[Studies on the relationship between gastric acidity and the development of MRSA. Especially for the prevention of MRSA enterocolitis]

Staphylococcal Enterotoxin C-An Update on SEC Variants, Their Structure and Properties, and Their Role in Foodborne Intoxications

Staphylococcal enterotoxins are the most common cause of foodborne intoxications (staphylococcal food poisoning) and cause a wide range of diseases. With at least six variants staphylococcal enterotoxin C (SEC) stands out as particularly diverse amongst the 25 known staphylococcal enterotoxins. Some variants present unique and even host-specific features. Here, we review the role of SEC in human and animal health with a particular focus on its role as a causative agent for foodborne intoxications. We highlight structural features unique to SEC and its variants, particularly, the emetic and superantigen activity, as well as the roles of SEC in mastitis and in dairy products. Information about the genetic organization as well as regulatory mechanisms including the accessory gene regulator and food-related stressors are provided.

Enterocolitis caused by methicillin-resistant Staphylococcus aureus: molecular characterization of respiratory and digestive tract isolates

We investigated the mechanism of outbreak of enterocolitis caused by methicillin-resistant Staphylococcus aureus (MRSA). Five epidemiological markers [coagulase type, enterotoxin type, toxic shock syndrome toxin-1 (TSST-1) production, beta-lactamase production and pulsed-field gel electrophoresis (PFGE)] of 45 strains of MRSA isolated simultaneously from the respiratory tract (nasal cavity and/or pharynx and/or sputum) and stool (plus one sample of gastric juice) in 13 patients (8 males and 5 females, mean age, 77.1 years) were compared retrospectively. Forty-four of the 45 isolates of MRSA were positive for enterotoxin C and TSST-1 production, and the remaining isolate was positive for enterotoxin A and negative for TSST-1 production. All isolates were coagulase type II, and 27 showed beta-lactamase production. The patterns of coagulase type, enterotoxin type, TSST-1 and beta-lactamase production of MRSA isolated from the respiratory tract were similar to those of MRSA isolated from the intestine in 12 of 13 patients. Molecular typing by PFGE demonstrated that the pattern of respiratory tract isolates was identical to those of stool isolates in 9 (69.2%), similar in 3 (23.1 %), and different in 1 (7.7%). The data suggested that enterocolitis might be caused by the MRSA colonized in the respiratory tract and incorporated into the digestive tracts. Therefore, we propose that early eradication of MRSA in the respiratory tract is important for protection of patients against the development of enterocolitis, particularly in susceptible patients, e.g., immunocompromised or pre-operated patients with digestive diseases, especially malignant disease.

Methicillin-resistant Staphylococcus aureus proliferation in the rat gut is influenced by gastric acid inhibition and the administration of antibiotics

The author studied methicillin-resistant Staphylococcus aureus (MRSA) proliferation in the rat gut which was influenced by gastric acid inhibition and the administration of antibiotics. When male Wistar rats were bred by total parenteral nutrition (TPN), and were continuously administered famotidine 4 mg/kg per day, the gastric acidity was observed to decrease to pH 6.4+/-0.1. However, when they were bred by TPN, and histamine 4 mg/kg per hour was continuously administered, the gastric acidity was observed to increase to pH 1.9+/-0.4. MRSA was thus able to cross over to the small intestine only during the famotidine medication. If rats were intravenously administered latamoxef (LMOX) after an oral inoculation of MRSA, then the viable MRSA counts in the stomach, small intestine, and large intestine all decreased on day 4. In contrast, if the gastric acidity decreased and the rats were treated by an oral administration of kanamycin and metronidazole before an oral inoculation of MRSA and thereafter were administered LMOX, then the MRSA count significantly increased. It is thus concluded that a suppression of gastric acid and a great disorder of the intestinal flora is indispensable for the colonization of MRSA into the small intestine, while in vitro the propagation of MRSA requires a continuity of suppression absent in the bacterial flora.