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A Sequalae of Lineage Divergence in Staphylococcus aureus from Community-Acquired Patterns in Youth to Hospital-Associated Profiles in Seniors Implied Age-Specific Host-Selection from a Common Ancestor. Diagnostics (Basel) 2023; 13:diagnostics13050819. [PMID: 36899963 PMCID: PMC10001379 DOI: 10.3390/diagnostics13050819] [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: 01/30/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
The rapidly changing epidemiology of Staphylococcus aureus and evolution of strains with enhanced virulence is a significant issue in global healthcare. Hospital-associated methicillin-resistant S. aureus (HA-MRSA) lineages are being completely replaced by community-associated S. aureus (CA-MRSA) in many regions. Surveillance programs tracing the reservoirs and sources of infections are needed. Using molecular diagnostics, antibiograms, and patient demographics, we have examined the distributions of S. aureus in Ha'il hospitals. Out of 274 S. aureus isolates recovered from clinical specimens, 181 (66%, n = 181) were MRSA, some with HA-MRSA patterns across 26 antimicrobials with almost full resistances to all beta-lactams, while the majority were highly susceptible to all non-beta-lactams, indicating the CA-MRSA type. The rest of isolates (34%, n = 93) were methicillin-susceptible, penicillin-resistant MSSA lineages (90%). The MRSA in men was over 56% among total MRSA (n = 181) isolates and 37% of overall isolates (n = 102 of 274) compared to MSSA in total isolates (17.5%, n = 48), respectively. However, these were 28.4% (n = 78) and 12.4% (n = 34) for MRSA and MSSA infections in women, respectively. MRSA rates per age groups of 0-20, 21-50, and >50 years of age were 15% (n = 42), 17% (n = 48), and 32% (n = 89), respectively. However, MSSA in the same age groups were 13% (n = 35), 9% (n = 25), and 8% (n = 22). Interestingly, MRSA increased proportional to age, while MSSA concomitantly decreased, implying dominance of the latter ancestors early in life and then gradual replacement by MRSA. The dominance and seriousness of MRSA despite enormous efforts in place is potentially for the increased use of beta-lactams known to enhance virulence. The Intriguing prevalence of the CA-MRSA patterns in young otherwise healthy individuals replaced by MRSA later in seniors and the dominance of penicillin-resistant MSSA phenotypes imply three types of host- and age-specific evolutionary lineages. Thus, the decreasing MSSA trend by age with concomitant increase and sub-clonal differentiation into HA-MRSA in seniors and CA-MRSA in young and otherwise healthy patients strongly support the notion of subclinal emergences from a resident penicillin-resistant MSSA ancestor. Future vertical studies should focus on the surveillance of invasive CA-MRSA rates and phenotypes.
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Ma M, Tao L, Li X, Liang Y, Li J, Wang H, Jiang H, Dong J, Han D, Du T. Changes in molecular characteristics and antimicrobial resistance of invasive Staphylococcus aureus infection strains isolated from children in Kunming, China during the COVID-19 epidemic. Front Microbiol 2022; 13:944078. [PMID: 36033878 PMCID: PMC9403864 DOI: 10.3389/fmicb.2022.944078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Invasive Staphylococcus aureus (S. aureus) infection is associated with high rates of mortality in children. No studies have been reported on invasive S. aureus infection among children in Kunming, China, and it remains unknown whether the COVID-19 epidemic has affected S. aureus prevalence in this region. Thus, this study investigated the changes in molecular characteristics and antimicrobial resistance of invasive S. aureus strains isolated from children in Kunming during 2019–2021. In total, 66 invasive S. aureus strains isolated from children were typed by multilocus sequence typing (MLST), spa, and Staphylococcal cassette chromosome mec (SCCmec), and antimicrobial resistance and virulence genes were analyzed. A total of 19 ST types, 31 spa types and 3 SCCmec types were identified. Thirty nine (59.09%) strains were methicillin-sensitive S. aureus (MSSA) and 27 (40.91%) strains were methicillin-resistant S. aureus (MRSA). The most common molecular type was ST22-t309 (22.73%, 15/66), followed by ST59-t437 (13.64%, 9/66). In 2019 and 2021, the dominant molecular type was ST22-t309, while in 2020, it was ST59-t437. After 2019, the dominant molecular type of MRSA changed from ST338-t437 to ST59-t437. All strains were susceptible to tigecycline, ciprofloxacin, moxifloxacin, vancomycin, quinopudine-dafoputin, linezolid, levofloxacin, and rifampicin. From 2019 to 2021, the resistance to penicillin and sulfamethoxazole initially decreased and then increased, a trend that contrasted with the observed resistance to oxacillin, cefoxitin, erythromycin, clindamycin, and tetracycline. Sixteen antimicrobial resistance profiles were identified, with penicillin-tetracycline-erythromycin-clindamycin-oxacillin-cefoxitin being the most common, and the antimicrobial resistance profiles varied by year. The carrier rates of virulence genes, icaA, icaD, hla, fnbA, fnbB, clfA, clfB, and cna were 100.00%. Furthermore, sak, pvl, icaC, icaR, fib, lip, hlb, hysA, sea, seb, and tsst-1 had carrier rates of 96.97, 92.42, 87.88, 69.70, 84.85, 62.12, 56.06, 50, 37.87, 30.30, and 7.58%, respectively. Since COVID-19 epidemic, the annual number of invasive S. aureus strains isolated from children in Kunming remained stable, but the molecular characteristics and antimicrobial resistance profiles of prevalent S. aureus strains have changed significantly. Thus, COVID-19 prevention and control should be supplemented by surveillance of common clinical pathogens, particularly vigilance against the prevalence of multidrug-resistant and high-virulence strains.
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Affiliation(s)
- Mingbiao Ma
- Department of Clinical Laboratory, Kunming Children’s Hospital, Kunming, China
- Yunnan Key Laboratory of Children’s Major Disease Research, Kunming Children’s Hospital, Kunming, China
- Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming Children’s Hospital, Kunming, China
| | - Lvyan Tao
- Yunnan Key Laboratory of Children’s Major Disease Research, Kunming Children’s Hospital, Kunming, China
- Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming Children’s Hospital, Kunming, China
- Yunnan Institute of Pediatrics, Kunming Children’s Hospital, Kunming, China
| | - Xinyue Li
- Department of Clinical Laboratory, Kunming Children’s Hospital, Kunming, China
| | - Yanqi Liang
- Department of Laboratory, Chuxiong Higher College of Medicine, Chuxiong, China
| | - Jue Li
- Department of Clinical Laboratory, Kunming Children’s Hospital, Kunming, China
| | - Haiping Wang
- Department of Clinical Laboratory, Kunming Children’s Hospital, Kunming, China
| | - Hongchao Jiang
- Yunnan Key Laboratory of Children’s Major Disease Research, Kunming Children’s Hospital, Kunming, China
- Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming Children’s Hospital, Kunming, China
- Yunnan Institute of Pediatrics, Kunming Children’s Hospital, Kunming, China
| | - Jing Dong
- Department of Clinical Laboratory, Kunming Children’s Hospital, Kunming, China
| | - Dingrui Han
- Department of Clinical Laboratory, Kunming Children’s Hospital, Kunming, China
| | - Tingyi Du
- Department of Clinical Laboratory, Kunming Children’s Hospital, Kunming, China
- Yunnan Key Laboratory of Children’s Major Disease Research, Kunming Children’s Hospital, Kunming, China
- Yunnan Province Clinical Research Center for Children’s Health and Disease, Kunming Children’s Hospital, Kunming, China
- *Correspondence: Tingyi Du,
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Comparative Genomic Analysis of a Panton–Valentine Leukocidin-Positive ST22 Community-Acquired Methicillin-Resistant Staphylococcus aureus from Pakistan. Antibiotics (Basel) 2022; 11:antibiotics11040496. [PMID: 35453247 PMCID: PMC9033113 DOI: 10.3390/antibiotics11040496] [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: 03/02/2022] [Revised: 03/27/2022] [Accepted: 04/06/2022] [Indexed: 02/01/2023] Open
Abstract
Staphylococcus aureus (S. aureus) ST22 is considered a clinically important clone because an epidemic strain EMRSA-15 belongs to ST22, and several outbreaks of this clone have been documented worldwide. We performed genomic analysis of an S. aureus strain Lr2 ST22 from Pakistan and determined comparative analysis with other ST22 strains. The genomic data show that Lr2 belongs to spa-type t2986 and harbors staphylococcal cassette chromosome mec (SCCmec) type IVa(2B), one complete plasmid, and seven prophages or prophage-like elements. The strain harbors several prophage-associated virulence factors, including Panton–Valentine leukocidin (PVL) and toxic shock syndrome toxin (TSST). The single nucleotide polymorphism (SNPs)-based phylogenetic relationship inferred from whole genome and core genome revealed that strain Lr2 exhibits the nearest identities to a South African community-acquired methicillin-resistant S. aureus (CA-MRSA) ST22 strain and makes a separate clade with an Indian CA-MRSA ST22 strain. Although most ST22 strains carry blaZ, mecA, and mutations in gyrA, the Lr2 strain does not have the blaZ gene but, unlike other ST22 strains, carries the antibiotic resistance genes erm(C) and aac(6′)-Ie-aph(2″)-Ia. Among ST22 strains analyzed, only the strain Lr2 possesses both PVL and TSST genes. The functional annotation of genes unique to Lr2 revealed that mobilome is the third-largest Cluster of Orthologous Genes (COGs) category, which encodes genes associated with prophages and transposons. This possibly makes methicillin-resistant S. aureus (MRSA) Lr2 ST22 strain highly virulent, and this study would improve the knowledge of MRSA ST22 strains in Pakistan. However, further studies are needed on a large collection of MRSA to comprehend the genomic epidemiology and evolution of this clone in Pakistan.
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Sahin-Tóth J, Albert E, Juhász A, Ghidán Á, Juhász J, Horváth A, Steward MC, Dobay O. Prevalence of Staphylococcus aureus in wild hedgehogs (Erinaceus europaeus) and first report of mecC-MRSA in Hungary. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 815:152858. [PMID: 34995585 DOI: 10.1016/j.scitotenv.2021.152858] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
In 2011 mecC, a new mecA gene homologue, was described in a bovine isolate in the UK. Since then, mecC-positive methicillin-resistant Staphylococcus aureus (mecC-MRSA) has also been found in wild animals. An especially high prevalence of mecC-MRSA has been reported among hedgehogs in Sweden (64%) and Denmark (61%). Based on these findings we aimed to survey the hedgehog population for mecC-MRSA in Hungary. Altogether 200 hedgehogs were screened for Staphylococcus aureus using a culture-based method. The antibiotic susceptibility of the isolates to nine drugs was determined, their genetic relatedness was established by PFGE and spa-typing, and virulence genes were identified by PCR. Whole genome sequencing was performed for the single mecC-MRSA isolate found. Of the 200 animals, 13 were carriers of S. aureus (6.5%). Among these, one isolate was mecA positive and one was mecC positive. The isolates were susceptible to non-beta-lactam antibiotics. Toxin genes were not found, but the majority carried genes responsible for adhesion and biofilm production. The mecC-MRSA isolate was a single-locus variant of ST130, had a new spa type (t19701) and belonged to SCCmec type XI. It carried a recently described, novel exfoliative toxin (etE). This is the first report of mecC-MRSA in Hungary and the first survey of staphylococcus carriage among wild animals in the country. The mecC prevalence was much lower than in Northern European countries and rather similar to other countries in our region. MecC-MRSA could potentially emerge as a novel human pathogen, especially where close contact occurs between humans and animals.
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Affiliation(s)
- Judit Sahin-Tóth
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4., HU-1089 Budapest, Hungary
| | - Ervin Albert
- Department of Pathology, University of Veterinary Medicine Budapest, Dóra major, HU-2225 Üllő, Hungary
| | - Alexandra Juhász
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4., HU-1089 Budapest, Hungary; Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Ágoston Ghidán
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4., HU-1089 Budapest, Hungary
| | - János Juhász
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4., HU-1089 Budapest, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter u. 50/A, HU-1083 Budapest, Hungary
| | - Andrea Horváth
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4., HU-1089 Budapest, Hungary
| | - Martin C Steward
- School of Medical Sciences, Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PT, UK; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., HU-1089 Budapest, Hungary
| | - Orsolya Dobay
- Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4., HU-1089 Budapest, Hungary.
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Goemanne S, Tilmanne A, Biarent D, Smeesters P, Simoni P, Mahadeb BA, Vicinanza A. Severe Staphylococcus aureus infections in children: Case reports and management of positive Panton-Valentine leucocidin cases. Front Pediatr 2022; 10:1003708. [PMID: 36313888 PMCID: PMC9612512 DOI: 10.3389/fped.2022.1003708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Staphylococcus aureus is a well-known bacterium associated with carriage and responsible for different types of infections. The Panton-Valentine leucocidin (PVL) is a key virulence factor causing tissue necrosis. PVL can, however, be present in both benign and life-threatening infections. CASE REPORTS AND MANAGEMENT We present three pediatric severe infections occurring over a period of only three weeks, in February 2021, and caused by genetically unrelated methicillin-sensitive Staphylococcus aureus producing PVL in a tertiary children's hospital in Belgium. The first one presented with necrotizing pneumonia, the second one with a neck abscess extended to the mediastinum, and the last one had sacral osteomyelitis complicated by endocarditis. The management of these infections is mostly based on expert opinions. The most appropriate treatment seems to be the combination of early surgical drainage of infected collections with an antibiotic regimen associating two antibiotics; beta-lactams and either clindamycin or linezolid. Human immunoglobulins also appear to be useful as adjunctive therapy. CONCLUSION PVL-producing Staphylococcus aureus is associated with life-threatening infections in children. Prompt management is needed including surgery and appropriate antibiotic regimens.
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Affiliation(s)
- Sophie Goemanne
- Department of Pediatrics, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Anne Tilmanne
- Division of Pediatric Infectious Diseases and Infection Prevention and Control, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Dominique Biarent
- Pediatric Intensive Care Unit, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Pierre Smeesters
- Department of Pediatrics, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Division of Pediatric Infectious Diseases and Infection Prevention and Control, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Laboratory of Molecular Bacteriology, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Paolo Simoni
- Department of Radiology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Bhavna Ansuya Mahadeb
- Department of Microbiology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Alfredo Vicinanza
- Pediatric Intensive Care Unit, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Najafi Olya Z, Najar-Peerayeh S, Yadegar A, Bakhshi B. Clonal diversity and genomic characterization of Panton-valentine Leukocidin (PVL)-positive Staphylococcus aureus in Tehran, Iran. BMC Infect Dis 2021; 21:372. [PMID: 33882854 PMCID: PMC8058961 DOI: 10.1186/s12879-021-06060-4] [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: 11/22/2020] [Accepted: 04/08/2021] [Indexed: 11/25/2022] Open
Abstract
Background Some Staphylococcus aureus strains produce Panton-Valentine leukocidin (PVL), a bi-component pore-forming toxin, which causes leukocyte lysis and tissue necrosis. Currently, there is very limited information on the molecular epidemiology of PVL-encoding S. aureus strains in Iran. This study aimed to determine the molecular epidemiology and genetic background of PVL-positive S. aureus clinical strains isolated from Iranian patients. Methods A total of 28 PVL-positive S. aureus strains were detected from 600 S. aureus isolates between February 2015 and March 2018 from different hospitals in Tehran, Iran. Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Molecular genotyping was performed using SCCmec and accessory gene regulator (agr) typing, PVL haplotyping, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). Results The highest antibiotic resistance rate was found to be against erythromycin (57.1%), followed by ciprofloxacin (42.8%) and clindamycin (35.7%). Moreover, 19 (67.9%) out of 28 S. aureus isolates were identified as MRSA, including CA-MRSA (14/19, 73.7%) and HA-MRSA (5/19, 26.3%). SCCmec type IVa was detected as the predominant type (10/19, 52.6%), followed by type III (5/19, 26.3%) and type V (4/19, 21.1%). The agr type I was identified as the most common type (14/28, 50%), and H and R haplotype groups were observed at frequencies of 67.9 and 32.1%, respectively. Among H variants, the predominant variant was H2 (78/9%). The isolates encompassed 21 different sequence types (STs), including 16 new STs (ST5147 to ST5162). Based on eBURST analysis, the isolates were clustered into five CCs, including CC30, CC22, CC1, CC8, and CC5 (ST5160), and nine singletons. PFGE typing showed that 24 isolates were clustered into A (4 pulsotypes), B (9 pulsotypes), and C (11 pulsotypes) clusters. Conclusions A high prevalence of PVL-positive CA-MRSA strains was detected in Iran. The majority of PVL-positive isolates were of H (mostly H2) variant, while R variant was harbored by 100% of PVL-positive MRSA strains. Also, CC8, CC22, and CC30 were identified as the dominant clones among PVL-encoding S. aureus strains. This study promotes a better understanding of the molecular epidemiology and evolution of PVL-positive S. aureus strains in Iran.
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Affiliation(s)
- Zahra Najafi Olya
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Jalal-Ale-Ahmad Ave, Tehran, 14117-13116, Iran
| | - Shahin Najar-Peerayeh
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Jalal-Ale-Ahmad Ave, Tehran, 14117-13116, Iran
| | - Abbas Yadegar
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bita Bakhshi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Jalal-Ale-Ahmad Ave, Tehran, 14117-13116, Iran.
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Mascaro V, Squillace L, Nobile CGA, Papadopoli R, Bosch T, Schouls LM, Casalinuovo F, Musarella R, Pavia M. Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage and pattern of antibiotic resistance among sheep farmers from Southern Italy. Infect Drug Resist 2019; 12:2561-2571. [PMID: 31692514 PMCID: PMC6708399 DOI: 10.2147/idr.s211629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/14/2019] [Indexed: 12/26/2022] Open
Abstract
PURPOSE We conducted a cross-sectional study to measure the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization, with a particular focus on livestock associated (LA)-MRSA in farmers working in contact with livestock (sheep) in one Italian region. Furthermore, we have assessed the antimicrobial resistance pattern of isolates and the association of carriage with specific characteristic of farms and working tasks. PATIENTS AND METHODS Demographic data, occupational history, and contact with animals information was collected. Nasal and oropharyngeal swabs were collected and all samples were tested for the isolation and identification of S. aureus. Isolates were examined for antimicrobial susceptibility and all MRSA strains underwent molecular analyses through multiple-locus variable number of tandem repeat analysis (MLVA). RESULTS A total of 115 sheep farms and 275 sheep farmers were enrolled. MRSA colonized workers were found in three farms; S. aureus was isolated in 97 workers (35.5%), whereas MRSA was isolated in 3 (1.1%) workers. All MRSA isolates were classified as multidrug resistant. Two of the MRSA isolates were resistant to quinupristin/dalfopristin (QDA), mupirocin, erythromycin, and tetracycline. Among methicillin-susceptible S. aureus (MSSA), 32 (34%) were resistant to tetracycline, 31 (33%) to erythromycin, 26 (27.6%) to QDA, and 22 (23.4%) to linezolid and clindamycin. One MRSA belonged to MLVA complex (MC) 001, found to colonize both humans and animals. CONCLUSION The picture of MRSA transmission among sheep farmers does not seem to be critical, although there is the need to improve adequate control measures to prevent and minimize any biological risk in sheep farms for both animal and human health. Specific monitoring/surveillance programs would help in better understanding the epidemiology of resistant strains.
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Affiliation(s)
- Valentina Mascaro
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| | - Lorena Squillace
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| | - Carmelo GA Nobile
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Cosenza, Italy
| | - Rosa Papadopoli
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| | - Thijs Bosch
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Leo M Schouls
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Francesco Casalinuovo
- Section of Catanzaro, Institute for Experimental Veterinary Medicine of Southern Italy, Catanzaro, Italy
| | - Rosanna Musarella
- Section of Catanzaro, Institute for Experimental Veterinary Medicine of Southern Italy, Catanzaro, Italy
| | - Maria Pavia
- Department of Health Sciences, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
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Xiao N, Yang J, Duan N, Lu B, Wang L. Community-associated Staphylococcus aureus PVL + ST22 predominates in skin and soft tissue infections in Beijing, China. Infect Drug Resist 2019; 12:2495-2503. [PMID: 31616166 PMCID: PMC6698600 DOI: 10.2147/idr.s212358] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/25/2019] [Indexed: 01/08/2023] Open
Abstract
Purpose Community-associated Staphylococcus aureus (CA S. aureus) is the most common causative pathogen of the skin and soft tissue infections (SSTIs). This study aims to determine clonal distribution, virulence factors of CA S. aureus clinical isolates from purulent SSTIs in Beijing, China. Materials and methods CA-S. aureus isolates were collected from 115 outpatients with purulent SSTIs from the department of dermatology from April 2015 to April 2017. Multilocus sequence typing and Staphylococcus cassette chromosome mec typing were performed to explore molecular characteristics. Phylogenetic analysis of 16S rRNA of dominant S. aureus isolates was performed using MEGA-X software. Virulence genes were detected by PCR, while biofilm formation was evaluated by a microtiter plate method. The antimicrobial susceptibility was tested by an automatic VITEK system. Results Forty-four CA-S. aureus isolates identified from SSTIs contain 9 methicillin-resistant S. aureus (MRSA) isolates (20.4%) and 35 methicillin-susceptible S. aureus isolates (MSSA) (79.6%). The dominant sequence types (STs) were ST22 (40.9%) and clonal complex 59 (CC59; 77.8%) in Community-associated methicillin resistant methicillin-resistant S. aureus. 27.8% of ST22 isolates were homologous to the epidemic ST22 EMRSA-15 in Europe. The prevalence of virulence genes lukS/lukF, tst-1, etA, edinA, icaA, and icaD was 50%, 93.2%, 4.5%, 4.5%, 100%, and 100%, respectively. All CC59 isolates exhibited stronger biofilm-forming capability than ST22 clones. Among the MSSA subgroup, the poor biofilm producers had significantly higher sensitivity to sulfamethoxazole/Trimethoprim. Conclusion The dominant epidemic clone PVL+ ST22 MSSA containing tst-1 occurs in Beijing, indicating that a PVL+ ST398 clone which was previously predominant in this district had been replaced by a new clone.
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Affiliation(s)
- Nan Xiao
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, People's Republic of China
| | - Jianghui Yang
- Department of Pathology, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, People's Republic of China
| | - Ning Duan
- Department of Laboratory Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, People's Republic of China
| | - Binghuai Lu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; National Clinical Research Center of Respiratory Diseases, Beijing 100029, People's Republic of China
| | - Lijun Wang
- Clinical Research Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, People's Republic of China
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Mascaro V, Capano MS, Iona T, Nobile CGA, Ammendolia A, Pavia M. Prevalence of Staphylococcus aureus carriage and pattern of antibiotic resistance, including methicillin resistance, among contact sport athletes in Italy. Infect Drug Resist 2019; 12:1161-1170. [PMID: 31123413 PMCID: PMC6511236 DOI: 10.2147/idr.s195749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/19/2019] [Indexed: 11/23/2022] Open
Abstract
Background and purpose: Athletes participating in contact or collision sports have a great chance of acquiring Staphylococcus aureus infections. The risk factors for colonization and infections include frequent antibiotic use, close contact situations, skin trauma, sharing of sports equipment, and poor hygiene. Therefore, our specific goals were to determine (1) prevalence of S. aureus among different types of contact sport athletes which were barely studied in the European region, (2) antimicrobial resistance of S. aureus isolates, and (3) association of carriage with particular risk factors of spor t practices. Patients and methods: A cross-sectional study was conducted among contact or collision sport athletes in Italy. A questionnaire was used to gather information about sociodemographic characteristics, specific sport activities, and participants’ health conditions. Swabs were collected from the nares, oropharynx, and fingers and tested for S. aureus isolation and antimicrobial susceptibility. Results:S. aureus was carried by 42% of 238 enrolled athletes. Colonization was associated with number of weekly training days, sharing of sports equipment, not taking a shower immediately after training, and a previous history of pharyngitis or sinusitis and skin manifestations. Isolates were resistant to clindamycin (24.8%) and erythromycin (15.8%). Of all athletes, 1.3% carried methicillin-resistant S. aureus (MRSA); MRSA were 3% of all S. aureus isolates. No strains were resistant to sulfamethoxazole/trimethoprim. Conclusion: Our results have shown a high prevalence of S. aureus carriage and a relevant resistance to antimicrobials used for the treatment of S. aureus infections. Prevention efforts aimed at reducing S. aureus colonization, and thus potentially reducing infections, should be improved.
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Affiliation(s)
- Valentina Mascaro
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Maria Simona Capano
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Teresa Iona
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | | | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Maria Pavia
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
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Outbreak report of investigation and control of an outbreak of Panton-Valentine Leukocidin-positive methicillin-sensitive Staphylococcus aureus (PVL-MSSA) infection in neonates and mothers. BMC Infect Dis 2019; 19:178. [PMID: 30786872 PMCID: PMC6381690 DOI: 10.1186/s12879-019-3802-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/11/2019] [Indexed: 11/16/2022] Open
Abstract
Background In January 2011, there was an outbreak of Panton-Valentine Leukocidin-positive methicillin-sensitive Staphylococcus aureus (PVL-MSSA) infection in a neonatal unit (NNU). We describe the investigation and control of an outbreak of PVL-MSSA infection in neonates. Setting: Neonatal unit in West London. Methods We performed descriptive and analytical (case-control study) epidemiological investigations. Microbiological investigations including screening of MSSA isolates by PCR for the presence of the luk-PV, mecA and mecC genes and comparison of isolate with Pulsed field gel electrophoresis (PFGE). Control measures were also introduced. Results Sixteen babies were infected/colonised with the outbreak strain. Of these, one baby developed blood stream infection, 12 developed skin pustules and four babies were colonised. Four mothers developed breast abscesses. Eighty-seven babies in the unit were screened and 16 were found to have same PVL-MSSA strain (spa type t005, belonging to MLST clonal complex 22). Multivariate analysis showed gestational age was significantly lower in cases compared to controls (mean gestational age: 31.7 weeks v 35.6 weeks; P = 0.006). Length of stay was significantly greater for cases, with a median of 25 days, compared to only 6 days for controls (P = 0.01). Most (88%) cases were born through caesarean section, compared to less than half of controls. (P = 0.002). No healthcare worker carriers and environmental source was identified. The outbreak was controlled by stopping new admissions to unit and reinforcing infection control precautions. The outbreak lasted for seven weeks. No further cases were reported in the following year. Conclusions Infection control teams have to be vigilant for rising prevalence of particular S. aureus clones in their local community as they may cause outbreaks in vulnerable populations in healthcare settings such as NNUs.
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Manara S, Pasolli E, Dolce D, Ravenni N, Campana S, Armanini F, Asnicar F, Mengoni A, Galli L, Montagnani C, Venturini E, Rota-Stabelli O, Grandi G, Taccetti G, Segata N. Whole-genome epidemiology, characterisation, and phylogenetic reconstruction of Staphylococcus aureus strains in a paediatric hospital. Genome Med 2018; 10:82. [PMID: 30424799 PMCID: PMC6234625 DOI: 10.1186/s13073-018-0593-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/29/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Staphylococcus aureus is an opportunistic pathogen and a leading cause of nosocomial infections. It can acquire resistance to all the antibiotics that entered the clinics to date, and the World Health Organization defined it as a high-priority pathogen for research and development of new antibiotics. A deeper understanding of the genetic variability of S. aureus in clinical settings would lead to a better comprehension of its pathogenic potential and improved strategies to contrast its virulence and resistance. However, the number of comprehensive studies addressing clinical cohorts of S. aureus infections by simultaneously looking at the epidemiology, phylogenetic reconstruction, genomic characterisation, and transmission pathways of infective clones is currently low, thus limiting global surveillance and epidemiological monitoring. METHODS We applied whole-genome shotgun sequencing (WGS) to 184 S. aureus isolates from 135 patients treated in different operative units of an Italian paediatric hospital over a timespan of 3 years, including both methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) from different infection types. We typed known and unknown clones from their genomes by multilocus sequence typing (MLST), Staphylococcal Cassette Chromosome mec (SCCmec), Staphylococcal protein A gene (spa), and Panton-Valentine Leukocidin (PVL), and we inferred their whole-genome phylogeny. We explored the prevalence of virulence and antibiotic resistance genes in our cohort, and the conservation of genes encoding vaccine candidates. We also performed a timed phylogenetic investigation for a potential outbreak of a newly emerging nosocomial clone. RESULTS The phylogeny of the 135 single-patient S. aureus isolates showed a high level of diversity, including 80 different lineages, and co-presence of local, global, livestock-associated, and hypervirulent clones. Five of these clones do not have representative genomes in public databases. Variability in the epidemiology is mirrored by variability in the SCCmec cassettes, with some novel variants of the type IV cassette carrying extra antibiotic resistances. Virulence and resistance genes were unevenly distributed across different clones and infection types, with highly resistant and lowly virulent clones showing strong association with chronic diseases, and highly virulent strains only reported in acute infections. Antigens included in vaccine formulations undergoing clinical trials were conserved at different levels in our cohort, with only a few highly prevalent genes fully conserved, potentially explaining the difficulty of developing a vaccine against S. aureus. We also found a recently diverged ST1-SCCmecIV-t127 PVL- clone suspected to be hospital-specific, but time-resolved integrative phylogenetic analysis refuted this hypothesis and suggested that this quickly emerging lineage was acquired independently by patients. CONCLUSIONS Whole genome sequencing allowed us to study the epidemiology and genomic repertoire of S. aureus in a clinical setting and provided evidence of its often underestimated complexity. Some virulence factors and clones are specific of disease types, but the variability and dispensability of many antigens considered for vaccine development together with the quickly changing epidemiology of S. aureus makes it very challenging to develop full-coverage therapies and vaccines. Expanding WGS-based surveillance of S. aureus to many more hospitals would allow the identification of specific strains representing the main burden of infection and therefore reassessing the efforts for the discovery of new treatments and clinical practices.
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Affiliation(s)
- Serena Manara
- Centre for Integrative Biology, University of Trento, Trento, Italy
| | - Edoardo Pasolli
- Centre for Integrative Biology, University of Trento, Trento, Italy
| | - Daniela Dolce
- Cystic Fibrosis Center, Interdisciplinary Specialist Department, Anna Meyer Children's University Hospital, Florence, Italy
| | - Novella Ravenni
- Cystic Fibrosis Center, Interdisciplinary Specialist Department, Anna Meyer Children's University Hospital, Florence, Italy
| | - Silvia Campana
- Cystic Fibrosis Center, Interdisciplinary Specialist Department, Anna Meyer Children's University Hospital, Florence, Italy
| | | | | | - Alessio Mengoni
- Department of Biology, University of Florence, Florence, Italy
| | - Luisa Galli
- Department of Health Sciences, University of Florence, Florence, Italy
- Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Carlotta Montagnani
- Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Elisabetta Venturini
- Infectious Diseases Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Omar Rota-Stabelli
- Department of Sustainable Agro-Ecosystems and Bioresources, Fondazione Edmund Mach, San Michele all'Adige, Italy
| | - Guido Grandi
- Centre for Integrative Biology, University of Trento, Trento, Italy
| | - Giovanni Taccetti
- Cystic Fibrosis Center, Interdisciplinary Specialist Department, Anna Meyer Children's University Hospital, Florence, Italy
| | - Nicola Segata
- Centre for Integrative Biology, University of Trento, Trento, Italy.
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Lei Z, Zhang D, Lu B, Zhou W, Wang D. Activation of mast cells in skin abscess induced by Staphylococcus aureus (S. aureus) infection in mice. Res Vet Sci 2018; 118:66-71. [PMID: 29421486 DOI: 10.1016/j.rvsc.2018.01.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/16/2018] [Accepted: 01/18/2018] [Indexed: 11/26/2022]
Abstract
The skin abscess is a common inflammatory disease that occurs following the ubiquitous S. aureus infection. In our study, a skin abscess murine model was established and the dynamics of mast cells chemotaxing was evaluated. In the S. aureus-infected mice, severe infiltration of inflammatory cells in the dermis were observed, and mast cells were markedly accumulated in the skins. Besides, tryptase, the marker for mast cells activation, has a positive correlation with mast cell activity. The mast cells identified in the tissues were likely to be activated since they were associated with cell degranulation and the presence of tryptase. Our results suggested that mast cells and its mediator tryptase contribute to the inflammation of skin abscess induced by S. aureus infection.
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Affiliation(s)
- Zhiqiang Lei
- Medical College of China Three Gorges University, Yichang, 443002, China; The Institute of Infection and Inflammation, China Three Gorges University, Yichang 443002, Hubei, China; Wuxue First People's Hospital, Wuxue 435400, Hubei, China
| | - Ding Zhang
- Department of Pathology, Yichang Central People's Hospital, Yichang 443003, Hubei, China
| | - Boyong Lu
- The Third Hospital of Yichang City, Yichang 443003, Hubei, China
| | - Wenjiang Zhou
- Shanghai Public Health Clinical Center, Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China
| | - Decheng Wang
- Medical College of China Three Gorges University, Yichang, 443002, China; The Institute of Infection and Inflammation, China Three Gorges University, Yichang 443002, Hubei, China.
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13
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Recurrent Familial Furunculosis Associated with Panton-Valentine Leukocidin-Positive Methicillin-SusceptibleStaphylococcus aureusST1. ACTA ACUST UNITED AC 2018. [DOI: 10.14776/piv.2018.25.e6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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An outbreak of skin infections in neonates due to a Staphylococcus aureus strain producing the exfoliative toxin A. Infection 2017; 46:49-54. [PMID: 29110142 DOI: 10.1007/s15010-017-1084-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 10/20/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE Staphylococcus aureus is an important cause of infections in hospitalized neonates. Preterm or low birthweight infants are especially at risk to develop a S. aureus infection due to the immaturity of the immune system, length of hospital stay and invasive procedures. Exfoliative toxin (ET)-producing S. aureus is often responsible for neonatal infections, causing clinical manifestations such as staphylococcal scalded skin syndrome, characterized by both localized blisters or generalized exfoliation of the skin. METHODS We describe an outbreak due to an S. aureus strain producing ETA occurring in a local hospital in Northern Italy. Molecular typing of the isolates included spa typing and multilocus sequence typing. DNA microarray hybridization was also performed on one representative strain. RESULTS In the period from July 2013 to February 2014, 12 neonates presented with skin infections, mainly bullae or pustules. Cultures of skin swabs yielded methicillin-susceptible S. aureus (MSSA). By molecular typing, an epidemic strain (t1393/ST5) was identified in nine neonates; microarray analysis and PCR revealed that it contained the ETA encoding gene. Screening of staff, mothers and healthy neonates and environmental cultures did not reveal the presence of the epidemic strain. However, the father of an infected neonate was found to be a carrier of MSSA t1393 five months after the outbreak started. CONCLUSION Implementation of hygiene procedures and sanitization of the ward twice terminated the outbreak. Timely surveillance of infections, supported by molecular typing, is fundamental to prevent similar episodes among neonates.
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15
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Esposito S, Bassetti M, Concia E, De Simone G, De Rosa FG, Grossi P, Novelli A, Menichetti F, Petrosillo N, Tinelli M, Tumbarello M, Sanguinetti M, Viale P, Venditti M, Viscoli C. Diagnosis and management of skin and soft-tissue infections (SSTI). A literature review and consensus statement: an update. J Chemother 2017; 29:197-214. [PMID: 28378613 DOI: 10.1080/1120009x.2017.1311398] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Skin and soft-tissue infections (SSTIs) are among the most common bacterial infections, posing considerable diagnostic and therapeutic challenges. Fourteen members of the Italian Society of Infectious Diseases, after a careful review of the most recent literature using Medline database and their own clinical experience, updated a previous paper published in 2011 by preparing a draught manuscript of the statements. The manuscript was successively reviewed by all members and ultimately re-formulated the present manuscript during a full day consensus meeting. The microbiological and clinical aspects together with diagnostic features were considered for necrotizing and not necrotizing SSTIs in the light of the most recent guidelines and evidences published in the last five years. The antimicrobial therapy was considered as well - both empirical and targeted to methicillin-resistant Staphylococcus aureus and/or other pathogens, also taking into account the epidemiological and bacterial resistance data and the availability of new antibacterial agents.
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Affiliation(s)
- Silvano Esposito
- a Department of Infectious Diseases, AOU San Giovanni di Dio e Ruggi d'Aragona , University of Salerno , Salerno , Italy
| | - Matteo Bassetti
- b Infectious Diseases Division , Santa Maria Misericordia Hospital , Udine , Italy
| | - Ercole Concia
- c Division of Infectious Diseases, Department of Pathology , AOU di Verona, Policlinico 'G.B. Rossi' , Verona , Italy
| | - Giuseppe De Simone
- a Department of Infectious Diseases, AOU San Giovanni di Dio e Ruggi d'Aragona , University of Salerno , Salerno , Italy
| | - Francesco G De Rosa
- d Department of Medical Science , University of Turin, Infectious Diseases Amedeo di Savoia Hospital , Turin , Italy
| | - Paolo Grossi
- e Infectious Diseases Unit , University of Insubria and University Hospital 'ASST Sette Laghi' , Varese , Italy
| | - Andrea Novelli
- f Department of Health Sciences, Section of Clinical Pharmacology and Oncology , University of Florence , Florence , Italy
| | | | - Nicola Petrosillo
- h National Institute for Infectious Diseases Lazzaro Spallanzani-INMU IRCCS , Rome , Italy
| | - Marco Tinelli
- i Division of Infectious and Tropical Diseases , Hospital of Lodi , Lodi , Italy
| | - Mario Tumbarello
- j Institute of Infectious Diseases , Catholic University of the Sacred Hearth, A. Gemelli Hospital , Rome , Italy
| | - Maurizio Sanguinetti
- k Institute of Microbiology , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Pierluigi Viale
- l Department of Medical Surgical Sciences , Alma Mater Studiorum University of Bologna , Bologna , Italy
| | - Mario Venditti
- m Department of Public Health and Infectious Diseases , 'Sapienza' University of Rome , Italy
| | - Claudio Viscoli
- n Infectious Diseases Division , University of Genoa and IRCCS San Martino-IST , Genoa , Italy
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16
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Russo A, Concia E, Cristini F, De Rosa FG, Esposito S, Menichetti F, Petrosillo N, Tumbarello M, Venditti M, Viale P, Viscoli C, Bassetti M. Current and future trends in antibiotic therapy of acute bacterial skin and skin-structure infections. Clin Microbiol Infect 2017; 22 Suppl 2:S27-36. [PMID: 27125562 DOI: 10.1016/s1198-743x(16)30095-7] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 04/15/2016] [Accepted: 04/17/2016] [Indexed: 12/26/2022]
Abstract
In 2013 the US Food and Drug Administration (FDA) issued recommendations and guidance on developing drugs for treatment of skin infection using a new definition of acute bacterial skin and skin-structure infection (ABSSSI). The new classification includes cellulitis, erysipelas, major skin abscesses and wound infection with a considerable extension of skin involvement, clearly referring to a severe subset of skin infections. The main goal of the FDA was to better identify specific infections where the advantages of a new antibiotic could be precisely estimated through quantifiable parameters, such as improvement of the lesion size and of systemic signs of infection. Before the spread and diffusion of methicillin-resistant Staphylococcus aureus (MRSA) in skin infections, antibiotic therapy was relatively straightforward. Using an empiric approach, a β-lactam was the preferred therapy and cultures from patients were rarely obtained. With the emergence of MRSA in the community setting, initial ABSSSI management has been changed and readdressed. Dalbavancin, oritavancin and tedizolid are new drugs, approved or in development for ABSSSI treatment, that also proved to be efficient against MRSA. Dalbavancin and oritavancin have a long half-life and can be dosed less frequently. This in turn makes it possible to treat patients with ABSSSI in an outpatient setting, avoiding hospitalization or potentially allowing earlier discharge, without compromising efficacy. In conclusion, characteristics of long-acting antibiotics could represent an opportunity for the management of ABSSSI and could profoundly modify the management of these infections by reducing or in some cases eliminating both costs and risks of hospitalization.
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Affiliation(s)
- A Russo
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - E Concia
- Division of Infectious Diseases, Department of Pathology, Azienda Ospedaliera Universitaria Integrata di Verona, Policlinico 'G.B. Rossi', Verona, Italy
| | - F Cristini
- Infectious Diseases Unit - Department of Medical and Surgical Sciences, University of Bologna, Teaching Hospital S. Orsola-Malpighi, Bologna, Italy
| | - F G De Rosa
- Department of Medical Sciences, University of Turin; Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy
| | - S Esposito
- Department of Infectious Diseases, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Università di Salerno, Salerno, Italy
| | - F Menichetti
- Infectious Disease Unit, Nuovo Santa Chiara Hospital, Pisa, Italy
| | - N Petrosillo
- National Institute for Infectious Diseases Lazzaro Spallanzani-INMI IRCCS, Rome, Italy
| | - M Tumbarello
- Institute of Infectious Diseases, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - M Venditti
- Department of Public Health and Infectious Diseases, 'Sapienza' University of Rome, Rome, Italy
| | - P Viale
- Infectious Diseases Unit - Department of Medical and Surgical Sciences, University of Bologna, Teaching Hospital S. Orsola-Malpighi, Bologna, Italy
| | - C Viscoli
- Infectious Diseases Division, University of Genoa and IRCCS San Martino-IST, Genoa, Italy
| | - M Bassetti
- Infectious Diseases Division, Santa Maria Misericordia Hospital, Udine, Italy.
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17
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Couvé-Deacon E, Tristan A, Pestourie N, Faure C, Doffoel-Hantz V, Garnier F, Laurent F, Lina G, Ploy MC. Outbreak of Panton-Valentine Leukocidin-Associated Methicillin-Susceptible Staphylococcus aureus Infection in a Rugby Team, France, 2010-2011. Emerg Infect Dis 2016; 22:96-9. [PMID: 26690308 PMCID: PMC4696688 DOI: 10.3201/eid2201.150597] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Staphylococcus aureus strains that produce Panton-Valentine leukocidin are known to cause community infections. We describe an outbreak of skin abscesses caused by Panton-Valentine leukocidin-producing methicillin-susceptible S. aureus (clonal complex 121) in a professional rugby team in France during July 2010-February 2011. Eight team members were carriers; 7 had skin abscesses.
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18
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A point mutation in AgrC determines cytotoxic or colonizing properties associated with phenotypic variants of ST22 MRSA strains. Sci Rep 2016; 6:31360. [PMID: 27511873 PMCID: PMC4980769 DOI: 10.1038/srep31360] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/18/2016] [Indexed: 01/03/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of skin and soft tissue infections. One of the highly successful and rapidly disseminating clones is MRSA ST22 commonly associated with skin tropism. Here we show that a naturally occurring single amino acid substitution (tyrosine to cysteine) at position 223 of AgrC determines starkly different ST22 S. aureus virulence phenotypes, e.g. cytotoxic or colonizing, as evident in both in vitro and in vivo skin infections. Y223C amino acid substitution destabilizes AgrC-AgrA interaction leading to a colonizing phenotype characterized by upregulation of bacterial surface proteins. The colonizing phenotype strains cause less severe skin tissue damage, show decreased susceptibility towards the antimicrobial LL-37 and induce autophagy. In contrast, cytotoxic strains with tyrosine at position 223 of AgrC cause infections characterized by inflammasome activation and severe skin tissue pathology. Taken together, the study demonstrates how a single amino acid substitution in the histidine kinase receptor AgrC of ST22 strains determines virulence properties and infection outcome.
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19
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Kumar B, Pathak R, Mary PB, Jha D, Sardana K, Gautam HK. New insights into acne pathogenesis: Exploring the role of acne-associated microbial populations. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2015.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Sanchini A, Del Grosso M, Villa L, Ammendolia M, Superti F, Monaco M, Pantosti A. Typing of Panton-Valentine leukocidin-encoding phages carried by methicillin-susceptible and methicillin-resistant Staphylococcus aureus from Italy. Clin Microbiol Infect 2014; 20:O840-6. [DOI: 10.1111/1469-0691.12679] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 03/24/2014] [Accepted: 05/12/2014] [Indexed: 01/07/2023]
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21
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André E, Thys F, Zech F. Anthrax staphylococcique. ANNALES FRANCAISES DE MEDECINE D URGENCE 2014. [DOI: 10.1007/s13341-013-0321-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Rojo P, Barrios M, Palacios A, Gomez C, Chaves F. Community-associatedStaphylococcus aureusinfections in children. Expert Rev Anti Infect Ther 2014; 8:541-54. [DOI: 10.1586/eri.10.34] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Pinto A, Seth R, Zhou F, Tallon J, Dempsey K, Tracy M, Gilbert G, O'Sullivan M. Emergence and control of an outbreak of infections due to Panton-Valentine leukocidin positive, ST22 methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit. Clin Microbiol Infect 2013; 19:620-7. [DOI: 10.1111/j.1469-0691.2012.03987.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Montagnani C, Cocchi P, Bianchi L, Resti M, de Martino M, Galli L. Severe infections caused by Panton-Valentine leukocidin-positive Staphylococcus aureus in infants: report of three cases and review of literature. Acta Paediatr 2013; 102:e284-7. [PMID: 23551699 DOI: 10.1111/apa.12225] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 02/25/2013] [Accepted: 02/28/2013] [Indexed: 12/11/2022]
Abstract
UNLABELLED We report three cases of severe infections in infants caused by Panton-Valentine leukocidin positive Staphylococcus aureus and evolved with a positive outcome. The literature of Panton-Valentine leukocidin positive Staphylococcus aureus infections in infants is reviewed. CONCLUSION Our findings suggest that a prompt identification of Panton-Valentine leukocidin positive Staphylococcus aureus and an appropriate therapy can reduce mortality and long-term sequelae. Further research is needed to specify features of Panton-Valentine leukocidin positive Staphylococcus aureus infections in infants.
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Affiliation(s)
- Carlotta Montagnani
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Priscilla Cocchi
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Leila Bianchi
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Massimo Resti
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Maurizio de Martino
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
| | - Luisa Galli
- Department of Health Sciences; University of Florence; Anna Meyer Children's University Hospital; Florence Italy
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Pantosti A. Whole-genome sequencing may be key to abating hospital-based methicillin-resistant Staphylociccus aureus outbreaks. J Pediatr 2013; 162:1079-80. [PMID: 23617977 DOI: 10.1016/j.jpeds.2013.02.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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26
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Barrios-López M, Rojo-Conejo P, Gómez-González C, Chaves-Sánchez F. [Community-onset Staphylococcus aureus infection in neonates]. Enferm Infecc Microbiol Clin 2012; 31:316-8. [PMID: 23260385 DOI: 10.1016/j.eimc.2012.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 10/09/2012] [Accepted: 10/31/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Staphylococcus aureus is a major cause of neonatal community-onset infections. The emergence of methicillin-resistant S. aureus infections in this age group has been reported in USA in the last few years; however there are no studies in Spain. The aim of this study is to describe the epidemiological, clinical and microbiological characteristics of S. aureus community-onset infections in neonates. METHODS We prospectively reviewed the S. aureus infections in neonates over a three year period (2007-2009) in the Pediatric Emergency Department of Hospital 12 de Octubre in Madrid (Spain). RESULTS We recorded 30 cases of neonatal S. aureus community-onset infections. Only one isolated (3.3%) was resistant to methicillin, and two (6.7%) were PVL(+). CONCLUSIONS Despite the emergence of MRSA outside the hospital in pediatric population in Spain, CA-MRSA and SA PVL(+) infections are not frequent in neonates.
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Outbreak of skin and soft tissue infections in a hospital newborn nursery in Italy due to community-acquired meticillin-resistant Staphylococcus aureus USA300 clone. J Hosp Infect 2012; 83:36-40. [PMID: 23158684 DOI: 10.1016/j.jhin.2012.09.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 09/28/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) is responsible for severe infections in previously healthy people acquired in the community in different areas of the world. AIM To report an outbreak of CA-MRSA in a hospital newborn nursery in northern Italy in September-October 2010, its investigation and control measures. METHODS The epidemiology of the outbreak is reported. The investigation included screening neonates, parents and staff for MRSA carriage. Molecular strain typing was performed on MRSA isolates. FINDINGS The outbreak affected nine neonates with three severe infections. In addition, four mothers had postpartum mastitis, and three mothers and one father had skin infection. The outbreak strain belonged to the USA300 CA-MRSA clone. Asymptomatic carriage of the outbreak strain was found among neonates, parents and hospital staff. The implementation of appropriate infection control measures in the hospital terminated the outbreak. CONCLUSIONS To our knowledge, this is the first report of a hospital outbreak caused by the USA300 CA-MRSA clone in Europe. It is important to reinforce infection control measures, particularly in high-risk groups, such as neonates, to prevent USA300 from becoming endemic in European hospitals.
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Tong A, Tong SYC, Zhang Y, Lamlertthon S, Sharma-Kuinkel BK, Rude T, Ahn SH, Ruffin F, Llorens L, Tamarana G, Biek D, Critchley I, Fowler VG. Panton-Valentine leukocidin is not the primary determinant of outcome for Staphylococcus aureus skin infections: evaluation from the CANVAS studies. PLoS One 2012; 7:e37212. [PMID: 22623995 PMCID: PMC3356380 DOI: 10.1371/journal.pone.0037212] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 04/17/2012] [Indexed: 01/08/2023] Open
Abstract
The impact of Panton-Valentine leukocidin (PVL) on the severity of complicated skin and skin structure infections (cSSSI) caused by Staphylococcus aureus is controversial. We evaluated potential associations between clinical outcome and PVL presence in both methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) isolates from patients enrolled in two large, multinational phase three clinical trials assessing ceftaroline fosamil for the treatment of cSSSI (the CANVAS 1 and 2 programs). Isolates from all microbiologically evaluable patients with monomicrobial MRSA or MSSA infections (n = 473) were genotyped by PCR for pvl and underwent pulsed-field gel electrophoresis (PFGE). Genes encoding pvl were present in 266/473 (56.2%) isolates. Infections caused by pvl-positive S. aureus were associated with younger patient age, North American acquisition, and presence of major abscesses (P<0.001 for each). Cure rates of patients infected with pvl-positive and pvl-negative S. aureus were similar overall (93.6% versus 92.8%; P = 0.72), and within MRSA-infected (94.5% vs. 93.1%; P = 0.67) and MSSA-infected patients (92.2% vs. 92.7%; P = 1.00). This finding persisted after adjustment for multiple patient characteristics. Outcomes were also similar when USA300 PVL+ and non-USA300 PVL+ infections were compared. The results of this contemporary, international study suggest that pvl presence was not the primary determinant of outcome in patients with cSSSI due to either MRSA or MSSA.
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Affiliation(s)
- Amy Tong
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Steven Y. C. Tong
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Yurong Zhang
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Supaporn Lamlertthon
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
- Naresuan University, Phitsanulok, Phitsanulok Province, Thailand
| | - Batu K. Sharma-Kuinkel
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Thomas Rude
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Sun Hee Ahn
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Felicia Ruffin
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Lily Llorens
- Cerexa, Inc., Oakland, California, United States of America
| | | | - Donald Biek
- Cerexa, Inc., Oakland, California, United States of America
| | - Ian Critchley
- Cerexa, Inc., Oakland, California, United States of America
| | - Vance G. Fowler
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Clinical Research Institute, Durham, North Carolina, United States of America
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An outbreak of post-partum breast abscesses in Mumbai, India caused by ST22-MRSA-IV: genetic characteristics and epidemiological implications. Epidemiol Infect 2012; 140:1809-12. [PMID: 22475374 DOI: 10.1017/s0950268812000593] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A cluster of methicillin-resistant Staphylococcus aureus (MRSA) breast abscesses in women who had given birth at a hospital in Mumbai, India was investigated retrospectively. Nineteen of 20 cases were caused by a single clone: pvl-positive, spa type 648 (Ridom t852), ccrB:dru subtype 3:0, ST22-MRSA-IV. Despite the presence of pvl and SCCmec type IV, which are common genetic markers in community-associated MRSA, this outbreak was caused by a healthcare-associated, community-onset MRSA that was common in the hospital environment. Thus, infection control practices may have an important role in limiting the spread of this virulent clone.
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Demir T, Coplu N, Bayrak H, Turan M, Buyukguclu T, Aksu N, Eksioglu M, Yalcin B, Atakan N, Kilic S, Karahan ZC, Esen B. Panton-Valentine leucocidin gene carriage among Staphylococcus aureus strains recovered from skin and soft tissue infections in Turkey. J Antimicrob Chemother 2012; 67:837-40. [PMID: 22240400 DOI: 10.1093/jac/dkr568] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Regardless of methicillin resistance, Panton-Valentine leucocidin (PVL)-positive Staphylococcus aureus isolates are associated with various types of infections and outbreaks. Limited data exist about the PVL content of S. aureus strains in Turkey. In this multicentre study, we aimed to assess the PVL positivity and antimicrobial susceptibilities of S. aureus isolates recovered from skin and soft tissue samples of both community and nosocomial origin in the study period, 2007-08. METHODS Two hundred and forty-two [92 community-acquired (CA) and 150 hospital-acquired (HA)] isolates were included in the study. Analysis of mecA and PVL was carried out using PCR. All isolates underwent susceptibility testing according to the CLSI. RESULTS Out of 242 isolates, 77 were mecA positive. PVL was not found among methicillin-resistant S. aureus (MRSA) isolates, but 8 (5.3%) HA methicillin-susceptible S. aureus (MSSA) and 14 (15.2%) CA-MSSA, mostly isolated from furuncles (71.4%), were positive for PVL. Among PVL-positive strains, the penicillin resistance rate was 90.9%. Low resistance rates, <10%, were detected for erythromycin, fusidic acid and co-trimoxazole. PVL-positive strains showed higher rates of susceptibility to erythromycin, gentamicin and rifampicin than negative isolates. CONCLUSIONS Based on the findings of this study, infection related to PVL-carrying CA-MRSA is not at an alarmingly high level, but population-based surveillance studies should be done to determine the real status.
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Affiliation(s)
- Tulin Demir
- Microbiology Department, Faculty of Medicine, Ahi Evran University, Kirsehir, Turkey.
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Prokocimer P, Bien P, Surber J, Mehra P, DeAnda C, Bulitta JB, Corey GR. Phase 2, randomized, double-blind, dose-ranging study evaluating the safety, tolerability, population pharmacokinetics, and efficacy of oral torezolid phosphate in patients with complicated skin and skin structure infections. Antimicrob Agents Chemother 2011; 55:583-92. [PMID: 21115795 PMCID: PMC3028792 DOI: 10.1128/aac.00076-10] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 06/09/2010] [Accepted: 11/02/2010] [Indexed: 11/20/2022] Open
Abstract
Torezolid (TR-700) is the active moiety of the prodrug torezolid phosphate ([TP] TR-701), a second-generation oxazolidinone with 4- to 16-fold greater potency than linezolid against Gram-positive species including methicillin-resistant Staphylococcus aureus (MRSA). A double-blind phase 2 study evaluated three levels (200, 300, or 400 mg) of oral, once-daily TP over 5 to 7 days for complicated skin and skin structure infections (cSSSI). Patients 18 to 75 years old with cSSSI caused by suspected or confirmed Gram-positive pathogens were randomized 1:1:1. Of 188 treated patients, 76.6% had abscesses, 17.6% had extensive cellulitis, and 5.9% had wound infections. S. aureus, the most common pathogen, was isolated in 90.3% of patients (139/154) with a baseline pathogen; 80.6% were MRSA. Cure rates in clinically evaluable patients were 98.2% at 200 mg, 94.4% at 300 mg, and 94.4% at 400 mg. Cure rates were consistent across diagnoses, regardless of lesion size or the presence of systemic signs of infection. Clinical cure rates in patients with S. aureus isolated at baseline were 96.6% overall and 96.8% for MRSA. TP was safe and well tolerated at all dose levels. No patients discontinued treatment due to an adverse event. Three-stage hierarchical population pharmacokinetic modeling yielded a geometric mean clearance of 8.28 liters/h (between-patient variability, 32.3%), a volume of the central compartment of 71.4 liters (24.0%), and a volume of the peripheral compartment of 27.9 liters (35.7%). Results of this study show a high degree of efficacy at all three dose levels without significant differences in the safety profile and support the continued evaluation of TP for the treatment of cSSSI in phase 3 trials.
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Affiliation(s)
- P Prokocimer
- Trius Therapeutics, Inc., 6310 Nancy Ridge Drive, Suite 105, San Diego, CA 92121, USA.
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Neonatal staphylococcal scalded skin syndrome: clinical and outbreak containment review. Eur J Pediatr 2010; 169:1503-9. [PMID: 20625909 DOI: 10.1007/s00431-010-1252-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 06/28/2010] [Indexed: 10/19/2022]
Abstract
Staphylococcal scalded skin syndrome (SSSS) is a toxin-mediated exfoliating skin condition predominated by desquamation and blistering. Neonatal outbreaks have already been reported; however, our outbreak highlights the potential for SSSS following neonatal health promotion measures such as intra-muscular vitamin K administration and metabolic screening (heel prick) as well as effective case containment measures and the value of staff screening. Between February and June 2007, five confirmed cases of neonatal SSSS were identified in full-term neonates born in an Irish regional maternity hospital. All infants were treated successfully. Analysis of contact and environmental screening was undertaken, including family members and healthcare workers. Molecular typing on isolates was carried out. An outbreak control team (OCT) was assembled and took successful prospective steps to prevent further cases. All five Staphylococcus aureus isolates tested positive for exfoliative toxin A, of which two distinct strains were identified on pulsed-field gel electrophoresis analysis. Two cases followed staphylococcal inoculation during preventive measures such as intra-muscular vitamin K administration and metabolic screening (heel prick). None of the neonatal isolates were methicillin resistant. Of 259 hospital staff (70% of staff) screened, 30% were colonised with S. aureus, and 6% were positive for MRSA carriage. This is the first reported outbreak of neonatal SSSS in Ireland. Effective case containment measures and clinical value of OCT is demonstrated. Results of staff screening underlines the need for vigilance and compliance in hand disinfection strategies in maternity hospitals especially during neonatal screening and preventive procedures.
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Sesli Cetin E, Us E, Güneş H, Kaya S, Tekeli A, Demirci M. Investigation of Panton-Valentine leukocidin expressing Staphylococcus aureus colonization among children in a child care center. Am J Infect Control 2010; 38:565-7. [PMID: 20371136 DOI: 10.1016/j.ajic.2010.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 12/22/2009] [Accepted: 01/05/2010] [Indexed: 11/15/2022]
Abstract
The presence of Panton-Valentine leukocidin expressing Staphylococcus aureus colonization was investigated with a qualitative nucleic acid hybridization assay among 122 children and 19 staff in a child care center. Genotyping of 5 Panton-Valentine leukocidin-positive isolates by pulsed-field gel electrophoresis revealed that one child and a teacher from the same class were colonized with the clonally related strains. This finding allowed us to suggest that close contact with colonized people is a risk factor for being colonized.
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Affiliation(s)
- Emel Sesli Cetin
- Süleyman Demirel University Faculty of Medicine, Medical Microbiology Department, Isparta, Turkey.
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David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev 2010; 23:616-87. [PMID: 20610826 PMCID: PMC2901661 DOI: 10.1128/cmr.00081-09] [Citation(s) in RCA: 1340] [Impact Index Per Article: 95.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Staphylococcus aureus is an important cause of skin and soft-tissue infections (SSTIs), endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, foreign-body infections, and sepsis. Methicillin-resistant S. aureus (MRSA) isolates were once confined largely to hospitals, other health care environments, and patients frequenting these facilities. Since the mid-1990s, however, there has been an explosion in the number of MRSA infections reported in populations lacking risk factors for exposure to the health care system. This increase in the incidence of MRSA infection has been associated with the recognition of new MRSA clones known as community-associated MRSA (CA-MRSA). CA-MRSA strains differ from the older, health care-associated MRSA strains; they infect a different group of patients, they cause different clinical syndromes, they differ in antimicrobial susceptibility patterns, they spread rapidly among healthy people in the community, and they frequently cause infections in health care environments as well. This review details what is known about the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection. It also addresses the therapy of these infections and strategies for their prevention.
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Affiliation(s)
- Michael Z David
- Department of Pediatrics and Department of Medicine, the University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA.
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