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1.
BMJ Case Rep ; 14(1)2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33495173

RESUMO

Surgery for prosthetic valve endocarditis in the mitral valve position is still challenging for surgeons. Reconstruction of the mitral annulus is useful for patients with a mitral annulus disputed by infection. Here, we report a redo mitral valve replacement using a collar-reinforced tissue valve, which was inserted into a mitral annulus reconstructed with a bovine patch. Though the preoperative blood culture detected Streptococcus anginosus, the intraoperative culture detected methicillin-resistant coagulase-negative staphylococci (MRCNS). MRCNS is rarely detected because of its indolent nature.


Assuntos
Antibacterianos/uso terapêutico , Endocardite Bacteriana/terapia , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Estenose da Valva Mitral/cirurgia , Infecções Relacionadas à Prótese/terapia , Infecções Estafilocócicas/terapia , Infecções Estreptocócicas/terapia , Idoso , Ampicilina/uso terapêutico , Hemocultura , Daptomicina/uso terapêutico , Desbridamento , Ecocardiografia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/microbiologia , Feminino , Humanos , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/etiologia , Imagem por Ressonância Magnética , Resistência a Meticilina/fisiologia , Infecções Relacionadas à Prótese/microbiologia , Procedimentos Cirúrgicos Reconstrutivos , Reoperação , Staphylococcus/isolamento & purificação , Staphylococcus/fisiologia , Streptococcus anginosus/isolamento & purificação , Streptococcus anginosus/fisiologia , Sulbactam/uso terapêutico
2.
BMC Infect Dis ; 20(1): 816, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33167886

RESUMO

BACKGROUND: The prevalence of Staphylococcus aureus varies depending on the healthcare facility, region and country. To understand its genetic diversity, transmission, dissemination, epidemiology and evolution in a particular geographical location, it is important to understand the similarities and variations in the population being studied. This can be achieved by using various molecular characterisation techniques. This study aimed to provide detailed molecular characterisation of South African mecA-positive S. aureus blood culture isolates by describing the SCCmec types, spa types and to lesser extent, the sequence types obtained from two consecutive national surveillance studies. METHODS: S. aureus blood culture isolates from a national laboratory-based and enhanced surveillance programme were identified and antimicrobial susceptibility testing was performed using automated systems. A real-time PCR assay confirmed the presence of the methicillin-resistance determinant, mecA. Conventional PCR assays were used to identify the SCCmec type and spa type, which was subsequently analysed using the Ridom StaphType™ software. Multilocus sequence typing was performed on selected isolates using conventional methods. MRSA clones were defined by their sequence type (ST), SCCmec type and spa type. RESULTS: A detailed description of findings is reported in this manuscript. SCCmec type III predominated overall followed by type IV. A total of 71 different spa types and 24 novel spa types were observed. Spa type t037 was the most common and predominated throughout followed by t1257. Isolates were multidrug resistant; isolates belonging to all SCCmec types were resistant to most of the antibiotics with the exception of type I; isolates with spa type t045 showed resistance to all antibiotics except vancomycin. The most diverse SCCmec-spa type complex was composed of the SCCmec type IV element and 53 different spa types. CONCLUSION: Although ST data was limited, thereby limiting the number of clones that could be identified, the circulating clones were relatively diverse.


Assuntos
Proteínas de Bactérias/genética , Variação Genética , Sequências Repetitivas Dispersas/genética , Staphylococcus aureus Resistente à Meticilina/genética , Proteínas de Ligação às Penicilinas/genética , Infecções Estafilocócicas/epidemiologia , Proteína Estafilocócica A/genética , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Proteínas de Bactérias/sangue , Hemocultura , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla/genética , Humanos , Meticilina/farmacologia , Meticilina/uso terapêutico , Resistência a Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Proteínas de Ligação às Penicilinas/sangue , Reação em Cadeia da Polimerase em Tempo Real , África do Sul/epidemiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Vancomicina/farmacologia , Vancomicina/uso terapêutico
3.
PLoS One ; 15(8): e0237714, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804961

RESUMO

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem. There is limited information regarding the genetics of MRSA strains among the native Iraqi and incoming Syrian refugee communities. We aimed to characterize the genotypes and different virulence factors of MRSA in strains isolated from these two communities. Frozen MRSA strains (125) isolated from the native Iraqi and Syrian refugee communities were used in this study. PCR (singleplex and multiplex) and agr typing was used for the genotypic analysis of different virulence genes. We tested for the presence of virulence genes including pvl, arcA, tst, lukE/lukD, hla, hlb, eta, etb and agr. Prevalence of arcA MRSA in the Iraqi community (56.58%) was significantly higher (p = 0.008) than that in the Syrian refugee community (32.66%). Prevalence of lukE-lukD was also significantly higher (p = 0.001) in the Iraqi (82.89%) compared to that in the Syrian refugee community (57.14%). Further, prevalence of hla MRSA in the Iraqi community was (93.4%) and in the Syrian refugee community was (71.4%); (p = 0.0008). No significant differences were observed in the prevalence of pvl, tst, eta, etb and hlb. The most dominant agr types in both Iraqi (76.1% and 10.5%) and Syrian refugee (44.9% and 18.37%) communities were I and III. To sum up, no significant differences were observed between the groups for a majority of virulence factors. This is the first investigation of MRSA genotypes and virulence in both these communities. These results could be useful for further studies that assess the genetic relatedness of strains in the region for epidemiological and monitoring purposes, which would be crucial to limiting the spread of MRSA.


Assuntos
Resistência a Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Refugiados , Infecções Estafilocócicas/microbiologia , Fatores de Virulência/genética , Proteínas de Bactérias/genética , Proteínas de Bactérias/isolamento & purificação , Cidades/epidemiologia , Exotoxinas/genética , Exotoxinas/isolamento & purificação , Genes Bacterianos/genética , Técnicas de Genotipagem , Humanos , Iraque/epidemiologia , Meticilina/farmacologia , Meticilina/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Prevalência , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Síria , Transativadores/genética , Transativadores/isolamento & purificação , Fatores de Virulência/isolamento & purificação
4.
Niger J Clin Pract ; 23(7): 912-918, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620719

RESUMO

Background: Investigating genetic relatedness between methicillin-resistant Staphylococcus aureus (MRSA) strains from humans and different animal species may clarify the epidemiological characteristic of MRSA infections together. Aim: The aim of the study was to perform genotypic characterization and type strains of MRSA isolated from different clinical sources, by molecular techniques. Materials and Methods: The molecular characterization of the strains was performed by polymerase chain reaction (PCR), using several specific oligonucleotides. These were as follows: S. aureus species-specific sau gene, mecA gene coding PBP2a responsible for methicillin resistance, femA gene coding for a protein, which influences the level of methicillin resistance of S. aureus, and is universally present in all MRSA strains; spa gene coding for protein A; coa gene coding for coagulase, and blaZ gene coding for the production of beta-lactamase. To determine the genetic diversity of these strains, random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) was performed. Results: Among the 415 S. aureus strains, 61 were phenotypically identified as MRSA, and confirmed as S. aureus by amplification of sau gene. However, 90.16% of the strains were mecA positive, while all were negative for femA gene. The presence and polymorphism of coa and spa genes were investigated and 83.60% and 18.03% strains were positive for coa and spa, respectively. While these strains were grouped into six coa-types by PCR, no polymorphism was found for spa gene among strains having only single 190 bp of the band. bla genes were found in 75.40% of strains. These strains were divided into 12 RAPD types. Conclusions: The results showed the relatively high heterogeneity and variation of coa gene among MRSA strains, while further studies on sequencing of these strains may identify which sequence type is predominant in this region.


Assuntos
Proteínas de Bactérias/genética , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Reação em Cadeia da Polimerase/métodos , Técnica de Amplificação ao Acaso de DNA Polimórfico/métodos , Animais , Antibacterianos/farmacologia , Proteínas de Bactérias/isolamento & purificação , Coagulase/genética , Genótipo , Humanos , Meticilina , Resistência a Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/genética
5.
J Dairy Sci ; 103(7): 5947-5963, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32359985

RESUMO

Staphylococcus aureus is a significant opportunistic pathogen in humans, dairy cattle, and camels. The presence of antibiotic-resistant and heat-resistant bacteria in camel milk has become a potential public health issue. The phenotypic and molecular characterization of methicillin-resistant staphylococcal strains recovered from pasteurized camel milk distributed in retail markets of Saudi Arabia was assessed. A total of 100 samples were collected between March and May 2017. Out of the 20 S. aureus isolates that were recovered from the pasteurized camel milk, 10 were found to be resistant to cefoxitin (30 µg) and, thus, were designated as methicillin-resistant strains. The resistance ratio of methicillin-resistant S. aureus isolates for a different class of antibiotics was determined by performing the antimicrobial susceptibility test and was estimated to be approximately 60%. Polymerase chain reaction assay was performed to amplify the methicillin-resistant gene mecA, and furthermore, nucleotide sequencing was performed to detect and verify the presence of methicillin-resistant strains. Upon sequencing the putative S. aureus methicillin-resistant strains, we obtained 96 to 100% similarity to the penicillin-binding protein 2a gene (mecA) of the S. aureus strain CS100. Moreover, the 10 methicillin-resistant S. aureus isolates were also identified to be heat resistant and were stable at temperatures up to 85°C for 60 s, with 3 isolates being heat resistant even at 90°C for 60 or 90 s. The mean decimal reduction time (D85 value) was 111 s for all the 10 isolates. No difference was observed in the profile of total protein between the 10 methicillin- and heat-resistant S. aureus isolates and the S. aureus strain ATCC 29737, which was determined by sodium dodecyl sulfate-PAGE analyses. Therefore, we could conclude that a relatively high percentage of the tested pasteurized camel milk samples were contaminated with S. aureus (20%) and methicillin- and heat-resistant S. aureus (10%).


Assuntos
Proteínas de Bactérias/genética , Camelus/microbiologia , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Leite/microbiologia , Proteínas de Ligação às Penicilinas/genética , Animais , Antibacterianos/farmacologia , Cefoxitina/farmacologia , Feminino , Temperatura Alta , Meticilina/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/fisiologia , Arábia Saudita , Termotolerância
6.
Epidemiol Infect ; 148: e149, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-32450935

RESUMO

Persistent methicillin-resistant Staphylococcus aureus (MRSA) infection in cystic fibrosis (CF) patients has been associated with a more rapid decline in lung function, increased hospitalisation and mortality. The aim of this study was to evaluate the clonal relationships among 116 MRSA isolates from 12 chronically colonised CF pediatric patients over a 6-year period in a Rio de Janeiro CF specialist centre. Isolates were characterised by antimicrobial resistance, SCCmec type, presence of Panton-Valentine Leukocidin (PVL) genes and grouped according to DNA macrorestriction profile by pulsed-field gel electrophoresis (PFGE) and spa gene type. High resistance rates were detected for erythromycin (78%) and ciprofloxacin (50%) and SCCmec IV was the most common type (72.4%). Only 8.6% of isolates were PVL positive. High genetic diversity was evident by PFGE (39 pulsotypes) and of nine that were identified spa types, t002 (53.1%) and t539 (14.8%) were the most prevalent. We conclude that the observed homogeneity of spa types within patients over the study period demonstrates the persistence of such strain lineages throughout the course of chronic lung infection.


Assuntos
Fibrose Cística/microbiologia , Staphylococcus aureus Resistente à Meticilina/genética , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Brasil/epidemiologia , Portador Sadio , Criança , Humanos , Resistência a Meticilina
7.
Sci Rep ; 10(1): 8682, 2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-32457307

RESUMO

Symptoms of Staphylococcus lugdunensis infection are often similar to those of Staphylococcus aureus infection, including skin and soft-tissue lesions, bacteremia and infective endocarditis. Despite the severity of these infections, S. lugdunensis is regarded as a less important pathogen than drug-resistant S. aureus. To investigate its ability to cause infectious diseases, a methicillin-resistant S. lugdunensis (MRSL) strain JICS135 was isolated from a patient with bacteremia and subjected to whole genome sequencing. Similar to most strains of methicillin-resistant S. aureus (MRSA), this MRSL strain possessed the staphylococcal cassette chromosome mec (SCCmec) located close to the origin of replication. However, the SCCmec in this MRSL strain, with three ccr complexes, was structurally unique and currently untypable. Moreover, the SCCmec of this MRSL strain was found to carry two genes encoding microbial surface components recognizing adhesive matrix molecules (MSCRAMM)-like proteins accompanied by glycosyl transferases, one of which may have been derived from S. aureus and the other from S. epidermidis, indicating that this MRSL evolved to carry virulence factors from other staphylococci. The emergence of this strain, the first MRSL strain whose genome has been sequenced completely, may be of public concern.


Assuntos
Proteínas de Bactérias/genética , Cromossomos Bacterianos , Resistência a Meticilina/genética , Staphylococcus lugdunensis/genética , Idoso , Antibacterianos/farmacologia , Bacteriemia/microbiologia , Bacteriemia/patologia , Cromossomos Bacterianos/genética , Humanos , Masculino , Testes de Sensibilidade Microbiana , Filogenia , Staphylococcus lugdunensis/classificação , Staphylococcus lugdunensis/efeitos dos fármacos , Sequenciamento Completo do Genoma
8.
PLoS One ; 15(4): e0231583, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294120

RESUMO

Infections caused by antibiotic-resistant strains of Staphylococcus aureus have reached epidemic proportions globally. Our previous study showed antimicrobial effects of anandamide (AEA) and arachidonoyl serine (AraS) against methicillin (MET)-resistant S. aureus (MRSA) strains, proposing the therapeutic potential of these endocannabinoid/endocannabinoid-like (EC/EC-like) agents for the treatment of MRSA. Here, we investigated the potential synergism of combinations of AEA and AraS with different types of antibiotics against MRSA grown under planktonic growth or biofilm formation. The most effective combinations under planktonic conditions were mixtures of AEA and ampicillin (AMP), and of AraS and gentamicin (GEN). The combination with the highest synergy in the biofilm formation against all tested bacterial strains was AEA and MET. Moreover, the combination of AraS and MET synergistically caused default of biofilm formation. Slime production of MRSA was also dramatically impaired by AEA or AraS combined with MET. Our data suggest the novel potential activity of combinations of EC/EC-like agents and antibiotics in the prevention of MRSA biofilm formation.


Assuntos
Antibacterianos/farmacologia , Ácidos Araquidônicos/farmacologia , Agonistas de Receptores de Canabinoides/farmacologia , Endocanabinoides/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Alcamidas Poli-Insaturadas/farmacologia , Infecções Estafilocócicas/tratamento farmacológico , Ampicilina/farmacologia , Ampicilina/uso terapêutico , Antibacterianos/uso terapêutico , Ácidos Araquidônicos/uso terapêutico , Biofilmes/efeitos dos fármacos , Agonistas de Receptores de Canabinoides/uso terapêutico , Avaliação Pré-Clínica de Medicamentos , Sinergismo Farmacológico , Quimioterapia Combinada/métodos , Endocanabinoides/uso terapêutico , Gentamicinas/farmacologia , Gentamicinas/uso terapêutico , Humanos , Resistência a Meticilina/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Alcamidas Poli-Insaturadas/uso terapêutico , Serina/análogos & derivados , Serina/farmacologia , Serina/uso terapêutico , Infecções Estafilocócicas/microbiologia
9.
R I Med J (2013) ; 103(2): 18-20, 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32122094

RESUMO

Hospital antibiograms, because they are typically derived from samples obtained from hospitalized patients, may overestimate the prevalence of methicillin resistance in S. aureus in individuals presenting to the hospital for surgery. Because hospital antibiograms are commonly used to justify empiric perioperative prophylactic antibiotic selection prior to surgery, this may lead to unnecessary treatment with broad-spectrum antibiotics such as vancomycin. In a single-institution study, we observed that in our hospital antibiogram the proportion of S. aureus that are methicillin-resistant (MRSA) was significantly higher (45%) than isolates in preoperative nasal cultures obtained at the same hospital in outpatients prior to their lower extremity joint replacement surgery (13%): mean difference 0.32, [95% CI 0.25, 0.39], p <0.0001. These data suggest that hospital antibiograms may overstate the true prevalence of MRSA in those at risk for MRSA surgical site infections who present from the outpatient setting.


Assuntos
Antibacterianos/farmacologia , Portador Sadio/microbiologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Cavidade Nasal/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Adulto , Antibacterianos/uso terapêutico , Portador Sadio/epidemiologia , Feminino , Humanos , Masculino , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Período Pré-Operatório , Prevalência , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/efeitos dos fármacos
10.
Artigo em Inglês | MEDLINE | ID: mdl-32178604

RESUMO

From 1 January to 31 December 2018, thirty-six institutions around Australia participated in the Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2018 was to determine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to methicillin, and to characterise the molecular epidemiology of the methicillin-resistant isolates. A total of 2,673 S. aureus bacteraemia episodes were reported, of which 78.9% were community-onset. A total of 17.4% of S. aureus isolates were methicillin resistant. The 30-day all-cause mortality associated with methicillin-resistant SAB was 17.1% which was not significantly higher than the 13.6% mortality associated with methicillin-susceptible SAB (p = 0.1). With the exception of the ß-lactams and erythromycin, antimicrobial resistance in methicillin-susceptible S. aureus was rare. However in addition to the ß-lactams approximately 42% of methicillin-resistant S. aureus (MRSA) were resistant to erythromycin, 36% to ciprofloxacin and approximately 13% resistant to co-trimoxazole, tetracycline and gentamicin. When applying the EUCAST breakpoints teicoplanin resistance was detected in two S. aureus isolates. Resistance was not detected for vancomycin and linezolid. Resistance to non-beta-lactam antimicrobials was largely attributable to two healthcare-associated MRSA clones: ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). The ST22-IV [2B] (EMRSA-15) clone is the predominant healthcare-associated clone in Australia. Seventy-eight percent of methicillin-resistant SAB episodes in 2018 were due to community-associated clones. Although polyclonal, approximately 76.3% of community-associated clones were characterised as ST93-IV [2B] (Queensland CA-MRSA), ST5-IV [2B], ST45-VT [5C2&5], ST1-IV [2B], ST30-IV [2B], ST78-IV [2B] and ST97-IV [2B]. Community-associated MRSA, in particular the ST45-VT [5C2&5] clone, has acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. The ST45-VT [5C2&5] clone accounted for 11.7% of CA-MRSA. As CA-MRSA is well established in the Australian community, it is important that antimicrobial resistance patterns in community- and healthcare-associated SAB are monitored, as this information will guide therapeutic practices in treating S. aureus sepsis.


Assuntos
Antibacterianos , Staphylococcus aureus Resistente à Meticilina , Sepse , Infecções Estafilocócicas , Staphylococcus aureus , Antibacterianos/farmacologia , Austrália/epidemiologia , Bacteriemia , Infecção Hospitalar/tratamento farmacológico , Farmacorresistência Bacteriana/efeitos dos fármacos , Humanos , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Sepse/tratamento farmacológico , Sepse/etiologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos
11.
Vet Surg ; 49(5): 971-976, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32196706

RESUMO

OBJECTIVE: To evaluate the presence of quaternary ammonium compound (QAC) (resistance genes, qac A/B, smr, qacG, and qacJ, in clinical isolates of methicillin-susceptible Staphylococcus pseudintermedius (MSSP) and methicillin-resistant S pseudintermedius (MRSP) from dogs and the impact on in vitro chlorhexidine susceptibility. STUDY DESIGN: Experimental in vitro study. SAMPLE POPULATION: Seventy isolates from dogs colonized or infected with MRSP (n = 50) or MSSP (n = 20). METHODS: Agar dilution was used to determine the minimum inhibitory concentration (MIC) of chlorhexidine digluconate. Real-time polymerase chain reaction was used to detect the presence of QAC resistance genes, qacA/B, smr, qacG, and qacJ genes. RESULTS: One or more qac genes were identified in 52 of 70 (74%) isolates. Overall, there was no association between chlorhexidine MIC and the presence of one or more qac genes (P = .85) or the presence of qacA/B (P = .31), smr (P = .72) or qacJ (P = .93) individually. There was an association between qacG and MIC (P = .012), with a median MIC of 1.5 µg/mL for isolates possessing this gene and 1 µg/mL for those not possessing it. CONCLUSION: Quaternary ammonium compound resistance genes were present in MRSP and MSSP isolates. With the exception of qacG, the presence of these genes was not associated with increased MIC. All isolates exhibited MIC 5000 to 80 000 times lower than the concentration recommended for use. CLINICAL SIGNIFICANCE: Despite the presence of QAC genes, chlorhexidine digluconate should be effective against MRSP and MSSP if used correctly.


Assuntos
Antibacterianos/farmacologia , Clorexidina/análogos & derivados , Doenças do Cão/microbiologia , Resistência a Meticilina/genética , Staphylococcus/efeitos dos fármacos , Animais , Antibacterianos/uso terapêutico , Clorexidina/farmacologia , Cães , Meticilina/farmacologia , Testes de Sensibilidade Microbiana , Infecções Estafilocócicas/veterinária
12.
mBio ; 11(1)2020 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-32071265

RESUMO

Staphylococcus epidermidis is a leading cause of nosocomial infections in patients with a compromised immune system and/or an implanted medical device. Seventy to 90% of S. epidermidis clinical isolates are methicillin resistant and carry the mecA gene, present in a mobile genetic element (MGE) called the staphylococcal cassette chromosome mec (SCCmec) element. Along with the presence of antibiotic and heavy metal resistance genes, MGEs can also contain genes encoding secreted or cell wall-anchored virulence factors. In our earlier studies of S. epidermidis clinical isolates, we discovered S. epidermidis surface protein J (SesJ), a prototype of a recently discovered subfamily of the microbial surface component recognizing adhesive matrix molecule (MSCRAMM) group. MSCRAMMs are major virulence factors of pathogenic Gram-positive bacteria. Here, we report that the sesJ gene is always accompanied by two glycosyltransferase genes, gtfA and gtfB, and is present in two MGEs, called the arginine catabolic mobile element (ACME) and the staphylococcal cassette chromosome (SCC) element. The presence of the sesJ gene was associated with the left-hand direct repeat DR_B or DR_E. When inserted via DR_E, the sesJ gene was encoded in the SCC element. When inserted via DR_B, the sesJ gene was accompanied by the genes for the type 1 restriction modification system and was encoded in the ACME. Additionally, the SCC element and ACME carry different isoforms of the SesJ protein. To date, the genes encoding MSCRAMMs have been seen to be located in the bacterial core genome. Here, we report the presence of an MSCRAMM in an MGE in S. epidermidis clinical isolates.IMPORTANCE S. epidermidis is an opportunistic bacterium that has established itself as a successful nosocomial pathogen. The modern era of novel therapeutics and medical devices has extended the longevity of human life, but at the same time, we also witness the evolution of pathogens to adapt to newly available niches in the host. Increasing antibiotic resistance among pathogens provides an example of such pathogen adaptation. With limited opportunities to modify the core genome, most of the adaptation occurs by acquiring new genes, such as virulence factors and antibiotic resistance determinants present in MGEs. In this study, we describe that the sesJ gene, encoding a recently discovered cell wall-anchored protein in S. epidermidis, is present in both ACME and the SCC element. The presence of virulence factors in MGEs can influence the virulence potential of a specific strain. Therefore, it is critical to study the virulence factors found in MGEs in emerging pathogenic bacteria or strains to understand the mechanisms used by these bacteria to cause infections.


Assuntos
Adesinas Bacterianas/genética , Proteínas de Bactérias/genética , Farmacorresistência Bacteriana/genética , Ilhas Genômicas/genética , Proteínas de Membrana/genética , Staphylococcus epidermidis/genética , Antibacterianos/farmacologia , Arginina/metabolismo , Genes Bacterianos/genética , Glicosiltransferases/genética , Humanos , Resistência a Meticilina/efeitos dos fármacos , Resistência a Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/genética , Prevalência , Infecções Estafilocócicas/microbiologia , Staphylococcus epidermidis/efeitos dos fármacos , Virulência , Fatores de Virulência/genética
13.
PLoS One ; 15(2): e0229026, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053668

RESUMO

Staphylococci are a key component of the human microbiota, and they mainly colonize the skin and anterior nares. However, they can cause infection in hospitalized patients and healthy individuals in the community. Although majority of the Staphylococcus aureus strains are coagulase-positive, some do not produce coagulase, and the isolation of coagulase-positive non-S. aureus isolates in humans is increasingly being reported. Therefore, sound knowledge of the species and characteristics of staphylococci in a given setting is important, especially isolates from children and immunocompromised individuals. The spectrum of Staphylococcus species colonizing children in Uganda is poorly understood; here, we aimed to determine the species and characteristics of staphylococci isolated from children in Eastern Uganda. Seven hundred and sixty four healthy children less than 5 years residing in Iganga and Mayuge districts in Eastern Uganda were enrolled. A total of 513 staphylococci belonging to 13 species were isolated from 485 children (63.5%, 485/764), with S. aureus being the dominant species (37.6%, 193/513) followed by S. epidermidis (25.5%, 131/513), S. haemolyticus (2.3%, 12/513), S. hominis (0.8%, 4/513) and S. haemolyticus/lugdunensis (0.58%, 3/513). Twenty four (4.95%, 24/485) children were co-colonized by two or more Staphylococcus species. With the exception of penicillin, antimicrobial resistance (AMR) rates were low; all isolates were susceptible to vancomycin, teicoplanin, linezolid and daptomycin. The prevalence of methicillin resistance was 23.8% (122/513) and it was highest in S. haemolyticus (66.7%, 8/12) followed by S. aureus (28.5%, 55/193) and S. epidermidis (23.7%, 31/131). The prevalence of multidrug resistance was 20.3% (104/513), and 59% (72/122) of methicillin resistant staphylococci were multidrug resistant. Four methicillin susceptible S. aureus isolates and a methicillin resistant S. scuiri isolate were mupirocin resistant (high-level). The most frequent AMR genes were mecA, vanA, ant(4')-Ia, and aac(6')-Ie- aph(2'')-Ia, pointing to presence of AMR drivers in the community.


Assuntos
Antibacterianos/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Daptomicina/farmacologia , Farmacorresistência Bacteriana Múltipla , Humanos , Linezolida/farmacologia , Resistência a Meticilina/genética , Testes de Sensibilidade Microbiana , Teicoplanina/farmacologia , Uganda , Vancomicina/farmacologia
14.
Spine Deform ; 8(4): 553-559, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32078142

RESUMO

STUDY DESIGN: Basic science. OBJECTIVE: Investigate the ability of local applicaiton of vancomycin, either in powder form or suspended within poly(lactic-co-glycolic acid) microspheres (MS), to treat infection using a rat spinal model. Surgical site infections (SSIs) are a serious complication after spine surgery and are associated with high morbidity and mortality and often caused my coagulase negative staphylococci. A comprehensive approach to reduce SSIs has been recommended including the use of topical vancomycin. Animal and human studies have shown improved control of infection with local compared to systemic antibiotics. METHODS: K-wires seeded with methicillin-resistant Staphylococcus epidermidis RP62A (MRSE) were treated with vancomycin powder, carboxymethylcellulose sodium salt (CMC) (microsphere carrier), vancomycin powder, blank MS or vancomycin-loaded MS for 24 or 48 h in vitro after which bacteria were enumerated. In addition, a spinal instrumentation model was developed in rats with a bacterial seeded K-wire implanted into the right side of L4 and L5. Rats underwent no treatment or were treated locally with either vancomycin powder, blank MS or vancomycin-loaded MS. After 8 weeks, the K-wire, bone, soft tissue and wire fastener were cultured and results analyzed. RESULTS: Vancomycin powder and vancomycin-loaded MS resulted in significantly fewer bacteria remaining in vitro than did CMC. Vancomycin powder- treated animals' cultures were significantly lower than all other groups (P < 0.0001) with negative culture results, except for one animal. The vancomycin-loaded MS-treated animals had lower bone bacterial counts than the controls (P < 0.0279); blank MS-treated animals had no differences in bacterial densities when compared to non-treated animals. CONCLUSION: Vancomycin powder and vancomycin-loaded MS were active against MRSE in vitro, in a rat MRSE implant model; however, vancomycin MS were inferior to the topical vancomycin powder. Vancomycin powder prevented MRSE infection in a rat spinal implant infection model.


Assuntos
Fios Ortopédicos/microbiologia , Coluna Vertebral/cirurgia , Staphylococcus epidermidis , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/microbiologia , Vancomicina/administração & dosagem , Animais , Carga Bacteriana , Modelos Animais de Doenças , Farmacorresistência Bacteriana , Feminino , Resistência a Meticilina , Microesferas , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Pós , Ratos Sprague-Dawley , Staphylococcus epidermidis/efeitos dos fármacos , Infecção da Ferida Cirúrgica/prevenção & controle , Vancomicina/farmacologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-31963695

RESUMO

Background: Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE), the most prevalent causes of hospital-associated and community-associated infections, could exist on frequently touched surfaces. This study aims to determine the contamination prevalence and the characteristics of MRSA and MRSE isolated from secondary school environments. Methods: We collected environmental samples from ten secondary schools in Guangzhou city between October 2016 and January 2017. The samples were confirmed for MRSA and MRSE isolates by using biochemical tests and polymerase chain reactions. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method. Staphylococcal cassette chromosome mec (SCCmec) typing, toxin gene screening, and multilocus sequence typing (MLST) were performed to further characterize the isolates. Data were analyzed by two-sample proportion tests. Results: A total of 1830 environmental samples were collected. The prevalence of MRSA and MRSE contamination were 1.86% (34/1830) and 5.14% (94/1830), respectively. The proportions of multidrug resistance in both MRSA (58.82%) and MRSE (63.83%) isolates were high. Seven clonal complexes (CC) and 12 sequence types (ST) were identified, with the CC5 (35.29%) and ST45 (25.53%) being the most prevalent. We found that 44.12% of the MRSA isolates were community-acquired and the main type was ST45-SCCmec IV. We found that 5.88% and 32.35% of MRSA isolates were positive to Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin-1 (tst) gene, respectively. No MRSE isolate was positive to the toxin genes. Conclusion: Our findings raise potential public health concerns for environmental contamination of MRSA and MRSE in school environments. Surfaces of school environments may potentially provide a source for cross-contamination with these bacteria into the wider community.


Assuntos
Microbiologia Ambiental , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/microbiologia , Antibacterianos/farmacologia , Toxinas Bacterianas , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Enterotoxinas , Exotoxinas , Humanos , Leucocidinas , Meticilina/farmacologia , Resistência a Meticilina , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Prevalência , Instituições Acadêmicas , Infecções Estafilocócicas/epidemiologia , Staphylococcus epidermidis/efeitos dos fármacos , Superantígenos
16.
BMC Infect Dis ; 20(1): 6, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900118

RESUMO

BACKGROUND: An efficient surface cleaning strategy would first target cleaning to surfaces that make large contributions to the risk of infections. METHODS: In this study, we used data from the literature about methicillin-resistant Staphylococcus aureus (MRSA) and developed an ordinary differential equations based mathematical model to quantify the impact of contact heterogeneity on MRSA transmission in a hypothetical 6-bed intensive care unit (ICU). The susceptible patients are divided into two types, these who are cared by the same nurse as the MRSA infected patient (Type 1) and these who are not (Type 2). RESULTS: The results showed that the mean MRSA concentration on three kinds of susceptible patient nearby surfaces was significantly linearly associated with the hand-touch frequency (p < 0.05). The noncompliance of daily cleaning on patient nearby high-touch surfaces (HTSs) had the most impact on MRSA transmission. If the HTSs were not cleaned, the MRSA exposure to Type 1 and 2 susceptible patients would increase 118.4% (standard deviation (SD): 33.0%) and 115.4% (SD: 30.5%) respectively. The communal surfaces (CSs) had the least impact, if CSs were not cleaned, the MRSA exposure to Type 1 susceptible patient would only increase 1.7% (SD: 1.3). The impact of clinical equipment (CE) differed largely for two types of susceptible patients. If the CE was not cleaned, the exposure to Type 1 patients would only increase 8.4% (SD: 3.0%), while for Type 2 patients, it can increase 70.4% (SD: 25.4%). CONCLUSIONS: This study provided a framework to study the pathogen concentration dynamics on environmental surfaces and quantitatively showed the importance of cleaning patient nearby HTSs on controlling the nosocomial infection transmission via contact route.


Assuntos
Busca de Comunicante/métodos , Unidades de Terapia Intensiva , Staphylococcus aureus Resistente à Meticilina/fisiologia , Modelos Teóricos , Infecções Estafilocócicas/transmissão , Busca de Comunicante/estatística & dados numéricos , Infecção Hospitalar/transmissão , Detergentes/farmacologia , Desinfecção , Feminino , Higiene das Mãos/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Transmissão de Doença Infecciosa do Profissional para o Paciente/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Resistência a Meticilina/fisiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Propriedades de Superfície
17.
J Vet Sci ; 21(1): e2, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31940681

RESUMO

The emergence of livestock-associated (LA)-methicillin-resistant Staphylococcus aureus (MRSA) in livestock animal has become a significant zoonotic concern. In the present study, we investigated nationwide prevalence of LA-MRSA across pork production chain including pig farms, slaughterhouses, and retail markets. A total of 40 MRSA strains were isolated during the investigation and the overall prevalence of MRSA was 3.4% (n = 37), 0.6% (n = 2), and 0.4% (n = 1) in pig farms, slaughterhouses, and retail markets, respectively. Multilocus sequence typing analyses revealed that the 2 most significant clonal lineages in pork production chain in Korea were ST398 (n = 25) and ST541 (n = 6). All of the 40 MRSA isolates were further characterized to investigate key genotypic and phenotypic correlates associated with the emergence and spread of clonal complex 398 (CC398; ST398, and ST541) LA-MRSA. Although the prevalence of swine-associated MRSA was still relatively low and mostly restricted to pig farms, multidrug-resistant CC398 LA-MRSA isolates with new spa types (t18102 and t18103) were identified as a major clonal lineage. The CC398 LA-MRSA strains tended to exhibit increased levels of multiple drug resistance (MDR) phenotype compared with non-CC398 MRSA strains. Of note, in comparison with non-CC398 MRSA isolates, CC398 LA-MRSA isolates exhibited significantly enhanced tetracycline (TET) and zinc resistance. These findings suggested that co-selection pressure associated with MDR phenotype, especially TET resistance, and zinc resistance may have played a significant role in the emergence and persistence of CC398 LA-MRSA in pig farms in Korea.


Assuntos
Antibacterianos/farmacologia , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Meticilina/farmacologia , Infecções Estafilocócicas/veterinária , Doenças dos Suínos/epidemiologia , Matadouros/estatística & dados numéricos , Animais , Cloretos/farmacologia , Fazendeiros/estatística & dados numéricos , Fazendas/estatística & dados numéricos , Staphylococcus aureus Resistente à Meticilina/genética , Tipagem de Sequências Multilocus/veterinária , Prevalência , República da Coreia/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Suínos , Doenças dos Suínos/microbiologia , Tetraciclina/farmacologia , Compostos de Zinco/farmacologia
18.
J Vet Sci ; 21(1): e11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31940690

RESUMO

The increase in canine skin and soft tissue infections, such as pyoderma and otitis, caused by Staphylococcus schleiferi strains, is of significant zoonotic concern. In this study, we report the first complete genome sequence for a methicillin-resistant clinical isolate of S. schleiferi (MRSS) designated as SS4, obtained from a dog with otitis externa, in Korea. The genome of SS4 strain was of 2,539,409 bp and presented high G+C content ratio (35.90%) with no plasmid. Comparative analysis of SS4 genome revealed that it is closely related to 2142-05 and 5909-02 strains isolated from the canine skin infections in the USA.


Assuntos
Doenças do Cão/microbiologia , Genoma Bacteriano , Resistência a Meticilina/genética , Meticilina/farmacologia , Otite Externa/veterinária , Staphylococcus/genética , Animais , Cães , Otite Externa/microbiologia , República da Coreia
19.
J Infect Public Health ; 13(1): 75-79, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31402312

RESUMO

PURPOSE: Emergence of multidrug-resistant and methicillin-resistant Staphylococcus aureus (MRSA) infections in HIV patients limit the treatment options and challenge the clinical management of infections. The periodic monitoring of S. aureus infections and its drug resistance profile in HIV patients are of paramount importance in clinical management. MATERIALS AND METHODS: A total of 7204 clinical specimens from HIV patients from 2012 to 2017 were processed for the isolation of S. aureus strains using conventional culture techniques and cultures were identified using standard biochemical test. Antibiotic susceptibility of S. aureus strains was tested by Kirby-Bauer disk diffusion method. RESULTS: A total of 380 (5.3%) S. aureus strains were isolated from HIV patients in the study period. High percentage of S. aureus strains were isolates from urine (69.5%) specimen and 58.4% of S. aureus infections were noted among hospitalized patients. Antibiotic susceptibility profile reveals S. aureus was highly resistant to penicillin (95.2%) followed by cephalexin (84.6%). Methicillin resistance was highly observed in the year 2017 (86%) and the rate of MRSA steadily increasing from 51.8% in 2012 to 86% in 2017. Significant increase of S. aureus infections (35%; p<0.001) and MRSA (76%; p=0.0007) were observed in the year 2016. CONCLUSIONS: This study reports the increasing trends of S. aureus infections and MRSA among HIV patients from Southern India. Multidrug-resistance profile of S. aureus could complicate the selection of proper antibiotic regimens and time cure of HIV patients.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Infecções por HIV/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Feminino , Infecções por HIV/complicações , Humanos , Índia , Masculino , Meticilina/farmacologia , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Pessoa de Meia-Idade , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/urina , Centros de Atenção Terciária , Adulto Jovem
20.
Ann Pharmacother ; 54(2): 131-137, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31544471

RESUMO

Background: For critically ill adults receiving empirical vancomycin, the duration of negative cultures after which vancomycin may be discontinued without risking subsequent growth of methicillin-resistant Staphylococcus aureus (MRSA) remains unknown. Objective: We hypothesized that if sputum cultures did not grow MRSA or blood cultures did not grow Gram-positive cocci on Gram stain by 48 hours, those cultures would not subsequently demonstrate MRSA. Methods: We conducted an ancillary analysis from patients enrolled in the Isotonic Solutions and Major Adverse Renal Events Trial (SMART). In this cohort of patients, we collected data on the time of either MRSA identification in culture or Gram-positive cocci identification on Gram stain and rate of vancomycin discontinuation. Results: Of the 15 802 patient admissions in the SMART study, 6553 (41.5%) received empirical intravenous vancomycin. Respiratory sputum cultures demonstrated MRSA during 178 patient admissions. Among respiratory cultures that would ultimately grow MRSA, 85% were positive within 48 hours, and 97% were positive within 72 hours. Cultures demonstrated MRSA bacteremia during 85 patient admissions. In 83 cases (97.6%) of MRSA bacteremia, Gram-positive cocci were identified within 48 hours after the culture was obtained. Conclusion and Relevance: This analysis of a large cohort of critically ill adults receiving empirical vancomycin found that Staphylococcus aureus was present in all but 15% of cases of MRSA-positive respiratory cultures after 48 hours, whereas Gram-positive cocci were identified within 48 hours during nearly all episodes of MRSA bacteremia. These findings may inform the timing of discontinuation of empirical vancomycin among critically ill adults.


Assuntos
Bacteriemia/microbiologia , Hemocultura , Resistência a Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento , Escarro/microbiologia , Infecções Estafilocócicas/microbiologia , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Bacteriemia/sangue , Bacteriemia/tratamento farmacológico , Estudos de Coortes , Estado Terminal , Estudos Cross-Over , Esquema de Medicação , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Estudos Prospectivos , Infecções Estafilocócicas/sangue , Infecções Estafilocócicas/tratamento farmacológico , Vancomicina/administração & dosagem , Vancomicina/uso terapêutico
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