RESUMEN
Staphylococcus lugdunensis is an emerging high-virulent pathogen causative of hospital-acquired infections. Biofilm formation is a complex pathogenic process that leads to well-established bacterial communities. There is a paucity of data on the composition of the biofilm matrix among S. lugdunensis strains. Here, twenty-two S. lugdunensis clinical isolates, mainly from orthopaedic infections but also from other clinical sources, were sub-grouped by ribotyping and dendrogram analysis. Biofilms were analysed by fluorimetric methods based on FITC-Wheat Germ Agglutinin, SYPRO Ruby and TOTO-1 dyes to detect exopolysaccharides, proteins and extracellular DNA (eDNA), respectively. Biofilm morphology was investigated under confocal laser scanning microscopy (CLSM). Isolates displayed intriguing diversities in biofilm mass and matrix composition. The content of exopolysaccharides was found to be to be strongly associated with the biofilm mass (R2 = 0.882), while the content of proteins turned out to be weakly (R2 = 0.465) and that of eDNA very weakly associated (R2 = 0.202) to the biofilm mass.
Asunto(s)
Proteínas Bacterianas/metabolismo , ADN Bacteriano/genética , Matriz Extracelular de Sustancias Poliméricas/metabolismo , Polisacáridos Bacterianos/metabolismo , Staphylococcus lugdunensis/crecimiento & desarrollo , Antibacterianos/farmacología , Proteínas Bacterianas/genética , Biopelículas/efectos de los fármacos , Biopelículas/crecimiento & desarrollo , Farmacorresistencia Bacteriana/efectos de los fármacos , Farmacorresistencia Bacteriana/genética , Matriz Extracelular de Sustancias Poliméricas/genética , Humanos , Pruebas de Sensibilidad Microbiana , Microscopía Confocal , Polisacáridos Bacterianos/genética , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/metabolismo , Staphylococcus lugdunensis/ultraestructuraRESUMEN
Staphylococcus lugdunensis is considered more pathogenic than other coagulase-negative Staphylococci (CoNS), with its virulence resembling that of Staphylococcus aureus. We report a retrospective study of all S. lugdunensis infection cases during a 3.5-year period in a large tertiary university hospital in Greece. S.lugdunensis was susceptible to most tested antibiotics, although a high resistance percentage was found to clindamycin (27%) and erythromycin (25%). The susceptibility rate to penicillin was 49%, much lower than previously reported elsewhere, indicating that penicillin may not be an optimal treatment choice for S. lugdunensis infections in our region.
Asunto(s)
Infecciones Estafilocócicas , Staphylococcus lugdunensis , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Coagulasa , Grecia/epidemiología , Humanos , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/aislamiento & purificación , Centros de Atención TerciariaRESUMEN
BACKGROUND: Staphylococcus lugdunensis is a significant pathogen that causes community-acquired and nosocomial infections. The high prevalence of oxacillin-resistant S. lugdunensis (ORSL) is of major concern. Resistance to ß-lactams is caused by acquisition of the staphylococcal cassette chromosome mec (SCCmec) element. The cassette is highly diverse, both structurally and genetically, among CoNS. Isolates carrying SCCmec II-ST6 are the major persistent clones in hospitals. OBJECTIVES: To investigate the structure and evolutionary origin of a novel type II SCCmec element in an endemic ST6 S. lugdunensis clone. METHODS: The structure of the SCCmec II element carried by ST6 strain CGMH-SL118 was determined by WGS and compared with those reported previously. RESULTS: A novel 39 kb SCCmec element, SCCmecCGMH-SL118, with a unique mosaic structure comprising 41 ORFs integrated into the 3' end of the rlmH gene, was observed. Some regions of SCCmecCGMH-SL118 were homologous to SCCmec IIa of the prototype MRSA strain N315. The structure of SCCmecCGMH-SL118 was similar to that of SCCmec IIb of the MRSA strain, JCSC3063, mainly lacking the aminoglycoside resistance determinant pUB110 in the J3 region but containing the insertion sequence IS256 in the J2 region. Notably, SCCmecCGMH-SL118 deletions in the J1 region compared with SCCmec types IIa and IIb, and a high homology to SCCmec elements of Staphylococcus aureus JCSC4610 and Staphylococcus haemolyticus strain 621 were found. CONCLUSIONS: The genetic diversity of the type II SCCmec element in ORSL suggests that CoNS is a potential reservoir for interspecies transfer of SCCmec to S. aureus in hospitals.
Asunto(s)
Antibacterianos/farmacología , Cromosomas Bacterianos , Farmacorresistencia Bacteriana , Oxacilina/farmacología , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/genética , Infección Hospitalaria/microbiología , ADN Bacteriano/genética , Variación Genética , Hospitales/estadística & datos numéricos , Humanos , Recién Nacido , Pruebas de Sensibilidad Microbiana , Análisis de Secuencia de ADN , Infecciones Estafilocócicas/sangre , Infecciones Estafilocócicas/microbiología , Taiwán , Secuenciación Completa del GenomaRESUMEN
Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CoNS) with unusual pathogenicity resembling that of S. aureus. Unlike other CoNS, S. lugdunensis remains susceptible to most antibiotics. The resistance to penicillin varies widely (range, 15-87% worldwide), whereas methicillin resistance is still rare. We aimed to evaluate treatment options for infections caused by S. lugdunensis and more specifically to investigate whether penicillin G could be a better treatment choice than oxacillin. Susceptibility testing was performed using the disc diffusion method for penicillin G, cefoxitin, trimethoprim/sulfamethoxazole, erythromycin, clindamycin, gentamicin, norfloxacin, fusidic acid, rifampicin, and fosfomycin. Isolates susceptible to penicillin G were further tested with a gradient test for penicillin G and oxacillin. Of the 540 clinical isolates tested, 74.6% were susceptible to penicillin G. Among these penicillin-susceptible isolates, the MIC50 and MIC90 values for penicillin G were threefold lower than that for oxacillin. A majority of the isolates were susceptible to all other antibiotics tested. Breakpoints for fosfomycin have not yet been defined, and so no conclusions could be drawn. Two isolates were resistant to cefoxitin and carried the mecA gene; whole-genome sequencing revealed that both harbored the SCCmec element type IVa(2B). S. lugdunensis isolated in Sweden were susceptible to most tested antibiotics. Penicillin G may be a more optimal treatment choice than oxacillin. Although carriage of the mecA gene is rare among S. lugdunensis, it does occur.
Asunto(s)
Antibacterianos/farmacología , Staphylococcus lugdunensis/efectos de los fármacos , Proteínas Bacterianas/genética , Pruebas Antimicrobianas de Difusión por Disco , Farmacorresistencia Bacteriana/genética , Oxacilina/farmacología , Oxacilina/uso terapéutico , Penicilina G/farmacología , Penicilina G/uso terapéutico , Staphylococcus lugdunensis/genética , Suecia , Secuenciación Completa del GenomaRESUMEN
The increasing production of goat milk and its derivatives is affected by the occurrence of intramammary infections, which are highly associated with the presence of Staphylococcus species, including some with zoonotic potential. Staphylococci in general can exchange mobile genetic elements, a process that may be facilitated by the isolate's capacity of forming biofilms. In this study we identified, to the species level, Staphylococcus isolated from goat milk samples by MALDI-TOF and confirmed the identification by sequencing housekeeping genes (rrs and tuf). Eight species were identified, more than half being either Staphylococcus epidermidis or Staphylococcus lugdunensis. The isolates were shown by pulsed-field gel electrophoresis to be genetically diverse between the studied herds. Resistance to ampicillin and penicillin was widespread, and 2 Staph. epidermidis isolates contained the methicillin-resistance gene mecA. Most of the isolates that were resistant to at least 1 of the 13 antimicrobials tested harbored plasmids, one of which was demonstrated to be conjugative, being transferred from a Staph. epidermidis to a Staphylococcus aureus strain. Biofilm formation was observed in almost every isolate, which may contribute to their capacity of exchanging antimicrobial resistance genes in addition to acting as a physical barrier to the access of drugs. Our results showed that antimicrobial resistance among goat staphylococci may be emerging in a process facilitated by the exchange of mobile genetic elements between the bacteria and the establishment of biofilms, which calls for careful monitoring and more effective control therapies.
Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana/genética , Enfermedades de las Cabras/microbiología , Leche/microbiología , Infecciones Estafilocócicas/veterinaria , Staphylococcus/genética , Ampicilina/farmacología , Animales , Industria Lechera , Femenino , Transferencia de Gen Horizontal , Cabras , Penicilina G/farmacología , Infecciones Estafilocócicas/microbiología , Staphylococcus/efectos de los fármacos , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/genéticaRESUMEN
Helicteres hirsuta Lour. (H. hirsuta) has been considered as a herbal medicine for the treatment of malaria and diabetes but limited studies have been conducted on its anticancer and antibacterial properties. In this study, the in vitro antibacterial and anticancer properties of the leaf and stem extracts and their two sub-fractions (aqueous and saponin-enriched butanol fractions) prepared from H. hirsuta were elucidated. MTT and CCK-8 assays were employed to assess their in vitro anticancer properties against various cancer cell lines. The antibacterial activity was assessed using the disc diffusion method and minimum inhibitory concentration (MIC) values were determined. The results revealed that the saponin-enriched fractions from H. hirsuta leaves and stems showed the highest antibacterial activity against E. coli (MIC values of 2.50 and 5.00 mg/mL, respectively) and S. lugdunensis (MIC values of 0.35 and 0.50 mg/mL, respectively). Importantly, these saponin-enriched fractions possessed strong anticancer activity in vitro towards a range of cancer cell lines including MIA PaCa-2 (pancreas); A2780 (ovarian); H460 (lung); A431 (skin); Du145 (prostate); HT29 (colon); MCF-7 (breast); SJ-G2, U87, SMA (glioblastoma) and BE2-C (neuroblastoma) at low doses (GI50 values of 0.36-11.17 µg/mL). They especially revealed potent anti-pancreatic cancer activity in vitro against MIA PaCa-2, BxPC-3 and CFPAC-1 cells with IC50 values of 1.80-6.43 µg/mL. This finding provides scientific evidence of the cytotoxic activity of the extracts prepared from H. hirsuta leaves and stems, and suggests further studies to isolate active compounds for development of new anticancer agents from these plant extracts.
Asunto(s)
Línea Celular Tumoral/efectos de los fármacos , Malvaceae/química , Malvaceae/metabolismo , Extractos Vegetales/uso terapéutico , Antibacterianos , Anticarcinógenos , Antioxidantes , Escherichia coli/efectos de los fármacos , Humanos , Malvaceae/genética , Pruebas de Sensibilidad Microbiana , Fitoterapia/métodos , Hojas de la Planta , Tallos de la Planta , Plantas Medicinales/química , Staphylococcus lugdunensis/efectos de los fármacosRESUMEN
Coagulase-negative staphylococci (CoNS) are the major causative agents of foreign-body-related infections, including catheter-related bloodstream infections. Because of the involvement of biofilms, foreign-body-related infections are difficult to treat. P128, a chimeric recombinant phage-derived ectolysin, has been shown to possess bactericidal activity on strains of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). We tested the killing potential of P128 on three clinically significant species of CoNS, S. epidermidis, S. haemolyticus, and S. lugdunensis, under a variety of physiological conditions representing growing and nongrowing states. The MIC90 and minimum bactericidal concentration at which 90% of strains tested are killed (MBC90) of P128 on 62 clinical strains of CoNS were found to be 16 and 32 µg/ml (0.58 and 1.16 µM), respectively, demonstrating the bactericidal nature of P128 on CoNS strains. Serum showed a potentiating effect on P128 inhibition, as indicated by 4- to 32-fold lower MIC values observed in serum. P128 caused a rapid loss of viability in all CoNS strains tested. Persisters of CoNS that were enriched in the presence of vancomycin or daptomycin were killed by P128 at 1× the MIC in a rapid manner. Low concentrations of P128 caused a 2- to 5-log reduction in CFU in stationary-phase or poorly metabolizing CoNS cultures. P128 at low concentrations eliminated CoNS biofilms in microtiter plates and on the surface of catheters. Combinations of P128 and standard-of-care (SoC) antibiotics were highly synergistic in inhibiting growth in preformed biofilms. Potent activity on planktonic cells, persisters, and biofilms of CoNS suggests that P128 is a promising candidate for the clinical development of treatments for foreign-body-related and other CoNS infections.
Asunto(s)
Antibacterianos/farmacología , Biopelículas/efectos de los fármacos , Proteínas Recombinantes de Fusión/farmacología , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus epidermidis/efectos de los fármacos , Staphylococcus haemolyticus/efectos de los fármacos , Staphylococcus lugdunensis/efectos de los fármacos , Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Infecciones Relacionadas con Catéteres/microbiología , Coagulasa/metabolismo , Daptomicina/farmacología , Sinergismo Farmacológico , Quimioterapia Combinada , Reacción a Cuerpo Extraño/tratamiento farmacológico , Reacción a Cuerpo Extraño/microbiología , Humanos , Pruebas de Sensibilidad Microbiana , Staphylococcus epidermidis/enzimología , Staphylococcus haemolyticus/enzimología , Staphylococcus lugdunensis/enzimología , Vancomicina/farmacologíaRESUMEN
Antimicrobial susceptibility results from broth microdilution MIC testing of 993 Staphylococcus lugdunensis isolates recovered from patients at a tertiary care medical center from 2008 to 2015 were reviewed. Ninety-two oxacillin-susceptible isolates were selected to assess the accuracy of penicillin MIC testing, the penicillin disk diffusion test, and three ß-lactamase tests, including the cefoxitin-induced nitrocefin test, penicillin cloverleaf assay, and penicillin disk zone edge test. The results of all phenotypic tests were compared to the results of blaZ PCR. The medical records of 62 patients from whom S. lugdunensis was isolated, including 31 penicillin-susceptible and 31 penicillin-resistant strains, were retrospectively reviewed to evaluate the clinical significance of S. lugdunensis isolation, the antimicrobial agents prescribed, if any, and the clinical outcome. MIC testing revealed that 517/993 (52.1%) isolates were susceptible to penicillin and 946/993 (95.3%) were susceptible to oxacillin. The induced nitrocefin test was 100% sensitive and specific for the detection of ß-lactamase compared to the blaZ PCR results, whereas the penicillin disk zone edge and cloverleaf tests showed sensitivities of 100% but specificities of only 9.1% and 89.1%, respectively. The penicillin MIC test had 100% categorical agreement with blaZ PCR, while penicillin disk diffusion yielded one major error. Only 3/31 patients with penicillin-susceptible isolates were treated with a penicillin family antimicrobial. The majority of cases were treated with other ß-lactams, trimethoprim-sulfamethoxazole, or vancomycin. These data indicate that nearly all isolates of S. lugdunensis are susceptible to narrow-spectrum antimicrobial agents. Clinical laboratories in areas with resistance levels similar to those described here can help promote the use of these agents versus vancomycin by effectively designing their antimicrobial susceptibility reports to convey this message.
Asunto(s)
Infecciones Estafilocócicas/microbiología , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/aislamiento & purificación , Resistencia betalactámica , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Oxacilina/farmacología , Penicilinas/farmacología , Reacción en Cadena de la Polimerasa , Estudios Retrospectivos , Infecciones Estafilocócicas/tratamiento farmacológico , Centros de Atención Terciaria , beta-Lactamasas/análisisRESUMEN
OBJECTIVES: Staphylococcus lugdunensis, a species of CoNS, has become an important hospital pathogen because of increasing resistance to ß-lactam antibiotics such as methicillin and oxacillin. Methicillin resistance is mainly due to the acquisition of the staphylococcal cassette chromosome (SCC) mec (SCCmec). Little is known about the structure of SCCmec in methicillin- or oxacillin-resistant CoNS. METHODS: WGS was performed to determine the structure of SCCmec elements of two clinical S. lugdunensis isolates: CMUH-22 and CMUH-25. RESULTS: These elements were found to be flanked by DRs and IRs with unique mosaic structures and a common integration site in the 3' end of the rlmH gene. The sequences of the regions located between rlmH and the ISSau4-like transposase genes of both elements were similar to those of SCCmec Vt of Staphylococcus aureus PM1. The SCCmec (type V, 5C2&4) of CMUH-25 harboured a novel ccrC complex and a C2-like mec complex in opposite orientations, similar to the type V SCCmec of S. aureus WIS. The sequences of the ccrA4B4 genes and J1 and J2 regions of CMUH-25 were similar to those of the SCC element of Staphylococcus haemolyticus NCTC 11042. In contrast, portions of the sequence of the J1 region of type Vt (5C2) SCCmec in strain CMUH-22 were highly similar to portions of those of Staphylococcus epidermidis RP62A and the composite SCCmec type V of S. aureus WAMRSA40. CONCLUSIONS: These observations suggest that the SCCmec elements of CMUH-25 and CMUH-22 evolved separately and assembled through different recombination events.
Asunto(s)
Antibacterianos/farmacología , Cromosomas Bacterianos , Orden Génico , Oxacilina/farmacología , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/genética , Resistencia betalactámica , Evolución Molecular , Genes Bacterianos , Humanos , Recombinación Genética , Infecciones Estafilocócicas/microbiología , Staphylococcus lugdunensis/aislamiento & purificación , Secuenciación Completa del GenomaRESUMEN
BACKGROUND: The objectives of this study were to characterize the diversity and magnitude of antimicrobial resistance among Staphylococcus species recovered from imported beef meat sold in the Egyptian market and the potential mechanisms underlying the antimicrobial resistance phenotypes including harboring of resistance genes (mecA, cfr, gyrA, gyrB, and grlA) and biofilm formation. RESULTS: The resistance gene mecA was detected in 50% of methicillin-resistant non-Staphylococcus aureus isolates (4/8). Interestingly, our results showed that: (i) resistance genes mecA, gyrA, gyrB, grlA, and cfr were absent in Staphylococcus hominis and Staphylococcus hemolyticus isolates, although S. hominis was phenotypically resistant to methicillin (MR-non-S. aureus) while S. hemolyticus was resistant to vancomycin only; (ii) S. aureus isolates did not carry the mecA gene (100%) and were phenotypically characterized as methicillin- susceptible S. aureus (MSS); and (iii) the resistance gene mecA was present in one isolate (1/3) of Staphylococcus lugdunensis that was phenotypically characterized as methicillin-susceptible non-S. aureus (MSNSA). CONCLUSIONS: Our findings highlight the potential risk for consumers, in the absence of actionable risk management information systems, of imported foods and advice a strict implementation of international standards by different venues such as CODEX to avoid the increase in prevalence of coagulase positive and coagulase negative Staphylococcus isolates and their antibiotic resistance genes in imported beef meat at the Egyptian market.
Asunto(s)
Antibacterianos/farmacología , Coagulasa/metabolismo , Farmacorresistencia Bacteriana/genética , Carne Roja/microbiología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/genética , Virulencia/genética , Animales , Proteínas Bacterianas/genética , Biopelículas/crecimiento & desarrollo , Bovinos , Chlorocebus aethiops , Girasa de ADN/genética , Egipto , Microbiología de Alimentos , Genes Bacterianos/genética , Proteínas Hemolisinas/metabolismo , Meticilina/farmacología , Resistencia a la Meticilina/efectos de los fármacos , Resistencia a la Meticilina/genética , Pruebas de Sensibilidad Microbiana , Proteínas de Unión a las Penicilinas/genética , Fenotipo , ARN Ribosómico 16S/genética , Infecciones Estafilocócicas/microbiología , Staphylococcus/clasificación , Staphylococcus/efectos de los fármacos , Staphylococcus/genética , Staphylococcus/aislamiento & purificación , Staphylococcus aureus/enzimología , Staphylococcus aureus/aislamiento & purificación , Staphylococcus haemolyticus/efectos de los fármacos , Staphylococcus haemolyticus/genética , Staphylococcus haemolyticus/aislamiento & purificación , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/genética , Staphylococcus lugdunensis/aislamiento & purificación , Vancomicina/farmacología , Células Vero/microbiologíaRESUMEN
OBJECTIVE: Staphylococcus lugdunensis is considered to be more aggressive than other coagulase-negative staphylococci (CoNS). There are gaps in knowledge regarding the importance of isolating S. lugdunensis from different sources and in different patient subsets. Our objective was to describe the spectrum, clinical manifestations, and outcomes of infections caused by S. lugdunensis in patients with cancer. METHODS: A retrospective review of all cancer patients from whom S. lugdunensis was isolated in a pure culture from clinically significant sites. RESULTS: Between 2011 and 2014, 2263 CoNS were isolated, of them 45 S. lugdunensis were isolated in a pure culture and were included in this analysis. Only three patients were neutropenic. Skin and skin structure infections (SSSIs) occurred most often (36 cases) followed by five blood stream infections, one of which had destructive endocarditis and four infections at other sites. Of the 36 SSSIs, 29 were related to surgical or invasive procedures, and six of these involved an implanted medical device. All isolates were susceptible to vancomycin, 98% to levofloxacin and 89% to oxacillin. All patients responded to the therapy. CONCLUSIONS: Cancer patients including those with neutropenia do not appear to have an increased frequency of infections caused by S. lugdunensis. SSSIs are predominant and are often associated with surgical procedures and/or implanted medical devices. Blood stream infections caused by S. lugdunensis are uncommon but may have an increased rate of serious complications such as endocarditis. Nevertheless, these organisms are generally susceptible to multiple classes of antimicrobial agents, and the overall response to therapy is high.
Asunto(s)
Neoplasias/microbiología , Enfermedades Cutáneas Bacterianas/microbiología , Infecciones Estafilocócicas/microbiología , Staphylococcus lugdunensis/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Enfermedades Cutáneas Bacterianas/diagnóstico , Enfermedades Cutáneas Bacterianas/tratamiento farmacológico , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus lugdunensis/efectos de los fármacos , Vancomicina/farmacología , Adulto JovenRESUMEN
Of 137 Staphylococcus lugdunensis isolates collected from two nephrology centers in Hong Kong, 10 (7.3%) and 3 (2.2%) isolates had high-level and low-level mupirocin resistance, respectively. Isolates with high-level resistance contained the plasmid-mediated ileS2 gene, while isolates with low-level resistance contained the mutation V588F within the chromosomal ileS gene. All but one of the ileS2-positive isolates belong to the predominating clone HKU1. Plasmids carrying the ileS2 gene were mosaic and also cocarry multiple other resistance determinants.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple/genética , Genes Bacterianos , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/genética , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Hong Kong , Humanos , Resistencia a la Meticilina/genética , Pruebas de Sensibilidad Microbiana , Mupirocina/farmacología , Mupirocina/uso terapéutico , Mutación , Plásmidos , Staphylococcus lugdunensis/aislamiento & purificaciónRESUMEN
Disk diffusion testing is widely used to detect methicillin resistance in staphylococci, and cefoxitin is currently considered the best marker for mecA-mediated methicillin resistance. In low-inoculum diffusion testing (colony suspension at 106 CFU/ml), the addition of moxalactam in combination with cefoxitin has been reported to improve on cefoxitin alone for the detection of methicillin-heteroresistant staphylococci. However, moxalactam is absent from EUCAST and CLSI guidelines, which use high-inoculum diffusion testing (colony suspension at 108 CFU/ml), calling into question the potential interest of including moxalactam in their recommendations. The inhibition zone diameters of cefoxitin and moxalactam, alone and in combination, were evaluated for concordance with mecA and mecC positivity in a large collection of clinical Staphylococcus isolates (611 Staphylococcus aureus, Staphylococcus lugdunensis, and Staphylococcus saprophyticus isolates and 307 coagulase-negative staphylococci other than S. lugdunensis and S. saprophyticus isolates, of which 22% and 53% were mecA-positive, respectively) and in 25 mecC-positive S. aureus isolates using high-inoculum diffusion testing. Receiver operating characteristic, sensitivity, and specificity analyses indicated that the detection of mecA- and mecC-positive and negative isolates did not improve with moxalactam, either alone or in combination with cefoxitin, compared to cefoxitin alone. These findings were similar in both the S. aureus/S. lugdunensis/S. saprophyticus group and in the coagulase-negative staphylococci group. Our results do not support the use of moxalactam as an additional marker of methicillin resistance when testing with high-inoculum disk diffusion.
Asunto(s)
Antibacterianos/farmacología , Cefoxitina/farmacología , Pruebas Antimicrobianas de Difusión por Disco/métodos , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Moxalactam/farmacología , Proteínas Bacterianas/genética , Humanos , Staphylococcus aureus Resistente a Meticilina/genética , Proteínas de Unión a las Penicilinas/genética , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/genética , Staphylococcus lugdunensis/aislamiento & purificación , Staphylococcus saprophyticus/efectos de los fármacos , Staphylococcus saprophyticus/genética , Staphylococcus saprophyticus/aislamiento & purificaciónRESUMEN
BACKGROUND: Staphylococcus lugdunensis (S. lugdunensis) is known as a common cause of clinically significant infections in adults although the clinical importance of S. lugdunensis isolates from pediatric samples is less known. The aim of this study is to assess the incidence, characteristics, and outcomes of S. lugdunensis bacteremia (SLB) in children. METHODS: From January 2009 to March 2014, all blood culture isolates were retrospectively screened for S. lugdunensis. We analyzed the isolates for antimicrobial susceptibility and patients who had developed SLB by reviewing the electronic medical records. Additionally, we identified mecA and blaZ for available isolates by polymerase chain reaction (PCR). RESULTS: Of the 647 positive blood cultures during the period, 277 (42.8%) yielded coagulase negative Staphylococcus (CoNS), and 10 of 277 CoNS were S. lugdunensis (3.6% of all CoNS isolates). Of eight SLB episodes identified, seven (87.5%) were considered to have clinically significant bacteremia. All patients had underlying diseases, and all SLB were either healthcare-associated or hospital acquired. There was no infectious endocarditis (IE) development. All patients were treated with antibiotics and recovered without sequelae. We found that the isolates in our study showed higher antibiotic resistance to penicillin (8/8: 100%) and oxacillin (6/8: 75.0%) than previously reported. Among isolates available, we detected mecA in all four isolates resistant to oxacillin and blaZ in 5 of 6 isolates resistant to penicillin. CONCLUSIONS: S. lugdunensis is a rare but an important cause of bacteremia in children.
Asunto(s)
Bacteriemia , Infecciones Estafilocócicas , Staphylococcus lugdunensis , Antibacterianos/farmacología , Bacteriemia/diagnóstico , Bacteriemia/epidemiología , Bacteriemia/microbiología , Proteínas Bacterianas , Niño , Preescolar , Coagulasa , Farmacorresistencia Bacteriana , Femenino , Humanos , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiología , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/enzimología , Staphylococcus lugdunensis/aislamiento & purificaciónRESUMEN
Unbiased species-level identification of coagulase-negative staphylococci (CoNS) using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) identified Staphylococcus lugdunensis to be a more commonly isolated CoNS in our laboratory than previously observed. It has also highlighted the possibility of vertical transmission.
Asunto(s)
Tipificación Molecular/métodos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Staphylococcus lugdunensis/química , Staphylococcus lugdunensis/clasificación , Adulto , Antibacterianos/farmacología , Coagulasa , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , Staphylococcus/química , Staphylococcus/clasificación , Staphylococcus/efectos de los fármacos , Staphylococcus lugdunensis/efectos de los fármacosRESUMEN
We report a severe case of Staphylococcus lugdunensis (S. lugdunensis) keratitis presenting as suppurative keratitis in a 77-year-old woman. The patient's chief complaint was eye pain and decreased visual acuity in her right eye. Suppurative keratitis with a severe corneal abscess was diagnosed by a slit-lamp ophthalmic examination. The causative organism was identified as S. lugdunensis by bacterial culture, using a corneal abrasion specimen. She was treated with an intravenous drip infusion of ceftazidime and instillation of gentamicin sulfate ophthalmic solution (six times daily) and ofloxacin ophthalmic ointment (once daily before bedtime) as empiric therapy. Her hospital course was complicated by a corneal perforation of her right eye. The antibiotic susceptibility for S. lugdunensis was sensitive, but with a slightly high MIC for antibiotics used in empiric therapy. The therapeutic drug was changed to levofloxacin ophthalmic solution. The corneal abscess left a scar after healing. Representative causative organisms of suppurative keratitis include Pseudomonas aeruginosa and Streptococcus pneumoniae, but care must be taken in cases involving rare causative organisms. Empiric therapy is necessary for rapidly progressing suppurative keratitis, but a detailed examination of the causative organism is important for therapeutic planning before empiric therapy.
Asunto(s)
Infecciones Bacterianas del Ojo , Queratitis , Infecciones Estafilocócicas , Staphylococcus lugdunensis , Anciano , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Ojo/microbiología , Ojo/patología , Femenino , Humanos , Pruebas de Sensibilidad Microbiana , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/aislamiento & purificaciónAsunto(s)
Genes Bacterianos , Variación Genética , Hidradenitis Supurativa/microbiología , Staphylococcus lugdunensis/aislamiento & purificación , Staphylococcus lugdunensis/patogenicidad , Antibacterianos/farmacología , Biopelículas , Estudios de Casos y Controles , Humanos , Pruebas de Sensibilidad Microbiana , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/genética , VirulenciaRESUMEN
A 79-year-old man who had undergone a right femoropopliteal (FP) bypass operation 6 weeks previously was diagnosed with vascular graft infection caused by Staphylococcus lugdunensis. Another FP bypass operation was performed, with long-term administration of antibiotics, and the patient eventually recovered well without any recurrences for over 2 years. Although S. lugdunens is classified as coagulase-negative Staphylococcus, its pathogenicity has been reported to be equal to that of S. aureus. Based on the literature review, the organism characteristically colonizes the inguinal area of human skin;thus, operations such as FP bypass grafting may place patients at a relatively high risk for infection by S. lugdunensis, a potentially high-pathogenicity organism.
Asunto(s)
Antibacterianos/uso terapéutico , Prótesis Vascular/efectos adversos , Arteria Femoral/cirugía , Arteria Poplítea/cirugía , Infecciones Relacionadas con Prótesis/microbiología , Infecciones Estafilocócicas/microbiología , Staphylococcus lugdunensis/aislamiento & purificación , Anciano , Arteriosclerosis Obliterante/cirugía , Humanos , Masculino , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus lugdunensis/efectos de los fármacosRESUMEN
Staphylococcus lugdunensis can cause virulent infections in immunosuppressed individuals. This report describes the first known case of hospital acquired pneumonia and septicemia due to methicillin-resistant Staphylococcus lugdunensis in a newborn at Felege Hiwot Referral Hospital, North Western Ethiopia. The strain was simultaneously resistant to trimethoprim-sulfamethoxazole, tetracycline (30 ug), chloramphenicol (30 ug), gentamycin (10ug) and ciprofloxacin (5ug) but sensitive to erythromycin (15ug) and clindamycin (10ug).
Asunto(s)
Clindamicina/administración & dosificación , Infección Hospitalaria/microbiología , Eritromicina/administración & dosificación , Resistencia a la Meticilina , Neumonía Estafilocócica , Staphylococcus lugdunensis , Antibacterianos/administración & dosificación , Humanos , Lactante , Masculino , Pruebas de Sensibilidad Microbiana/métodos , Neumonía Estafilocócica/complicaciones , Neumonía Estafilocócica/diagnóstico , Neumonía Estafilocócica/tratamiento farmacológico , Neumonía Estafilocócica/microbiología , Neumonía Estafilocócica/fisiopatología , Sepsis/tratamiento farmacológico , Sepsis/etiología , Sepsis/microbiología , Staphylococcus lugdunensis/efectos de los fármacos , Staphylococcus lugdunensis/aislamiento & purificación , Resultado del TratamientoRESUMEN
Recently, a novel cyclo-heptapeptide composed of alternating D,L-amino acids and a unique thiazolidine heterocycle, called lugdunin, was discovered, which is produced by the nasal and skin commensal Staphylococcus lugdunensis. Lugdunin displays potent antimicrobial activity against a broad spectrum of Gram-positive bacteria, including challenging-to-treat methicillin-resistant Staphylococcus aureus (MRSA). Lugdunin specifically inhibits target bacteria by dissipating their membrane potential. However, the precise mode of action of this new class of fibupeptides remains largely elusive. Here, we disclose the mechanism by which lugdunin rapidly destabilizes the bacterial membrane potential using an in vitro approach. The peptide strongly partitions into lipid compositions resembling Gram-positive bacterial membranes but less in those harboring the eukaryotic membrane component cholesterol. Upon insertion, lugdunin forms hydrogen-bonded antiparallel ß-sheets by the formation of peptide nanotubes, as demonstrated by ATR-FTIR spectroscopy and molecular dynamics simulations. These hydrophilic nanotubes filled with a water wire facilitate not only the translocation of protons but also of monovalent cations as demonstrated by voltage-clamp experiments on black lipid membranes. Collectively, our results provide evidence that the natural fibupeptide lugdunin acts as a peptidic channel that is spontaneously formed by an intricate stacking mechanism, leading to the dissipation of a bacterial cell's membrane potential.