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Zajmi A, Shiranee F, Gee Hoon Tang S, A.M. Alhoot M, Abdul Karim S. Multidrug-Resistant Staphylococcus aureus as Coloniser in Healthy Individuals. Infect Dis (Lond) 2022. [DOI: 10.5772/intechopen.108410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Staphylococcus aureus is a common human pathogen that can cause mild superficial infections to deep-seated abscesses and sepsis. One of the characteristics of S. aureus is the ability to colonise healthy individuals while leaving them asymptomatic. These carriers’ risk harbouring an antibiotic-resistant strain that may be harmful to the individual and the community. S. aureus carriage in healthcare personnel is being studied extensively in many parts of the world. However, the relationship between colonisation and disease among those with no previous exposure to healthcare remains untouched. Colonisation of the nasal cavity and its surrounding by pathogenic organisms such as S. aureus leads to the increased risk of infection. Hospital-acquired infections associated with S. aureus infections are common and studies related to these types of infections among various study groups are largely documented. However, over the last decade, an increase in community-associated methicillin-resistant S. aureus has been noted, increasing the need to identify the prevalence of the organism among healthy individuals and assessing the antibiotic resistance patterns. Systemic surveillance of the community for colonisation of S. aureus and identifying the antibiotic-resistant pattern is critical to determine the appropriate empiric antibiotic treatment.
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Román F, Mendez‐Echevarria A, Del Rosal T, Garcia‐Vera C, Escosa‐Garcia L, Agud M, Chaves F, Gutiérrez‐Fernández J, Ruiz de Gopegui E, Ruiz‐Carrascoso G, Ruiz‐Gallego MDC, Bernet A, Quevedo SM, Fernández‐Verdugo AM, Sainz T, Calvo C. Characterization of methicillin-resistant Staphylococcus aureus strains colonizing the nostrils of Spanish children. Microbiologyopen 2021; 10:e1235. [PMID: 34713607 PMCID: PMC8494715 DOI: 10.1002/mbo3.1235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To characterize the Staphylococcus aureus strains colonizing healthy Spanish children. METHODS Between March and July 2018, 1876 Spanish children younger than 14 years attending primary healthcare centers were recruited from rural and urban areas. Staphylococcus aureus colonization of the anterior nostrils was analyzed. MecA and mecC genes, antibiotic susceptibility, and genotyping according to the spa were determined in all strains, and the following toxins were examined: Panton-Valentine leucocidin (pvl), toxic shock syndrome toxin (tst), and exfoliative toxins (eta, etb, etd). Multilocus sequence typing (MLST) and staphylococcal cassette chromosome (SCCmec) typing were performed on methicillin-resistant Staphylococcus aureus (MRSA) strains, as well as pulsed-field gel electrophoresis (PFGE). RESULTS 619 strains were isolated in 1876 children (33%), and 92% of them were sent for characterization to the Spanish National Centre of Microbiology (n = 572). Twenty (3.5%) of these strains were mecA-positive. Several spa types were detected among MRSA, being t002 the most frequently observed (30%), associating with SCCmec IVc. Among MSSA, 33% were positive for tst, while only 0.73% were positive for pvl. The 20 MRSA strains were negative for pvl, and 6 (30%) harbored the tst gene. CONCLUSIONS methicillin-resistant Staphylococcus aureus nasal colonization in Spanish children is rare, with t002 being the most observed spa type, associated with SCCmec IVc. None of the MRSA strains produced pvl, but up to 30% of S. aureus strains were positive for tst.
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Affiliation(s)
- Federico Román
- Nosocomial Infections UnitCNMCarlos III Health InstituteMadridSpain
| | - Ana Mendez‐Echevarria
- Paediatric Infectious and Tropical Diseases DepartmentLa Paz University Hospital and Translational Research Network in Paediatric Infectious Diseases (RITIP)Institute for Health Research IdiPAZMadridSpain
| | - Teresa Del Rosal
- Paediatric Infectious and Tropical Diseases DepartmentLa Paz University Hospital and Translational Research Network in Paediatric Infectious Diseases (RITIP)Institute for Health Research IdiPAZMadridSpain
| | - Cesar Garcia‐Vera
- Primary Healthcare Centre "José Ramón Muñoz Fernández"Aragón Health ServiceZaragozaSpain
| | - Luis Escosa‐Garcia
- Paediatric Infectious and Tropical Diseases DepartmentLa Paz University Hospital and Translational Research Network in Paediatric Infectious Diseases (RITIP)Institute for Health Research IdiPAZMadridSpain
| | - Martin Agud
- Paediatric Infectious and Tropical Diseases DepartmentLa Paz University HospitalMadridSpain
| | - Fernando Chaves
- Department of Clinical MicrobiologyUniversity Hospital 12 de OctubreMadridSpain
| | - José Gutiérrez‐Fernández
- Department of MicrobiologyHospital Virgen de las NievesInstitute for Biosanitary Research‐IbsGranadaSpain
| | | | | | | | - Albert Bernet
- Section of MicrobiologyArnau de Vilanova University HospitalLleidaSpain
| | | | | | - Talia Sainz
- Paediatric Infectious and Tropical Diseases DepartmentLa Paz University Hospital and Translational Research Network in Paediatric Infectious Diseases (RITIP)Institute for Health Research IdiPAZMadridSpain
| | - Cristina Calvo
- Paediatric Infectious and Tropical Diseases DepartmentLa Paz University Hospital and Translational Research Network in Paediatric Infectious Diseases (RITIP)Institute for Health Research IdiPAZMadridSpain
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Randad PR, Dillen CA, Ortines RV, Mohr D, Aziz M, Price LB, Kaya H, Larsen J, Carroll KC, Smith TC, Miller LS, Heaney CD. Comparison of livestock-associated and community-associated Staphylococcus aureus pathogenicity in a mouse model of skin and soft tissue infection. Sci Rep 2019; 9:6774. [PMID: 31043631 PMCID: PMC6494861 DOI: 10.1038/s41598-019-42919-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 04/08/2019] [Indexed: 11/08/2022] Open
Abstract
Industrial hog operation (IHO) workers are at increased risk of carrying Staphylococcus aureus in their nares, particularly strains that are livestock-associated (LA) and multidrug-resistant. The pathogenicity of LA-S. aureus strains remains unclear, with some prior studies suggesting reduced transmission and virulence in humans compared to community-associated methicillin-resistant (CA-MRSA) S. aureus. The objective of this study was to determine the degree to which LA-S. aureus strains contracted by IHO workers cause disease relative to a representative CA-MRSA strain in a mouse model of skin and soft tissue infection (SSTI). Mice infected with CC398 LA-S. aureus strains (IHW398-1 and IHW398-2) developed larger lesion sizes with higher bacterial burden than mice infected with CA-MRSA (SF8300) (p < 0.05). The greatest lesion size and bacterial burden was seen with a CC398 strain that produced a recurrent SSTI in an IHO worker. The LA-S. aureus infected mice had decreased IL-1β protein levels compared with CA-MRSA-infected mice (p < 0.05), suggesting a suboptimal host response to LA-S. aureus SSTIs. WGSA revealed heterogeneity in virulence factor and antimicrobial resistance genes carried by LA-S. aureus and CA-MRSA strains. The observed pathogenicity suggest that more attention should be placed on preventing the spread of LA-S. aureus into human populations.
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Affiliation(s)
- Pranay R. Randad
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
| | - Carly A. Dillen
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland USA
| | - Roger V. Ortines
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland USA
| | - David Mohr
- Genetic Resources Core Facility, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland USA
| | - Maliha Aziz
- Department of Environmental and Occupational Health, George Washington University, Washington, D.C. USA
- Antibiotic Resistance Action Center, George Washington University, Washington, D.C. USA
| | - Lance B. Price
- Department of Environmental and Occupational Health, George Washington University, Washington, D.C. USA
- Antibiotic Resistance Action Center, George Washington University, Washington, D.C. USA
| | - Hülya Kaya
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Jesper Larsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Karen C. Carroll
- Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland USA
| | - Tara C. Smith
- Department of Epidemiology and Biostatistics, Kent State University, Kent, Ohio, USA
| | - Lloyd S. Miller
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland USA
| | - Christopher D. Heaney
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
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Nadimpalli ML, Stewart JR, Pierce E, Pisanic N, Love DC, Hall D, Larsen J, Carroll KC, Tekle T, Perl TM, Heaney CD. Face Mask Use and Persistence of Livestock-associated Staphylococcus aureus Nasal Carriage among Industrial Hog Operation Workers and Household Contacts, USA. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:127005. [PMID: 30675826 PMCID: PMC6371678 DOI: 10.1289/ehp3453] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 11/16/2018] [Accepted: 11/17/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND Industrial hog operation (IHO) workers may persistently carry antibiotic-resistant, livestock-associated Staphylococcus aureus in their nasal cavities. It is unclear whether IHO work activities can alter IHO workers' and their household members' exposure to these bacteria. OBJECTIVE Our objective was to investigate the relationship of IHO work activities with persistence of antibiotic-resistant, livestock-associated S. aureus nasal carriage among IHO workers and their household members. METHODS At biweekly intervals over 4 months, IHO workers and their household members completed questionnaires and provided nasal swabs that were assessed for S. aureus, multidrug-resistant S. aureus (MDRSA), and livestock-associated markers (tetracycline resistance, scn absence, spa type). We examined the association between transient and habitual IHO work activities and S. aureus nasal carriage outcomes. RESULTS One hundred one IHO workers and 79 household members completed 1,456 study visits. Face mask use (each 25% increase) was associated with reduced odds of nasal carriage of MDRSA (odds ratio [OR]: 0.65 [95% confidence interval (CI): 0.46, 0.92], tetracycline-resistant S. aureus [OR = 0.74 (95% CI: 0.56, 0.97)], and S. aureus clonal complex (CC) 398/CC9 [OR = 0.77 (95% CI: 0.60, 0.99)]. IHO workers who ever (vs. never) gave pigs injections had higher odds of these outcomes. Among household members, living with an IHO worker who consistently ([Formula: see text] of the time) versus sometimes or never used a face mask was associated with reduced odds of carrying scn-negative S. aureus, tetracycline-resistant S. aureus, and S. aureus CC398/CC9 (OR range: 0.12-0.20, all [Formula: see text]), and consistent IHO worker coveralls use was associated with reduced odds of household member MDRSA carriage only. Living with an IHO worker who habitually had contact with [Formula: see text] hogs (vs. [Formula: see text]) was associated with higher odds of household member livestock-associated S. aureus carriage. CONCLUSIONS Consistent face mask use was associated with reduced exposure to antibiotic-resistant, livestock-associated S. aureus among IHO workers and their household members. https://doi.org/10.1289/EHP3453.
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Affiliation(s)
- Maya L Nadimpalli
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jill R Stewart
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth Pierce
- Department of Environmental Sciences and Engineering, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nora Pisanic
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David C Love
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, Maryland, USA
| | - Devon Hall
- Rural Empowerment Association for Community Help, Warsaw, North Carolina, USA
| | - Jesper Larsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Karen C Carroll
- Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Tsigereda Tekle
- Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Trish M Perl
- Division of Infectious Diseases, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Christopher D Heaney
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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