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Xiong Z, Zhang C, Sarbandi K, Liang Z, Mai J, Liang B, Cai H, Chen X, Gao F, Lan F, Liu X, Liu S, Zhou Z. Clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae in pediatric inpatients in South China. Microbiol Spectr 2023; 11:e0283923. [PMID: 37819092 PMCID: PMC10714942 DOI: 10.1128/spectrum.02839-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/07/2023] [Indexed: 10/13/2023] Open
Abstract
IMPORTANCE This study assessed the clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae in pediatric inpatients at three hospitals in South China by means of screening stool samples for carbapenem-resistant genes and a nested case-control study to determine risk factors for carriage of carbapenem-resistant Enterobacteriaceae. Of 4,033 fecal samples screened, 158 (3.92%) were positive for CRE, including Escherichia coli (51.27 %), Klebsiella pneumoniae (37.97%), and Enterobacter cloacae (6.96%). The most common carbapenemase genes harbored by gastrointestinal CRE strains were blaNDM-5, blaNDM-1, and blaIMP-4. Hematological malignancies, respiratory diseases, otolaryngological diseases, nervous system diseases, oral administration of third-generation cephalosporins, and the combined use of two or more antibiotics were independently associated with CRE colonization.
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Affiliation(s)
- Zhile Xiong
- Longgang Maternity and Child Institute of Shantou University Medical College (Longgang District Maternity & Child Healthcare Hospital of Shenzhen City), Clinical Laboratory, Shenzhen, China
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Institute of Microbiology, Infectious Diseases and Immunology, Berlin, Germany
| | - Chao Zhang
- Longgang Maternity and Child Institute of Shantou University Medical College (Longgang District Maternity & Child Healthcare Hospital of Shenzhen City), Clinical Laboratory, Shenzhen, China
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
| | - Kurosh Sarbandi
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Institute of Microbiology, Infectious Diseases and Immunology, Berlin, Germany
| | - Zhuwei Liang
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
| | - Jialiang Mai
- Longgang Maternity and Child Institute of Shantou University Medical College (Longgang District Maternity & Child Healthcare Hospital of Shenzhen City), Clinical Laboratory, Shenzhen, China
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
| | - Bingshao Liang
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
| | - Hao Cai
- Longgang Maternity and Child Institute of Shantou University Medical College (Longgang District Maternity & Child Healthcare Hospital of Shenzhen City), Clinical Laboratory, Shenzhen, China
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
| | - Xiantang Chen
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
| | - Fei Gao
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
| | - Fangjun Lan
- Longgang Maternity and Child Institute of Shantou University Medical College (Longgang District Maternity & Child Healthcare Hospital of Shenzhen City), Clinical Laboratory, Shenzhen, China
| | - Xiaochun Liu
- Longgang Maternity and Child Institute of Shantou University Medical College (Longgang District Maternity & Child Healthcare Hospital of Shenzhen City), Clinical Laboratory, Shenzhen, China
| | - Shuyan Liu
- Longgang Maternity and Child Institute of Shantou University Medical College (Longgang District Maternity & Child Healthcare Hospital of Shenzhen City), Clinical Laboratory, Shenzhen, China
| | - Zhenwen Zhou
- Longgang Maternity and Child Institute of Shantou University Medical College (Longgang District Maternity & Child Healthcare Hospital of Shenzhen City), Clinical Laboratory, Shenzhen, China
- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Clinical Laboratory, Guangzhou, Guangdong, China
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Zhou Y, Yu S, Su C, Gao S, Jiang G, Zhou Z, Li H. Molecular Characteristics of Methicillin-Resistant and Susceptible Staphylococcus aureus from Pediatric Patients in Eastern China. Pathogens 2023; 12:pathogens12040549. [PMID: 37111435 PMCID: PMC10146695 DOI: 10.3390/pathogens12040549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Staphylococcus aureus is an opportunistic pathogen that causes invasive infections in humans. In recent years, increasing studies have focused on the prevalence of S. aureus infections in adults; however, the epidemiology and molecular characteristics of S. aureus from Chinese pediatric patients remain unknown. The present study examined the population structure, antimicrobial resistance, and virulent factors of methicillin-resistant and -susceptible S. aureus isolated from Chinese pediatric patients from one medical center in eastern China. A total of 81 cases were screened with positive S. aureus infections among 864 pediatric patients between 2016 and 2022 in eastern China. Molecular analysis showed that ST22 (28.4%) and ST59 (13.6%) were the most typical strains, and associations between different clonal complex (CC) types/serotype types (ST) and the age of pediatric patients were observed in this study. CC398 was the predominant type in neonates under 1 month of age, while CC22 was mainly found in term-infant (under 1 year of age) and toddlers (over 1 year of age). Additionally, 17 S. aureus isolates were resistant to at least three antimicrobials and majority of them belonged to CC59. The blaZ gene was found in 59 isolates and mecA gene was present in 26 strains identified as methicillin-resistant. Numerous virulent factors were detected in S. aureus isolated from present pediatric patients. Remarkably, lukF-PV and lukS-PV were dominantly carried by CC22, tsst-1 genes were detected in CC188, CC7, and CC15, while exfoliative toxin genes were found only in CC121. Only 41.98% of the S. aureus isolates possessed scn gene, indicating that the sources of infections in pediatric patients may include both human-to-human transmissions as well as environmental and nosocomial infections. Together, the present study provided a phylogenetic and genotypic comparison of S. aureus from Chinese pediatric patients in Suzhou city. Our results suggested that the colonization of multi-drug resistant isolates of S. aureus may raise concern among pediatric patients, at least from the present medical center in eastern China.
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Affiliation(s)
- Yuxuan Zhou
- Pasteurien College, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Shuyang Yu
- Pasteurien College, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Chenjun Su
- Pasteurien College, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Shengqi Gao
- Pasteurien College, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Guilai Jiang
- Pasteurien College, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Zhemin Zhou
- Pasteurien College, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Heng Li
- Pasteurien College, Suzhou Medical College of Soochow University, Suzhou 215123, China
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Li Y, Tang Y, Qiao Z, Jiang Z, Wang Z, Xu H, Jiao X, Li Q. Prevalence and molecular characteristics of community-associated methicillin-resistant Staphylococcus aureus in the respiratory tracts of Chinese adults with community-acquired pneumonia. J Infect Public Health 2023; 16:713-718. [PMID: 36940498 DOI: 10.1016/j.jiph.2023.03.014] [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: 09/01/2022] [Revised: 02/20/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an important pathogen causing healthcare-associated infections. In recent years, an increasing number of CA-MRSA clones have emerged and rapidly spread in the community and hospital settings in China. OBJECTIVES To investigate the molecular epidemiology and resistance of CA-MRSA in the respiratory tracts of Chinese adults with community-acquired pneumonia (CAP). METHODS A total of 243 sputum samples were collected from adult patients with CAP at the Nantong Hospital in China between 2018 and 2021. S. aureus was identified using PCR, and its susceptibility to 14 antimicrobials was tested using the broth dilution method. Genomic characterization of respiratory CA-MRSA and our previously collected intestinal CA-MRSA isolates was performed using whole-genome sequencing, and the evolutionary relationships of these isolates were assessed using phylogenetic analysis. RESULTS The CA-MRSA colonization rate among adults with CAP in China was 7.8 % (19/243). Antimicrobial resistance analysis revealed that the proportion of multidrug-resistant respiratory CA-MRSA isolates (100 %) was higher than that of intestinal CA-MRSA isolates (6.3 %). Among the 35 CA-MRSA isolates, 10 MLST types were identified and clustered into five clone complexes (CCs). CC5 (48.6 %) and CC88 (20 %) were predominant CA-MRSA clones. Notably, the CC5 clone ST764/ST6292-MRSA-II-t002 was identified as the major lineage causing respiratory tract infections in Chinese adults with CAP. CONCLUSIONS The prevalence of CA-MRSA among Chinese adults with CAP is high and often involves ST764/ST6292-MRSA-II-t002 as the causal pathogen.
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Affiliation(s)
- Yang Li
- Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China
| | - Yuanyue Tang
- Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, China
| | - Zhuang Qiao
- Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China
| | - Zhongyi Jiang
- Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China
| | - Zhenyu Wang
- Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China
| | - Haiyan Xu
- Nantong Center for Disease Control and Prevention, Nantong, China.
| | - Xinan Jiao
- Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, China.
| | - Qiuchun Li
- Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, China.
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Phylogenetic Analysis and Virulence Characteristics of Methicillin-Resistant Staphylococcus aureus ST45 in China: a Hyper-Virulent Clone Associated with Bloodstream Infections. mSystems 2023; 8:e0002923. [PMID: 36877043 PMCID: PMC10134793 DOI: 10.1128/msystems.00029-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) sequence type 45 (ST45) was rarely found in China. This study was conducted to trace the transmission and evolution of emerging MRSA ST45 strains in mainland China and explore its virulence. A total of 27 ST45 isolates were included for whole-genome sequencing and genetic characteristic analysis. Epidemiological results showed that MRSA ST45 isolates were often obtained from blood, primarily originated in Guangzhou, and carried diverse virulence and drug resistance genes. Staphylococcal cassette chromosome mec type IV (SCCmec IV) dominated in MRSA ST45 (23/27, 85.2%). ST45-SCCmec V was located on a phylogenetic clade distinct from the SCCmec IV cluster. We selected two representative isolates, MR370 (ST45-SCCmec IV) and MR387 (ST45-SCCmec V), and performed hemolysin activity, a blood killing assay, a Galleria mellonella infection model, and a mouse bacteremia model, as well as real-time fluorescence quantitative PCR. MR370 was proved to have extreme virulence in the phenotypic assays and at the mRNA level compared with ST59, ST5, and USA300 MRSA strains. MR387 was comparable to USA300-LAC on the phenotype and was verified to have higher expression of scn, chp, sak, saeR, agrA, and RNAIII than USA300-LAC. The results emphasized the extraordinary performance of MR370 and the good potential of MR387 in virulence causing bloodstream infection. Meanwhile, we conclude that China MRSA ST45 showed two different clonotypes, which may be widespread in the future. The entire study is valuable as a timely reminder and reports virulence phenotypes of China MRSA ST45 for the first time. IMPORTANCE Methicillin-resistant Staphylococcus aureus ST45 is epidemic worldwide. This study contributed to the awareness of the Chinese hyper-virulent MRSA ST45 strains and served as a timely reminder of its wide dissemination of clonotypes. Further, we provide novel insights for prevention from the perspective of bloodstream infections. ST45-SCCmec V is a clonotype deserving special attention in China, and we performed genetic and phenotypic analyses for the first time on it.
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Li Y, Tang Y, Jiang Z, Wang Z, Li Q, Jiao X. Molecular Characterization of Methicillin-Sensitive Staphylococcus aureus from the Intestinal Tracts of Adult Patients in China. Pathogens 2022; 11:pathogens11090978. [PMID: 36145410 PMCID: PMC9504698 DOI: 10.3390/pathogens11090978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Intestinal infections caused by methicillin-sensitive Staphylococcus aureus (MSSA) have posed a great challenge for clinical treatments. In recent years, the intestinal carriage rates of MSSA have risen steadily in hospital settings in China. However, the epidemiology and molecular characteristics of MSSA from the intestinal tracts of Chinese adult patients remain unknown. In the present study, a total of 80 S. aureus isolates, including 64 MSSA and 16 methicillin-resistant Staphylococcus aureus (MRSA), were recovered from 466 fecal swabs in adult patients between 2019 and 2021 in China. The MSSA isolates exhibited high resistance to penicillin (92.2%) and erythromycin (45.3%). In addition, a higher proportion of MSSA isolates (14.1%) were multidrug-resistant (MDR) strains than that of MRSA isolates (1.3%). Among the 64 MSSA isolates, we identified 17 MLST types, of which ST398 and ST15 were the most predominant types. The most frequently detected resistance genes were blaZ (87.5%) and erm(C) (21.9%). The hemolysin genes (hla, hld, hlgA, hlgB, hlgC) were detected in all the MSSA isolates, but the Panton–Valentine leucocidin (pvl) gene was identified in 1.7% of the MSSA isolates. Our findings indicated that the prevalence and antimicrobial resistance of intestinal MSSA was a serious concern among adult patients in China.
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Affiliation(s)
- Yang Li
- Jiangsu Key Lab of Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225000, China
- Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-Food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou 225000, China
| | - Yuanyue Tang
- Jiangsu Key Lab of Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225000, China
- Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-Food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou 225000, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, Yangzhou 225000, China
| | - Zhongyi Jiang
- Jiangsu Key Lab of Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225000, China
- Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-Food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou 225000, China
| | - Zhenyu Wang
- Jiangsu Key Lab of Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225000, China
- Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-Food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou 225000, China
| | - Qiuchun Li
- Jiangsu Key Lab of Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225000, China
- Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-Food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou 225000, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, Yangzhou 225000, China
- Correspondence: (Q.L.); (X.J.); Tel.: +86-514-8797-1136 (Q.L. & X.J.)
| | - Xinan Jiao
- Jiangsu Key Lab of Zoonosis, Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225000, China
- Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-Food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou 225000, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, Yangzhou 225000, China
- Correspondence: (Q.L.); (X.J.); Tel.: +86-514-8797-1136 (Q.L. & X.J.)
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Qodrati M, SeyedAlinaghi S, Dehghan Manshadi SA, Abdollahi A, Dadras O. Antimicrobial susceptibility testing of Staphylococcus aureus isolates from patients at a tertiary hospital in Tehran, Iran, 2018-2019. Eur J Med Res 2022; 27:152. [PMID: 35978369 PMCID: PMC9382727 DOI: 10.1186/s40001-022-00778-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/01/2022] [Indexed: 01/04/2023] Open
Abstract
Background Staphylococcus aureus, a human skin and mucous membranes colonizer, could opportunistically cause a variety of infectious diseases. Frequently, it is resistant to methicillin (MRSA), and often, co-resistant to many clinically available antibiotics. MRSA is a major burden for healthcare systems and communities all over the world, especially in developing countries. We addressed the issue that more than a decade had passed since the last report about cumulative antibiogram for S. aureus from our center, whereas The Clinical and Laboratory Standards Institute (CLSI) recommends to analyze and report it on an annual basis in order to guide clinicians to select the best initial empiric antimicrobial therapy. Methods In a cross-sectional retrospective design, data of culture-proven S. aureus from clinical specimens of hospitalized patients at Imam Khomeini Hospital Complex, Tehran, Iran, were collected from September 2018 to September 2019. Antimicrobial susceptibility testing (AST) had been performed using either Kirby–Bauer disk diffusion or VITEK 2 automated system which is based on minimum inhibitory concentration (MIC). The Chi-squared test was used considering the critical p-value to be ≤ .05. Results Among 576 unique isolates, the overall prevalence of MRSA was 37.5%. Patients admitted to the infectious diseases ward and ICUs have a greater chance to have such an isolate. Methicillin resistance was predictive of resistance to most antibiotics: erythromycin (90.9%), clindamycin (85.4% including inducible resistance), gentamicin, cipro-/levo-/moxi-floxacin, trimethoprim–sulfamethoxazole (58.3%), tetracycline, and rifampin. Resistance rate of zero was observed for daptomycin, linezolid, tigecycline, and (roughly) vancomycin. The prevalence of multiple-drug resistant (MDR) isolates was 48.5%. Conclusions Although in this study, the prevalence of MRSA was lower than the previous ones from the same hospital, it is still far from the desired rates. Besides, resistance to clindamycin and trimethoprim–sulfamethoxazole were remarkable. So far, vancomycin is the best choice for empiric treatment of MRSA, with linezolid as the second choice. It is advised to avoid prescribing the newer antibacterial agents as long as the older ones are effective to prevent the emergence of MDR species.
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Affiliation(s)
- Mohammad Qodrati
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences; Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419733141, Iran.
| | - Seyed Ali Dehghan Manshadi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences; Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419733141, Iran. .,Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical University, Tehran, Iran.
| | - Alireza Abdollahi
- Division of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences Tehran, Tehran, Iran
| | - Omid Dadras
- Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway
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Feng Y, Gu D, Wang Z, Lu C, Fan J, Zhou J, Wang R, Su X. Comprehensive evaluation and analysis of the salinity stress response mechanisms based on transcriptome and metabolome of Staphylococcus aureus. Arch Microbiol 2021; 204:28. [PMID: 34921629 DOI: 10.1007/s00203-021-02624-9] [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: 06/19/2021] [Revised: 10/03/2021] [Accepted: 10/07/2021] [Indexed: 10/19/2022]
Abstract
Staphylococcus aureus possesses an extraordinary ability to deal with a wide range of osmotic pressure. This study performed transcriptomic and metabolomic analyses on the potential mechanism of gradient salinity stress adaptation in S. aureus ZS01. The results revealed that CPS biosynthetic protein genes were candidate target genes for directly regulating the phenotypic changes of biofilm. Inositol phosphate metabolism was downregulated to reduce the conversion of functional molecules. The gluconeogenesis pathway and histidine synthesis were downregulated to reduce the production of endogenous glucose. The pyruvate metabolism pathway was upregulated to promote the accumulation of succinate. TCA cycle metabolism pathway was downregulated to reduce unnecessary energy loss. L-Proline was accumulated to regulate osmotic pressure. Therefore, these self-protection mechanisms can protect cells from hypertonic environments and help them focus on survival. In addition, we identified ten hub genes. The findings will aid in the prevention and treatment strategies of S. aureus infections.
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Affiliation(s)
- Ying Feng
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Ningbo University, Ningbo, China.,College of Life Sciences, Tonghua Normal University, Tonghua, China.,School of Marine Sciences, Ningbo University, 169 Qixing South Road, Ningbo City, 315211, Zhejiang Province, China
| | - Dizhou Gu
- College of Life Sciences, Tonghua Normal University, Tonghua, China
| | - Ziyan Wang
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Ningbo University, Ningbo, China.,School of Marine Sciences, Ningbo University, 169 Qixing South Road, Ningbo City, 315211, Zhejiang Province, China
| | - Chenyang Lu
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Ningbo University, Ningbo, China.,School of Marine Sciences, Ningbo University, 169 Qixing South Road, Ningbo City, 315211, Zhejiang Province, China
| | - Jingfeng Fan
- National Marine Environmental Monitoring Center, Dalian, China
| | - Jun Zhou
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Ningbo University, Ningbo, China.,School of Marine Sciences, Ningbo University, 169 Qixing South Road, Ningbo City, 315211, Zhejiang Province, China
| | - Rixin Wang
- School of Marine Sciences, Ningbo University, 169 Qixing South Road, Ningbo City, 315211, Zhejiang Province, China.
| | - Xiurong Su
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products, Ningbo University, Ningbo, China. .,School of Marine Sciences, Ningbo University, 169 Qixing South Road, Ningbo City, 315211, Zhejiang Province, China.
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Liang B, Liang X, Gao F, Long Y, Mai J, Ai X, Wang J, Gao X, Xiong Z, Liang Z, Zhang C, Gong S, Zhou Z. Active Surveillance, Drug Resistance, and Genotypic Profiling of Staphylococcus aureus Among School-Age Children in China. Front Med (Lausanne) 2021; 8:701494. [PMID: 34447764 PMCID: PMC8382981 DOI: 10.3389/fmed.2021.701494] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/09/2021] [Indexed: 12/11/2022] Open
Abstract
Methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization predisposes individuals for endogenous infections and is a major threat to children. Recently, oxacillin/cefoxitin-susceptible mecA-positive S. aureus (OS-MRSA) has been reported worldwide. Herein, a prospective, cross-sectional study was conducted across five schools, representing three educational stages, in Guangzhou, China. Nasal swabs from 2,375 students were cultured for S. aureus and all isolates were subjected to antibiotic susceptibility testing phenotypically and confirmed by femB and mecA genetic detection; all the isolates were classified as MSSA, MRSA, or OS-MRSA. All strains were also analyzed by multi-locus sequence typing. Among the 2,375 swabs, S. aureus was detected in 744 children (31.3%, 95% CI: 25.9–36.7%), of whom 72 had MRSA (3.0%, 95% CI: 0.6–5.4%) and 4 had OS-MRSA (0.2%, 95% CI: 0.1–0.3%), of which an oxacillin- and cefoxitin-susceptible MRSA strain was identified. The prevalence of S. aureus and MRSA was higher in younger children. The highest percentage of drug resistance of the S. aureus isolates (n = 744) was to penicillin (85.5%), followed by erythromycin (43.3%) and clidamycin (41.0%). The most prevalent sequence types (STs) were ST30, ST45, and ST188 in MSSA, accounting for 38.7% of the total isolates, whereas ST45, ST59, and ST338 accounted for 74.6% of the MRSA isolates and ST338 accounted for 50.0% of the OS-MRSA isolates. The MRSA and OS-MRSA isolates (n = 76) were grouped into three clades and one singleton, with clonal complex (CC) 45 as the most predominant linkage. The top nine multi-locus sequence typing-based CCs (CC30, CC45, CC5, CC1, CC15, CC944, CC398, CC59, CC7) represented 86.7% of all S. aureus isolates. All CC30 isolates were resistant to erythromycin and clidamycin, and almost all these isolates were also resistant to penicillin (99.2%). The CC45 and CC59 isolates exhibited high resistance rates to oxacillin at 31.5 and 59.0%, respectively. This study provides updated data valuable for designing effective control strategies to mitigate the burden of disease and to improve the adequacy of empirical antimicrobial treatments for potentially harmful infections.
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Affiliation(s)
- Bingshao Liang
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaoyun Liang
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Fei Gao
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yan Long
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jialiang Mai
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiaolan Ai
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jielin Wang
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiurong Gao
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhile Xiong
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhuwei Liang
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Chao Zhang
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Sitang Gong
- Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhenwen Zhou
- Clinical Laboratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Laboratory Medicine, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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9
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Li Z, Su M, Cheng W, Xia J, Liu S, Liu R, Sun S, Feng L, Zhu X, Zhang X, Tian X, Qu L. Pharmacokinetics, Urinary Excretion, and Pharmaco-Metabolomic Study of Tebipenem Pivoxil Granules After Single Escalating Oral Dose in Healthy Chinese Volunteers. Front Pharmacol 2021; 12:696165. [PMID: 34326771 PMCID: PMC8314177 DOI: 10.3389/fphar.2021.696165] [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: 04/16/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Tebipenem pivoxil (TBPM-PI), an oral carbapenem antibiotic, has shown special advantages in pediatric infections and was in urgent need in China. Although pharmacokinetics, urinary excretion, and metabolite information of its active form tebipenem (TBPM) has been reported, ethnic differences may exist among the Chinese and Japanese population. By now, no systematic pharmacokinetics, urinary excretion, metabolites, or safety information has been revealed to the Chinese population. The purpose of the present work was to investigate abovementioned information of TBPM-PI granules after oral single ascending doses of 100, 200, and 400 mg in Chinese volunteers. Based on the pharmacokinetic study, the urine pharmaco-metabolomic analysis was conducted to reveal metabolomic interruptions and metabolite information. The study design was a single-center, open-label, randomized, single-dose pharmacokinetic study of 36 healthy volunteers (with half of them being male and the other half female). Time to maximum concentration (T max) was reached at 0.50, 0.50, or 0.67 h for 100, 200, or 400 mg, respectively. The linear pharmacokinetic characteristic of maximum plasma concentration (C max) was detected over 100-200 mg. The area under the concentration time curve (AUC) was proportional to the dose in the range of 100-400 mg. The maximum urinary excretion rate was detected at 0-1 or 1-2 h for dose of 100 or 200-400 mg. Cumulative amount of TBPM excreted in urine by 24 h accounted up to 90, 95, and 80% of dose administered for three groups, respectively. The pharmaco-metabolomic analysis revealed urine metabolic trajectory of deviation at 0-1 or 1-2 h and gradually regressing back to the pre-dose group at the following time periods. Urine metabolites from M1 to M4 were identified, indicating ethnic difference in metabolites among the Chinese or Japanese population. The current work proved safety and tolerance of single-dose administration of oral TBPM-PI in Chinese healthy volunteers over doses of 100-400 mg. All these results provide pharmacokinetics, urine excretion, urine metabolomics, urine metabolites, and safety information in healthy Chinese volunteers after oral single ascending doses of TBPM-PI, benefitting further development and clinical utilities.
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Affiliation(s)
- Zeyun Li
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Mei Su
- Jiangsu Carephar Pharmaceutical Co., Ltd, Nanjing, China
| | - Weiyan Cheng
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Jueyu Xia
- Jiangsu Carephar Pharmaceutical Co., Ltd, Nanjing, China
| | - Shuaibing Liu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Ruijuan Liu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Suke Sun
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Luyao Feng
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Xueya Zhu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Xiaojian Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Xin Tian
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Lingbo Qu
- College of Chemistry and Molecular Engineering, Zhengzhou University, Zhengzhou, China
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