1
|
Essigmann HT, Hanis CL, DeSantis SM, Perkison WB, Aguilar DA, Jun G, Robinson DA, Brown EL. Worsening Glycemia Increases the Odds of Intermittent but Not Persistent Staphylococcus aureus Nasal Carriage in Two Cohorts of Mexican American Adults. Microbiol Spectr 2022; 10:e0000922. [PMID: 35583495 PMCID: PMC9241628 DOI: 10.1128/spectrum.00009-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/21/2022] [Indexed: 12/14/2022] Open
Abstract
Numerous host and environmental factors contribute to persistent and intermittent nasal Staphylococcus aureus carriage in humans. The effects of worsening glycemia on the odds of S. aureus intermittent and persistent nasal carriage was established in two cohorts from an adult Mexican American population living in Starr County, Texas. The anterior nares were sampled at two time points and the presence of S. aureus determined by laboratory culture and spa-typing. Persistent carriers were defined by the presence of S. aureus of the same spa-type at both time points, intermittent carriers were S. aureus-positive for 1 of 2 swabs, and noncarriers were negative for S. aureus at both time points. Diabetes status was obtained through personal interview and physical examination that included a blood draw for the determination of percent glycated hemoglobin A1c (%HbA1c), fasting plasma glucose, and other blood chemistry values. Using logistic regression and general estimating equations, the odds of persistent and intermittent nasal carriage compared to noncarriers across the glycemic spectrum was determined controlling for covariates. Increasing fasting plasma glucose and %HbA1c in the primary and replication cohort, respectively, were significantly associated with increasing odds of S. aureus intermittent, but not persistent nasal carriage. These data suggest that increasing dysglycemia is a risk factor for intermittent S. aureus nasal carriage potentially placing those with poorly controlled diabetes at an increased risk of acquiring an S. aureus infection. IMPORTANCE Factors affecting nasal S. aureus colonization have been studied primarily in the context of persistent carriage. In contrast, few studies have examined factors affecting intermittent nasal carriage with this pathogen. This study demonstrates that the odds of intermittent but not persistent nasal carriage of S. aureus significantly increases with worsening measures of dysglycemia. This is important in the context of poorly controlled diabetes since the risk of becoming colonized with one of the primary organisms associated with diabetic foot infections can lead to increased morbidity and mortality.
Collapse
Affiliation(s)
- Heather T. Essigmann
- Center for Infectious Disease, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - Craig L. Hanis
- Human Genetics Center, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - Stacia M. DeSantis
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center, Houston, Texas, USA
| | - William B. Perkison
- Human Genetics Center, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - David A. Aguilar
- Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Goo Jun
- Human Genetics Center, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - D. Ashley Robinson
- Department of Microbiology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Eric L. Brown
- Center for Infectious Disease, Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA
| |
Collapse
|
2
|
Israelsson E, Chaussabel D, Fischer RSB, Moore HC, Robinson DA, Dunkle JW, Essigmann HT, Record S, Brown EL. Characterization of peripheral blood mononuclear cells gene expression profiles of pediatric Staphylococcus aureus persistent and non-carriers using a targeted assay. Microbes Infect 2020; 22:540-549. [PMID: 32758644 DOI: 10.1016/j.micinf.2020.07.006] [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: 01/09/2020] [Revised: 06/26/2020] [Accepted: 07/25/2020] [Indexed: 11/28/2022]
Abstract
Defects in innate immunity affect many different physiologic systems and several studies of patients with primary immunodeficiency disorders demonstrated the importance of innate immune system components in disease prevention or colonization of bacterial pathogens. To assess the role of the innate immune system on nasal colonization with Staphylococcus aureus, innate immune responses in pediatric S. aureus nasal persistent carriers (n = 14) and non-carriers (n = 15) were profiled by analyzing co-clustered gene sets (modules). We stimulated previously frozen peripheral blood mononuclear cells (PBMCs) from these subjects with i) a panel of TLR ligands, ii) live S. aureus (either a mixture of strains or stimulation with respective carriage isolates), or iii) heat-killed S. aureus. We found no difference in responses between carriers and non-carriers when PBMCs were stimulated with a panel of TLR ligands. However, PBMC gene expression profiles differed between persistent and non-S. aureus carriers following stimulation with either live or dead S. aureus. These observations suggest that individuals susceptible to persistent carriage with S. aureus may possess differences in their live/dead bacteria recognition pathway and that innate pathway signaling is different between persistent and non-carriers of S. aureus.
Collapse
Affiliation(s)
- Elisabeth Israelsson
- Department of Systems Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
| | - Damien Chaussabel
- Systems Biology Department, Sidra Medical and Research Center, Doha, Qatar
| | - Rebecca S B Fischer
- Texas A&M Health Science Center School of Public Health, Department of Epidemiology and Biostatistics, College Station, TX, USA
| | - Heather C Moore
- Baylor College of Medicine, Complex Care Clinic, Texas Children's Hospital, Houston, TX, USA
| | - D Ashley Robinson
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jesse W Dunkle
- Icahn School of Medicine, Mount Sinai Hospital, Institute for Advanced Medicine, New York, NY, USA
| | - Heather T Essigmann
- Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Sharron Record
- Texas Children's Hospital, Department of Pediatrics, TX, USA
| | - Eric L Brown
- Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA.
| |
Collapse
|
3
|
Neves FPG, Marlow MA, Rezende-Pereira G, Pinheiro MG, Dos Santos AFM, de Fátima Nogueira de Freitas M, Barros RR, Aguiar-Alves F, Cardoso CAA, Riley LW. Differences in gram-positive bacterial colonization and antimicrobial resistance among children in a high income inequality setting. BMC Infect Dis 2019; 19:478. [PMID: 31142269 PMCID: PMC6540362 DOI: 10.1186/s12879-019-4104-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/16/2019] [Indexed: 12/26/2022] Open
Abstract
Background Staphylococcus aureus and beta-hemolytic streptococci (BHS) diseases disproportionately affect populations in middle/low-income countries. To assess if this disparity is reflected in colonization by these organisms, we compared their colonization frequency among children from different socioeconomic status (SES) communities in a city with high income inequality. Methods Between May–August 2014, we collected nasal and throat swabs to investigate S. aureus and BHS colonization among children who attended private and public pediatric clinics. Patients were classified as high SES, middle/low SES, and slum residents. We investigated the antimicrobial resistance profile, the SCCmec types and the presence of PVL genes among methicillin-resistant S. aureus (MRSA). We also examined the antimicrobial resistance profile and serogroups of BHS. Results Of 598 children, 221 (37%) were colonized with S. aureus, of which 49 (22%) were MRSA. MRSA colonization was higher in middle/low SES (n = 18; 14%) compared with high SES (n = 17; 6%) and slum (n = 14; 8%) residents (p = 0.01). All MRSA strains were susceptible to clindamycin, nitrofurantoin, and rifampin. The highest non-susceptibility frequency (42.9%) was observed to erythromycin. SCCmec type V was only found in isolates from high SES children; types I and II were found only in middle/low SES children. Ten (20%) MRSA isolates carried PVL genes. Twenty-four (4%) children were BHS carriers. All BHS (n = 8) found in high SES children and six (67%) isolates from slum patients belonged to group A. All group B streptococci were from middle/low SES children, corresponding to five (71%) of the seven BHS isolated in this group. BHS isolates were susceptible to all drugs tested. Conclusions Children from different SES communities had distinct bacterial colonization profiles, including MRSA carriage. Public health officials/researchers should consider SES when assessing disease transmission and control measures.
Collapse
Affiliation(s)
| | | | | | - Marcos Gabriel Pinheiro
- Laboratório Universitário Rodolpho Albino, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | | | | | - Fábio Aguiar-Alves
- Laboratório Universitário Rodolpho Albino, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | | |
Collapse
|
4
|
Donkor ES, Kotey FCN, Dayie NTKD, Duodu S, Tetteh-Quarcoo PB, Osei MM, Tette EMA. Colonization of HIV-Infected Children with Methicillin-Resistant Staphylococcus aureus. Pathogens 2019; 8:E35. [PMID: 30884909 PMCID: PMC6470964 DOI: 10.3390/pathogens8010035] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/17/2019] [Accepted: 02/21/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) poses a public health threat owing to its extensive resistance to antibiotics, association with persistent outbreaks, and markedly increased healthcare costs. Moreover, HIV-infected individuals are at a greater risk for colonization with MRSA, and may act as reservoirs for subsequent transmission to other individuals. In Ghana, little is known about MRSA in relation to at-risk populations, such as HIV-infected children. The aim of this study was to investigate nasal carriage of S. aureus and MRSA among HIV-infected children in Accra, including the prevalence, risk factors and antibiotic resistance. METHODOLOGY The study was cross-sectional, and involved 107 children with HIV infection and an equal number of sex- and age group- matched apparently healthy controls recruited from the Princess Marie Louis Children's Hospital in Accra. Nasal swab specimens were collected from the study participants and cultured for bacteria. S. aureus isolates were confirmed by the coagulase test while MRSA was confirmed by PCR of the mecA gene. Antimicrobial susceptibility testing of S. aureus isolates was done by the Kirby Bauer method. A structured questionnaire was used to collect data on demographic, household and clinical features of the study participants. A logistic regression analysis was performed to identify determinants of S. aureus and MRSA carriage among participants of both study groups. RESULTS The carriage prevalence of S. aureus and MRSA were 44.9% (48) and 5.6% (6), respectively, among the HIV-infected individuals, and the corresponding values within the control group were 23.4% (25) and 0.9% (1). There was a significant association between HIV infection and S. aureus colonization (p < 0.001), but not MRSA colonization (p = 0.055). The main predictor of S. aureus colonization in both study groups was absence of colonization with coagulase negative staphylococcus (p < 0.001). Furthermore, the main predictor of MRSA colonization was regular hand washing with soap (p = 0.043); this was observed among HIV-infected individuals but not the control group. The proportion of S. aureus isolates that were multidrug resistant was 62.3% (33/53) in the HIV-infected group and 80% (20/25) in the control group (p = 0.192). CONCLUSIONS HIV infection is a risk factor for nasal colonization of S. aureus among children in Accra but may not be for MRSA. Both the HIV-infected and uninfected children are reservoirs of multidrug resistant S. aureus. Demographic, household and clinical features appear to have little or no relationship with S. aureus and MRSA colonization in the study children.
Collapse
Affiliation(s)
- Eric S Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
| | - Fleischer C N Kotey
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
- FleRhoLife Research Consult, P. O. Box TS 853, Teshie, Accra, Ghana.
| | - Nicholas T K D Dayie
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, P. O. Box LG 54, Legon, Accra, Ghana.
| | - Patience B Tetteh-Quarcoo
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, P. O. Box KB 143, Korle Bu, Accra, Ghana.
| | - Edem M A Tette
- Department of Community Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana.
| |
Collapse
|