Unreported Male Sex Partners Among Men with Newly Diagnosed HIV Infection - North Carolina, 2011-2013

Emerging resistance mechanisms for 4 types of common anti-MRSA antibiotics in Staphylococcus aureus: A comprehensive review

Staphylococcus aureus is one of the leading hospital-associated and community-associated pathogens, which has caused a global public health concern. The emergence of methicillin-resistant S. aureus (MRSA) along with the widespread use of different classes of antibiotics has become a significant therapeutic challenge. Antibiotic resistance is a disturbing problem that poses a threat to humans. Treatment options for S. aureus resistant to β-lactam antibiotics include glycopeptide antibiotic, cyclic lipopeptide antibiotic, cephalosporins and oxazolidinone antibiotic. The most representative types of these antibiotics are vancomycin, daptomycin, ceftaroline and linezolid. The frequent use of the first-line drug vancomycin for MRSA treatment has increased the number of resistant strains, namely vancomycin intermediate resistant S. aureus (VISA) and vancomycin resistant S. aureus (VRSA). A systematic literature review of relevant published studies in PubMed before 2020 was conducted. In recent years, there have been some reports on the relevant resistant mechanisms of vancomycin, daptomycin, ceftaroline and linezolid. In this review, we have summarized the antibiotic molecular modes of action and different gene mutants at the whole-genome level, which will aid in further development on new drugs for effective MRSA treatment based on describing different resistance mechanisms of classic antibiotics.

Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci co-colonization in patients: A meta-analysis

BACKGROUND

Co-colonization of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) may result in the transfer of drug-resistant genes. The aim of this meta-analysis was to estimate the pooled co-colonization prevalence of MRSA and VRE.

METHODS

We searched PubMed, Embase, and Web of Science databases. The co-colonization prevalence of MRSA and VRE was assessed by calculating the proportion and 95% confidence intervals (CI). The random-effects model was used to calculate the pooled prevalence.

RESULTS

Eleven eligible studies were included in this meta-analysis. The pooled co-colonization prevalence of MRSA and VRE in patients was 7% (95% CI, 5.0%-9.0%). The results of regression analysis showed that co-colonization prevalence of MRSA and VRE was related to study design, setting, screening sites, and detection methods. We found that male patients (odds ratio [OR], 1.58; 95% CI, 1.09-2.28), patients with comorbid conditions such as diabetes mellitus (OR, 1.37; 95% CI, 1.05-1.78), chronic obstructive pulmonary disease (OR, 1.88; 95% CI, 1.27-2.79), and use of indwelling devices (OR, 4.08; 95% CI, 2.21-7.53) were risk factors for co-colonization by MRSA and VRE.

CONCLUSIONS

The co-colonization prevalence of MRSA and VRE in the patients was common. Appropriate measures should be adopted to limit the horizontal transmission of MRSA and VRE to minimize the future potential for co-colonization and the transfer of resistance genes among these pathogens.

Concordance between self-reported STI history and biomedical results among men who have sex with men in Los Angeles, California

OBJECTIVES

HIV studies and risk assessments among men who have sex with men (MSM) frequently use self-reported STI history as a proxy for true STI history. The objective of our study was to assess the validity of self-reported STI history through comparison with laboratory-confirmed biomedical results.

METHODS

Data were analysed for MSM attending the Los Angeles LGBT Center (the Center) from August 2011 to July 2015. We identified 10 529 unique MSM who received testing for chlamydia, gonorrhoea and/or syphilis and had a later visit in which they self-reported their STI history to a clinic counsellor during a risk assessment.

RESULTS

MSM who had an STI in the past year self-reported their STI history with 51%-56% accuracy, and MSM who had an STI more than a year ago self-reported their STI history with 65%-72% accuracy. Among MSM with any positive STIs at the Center, black/African-American and Hispanic MSM were more likely to inaccurately self-report their positive results for gonorrhoea (adjusted OR (aOR): 1.48, 95% CI 1.09 to 2.01; aOR: 1.39, 95% CI 1.14 to 1.70). Additionally, HIV-positive MSM were more likely to inaccurately self-report their positive results for gonorrhoea (aOR: 1.63, 95% CI 1.22 to 2.18) and/or syphilis (aOR: 2.19, 95% CI 1.08 to 4.47).

CONCLUSIONS

This is the first study that attempts to evaluate the validity of self-reported STI history among MSM. We found that self-reported STI history may not be an appropriate proxy for true STI history in certain settings and minority populations. Clinical guidelines and research studies that rely on self-reported STI history will need to modify their recommendations in light of the limited validity of these data.