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1.
J Infect Dev Ctries ; 8(9): 1119-28, 2014 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-25212076

RESUMO

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) emerged at the Pediatric Hospital of Misiones Province, north Argentina, in 2003 as a cause of community-acquired (CA) infections, mostly associated with skin and soft tissue infections (SSTIs). This study aimed to assess the microbiological, epidemiological, and clinical features of CA-MRSA SSTIs treated at the hospital. METHODOLOGY: From 2003 through 2006, a longitudinal study on CA-MRSA SSTIs was conducted. Clinical, bacteriological, and molecular data were collected and analyzed by multiple correspondences and cluster analysis (MCCA). RESULTS: A total of 138 children were enrolled; 55.8% of the children required hospitalization. The main clinical presentation was abscesses (51%). Antibiotic therapy in the previous six months was registered in 41% of the patients, and 72% of the patients had relatives with similar symptoms. Resistance to non-b-lactam antibiotics was found in less than 12% of patients. All 44 isolates carried staphylococcal cassette chromosomemec (SCCmec) type IV, and 30/44 had Panton-Valentine leucocidin (PVL) coding genes. Six pulsed-field gel electrophoresis (PFGE) patterns were detected from 17 isolates. MCCA hierarchic classification resulted in four distinctive patient classes (new variable). No relationship could be observed regarding the PVL detection, as PVL (+) isolates were detected in all classes; the same lack of significance was observed concerning the distribution of resistance to non-ß-lactam antibiotics. CONCLUSIONS: This study increases the understanding and knowledge about CA-MRSA skin and soft tissue infections in pediatric patients. Continuous efforts should be made to control this significant public health problem.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções dos Tecidos Moles/epidemiologia , Infecções Cutâneas Estafilocócicas/epidemiologia , Adolescente , Antibacterianos/farmacologia , Argentina/epidemiologia , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/patologia , Eletroforese em Gel de Campo Pulsado , Feminino , Genótipo , Hospitais Pediátricos , Humanos , Lactente , Estudos Longitudinais , Masculino , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/genética , Tipagem Molecular , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/patologia , Infecções Cutâneas Estafilocócicas/microbiologia , Infecções Cutâneas Estafilocócicas/patologia , Fatores de Virulência/genética , beta-Lactamas/farmacologia
2.
PLoS One ; 8(11): e78303, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24324543

RESUMO

BACKGROUND: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is now the most common cause of skin and skin structure infections (SSSI) in several world regions. In Argentina prospective, multicenter clinical studies have only been conducted in pediatric populations. OBJECTIVE: PRIMARY: describe the prevalence, clinical and demographic characteristics of adult patients with community acquired SSSI due to MRSA; secondary: molecular evaluation of CA-MRSA strains. Patients with MRSA were compared to those without MRSA. MATERIALS AND METHODS: Prospective, observational, multicenter, epidemiologic study, with molecular analysis, conducted at 19 sites in Argentina (18 in Buenos Aires) between March 2010 and October 2011. Patients were included if they were ≥ 14 years, were diagnosed with SSSI, a culture was obtained, and there had no significant healthcare contact identified. A logistic regression model was used to identify factors associated with CA-MRSA. Pulse field types, SCCmec, and PVL status were also determined. RESULTS: A total of 311 patients were included. CA-MRSA was isolated in 70% (218/311) of patients. Clinical variables independently associated with CA-MRSA were: presence of purulent lesion (OR 3.29; 95%CI 1.67, 6.49) and age <50 years (OR 2.39; 95%CI 1.22, 4.70). The vast majority of CA-MRSA strains causing SSSI carried PVL genes (95%) and were SCCmec type IV. The sequence type CA-MRSA ST30 spa t019 was the predominant clone. CONCLUSIONS: CA-MRSA is now the most common cause of SSSI in our adult patients without healthcare contact. ST30, SCCmec IV, PVL+, spa t019 is the predominant clone in Buenos Aires, Argentina.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Staphylococcus aureus Resistente à Meticilina/fisiologia , Pele/microbiologia , Infecções Cutâneas Estafilocócicas/diagnóstico , Infecções Cutâneas Estafilocócicas/epidemiologia , Adulto , Argentina/epidemiologia , Infecções Comunitárias Adquiridas/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
3.
J Infect Dis ; 206(1): 81-90, 2012 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-22535996

RESUMO

Staphylococcus aureus protein A (SpA) plays a critical role in the induction of inflammation. This study was aimed to determine whether the number of short sequence repeats (SSRs) present in the polymorphic region modulates the inflammatory response induced by SpA. We demonstrated that there is a dose-response effect in the activation of interferon (IFN)-ß signaling in airway epithelial and immune cells, depending on the number of SSRs, which leads to differences in neutrophil recruitment. We also determined that a significant proportion of isolates from patients with chronic infections such as osteomyelitis and cystic fibrosis carry fewer SSRs than do isolates from patients with acute infections or healthy carriers and that there was an inverse correlation between the number of SSRs and the length of disease course. Given the importance of IFN signaling in eradication of S. aureus, loss of SSRs may represent an advantageous mechanism to adapt to and persist in the host.


Assuntos
Inflamação/genética , Infecções Estafilocócicas/microbiologia , Proteína Estafilocócica A/metabolismo , Adolescente , Adulto , Animais , Linhagem Celular , Criança , Pré-Escolar , Doença Crônica , Fibrose Cística/genética , Fibrose Cística/imunologia , Fibrose Cística/metabolismo , Fibrose Cística/microbiologia , Relação Dose-Resposta Imunológica , Humanos , Lactente , Inflamação/imunologia , Inflamação/metabolismo , Inflamação/microbiologia , Interferon beta/imunologia , Interferon beta/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Repetições de Microssatélites , Infiltração de Neutrófilos/genética , Infiltração de Neutrófilos/imunologia , Osteomielite/genética , Osteomielite/imunologia , Osteomielite/metabolismo , Osteomielite/microbiologia , Polimorfismo Genético , Mucosa Respiratória/imunologia , Mucosa Respiratória/microbiologia , Infecções Estafilocócicas/genética , Infecções Estafilocócicas/imunologia , Infecções Estafilocócicas/metabolismo , Proteína Estafilocócica A/genética , Proteína Estafilocócica A/imunologia , Staphylococcus aureus/genética , Staphylococcus aureus/metabolismo , Adulto Jovem
8.
Int J Microbiol ; 2009: 472126, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-20016669

RESUMO

We analyzed 90 nonduplicates community-associated methicillin-resistant S. aureus (CA-MRSA) strains isolated from skin and soft-tissue infections. All strains were mecA positive. Twenty-four of the 90 strains showed inducible macrolide-lincosamide-streptogramin B resistance. All strains produced alpha-toxin; 96% and 100% of them displayed positive results for lukS-F and cna genes, respectively. Eigthy-five strains expressed capsular polysaccharide serotype 8. Six different pulsotypes were discriminated by pulsed-field gel electrophoresis (PFGE) and three predominant groups of CA-MRSA strains (1, 2, and 4) were identified, in agreement with phenotypic and genotypic characteristics. Strains of group 1 (pulsotype A, CP8+, and Panton-Valentine leukocidin (PVL)+) were the most frequently recovered and exhibited a PFGE band pattern identical to other CA-MRSA strains previously isolated in Uruguay and Brazil. Three years after the first local CA-MRSA report, these strains are still producing skin and soft-tissue infections demonstrating the stability over time of this community-associated emerging pathogen.

9.
Diagn Microbiol Infect Dis ; 62(3): 343-7, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18715738

RESUMO

Sixty-nine community-associated methicillin-resistant Staphylococcus aureus recovered in 6 healthcare centers from northeastern and eastern Argentina were genotyped by pulsed-field gel electrophoresis. The predominant pulsotype was widely distributed harbored SCCmec type IV and Panton-Valentine leukocidin genes. Representative isolates were characterized by multilocus sequence typing and spa typing, demonstrating that this clone belonged to ST5 and spa type 311.


Assuntos
Infecções Comunitárias Adquiridas/classificação , Infecções Comunitárias Adquiridas/genética , Staphylococcus aureus Resistente à Meticilina/genética , Infecções Estafilocócicas/classificação , Infecções Estafilocócicas/genética , Argentina/epidemiologia , Proteínas de Bactérias/genética , Toxinas Bacterianas/genética , Técnicas de Tipagem Bacteriana/métodos , Infecções Comunitárias Adquiridas/epidemiologia , Impressões Digitais de DNA/métodos , Farmacorresistência Bacteriana/genética , Eletroforese em Gel de Campo Pulsado/métodos , Exotoxinas/genética , Genótipo , Humanos , Leucocidinas/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Proteínas de Ligação às Penicilinas , Reação em Cadeia da Polimerase/métodos , Infecções Estafilocócicas/epidemiologia
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