history of colonization and infection. Such information allows the development of new methodologies to identify and compare relatedness and predict antimicrobial resistance. Future clinical studies that employ suitable sampling frames coupled with the application of high-resolution whole-genome sequencing may aid the development of more discriminatory diagnostic approaches to coagulase-staphylococcal infection.
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Affiliation(s)
- Kevin Cole
- Brighton and Sussex Medical School, Brighton, UK.,Public Health England Collaborating Centre, Royal Sussex County Hospital, Brighton, UK
| | | | - Martin Llewelyn
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.,Brighton and Sussex Medical School, Brighton, UK
| | - John Paul
- Public Health England Collaborating Centre, Royal Sussex County Hospital, Brighton, UK.,Brighton and Sussex Medical School, Brighton, UK
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15
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Distinct clonal lineages and within-host diversification shape invasive Staphylococcus epidermidis populations. PLoS Pathog 2021; 17:e1009304. [PMID: 33544760 PMCID: PMC7891712 DOI: 10.1371/journal.ppat.1009304] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/18/2021] [Accepted: 01/11/2021] [Indexed: 12/15/2022] Open
Abstract
S. epidermidis is a substantial component of the human skin microbiota, but also one of the major causes of nosocomial infection in the context of implanted medical devices. We here aimed to advance the understanding of S. epidermidis genotypes and phenotypes conducive to infection establishment. Furthermore, we investigate the adaptation of individual clonal lines to the infection lifestyle based on the detailed analysis of individual S. epidermidis populations of 23 patients suffering from prosthetic joint infection. Analysis of invasive and colonizing S. epidermidis provided evidence that invasive S. epidermidis are characterized by infection-supporting phenotypes (e.g. increased biofilm formation, growth in nutrient poor media and antibiotic resistance), as well as specific genetic traits. The discriminating gene loci were almost exclusively assigned to the mobilome. Here, in addition to IS256 and SCCmec, chromosomally integrated phages was identified for the first time. These phenotypic and genotypic features were more likely present in isolates belonging to sequence type (ST) 2. By comparing seven patient-matched nasal and invasive S. epidermidis isolates belonging to identical genetic lineages, infection-associated phenotypic and genotypic changes were documented. Besides increased biofilm production, the invasive isolates were characterized by better growth in nutrient-poor media and reduced hemolysis. By examining several colonies grown in parallel from each infection, evidence for genetic within-host population heterogeneity was obtained. Importantly, subpopulations carrying IS insertions in agrC, mutations in the acetate kinase (AckA) and deletions in the SCCmec element emerged in several infections. In summary, these results shed light on the multifactorial processes of infection adaptation and demonstrate how S. epidermidis is able to flexibly repurpose and edit factors important for colonization to facilitate survival in hostile infection environments. S. epidermidis is a substantial component of the human skin microbiota, but also a major cause of nosocomial infections related to implanted medical devices. While phenotypic and genotypic determinants supporting invasion were identified, none appears to be necessary. By analysis of S. epidermidis from prosthetic joint infections, we here show that adaptive events are of importance during the transition from commensalism to infection. Adaptation to the infectious lifestyle is characterised by the development of intra-clonal heterogeneity, increased biofilm formation and enhanced growth in iron-free and nutrient-poor media, as well as reduced production of hemolysins. Importantly, during infection subpopulations emerge that carry mutations in a number of genes, most importantly the acetate kinase (ackA) and the β-subunit of the RNA polymerase (rpoB), have deleted larger chromosomal fragments (e.g. within the SCCmec element) or IS insertions in AgrC, a component of the master quorum sensing system in S. epidermidis. These results shed light on the multifactorial processes of infection adaptation and demonstrate how S. epidermidis is able to flexibly repurpose and edit factors important for colonization to facilitate survival under hostile infection conditions. While mobilome associated factors are important for S. epidermidis invasive potential, the species possesses a multi-layered and complex ability for adaptation to hostile environments, supporting the progression to chronic implant-associated infections.
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16
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Nicolosi D, Cinà D, Di Naso C, D’Angeli F, Salmeri M, Genovese C. Antimicrobial Resistance Profiling of Coagulase-Negative Staphylococci in a Referral Center in South Italy: A Surveillance Study. Open Microbiol J 2020. [DOI: 10.2174/1874285802014010091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background:
CoNS are part of the normal flora of the skin, upper respiratory tract and human intestine. CoNS are able to colonize host tissues or inert materials such as prosthetics, heart valves, pacemakers, and urinary and venous catheters. They can also internalize in host cells, thus eluding immune defenses and attack by antibiotics.
Objective:
In this study, we collected the epidemiological data and determined the antibiotic susceptibility of 828 CoNS, collected in Garibaldi Hospital (Catania, Italy) between January 2016 and October 2018.
Methods:
Strains were evaluated by determining the Minimum Inhibitory Concentration (MIC) using the broth microdilution method, according to the guidelines of the Clinical and Laboratory Standards Institute. The antibiotic sensitivity pattern of CoNS against eighteen antibiotics was determined.
Results:
For all the 828 clinical isolates, varying resistance rates were observed: ampicillin (87%), penicillin (86%), amoxicillin-clavulanate (71%), oxacillin (70%), erythromycin (69%), azithromycin (68%), levofloxacin (55%), ciprofloxacin (54%), gentamycin (47%), moxifloxacin (42%), trimethoprim-sulfamethoxazole (30%), clindamycin (28%), tetracycline (24%), rifampicin (20%), quinupristin-dalfopristin (synercid) (4%). No strains investigated demonstrated resistance to teicoplanin, vancomycin and linezolid.
Conclusion:
Our results highlight the importance of monitoring the evolution of CoNS resistance in order to implement control measures and reduce the risk of spread in the population.
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17
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Kosecka-Strojek M, Sadowy E, Gawryszewska I, Klepacka J, Tomasik T, Michalik M, Hryniewicz W, Miedzobrodzki J. Emergence of linezolid-resistant Staphylococcus epidermidis in the tertiary children's hospital in Cracow, Poland. Eur J Clin Microbiol Infect Dis 2020; 39:1717-1725. [PMID: 32350737 PMCID: PMC7427702 DOI: 10.1007/s10096-020-03893-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Abstract
Coagulase-negative staphylococci, ubiquitous commensals of human skin, and mucous membranes represent important pathogens for immunocompromised patients and neonates. The increasing antibiotic resistance among Staphylococcus epidermidis is an emerging problem worldwide. In particular, the linezolid-resistant S. epidermidis (LRSE) strains are observed in Europe since 2014. The aim of our study was to genetically characterize 11 LRSE isolates, recovered mostly from blood in the University Children’s Hospital in Krakow, Poland, between 2015 and 2017. For identification of the isolates at the species level, we used 16S rRNA sequencing and RFLP of the saoC gene. Isolates were characterized phenotypically by determining their antimicrobial resistance patterns and using molecular methods such as PFGE, MLST, SCCmec typing, detection of the ica operon, and analysis of antimicrobial resistance determinants. All isolates were multidrug-resistant, including resistance to methicillin, and exhibited so-called PhLOPSA phenotype. In PFGE, all isolates (excluding one from a catheter) represented identical patterns, were identified as ST2, and harbored the ica operon, responsible for biofilm formation. Linezolid resistance was associated with acquisition of A157R mutation in the ribosomal protein L3 and the presence of cfr gene. All isolates revealed new SCCmec cassette element composition. Recently, pediatric patients with serious staphylococcal infections are often treated with linezolid. The increasing linezolid resistance in bacterial strains becomes a real threat for patients, and monitoring such infections combined with surveillance and infection prevention programs is very important to decrease number of linezolid-resistant staphylococcal strains.
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Affiliation(s)
- Maja Kosecka-Strojek
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387, Krakow, Poland
| | - Ewa Sadowy
- Department of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| | - Iwona Gawryszewska
- Department of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| | - Joanna Klepacka
- Department of Clinical Microbiology, Children's University Hospital, Jagiellonian University, Krakow, Poland
| | - Tomasz Tomasik
- Department of Clinical Microbiology, Children's University Hospital, Jagiellonian University, Krakow, Poland
| | | | - Waleria Hryniewicz
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Jacek Miedzobrodzki
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387, Krakow, Poland.
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18
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Sánchez A, Benito N, Rivera A, García L, Miró E, Mur I, González Y, Gutiérrez C, Horcajada JP, Espinal P, Navarro F. Pathogenesis of Staphylococcus epidermidis in prosthetic joint infections: Can identification of virulence genes differentiate between infecting and commensal strains? J Hosp Infect 2020; 105:S0195-6701(20)30201-2. [PMID: 32339618 DOI: 10.1016/j.jhin.2020.04.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/17/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Staphylococcus epidermidis is a commensal of human skin flora and a frequent causative microorganism in prosthetic joint infections (PJIs). To date, no single marker has been identified to distinguish infecting strains from commensal S. epidermidis populations. AIM We aimed to find possible genetic markers to distinguish between the two populations. METHODS We analyzed 50 S. epidermidis strains from patients with PJIs, 50 from skin of healthy individuals (commensal strains) and 17 from the surgical field of patients undergoing primary arthroplasty. In these three groups we studied the antimicrobial susceptibility profile, sequence type, biofilm formation, and virulence factors. Strains from the surgical field have not been compared previously with strains from the other two groups. FINDINGS S. epidermidis strains from PJI patients were significantly more antibiotic resistant than commensal strains and surgical field strains. A wide variety of sequences types was found in commensal and surgical field strains. The predominant sequence type was ST2 and it was only present in PJI strains (44%). Differences in biofilm production did not differ between populations. Virulence genes sdrF and bhp, the complete ica operon, and the insertion sequence IS256 were significantly predominant in PJI strains. In contrast, embp and hld genes and the mobile element ACME were more prevalent in commensal strains. Surgical field strains could be a valid control group to discriminate between infecting and commensal strains. CONCLUSION A combination of characteristic features can differentiate between infecting and commensal S. epidermidis strains in PJI, while a single marker cannot.
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Affiliation(s)
- Alba Sánchez
- Department of Microbiology, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Genetics and Microbiology Department. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Natividad Benito
- Infectious Diseases Unit, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alba Rivera
- Department of Microbiology, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Lucas García
- Department of Microbiology, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Elisenda Miró
- Department of Microbiology, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Isabel Mur
- Infectious Diseases Unit, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yesica González
- Department of Microbiology, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Cristina Gutiérrez
- Department of Microbiology, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | | | - Paula Espinal
- Department of Microbiology, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.
| | - Ferran Navarro
- Department of Microbiology, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Genetics and Microbiology Department. Universitat Autònoma de Barcelona, Barcelona, Spain.
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19
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Chabi R, Momtaz H. Virulence factors and antibiotic resistance properties of the Staphylococcus epidermidis strains isolated from hospital infections in Ahvaz, Iran. Trop Med Health 2019; 47:56. [PMID: 31844416 PMCID: PMC6896349 DOI: 10.1186/s41182-019-0180-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Resistant Staphylococcus epidermidis strains are considered to be one of the major causes of human clinical infections in hospitals. The present investigation was done to study the pattern of antibiotic resistance and the prevalence of virulence and antibiotic resistance genes amongst the S. epidermidis strains isolated from human hospital infections. METHODS One hundred hospital infectious samples were collected and S. epidermidis strains were identified using culture and biochemical tests. Isolated strains were subjected to disk diffusion and PCR. RESULTS Forty-six out of 100 hospital infectious samples (46%) were positive for S. epidermidis. S. epidermidis strains harbored the highest prevalence of resistance against penicillin (95.65%), tetracycline (91.30%), erythromycin (82.60%), cefazolin (78.26%), and trimethoprim-sulfamethoxazole (73.91%). All S. epidermidis strains had resistance against at least three different types of antibiotics, while the prevalence of resistance against more than seven types of antibiotics was 17.39%. AacA-D (69.56%), tetK (56.52%), mecA (45.65%), msrA (39.13%), and tetM (39.13%) were most commonly detected antibiotic resistance genes. The prevalence of vatC (4.34%), ermA (8.69%), vatA (8.69%), vatB (13.04%), ermC (13.04%), and linA (10.86%) were lower than other detected antibiotic resistance genes. ClfA (32.60%), agrIII (17.39%), and etB (13.04%) were the most commonly detected virulence factors. CONCLUSIONS The presence of virulent and multi-drug resistance S. epidermidis strains showed an important public health issue in hospitals.
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Affiliation(s)
- Roya Chabi
- Department of Microbiology, Shahrekord Branch, Islamic Azad University, PO. Box: 166, Shahrekord, Iran
| | - Hassan Momtaz
- Department of Microbiology, Shahrekord Branch, Islamic Azad University, PO. Box: 166, Shahrekord, Iran
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20
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Noshak MA, Ahangarzadeh Rezaee M, Hasani A, Mirzaii M, Memar MY. Biofilm formation capacity in common SCCmec types of coagulase-negative staphylococci isolated from hospitalized patients and health-care workers in northwest of Iran. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Espadinha D, Sobral RG, Mendes CI, Méric G, Sheppard SK, Carriço JA, de Lencastre H, Miragaia M. Distinct Phenotypic and Genomic Signatures Underlie Contrasting Pathogenic Potential of Staphylococcus epidermidis Clonal Lineages. Front Microbiol 2019; 10:1971. [PMID: 31507574 PMCID: PMC6719527 DOI: 10.3389/fmicb.2019.01971] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/12/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Staphylococcus epidermidis is a common skin commensal that has emerged as a pathogen in hospitals, mainly related to medical devices-associated infections. Noteworthy, infection rates by S. epidermidis have the tendency to rise steeply in next decades together with medical devices use and immunocompromized population growth. Staphylococcus epidermidis population structure includes two major clonal lineages (A/C and B) that present contrasting pathogenic potentials. To address this distinction and explore the basis of increased pathogenicity of A/C lineage, we performed a detailed comparative analysis using phylogenetic and integrated pangenome-wide-association study (panGWAS) approaches and compared the lineages's phenotypes in in vitro conditions mimicking carriage and infection. Results: Each S. epidermidis lineage had distinct phenotypic signatures in skin and infection conditions and differed in genomic content. Combination of phenotypic and genotypic data revealed that both lineages were well adapted to skin environmental cues. However, they appear to occupy different skin niches, perform distinct biological functions in the skin and use different mechanisms to complete the same function: lineage B strains showed evidence of specialization to survival in microaerobic and lipid rich environment, characteristic of hair follicle and sebaceous glands; lineage A/C strains showed evidence for adaption to diverse osmotic and pH conditions, potentially allowing them to occupy a broader and more superficial skin niche. In infection conditions, A/C strains had an advantage, having the potential to bind blood-associated host matrix proteins, form biofilms at blood pH, resist antibiotics and macrophage acidity and to produce proteases. These features were observed to be rare in the lineage B strains. PanGWAS analysis produced a catalog of putative S. epidermidis virulence factors and identified an epidemiological molecular marker for the more pathogenic lineage. Conclusion: The prevalence of A/C lineage in infection is probably related to a higher metabolic and genomic versatility that allows rapid adaptation during transition from a commensal to a pathogenic lifestyle. The putative virulence and phenotypic factors associated to A/C lineage constitute a reliable framework for future studies on S. epidermidis pathogenesis and the finding of an epidemiological marker for the more pathogenic lineage is an asset for the management of S. epidermidis infections.
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Affiliation(s)
- Diana Espadinha
- Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal.,Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Rita G Sobral
- Laboratory of Molecular Microbiology of Bacterial Pathogens, UCIBIO/REQUIMTE, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Costa de Caparica, Portugal
| | - Catarina Inês Mendes
- Molecular Microbiology and Infection Unit, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Guillaume Méric
- The Milner Centre for Evolution, University of Bath, Bath, United Kingdom
| | - Samuel K Sheppard
- The Milner Centre for Evolution, University of Bath, Bath, United Kingdom.,MRC CLIMB Consortium, Bath, United Kingdom
| | - João A Carriço
- Molecular Microbiology and Infection Unit, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Hermínia de Lencastre
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal.,Laboratory of Microbiology and Infectious Diseases, The Rockefeller University, New York, NY, United States
| | - Maria Miragaia
- Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal
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22
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Guo Y, Ding Y, Liu L, Shen X, Hao Z, Duan J, Jin Y, Chen Z, Yu F. Antimicrobial susceptibility, virulence determinants profiles and molecular characteristics of Staphylococcus epidermidis isolates in Wenzhou, eastern China. BMC Microbiol 2019; 19:157. [PMID: 31288755 PMCID: PMC6617921 DOI: 10.1186/s12866-019-1523-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 06/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Staphylococcus epidermidis has emerged as an often encountered pathogen responsible for hospital-acquired infections. The aim of present study is to investigate the microbiological characteristic of S. epidermidis isolates isolated from sterile specimens and skin in a Chinese tertiary hospital. METHODS A total of 223 non-duplicate S. epidermidis were collected from various sterile specimens of inpatients among 10 years in Wenzhou, China. 106 S. epidermidis obtained from the skin (urethral orifices) of healthy volunteers. All isolates were tested for antimicrobial susceptibility. PCR was used to detect the virulence- and resistance-associated genes and 7 housekeeping genes to determine the sequence types (STs) of selected isolates. RESULTS The resistance rates to antimicrobials tested except linezolid and vancomycin and the prevalence of methicillin-resistant S. epidermidis (MRSE) of S. epidermidis clinical isolates were significantly higher than those among colonized isolates (P < 0.05). The positive rates of virulence-associated genes including aap, sesI, ACME-arcA, IS256, bhp, altE, aae and gehD for S. epidermidis clinical isolates were significantly higher than those for colonized isolate (P < 0.05). A total of 60 STs including 28 from clinical isolates and 32 from colonized isolates were identified by MLST. A novel, rarely encountered clone, ST466, was found to be the second prevalent clone among clinical isolates. The great majority of the S. epidermidis isolates tested (73.86%) belonged to clone complex 2 (CC2). Compared with ST2, ST130, ST20 and ST59 clones, ST466 clone had the highest resistance rate to tetracycline (50.00%), the second highest prevalence of ACME-arcA (65.00%), bhp (30.00%) and qacA/B (65.00%), very low prevalence of carriage of icaA (0.00%) and biofilm formation (0.00%), the lack of sesI and high prevalence of aap, altE and aae (> 90%), which was similar to the characteristics of ST59 clone with one locus difference from ST466. ST466 clone competence with Staphylococcus aureus was relatively stronger, relative to ST2, ST20, ST130 and ST59 clones. CONCLUSION Taken together, a high-level of genetic diversity was found between clinical and colonized S. epidermidis isolates. A novel ST466 clone with distinct and similar characteristics relative to other prevalent clones, emerging as a prevalent clone in China, should be of major concern.
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Affiliation(s)
- Yinjuan Guo
- Department of Laboratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200082, China
| | - Yu Ding
- Department of Laboratory Medicine, Hunan Provincial People's Hospital, Changsha, 410000, China
| | - Li Liu
- Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Xiaofei Shen
- Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Zhihao Hao
- Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Jingjing Duan
- Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Ye Jin
- Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Zengqiang Chen
- Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Fangyou Yu
- Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
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Weßels C, Strommenger B, Klare I, Bender J, Messler S, Mattner F, Krakau M, Werner G, Layer F. Emergence and control of linezolid-resistant Staphylococcus epidermidis in an ICU of a German hospital. J Antimicrob Chemother 2019; 73:1185-1193. [PMID: 29438544 DOI: 10.1093/jac/dky010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/02/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate an outbreak of linezolid-resistant Staphylococcus epidermidis (LRSE) in an interdisciplinary ICU, linezolid consumption and infection control measures taken. Methods Routine surveillance of nosocomial infections revealed colonization and infection with LRSE affecting 14 patients during a 15 month period. LRSE isolates were analysed with respect to their clonal relatedness, antimicrobial susceptibility, the presence of cfr and/or mutations in the 23S rRNA, rplC, rplD and rplV genes. cfr plasmids were characterized by Illumina sequencing. Medical records were reviewed and antibiotic consumption was determined. Results Molecular typing identified the presence of three different LRSE clusters: PFGE type I/ST168 (n = 5), PFGE type II/ST5 (n = 10) and PFGE type III/ST2 (n = 1). Ten strains harboured the cfr gene; we also detected mutations in the respective ribosomal protein genes. WGS revealed an almost identical 39 kb cfr plasmid obtained from strains of different genetic background (ST2, ST5, ST168) that shows high similarity to the recently published LRSE plasmid p12-02300. Due to an increase in the number of patients treated for infections with MRSA, a significant increase in linezolid usage was noted from January to July 2014 (from 5.55 to 20.41 DDDs/100 patient-days). Conclusions Here, we report the molecular epidemiology of LRSE in an ICU. Our results suggest the selection of resistant mutants under linezolid treatment as well as the spread of cfr-carrying plasmids. The reduction of linezolid usage and the strengthening of contact precautions proved to be effective infection control measures.
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Affiliation(s)
- Christina Weßels
- Institute of Hospital Hygiene, City of Cologne Hospitals, Cologne, Germany
| | - Birgit Strommenger
- National Reference Centre for Staphylococci and Enterococci, Division 13: Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Ingo Klare
- National Reference Centre for Staphylococci and Enterococci, Division 13: Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Jennifer Bender
- National Reference Centre for Staphylococci and Enterococci, Division 13: Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Sabine Messler
- Labor im Sommershof, Praxis für Laboratoriumsmedizin Dr. med. Christiane Boogen, Cologne, Germany
| | - Frauke Mattner
- Institute of Hospital Hygiene, City of Cologne Hospitals, Cologne, Germany
| | - Michael Krakau
- Department of Internal Medicine, City of Cologne Hospitals, Cologne, Germany
| | - Guido Werner
- National Reference Centre for Staphylococci and Enterococci, Division 13: Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Franziska Layer
- National Reference Centre for Staphylococci and Enterococci, Division 13: Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
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Ortega-Peña S, Vargas-Mendoza CF, Franco-Cendejas R, Aquino-Andrade A, Vazquez-Rosas GJ, Betanzos-Cabrera G, Guerrero-Barajas C, Jan-Roblero J, Rodríguez-Martínez S, Cancino-Diaz ME, Cancino Diaz JC. sesA, sesB, sesC, sesD, sesE, sesG, sesH,andembpgenes are genetic markers that differentiate commensal isolates ofStaphylococcus epidermidisfrom isolates that cause prosthetic joint infection. Infect Dis (Lond) 2019; 51:435-445. [DOI: 10.1080/23744235.2019.1597276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Silvestre Ortega-Peña
- Laboratory of Infectology, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
- Departments of Microbiology, Zoology and Immunology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Carlos F. Vargas-Mendoza
- Departments of Microbiology, Zoology and Immunology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Rafael Franco-Cendejas
- Laboratory of Infectology, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | | | | | - Gabriel Betanzos-Cabrera
- Área Académica de Nutrición and Toxicología Clínica, Instituto de Ciencias de la Salud Universidad Autónoma del Estado de Hidalgo, Pachuca Hidalgo, Mexico
| | - Claudia Guerrero-Barajas
- Deparment of Bioprocesses, Unidad Profesional Interdisciplinaria de Biotecnología, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Janet Jan-Roblero
- Departments of Microbiology, Zoology and Immunology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Sandra Rodríguez-Martínez
- Departments of Microbiology, Zoology and Immunology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Mario E. Cancino-Diaz
- Departments of Microbiology, Zoology and Immunology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Juan C. Cancino Diaz
- Departments of Microbiology, Zoology and Immunology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
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Strus M, Helwich E, Lauterbach R, Rzepecka-Węglarz B, Nowicka K, Wilińska M, Szczapa J, Rudnicka M, Sławska H, Szczepański M, Waśko A, Mikołajczyk-Cichońska A, Tomusiak-Plebanek A, Heczko PB. Effects of oral probiotic supplementation on gut Lactobacillus and Bifidobacterium populations and the clinical status of low-birth-weight preterm neonates: a multicenter randomized, double-blind, placebo-controlled trial. Infect Drug Resist 2018; 11:1557-1571. [PMID: 30288066 PMCID: PMC6160268 DOI: 10.2147/idr.s166348] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim Probiotic bacteria administered directly after birth to preterm neonates may improve gastrointestinal function and may reduce the incidence of late-onset sepsis, which is a frequent complication in this group. Purpose The main objective of this study was to evaluate whether a new probiotic bacterial mixture of Lactobacillus rhamnosus KL53A and Bifidobacterium breve PB04 given to preterm, low-birth-weight neonates would influence composition of their gut microbiota and sepsis rates. Patients and methods This study was a multicenter, randomized, double-blind, placebo-controlled trial conducted in clinical centers of neonatal care in Poland. A probiotic or placebo preparation was given twice daily to 181 preterm low-birth-weight neonates who were eligible for enteral feeding between July 2012 and July 2013. The probiotic was given to 90 neonates, while placebo was given to 91 neonates. The gut microbiota was monitored by microbiological analysis of stool samples. Sepsis episodes were detected on the basis of clinical and laboratory findings and confirmed by blood cultures. Results Tested probiotic administration resulted in continuous increase of the Lactobacillus and Bifidobacterium counts in the gut microbiota. The applied tested strains successfully colonized the neonates gut since they were present in over 90% of stool samples, which was confirmed by molecular analysis. Regardless of the study group (probiotic or placebo), B. breve colonization correlated with lower staphylococcal sepsis incidence, which was irrespective of whether probiotics were given. No sepsis case caused by strains included in study probiotic was recorded. Conclusion Appropriately selected and characterized probiotic bacteria may be safely given to preterm neonates to normalize their distorted gut microbiota and may contribute to lower staphylococcal sepsis rates.
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Affiliation(s)
- Magdalena Strus
- Department of Microbiology, Jagiellonian University Medical College, Kraków, Poland,
| | - Ewa Helwich
- Department of Neonatology, Institute of Mother and Child, Warszawa, Poland
| | | | | | - Katarzyna Nowicka
- Department of Neonatology, Institute of Mother and Child, Warszawa, Poland
| | - Maria Wilińska
- Clinical Department of Neonatology, Independent Public Clinical Hospital CMKP, Warszawa, Poland
| | - Jerzy Szczapa
- Department of Neonatology, Gynecology and Obstetrics Clinical Hospital, Poznań, Poland
| | | | - Helena Sławska
- Department of Neonatology, Specialist Hospital No. 2, Bytom, Poland
| | - Marek Szczepański
- Clinic Department of Neonatology and Neonatal Intensive Care, University Clinical Hospital, Białystok, Poland
| | - Aneta Waśko
- Medical Department, IBSS BIOMED S.A., Kraków, Poland
| | | | | | - Piotr B Heczko
- Department of Microbiology, Jagiellonian University Medical College, Kraków, Poland,
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Kang SJ, Choi SM, Choi JA, Choi JU, Oh TH, Kim SE, Kim UJ, Won EJ, Jang HC, Park KH, Shin JH, Kweon SS, Jung SI. Factors affecting the clinical relevance of Corynebacterium striatum isolated from blood cultures. PLoS One 2018; 13:e0199454. [PMID: 29928059 PMCID: PMC6013186 DOI: 10.1371/journal.pone.0199454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 06/07/2018] [Indexed: 02/07/2023] Open
Abstract
This study aimed to identify clinical or microbiological factors affecting the clinical relevance of Corynebacterium striatum isolated from blood cultures. A total of 64 isolates from 51 patients identified as C. striatum by matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing were assessed. More than two blood cultures were positive in 25 (48.1%) patients. Diabetes, solid tumor, and a history of previous exposure to antibiotics were more common in patients with multiple positive blood cultures. Charlson comorbidity scores were also higher, and more isolates were recovered after 48 hours of hospital stay in patients with multiple positive blood cultures. Strains recovered from patients with multiple positive blood cultures produced significantly more biofilm. Based on multilocus sequence typing (MLST), sequence type (ST) 20 (31.3%) was the most dominant, followed by ST2 (20.3%) and ST23 (10.9%). There was no relationship between the number of positive blood culture sets and sequence typing. In multivariate analyses, Carlson comorbidity score (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.09–3.36; P = 0.03) and biofilm formation were associated with multiple positive blood cultures (OR, 17.43; 95% CI, 3.71–81.91; P = 0.03). This study provides evidence that the biofilm phenotype could contribute to determining the clinical significance of C. striatum in patients with severe underlying conditions. The predominance of certain STs suggests the relatedness of C. striatum infection and the nosocomial environment.
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Affiliation(s)
- Seung Ji Kang
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Su-Mi Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jin-A Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jin Un Choi
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Tae-Hoon Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Seong Eun Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Uh Jin Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Eun Jeong Won
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Hee-Chang Jang
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Kyung-Hwa Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Sook-In Jung
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
- * E-mail:
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Freitas AI, Lopes N, Oliveira F, Brás S, França Â, Vasconcelos C, Vilanova M, Cerca N. Comparative analysis between biofilm formation and gene expression in Staphylococcus epidermidis isolates. Future Microbiol 2018; 13:415-427. [PMID: 29469610 DOI: 10.2217/fmb-2017-0140] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To understand the relationship between ica, aap and bhp gene expression and the implications in biofilm formation in selected clinical and commensal Staphylococcus epidermidis isolates. MATERIAL & METHODS Isolates were analyzed regarding their biofilm-forming capacity, biochemical matrix composition, biofilm spatial organization and expression of biofilm-related genes. RESULTS On polysaccharide intercellular adhesin-dependent biofilms, aap and bhp contributions for the biofilm growth were negligible, despite very high levels of expression. In contrast, smaller increases in icaA expression contributed significantly to biofilm growth. Interestingly, no biological differences were observed between clinical and commensal strains. CONCLUSION These results reinforce the concept that S. epidermidis is an 'accidental pathogen,' and that the ica operon is the main mechanism of biofilm formation in clinical and commensal isolates.
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Affiliation(s)
- Ana I Freitas
- Centre of Biological Engineering, Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.,Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313 Porto, Portugal
| | - Nathalie Lopes
- Centre of Biological Engineering, Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Fernando Oliveira
- Centre of Biological Engineering, Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Susana Brás
- Centre of Biological Engineering, Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Ângela França
- Centre of Biological Engineering, Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Carlos Vasconcelos
- Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313 Porto, Portugal.,Hospital Santo António, Centro Hospitalar do Porto, Porto, 4099-001, Portugal
| | - Manuel Vilanova
- Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313 Porto, Portugal.,Instituto de Investigação e Inovação em Saúde & Instituto de Biologia Molecular e Celular, Universidade do Porto, 4150-180 Porto, Portugal
| | - Nuno Cerca
- Centre of Biological Engineering, Laboratory of Research in Biofilms Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
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Larssen KW, Nor A, Bergh K. Rapid discrimination of Staphylococcus epidermidis genotypes in a routine clinical microbiological laboratory using single nucleotide polymorphisms in housekeeping genes. J Med Microbiol 2018; 67:169-182. [PMID: 29293080 DOI: 10.1099/jmm.0.000663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Staphylococcus epidermidis colonies often display several morphologies and antimicrobial susceptibility patterns when cultured from device-related infections, and may represent one or multiple genotypes. Genotyping may be helpful in the clinical interpretation, but is time consuming and expensive. We wanted to establish a method for rapid discrimination of S. epidermidis genotypes for use in a routine microbiology laboratory. METHODOLOGY A real-time PCR targeting eight discriminatory class I or II single-nucleotide polymorphisms (SNPs) in six of the seven housekeeping genes was constructed. Post PCR, high-resolution melt (HRM) analysis using EvaGreen as fluorophore discriminated amplicons based on their percentage GC content. RESULTS In silico, 42 representative sequence types (STs), including all major MLST group and subgroup founders, were separated into 23 different cluster profiles with a Simpson's index of diversity of 0.97. By HRM-PCR, 11 commonly encountered hospital and outbreak STs were separated into eight HRM patterns. CONCLUSION This method can rapidly establish whether S. epidermidis strains belong to different genotypes. It can be used in patients with S. epidermidis infections, as an aid in outbreak investigations and to select strains for investigation with more discriminatory methods, saving workload and costs. Results may be obtained the same day as culture results. Its strength lies mainly in indicating differences, as some STs may have the same melt profile. Changes in S. epidermidis epidemiology may warrant alterations in the inclusion of SNPs. We believe this method can reduce the threshold for performing genotyping analysis on an increasingly important nosocomial pathogen.
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Affiliation(s)
- Kjersti Wik Larssen
- Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anne Nor
- Department of Laboratory medicine, Children's and Women's health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kåre Bergh
- Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Laboratory medicine, Children's and Women's health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Jena S, Panda S, Nayak KC, Singh DV. Identification of Major Sequence Types among Multidrug-Resistant Staphylococcus epidermidis Strains Isolated from Infected Eyes and Healthy Conjunctiva. Front Microbiol 2017; 8:1430. [PMID: 28824564 PMCID: PMC5543311 DOI: 10.3389/fmicb.2017.01430] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/14/2017] [Indexed: 01/13/2023] Open
Abstract
We examined the presence of virulence and antibiotic resistance genes, SCCmec types and determined the genomic diversity among ocular S. epidermidis isolates (patients-23, healthy controls-29). PCR determined the presence of antibiotic resistance genes, virulence genes and SCCmec types among all isolates. MLST and PFGE determined the genomic relatedness among them. All isolates of S. epidermidis showed resistance to at least one class of antibiotics of which 48 isolates were multidrug resistant and carried ARGs. Thirty-five isolates were methicillin resistant and carried mecA gene. Majority of the isolates were resistant to fluoroquinolones and showed mutation in gyrA, parC, and parE genes, however, few isolates showed additional novel mutations in parC gene. Of the MRSE strains, 17 strains carried SCCmec type IV, four type V, two type II, and two UT4. Seven strains carried novel combination of ccr complex and SCCmercury element, not reported earlier. All the S. epidermidis strains harbored icaA and icaD genes, 47 carried ACME operon, and 50 contained IS256. A noteworthy finding was the presence of ST179 among 43% of infected eye isolates an observation rarely reported among S. epidermidis. PFGE and MLST analysis showed genomic diversity among them. Statistical analysis suggests that few healthy conjunctiva isolates had characteristics similar to infected eye isolates. S. epidermidis strains carrying mecA gene are multidrug resistant, virulent and diverse irrespective of sources of isolation. IS256 cannot be used as marker to differentiate isolates of infected eye from healthy conjunctiva.
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Affiliation(s)
- Smrutiti Jena
- Infectious Disease Biology, Institute of Life SciencesBhubaneswar, India
| | - Sasmita Panda
- Infectious Disease Biology, Institute of Life SciencesBhubaneswar, India
| | - Kinshuk C Nayak
- Bioinformatics Center, Institute of Life SciencesBhubaneswar, India
| | - Durg V Singh
- Infectious Disease Biology, Institute of Life SciencesBhubaneswar, India
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Halaji M, Karimi A, Shoaei P, Nahaei M, Khorvash F, Ataei B, Yaran M, Havaei SA. Distribution of SCCmec Elements and Presence of Panton-Valentine Leukocidin in Methicillin-Resistant Staphylococcusepidermidis Isolated from Clinical Samples in a University Hospital of Isfahan City, Iran. J Clin Diagn Res 2017; 11:DC27-DC31. [PMID: 28892893 DOI: 10.7860/jcdr/2017/25518.10258] [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: 11/20/2016] [Accepted: 04/20/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Coagulase Negative Staphylococcus (CoNS) is considered as a major pathogen of nosocomial infections among immunosuppressed patients. AIM The aim of this study was to identify the types of Staphylococcal Cassette Chromosome mec (SCCmec) and Panton-Valentine Leukocidin (PVL) gene among clinical Methicillin-Resistant S. epidermidis (MRSE) isolates collected from Isfahan. MATERIALS AND METHODS This cross-sectional study was performed from March 2014 to January 2015 at a tertiary care hospital of Isfahan, Iran. Antimicrobial susceptibility tests of S. epidermidis isolates were performed by the disc diffusion method. All the strains were screened for methicillin resistance based on resistance to cefoxitin (30 μg) disc and presence of mecA gene. Determination of SCCmec typing and PVL toxin gene were performed by PCR method. For categorical variables different groups were compared using the Chi-square test or Fisher exact test. A p-value of <0.05 was considered significant for all statistical tests. RESULTS The frequency of MRSE was 53.8% according to the presence of mecA gene. The overall resistance rate was high with ciprofloxacin (81.4%). PCR analysis showed that 17% (12/70) of MRSE isolate carried the PVL gene and 43% (30/70) were SCCmec type I; 11.4% (8/70) were type II; and 34.2% (24/70) were type IV, whereas, 11.4% (8/70) of the MRSE isolates could not be typed. CONCLUSION SCCmec type I was the major type of SCCmec, which indicates an emergence of this SCCmec type in the studied medical centers. Increased prevalence of SCCmec types in community is cause of an increase in antibiotic resistance among microorganisms.
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Affiliation(s)
- Mehrdad Halaji
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashkan Karimi
- Department of Microbiology, Ahar Branch, Islamic Azad University, Ahar, Iran
| | - Parisa Shoaei
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Nahaei
- Department of Microbiology, Ahar Branch, Islamic Azad University, Ahar, Iran
| | - Farzin Khorvash
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Yaran
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Asghar Havaei
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Prevalence of atlE, ica, mecA, and mupA Genes in Staphylococcus epidermidis Isolates. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2017. [DOI: 10.1097/ipc.0000000000000437] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study. BMC Infect Dis 2016; 16:743. [PMID: 27938344 PMCID: PMC5148920 DOI: 10.1186/s12879-016-2094-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 12/06/2016] [Indexed: 01/22/2023] Open
Abstract
Background During the last decades, healthcare-associated genotypes of methicillin-resistant Staphylococcus epidermidis (HA-MRSE) have been established as important opportunistic pathogens. However, data on potential reservoirs on HA-MRSE is limited. The aim of the present study was to investigate the dynamics and to which extent HA-MRSE genotypes colonize patients, healthcare workers (HCWs) and the environment in an intensive care unit (ICU). Methods Over 12 months in 2006–2007, swab samples were obtained from patients admitted directly from the community to the ICU and patients transferred from a referral hospital, as well as from HCWs, and the ICU environment. Patients were sampled every third day during hospitalization. Antibiotic susceptibility testing was performed according to EUCAST guidelines. Pulsed-field gel electrophoresis and multilocus sequence typing were used to determine the genetic relatedness of a subset of MRSE isolates. Results We identified 620 MRSE isolates from 570 cultures obtained from 37 HCWs, 14 patients, and 14 environmental surfaces in the ICU. HA-MRSE genotypes were identified at admission in only one of the nine patients admitted directly from the community, of which the majority subsequently were colonized by HA-MRSE genotypes within 3 days during hospitalization. Almost all (89%) of HCWs were nasal carriers of HA-MRSE genotypes. Similarly, a significant proportion of patients transferred from the referral hospital and fomites in the ICU were widely colonized with HA-MRSE genotypes. Conclusions Patients transferred from a referral hospital, HCWs, and the hospital environment serve as important reservoirs for HA-MRSE. These observations highlight the need for implementation of effective infection prevention and control measures aiming at reducing HA-MRSE transmission in the healthcare setting. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-2094-x) contains supplementary material, which is available to authorized users.
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Saffari F, Widerström M, Gurram BK, Edebro H, Hojabri Z, Monsen T. Molecular and Phenotypic Characterization of Multidrug-Resistant Clones ofStaphylococcus epidermidisin Iranian Hospitals: Clonal Relatedness to Healthcare-Associated Methicillin-Resistant Isolates in Northern Europe. Microb Drug Resist 2016; 22:570-577. [DOI: 10.1089/mdr.2015.0283] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fereshteh Saffari
- Department of Microbiology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Micael Widerström
- Department of Clinical Microbiology, Unit of Research, Education and Development-Östersund, Umeå University, Umeå, Sweden
| | | | - Helen Edebro
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Zoya Hojabri
- Department of Microbiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Tor Monsen
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
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Deplano A, Vandendriessche S, Nonhoff C, Dodémont M, Roisin S, Denis O. National surveillance ofStaphylococcus epidermidisrecovered from bloodstream infections in Belgian hospitals. J Antimicrob Chemother 2016; 71:1815-9. [DOI: 10.1093/jac/dkw086] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/28/2016] [Indexed: 01/18/2023] Open
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Argudín MA, Vanderhaeghen W, Vandendriessche S, Vandecandelaere I, Denis O, Coenye T, Butaye P. Biofilm formation of ica operon-positive Staphylococcus epidermidis from different sources. APMIS 2016; 123:1081-9. [PMID: 26547374 DOI: 10.1111/apm.12472] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/02/2015] [Indexed: 12/17/2022]
Abstract
Information on the prevalence of biofilm-related factors (PIA, Bhp, Aap, Embp) in Staphylococcus epidermidis of animal origin is scarce. In this study, 263 S. epidermidis isolates of diverse origin (animal, farmers, patients, and laboratory staff) were investigated for the presence of the ica operon (icaRADBC). The icaRADBC-positive isolates were further characterized by means of biofilm formation, presence of other biofilm-related genes, antimicrobial resistance, and population structure. Of all isolates, 28.5% (n = 75) were icaRADBC-positive, including 16.5% of animal origin, 29.1% farmer isolates, and 44.6% hospital-associated isolates (including patients and laboratory staff isolates). Most icaRADBC-positive isolates carried embp (n = 73), aap (n = 57), bhp (n = 22), and IS256 (n = 29). Statistical differences were found between animal and patient isolates for the presence of icaRADBC, bhp, and aap. No statistically significant relation was found between the presence of one or more genes and the level of biofilm formation. Most icaRADBC-positive isolates belonged to the clonal complex 5 (formerly 2) and most sequence types corresponded to types previously observed in community and nosocomial S. epidermidis populations. Although the prevalence of S. epidermidis in the nasal cavity of bovines and poultry is low, some isolates belong to STs related to ica-positive clinical strains.
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Affiliation(s)
- Maria Angeles Argudín
- Department of Bacterial Diseases, Veterinary and Agrochemical Research Centre, Brussels, Belgium
| | - Wannes Vanderhaeghen
- Department of Obstetrics, Reproduction and Herd Health, Ghent University, Merelbeke, Belgium
| | - Stien Vandendriessche
- Department of Microbiology, National Reference Centre - Staphylococcus aureus, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Ilse Vandecandelaere
- Laboratory of Pharmaceutical Microbiology, Department of Pharmaceutical analysis, Ghent University, Ghent, Belgium
| | - Olivier Denis
- Department of Microbiology, National Reference Centre - Staphylococcus aureus, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Tom Coenye
- Laboratory of Pharmaceutical Microbiology, Department of Pharmaceutical analysis, Ghent University, Ghent, Belgium
| | - Patrick Butaye
- Department of Pathology, Bacteriology, and Avian Diseases, Ghent University, Merelbeke, Belgium.,Department of Biomedical Sciences, School of Veterinary Medicine, Ross University, St Kitts and Nevis, West Indies
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Soroush S, Jabalameli F, Taherikalani M, Amirmozafari N, Fooladi AAI, Asadollahi K, Beigverdi R, Emaneini M. Investigation of biofilm formation ability, antimicrobial resistance and the staphylococcal cassette chromosome mec patterns of methicillin resistant Staphylococcus epidermidis with different sequence types isolated from children. Microb Pathog 2016; 93:126-30. [PMID: 26821355 DOI: 10.1016/j.micpath.2016.01.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 11/17/2022]
Abstract
This study investigated the molecular characterizations of 80 methicillin resistant Staphylococcus epidermidis (MRSE) collected during 2012-2013 in Tehran Children's Medical Center, Iran. About 90% of MRSE isolates were multi-drug resistant (MDR) and the highest resistance was observed to cotrimoxazole and they were quite sensitive to quinupristin-dalfopristin and linezolid. Though vanA gene was not detected, the majority of isolates showed intermediate resistance to vancomycin (MIC90 16 μg/ml). Resistance to mupirocin was observed in 18 isolates. Staphylococcal cassette chromosome mec (SCCmec) types V, III, IV and II were detected in 23.75%, 7.5%, 6.25% and 5% of isolates respectively, in some of which the additional parts of mec or ccr complexes were observed. In 57.5% MRSE isolates SCCmec types were not classified. 41.2% of MRSE isolates were carrying intercellular adhesion (ica) operon and 40% had strong or intermediate biofilm. The types of arginine catabolic mobile element (ACME) were limited to type I and II. Nine sequence types (STs) were seen in mupirocin resistant MRSE isolates. The common STs were ST2, ST5 and ST22 with 27.7% (5/18), 22.2% (4/18) and 16.6% (3/18) frequencies, respectively. ST23, ST54 and ST179 plus three novels STs 580, 581,588 were also observed. The majority of STs, 83.3% (15/18) belonged to clonal complex 2 (CC2). The spread of antibiotic resistance and virulence factors among MRSE species is an alarming sign in Children's Hospitals. The combination of these two issues leads to increase the chance of successfully establishing of common STs in hospital environments, and promotes the device-related infections and bacteremia.
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Affiliation(s)
- Setareh Soroush
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Fereshteh Jabalameli
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Morovat Taherikalani
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Nour Amirmozafari
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Ali Imani Fooladi
- Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Khairollah Asadollahi
- Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Reza Beigverdi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Farid A, Naz I, Ashraf A, Ali A, Rehman AU, Sarwar Y, Haque A. Molecular detection of antimicrobial resistance in local isolates of Staphylococcus epidermidis from urinary tract infections in Faisalabad region of Pakistan. EXCLI JOURNAL 2015; 14:697-705. [PMID: 26648821 PMCID: PMC4669908 DOI: 10.17179/excli2015-294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 05/12/2015] [Indexed: 11/10/2022]
Abstract
Staphylococci are one of the foremost causes of urinary tract infections (UTIs) in humans. The emergence of multiple drug resistance (MDR) among Staphylococci poses serious challenges in antimicrobial therapy for UTIs. Most work has been done on S. aureus while coagulase negative Staphylococci (mainly S. epidermidis) are often neglected. This study was conducted to establish a baseline profile of drug resistance in local S. epidermidis isolates from UTIs. Eighty urine samples were collected from suspected UTIs cases and screened for S. epidermidis. Twenty isolates were suspected as S. epidermidis based on colony morphology and Gram staining. Molecular detection by polymerase chain reaction (PCR) confirmed 13 isolates as S. epidermidis. Using disc diffusion method, phenotypic drug resistance of the isolates was observed towards erythromycin (100 %), gentamycin, azithromycin and tetracycline (92.3 %), ampicillin and oxytetracyclin (84.6 %), amikacin and srteptomycin (76.9 %), methicillin (69.2 %), cephradine, cefaclor and cefazolin (53.8 %) and vancomycin (15.3 %). Eighteen most commonly reported genes responsible for conferring resistance towards these drugs were targeted by PCR: among these tetM gene was found most prevalent (46.1 %) followed by tetK (30.7 %), aac(6')/aph(2") (30.7 %), aacA-aphD (23 %), ermA (23 %), blaZ (23 %), mecA (23 %) blaTEM-1 (23 %), MeccA (23 %) and mecA (15.3 %). No gene fragment for vancomycin resistance was detected. The salient finding was that all S. epidermidis isolates were multiple drugs resistant as they showed resistance against at least three structurally different antimicrobial agents. It is concluded that in addition to the mostly used antimicrobial agent vancomycin, the cephalosporins including cephradine, cefaclor and cefazolin are also the drugs of choice against UTIs caused by S. epidermidis.
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Affiliation(s)
- Anam Farid
- Institute of Industrial Biotechnology, Government College University, Lahore
| | - Iram Naz
- Government College University, Faisalabad
| | | | - Aamir Ali
- National Institute for Biotechnology and Genetic Engineering (NIBGE), Faisalabad
| | - Asad-Ur Rehman
- Institute of Industrial Biotechnology, Government College University, Lahore
| | - Yasra Sarwar
- National Institute for Biotechnology and Genetic Engineering (NIBGE), Faisalabad
| | - Abdul Haque
- Madina Teaching Hospital, The University of Faisalabad, Faisalabad, Pakistan
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Flores-Páez LA, Zenteno JC, Alcántar-Curiel MD, Vargas-Mendoza CF, Rodríguez-Martínez S, Cancino-Diaz ME, Jan-Roblero J, Cancino-Diaz JC. Molecular and Phenotypic Characterization of Staphylococcus epidermidis Isolates from Healthy Conjunctiva and a Comparative Analysis with Isolates from Ocular Infection. PLoS One 2015; 10:e0135964. [PMID: 26275056 PMCID: PMC4537226 DOI: 10.1371/journal.pone.0135964] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 07/29/2015] [Indexed: 11/26/2022] Open
Abstract
Staphylococcus epidermidis is a common commensal of healthy conjunctiva and it can cause endophthalmitis, however its presence in conjunctivitis, keratitis and blepharitis is unknown. Molecular genotyping of S. epidermidis from healthy conjunctiva could provide information about the origin of the strains that infect the eye. In this paper two collections of S. epidermidis were used: one from ocular infection (n = 62), and another from healthy conjunctiva (n = 45). All isolates were genotyped by pulsed field gel electrophoresis (PFGE), multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec), detection of the genes icaA, icaD, IS256 and polymorphism type of agr locus. The phenotypic data included biofilm production and antibiotic resistance. The results displayed 61 PFGE types from 107 isolates and they were highly discriminatory. MLST analysis generated a total of 25 STs, of which 11 STs were distributed among the ocular infection isolates and lineage ST2 was the most frequent (48.4%), while 14 STs were present in the healthy conjunctiva isolates and lineage ST5 was the most abundant (24.4%). By means of a principal coordinates analysis (PCoA) and a discriminant analysis (DA) it was found that ocular infection isolates had as discriminant markers agr III or agr II, SCCmec V or SCCmec I, mecA gene, resistance to tobramycin, positive biofilm, and IS256+. In contrast to the healthy conjunctiva isolates, the discriminating markers were agr I, and resistance to chloramphenicol, ciprofloxacin, gatifloxacin and oxacillin. The discriminant biomarkers of ocular infection were examined in healthy conjunctiva isolates, and it was found that 3 healthy conjunctiva isolates [two with ST2 and another with ST9] (3/45, 6.66%) had similar genotypic and phenotypic characteristics to ocular infection isolates, therefore a small population from healthy conjunctiva could cause an ocular infection. These data suggest that the healthy conjunctiva isolates do not, in almost all cases, infect the eye due to their large genotypic and phenotypic difference with the ocular infection isolates.
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Affiliation(s)
- Luis A. Flores-Páez
- Department of Microbiology, Escuela Nacional de Ciencias Biológicas-Instituto Politécnico Nacional, Mexico City, Mexico
| | - Juan C. Zenteno
- Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico
| | | | - Carlos F. Vargas-Mendoza
- Department of Zoology, Escuela Nacional de Ciencias Biológicas-Instituto Politécnico Nacional, Mexico City, Mexico
| | - Sandra Rodríguez-Martínez
- Department of Immunology, Escuela Nacional de Ciencias Biológicas-Instituto Politécnico Nacional, Mexico City, Mexico
| | - Mario E. Cancino-Diaz
- Department of Immunology, Escuela Nacional de Ciencias Biológicas-Instituto Politécnico Nacional, Mexico City, Mexico
| | - Janet Jan-Roblero
- Department of Microbiology, Escuela Nacional de Ciencias Biológicas-Instituto Politécnico Nacional, Mexico City, Mexico
| | - Juan C. Cancino-Diaz
- Department of Microbiology, Escuela Nacional de Ciencias Biológicas-Instituto Politécnico Nacional, Mexico City, Mexico
- * E-mail:
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Batista KCDO, Tipple AFV, Leão-Vasconcelos LSNDO, Ribeiro EL, Prado MAD. Contaminação de torniquetes para punção intravenosa periférica. ACTA PAUL ENFERM 2015. [DOI: 10.1590/1982-0194201500072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Identificar a presença de contaminação em torniquetes para punção intravenosa periférica e caracterizar o perfil dosStaphylococcus spp. e leveduras isolados. Métodos Estudo transversal que inseriu análise de 18 torniquetes para punção intravenosa periférica em uso no hospital. Os torniquetes foram imersos em caldo BHI por 24h e cultivados em meios seletivos para isolamento e identificação de Staphylococcus spp. e leveduras. O método disco-difusão foi empregado para analisar o perfil de suscetibilidade dosStaphylococcus spp. aos antimicrobianos. Resultados Treze (72,2%) torniquetes apresentaram crescimento de algum micro-organismo sendo 11 (52,4%) Staphylococcus coagulase-negativo, dois (9,5%) Staphylococcusaureus, quatro (19%)Rodothorulamucilaginosa, três (14,3%)Candidaalbicans. 61,5% dosStaphylococcus spp. apresentaram resistência a oxacilina. Os profissionais da equipe não relataram protocolos para limpeza, desinfecção ou substituição controlada destes materiais na instituição. Conclusão Foi identificada a contaminação de torniquetes por micro-organismos patogênicos com perfil de resistência aos antibióticos muito utilizados em instituições hospitalares.
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Bender J, Strommenger B, Steglich M, Zimmermann O, Fenner I, Lensing C, Dagwadordsch U, Kekulé AS, Werner G, Layer F. Linezolid resistance in clinical isolates of Staphylococcus epidermidis from German hospitals and characterization of two cfr-carrying plasmids. J Antimicrob Chemother 2015; 70:1630-8. [PMID: 25740949 DOI: 10.1093/jac/dkv025] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 01/21/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study was a detailed investigation of Staphylococcus epidermidis clinical isolates exhibiting linezolid resistance. METHODS Thirty-six linezolid-resistant S. epidermidis from eight German hospitals, including isolates from suspected hospital-associated outbreaks between January 2012 and April 2013, were analysed with respect to their antimicrobial susceptibility and the presence of cfr and/or mutations in the 23S rRNA, rplC, rplD and rplV genes. Relatedness of isolates was estimated by MLST and SmaI macrorestriction analysis. Characterization of cfr plasmids was carried out by means of Illumina sequencing. RESULTS The MICs of linezolid varied substantially between the isolates. No apparent correlation was detected between the level of resistance, the presence of cfr and ribosomal target site mutations. S. epidermidis isolates from two hospitals were confirmed as clonally related, indicating the spread of the respective clone over a period of 1 year. Next-generation sequencing revealed two different categories of cfr-expressing plasmids, both of them varying in genetic arrangement and composition from previously published cfr plasmids: p12-00322-like plasmids showed incorporation of cfr into a pGO1-like backbone and displayed capabilities for intra- and inter-species conjugational transfer. CONCLUSIONS To date, linezolid-resistant S. epidermidis have rarely been isolated from human clinical sources in Germany. Here, we describe the emergence and outbreaks of these strains. We detected previously described and novel point mutations in the 23S ribosomal genes. The cfr gene was only present in six isolates. However, this is the first known description of cfr incorporation into conjugative vectors; under selective pressure, these vectors could give reasonable cause for concern.
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Affiliation(s)
- Jennifer Bender
- National Reference Centre for Staphylococci and Enterococci, Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Burgstraße 37, 38855 Wernigerode, Germany
| | - Birgit Strommenger
- National Reference Centre for Staphylococci and Enterococci, Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Burgstraße 37, 38855 Wernigerode, Germany
| | - Matthias Steglich
- National Reference Centre for Staphylococci and Enterococci, Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Burgstraße 37, 38855 Wernigerode, Germany
| | - Ortrud Zimmermann
- Institute of Medical Microbiology, University Medical Centre Göttingen, Kreuzbergring 57, 37075 Göttingen, Germany
| | - Ines Fenner
- MVZ Labor Fenner und Kollegen, Bergstraße 14, 20095 Hamburg, Germany
| | - Carmen Lensing
- MVZ Labor Fenner und Kollegen, Bergstraße 14, 20095 Hamburg, Germany
| | - Urantschimeg Dagwadordsch
- Institute of Medical Microbiology, Martin Luther University Halle/Wittenberg, Magdeburger Straße 6, 06112 Halle, Germany
| | - Alexander S Kekulé
- Institute of Medical Microbiology, Martin Luther University Halle/Wittenberg, Magdeburger Straße 6, 06112 Halle, Germany
| | - Guido Werner
- National Reference Centre for Staphylococci and Enterococci, Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Burgstraße 37, 38855 Wernigerode, Germany
| | - Franziska Layer
- National Reference Centre for Staphylococci and Enterococci, Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Burgstraße 37, 38855 Wernigerode, Germany
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