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Alexander A, Smith AH, Krantz M, Simon R, Caputo FJ, Quatromoni JG. Explant of an infected, endo-trashed IVC filter in an immunosuppressed patient with chronically occluded iliocaval stents. Vascular 2025; 33:182-185. [PMID: 38479406 DOI: 10.1177/17085381241238832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2025]
Abstract
BACKGROUND In the absence of a contiguous bowel perforation or intraabdominal source, infection of a retained vena cava filter in an occluded IVC has never been described. OBJECTIVE To describe a case of an infected IVC filter in a chronically occluded iliocaval segment. METHODS Here we present a case of an immunosuppressed 35-year-old female with chronically occluded iliocaval stents and an extensive staphylococcus hominis infection of a previously endo-trashed Bard Eclipse® filter. Particular attention is paid to supportive imaging in establishing the diagnosis and technical aspects of successful device explant and retroperitoneal debridement. RESULTS At 6 months postoperatively, the patient was doing well without evidence of recurrent infection. Her lower extremity edema was controlled with compression alone. CONCLUSIONS The main objective of this operation was source control with debridement of the infection and removal of the filter and as much of the iliac vein as safely possible. Superinfection of a previously placed iliocaval stents and inferior vena cava filter remains a concern in patients with retroperitoneal infection and chronic iliocaval occlusion. Operative explant and debridement can be safely performed in patients with favorable cardiopulmonary risk.
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Affiliation(s)
- Alice Alexander
- Department of Vascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Andrew H Smith
- Department of Vascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Matthew Krantz
- Department of Surgery, Marshall University Medical Center, Huntington, WV, USA
| | - Robert Simon
- Department of Hepatopancreaticobiliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Francis J Caputo
- Department of Vascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jon G Quatromoni
- Department of Vascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
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Michels R, Papan C, Boutin S, Alhussein F, Becker SL, Nurjadi D, Last K. Clinical relevance of Staphylococcus saccharolyticus detection in human samples: a retrospective cohort study. Infection 2025; 53:145-153. [PMID: 38963607 PMCID: PMC11825615 DOI: 10.1007/s15010-024-02334-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/25/2024] [Indexed: 07/05/2024]
Abstract
PURPOSE To characterize the clinical relevance of S. saccharolyticus and to identify criteria to distinguish between infection and contamination. METHODS We retrospectively investigated clinical features of patients with S. saccharolyticus detection between June 2009 and July 2021. Based on six criteria, infection was considered likely for patients with a score from 3 to 6 points, infection was considered unlikely for patients with a score from 0 to 2 points. We performed group comparison and logistic regression to identify factors than are associated with likely infection. In addition, whole genome sequencing (WGS) of 22 isolates was performed. RESULTS Of 93 patients in total, 44 were assigned to the group "infection likely" and 49 to the group "infection unlikely". Multiple regression analysis revealed "maximum body temperature during hospital stay" to have the strongest predictive effect on likely infection (adjusted odds ratio 4.40, 95% confidence interval 2.07-9.23). WGS revealed two different clades. Compared to isolates from clade A, isolates from clade B were more frequently associated with implanted medical devices (3/10 vs. 9/12, p = 0.046) and a shorter time to positivity (TTP) (4.5 vs. 3, p = 0.016). Both clades did neither differ significantly in terms of causing a likely infection (clade A 7/10 vs. clade B 5/12, p = 0.23) nor in median length of hospital stay (28 vs. 15.5 days, p = 0.083) and length of stay at the ICU (21 vs. 3.5 days, p = 0.14). CONCLUSION These findings indicate that S. saccharolyticus can cause clinically relevant infections. Differentiation between infection and contamination remains challenging.
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Affiliation(s)
- Ricarda Michels
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Cihan Papan
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
- Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany.
| | - Sébastien Boutin
- Department of Infectious Diseases, Medical Microbiology and Hospital Hygiene, University Hospital Heidelberg, Heidelberg, Germany
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Airway Research Center North (ARCN), German center for Lung Research (DZL), Lübeck, Germany
| | - Farah Alhussein
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Sören L Becker
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Dennis Nurjadi
- Department of Infectious Diseases, Medical Microbiology and Hospital Hygiene, University Hospital Heidelberg, Heidelberg, Germany
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Lübeck, Germany
| | - Katharina Last
- Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
- Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany
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Watkin S, Cloutman-Green E, Kiernan M, Ciric L. Trends in viable microbial bioburden on surfaces within a paediatric bone marrow transplant unit. J Hosp Infect 2024; 148:167-177. [PMID: 38621514 DOI: 10.1016/j.jhin.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Despite their role being historically overlooked, environmental surfaces have been shown to play a key role in the transmission of pathogens causative of healthcare-associated infection. To guide infection prevention and control (IPC) interventions and inform clinical risk assessments, more needs to be known about microbial surface bioburdens. AIM To identify the trends in culturable bacterial contamination across communal touch sites over time in a hospital setting. METHODS Swab samples were collected over nine weeks from 22 communal touch sites in a paediatric bone marrow transplant unit. Samples were cultured on Columbia blood agar and aerobic colony counts (ACC) per 100 cm2 were established for each site. Individual colony morphologies were grouped and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry or 16s rDNA sequencing. FINDINGS Highest mean counts were observed for sites associated with ward management activity and computer devices (3.29 and 2.97 ACC/100 cm2 respectively). A nurses' station keyboard had high mean ACC/100 cm2 counts (10.67) and diversity, while laundry controls had high mean ACC/100 cm2 counts (4.70) and low diversity. Micrococcus luteus was identified in all sampling groups. Clinical staff usage sites were contaminated with similar proportions of skin and environmental flora (52.19-46.59% respectively), but sites associated with parental activities were predominantly contaminated by environmental microflora (86.53%). CONCLUSION The trends observed suggest patterns in microbial loading based on site activities, surface types and user groups. Improved understanding of environmental surface contamination could help support results interpretation and IPC interventions, improving patient safety.
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Affiliation(s)
- S Watkin
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK.
| | - E Cloutman-Green
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK; Microbiology, Virology and Infection Prevention and Control, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - M Kiernan
- Richard Wells Research Centre, University of West London, London, UK
| | - L Ciric
- Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK
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4
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Velazquez-Meza ME, Galarde-López M, Cornejo-Juárez P, Carrillo-Quiroz BA, Velázquez-Acosta C, Bobadilla-del-Valle M, Ponce-de-León A, Alpuche-Aranda CM. Multidrug-Resistant Staphylococcus sp. and Enterococcus sp. in Municipal and Hospital Wastewater: A Longitudinal Study. Microorganisms 2024; 12:645. [PMID: 38674590 PMCID: PMC11051902 DOI: 10.3390/microorganisms12040645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/12/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
The objective of the study was to detect multidrug-resistant Staphylococcus sp. and Enterococcus sp. isolates in municipal and hospital wastewater and to determine their elimination or persistence after wastewater treatment. Between August 2021 and September 2022, raw and treated wastewater samples were collected at two hospital and two community wastewater treatment plants (WWTPs). In each season of the year, two treated and two raw wastewater samples were collected in duplicate at each of the WWTPs studied. Screening and presumptive identification of staphylococci and enterococci was performed using chromoagars, and identification was performed with the Matrix Assisted Laser Desorption Ionization Time of Flight mass spectrometry (MALDI-TOF MS®). Antimicrobial susceptibility was performed using VITEK 2® automated system. There were 56 wastewater samples obtained during the study period. A total of 182 Staphylococcus sp. and 248 Enterococcus sp. were identified. The highest frequency of Staphylococcus sp. isolation was in spring and summer (n = 129, 70.8%), and for Enterococcus sp. it was in autumn and winter (n = 143, 57.7%). Sixteen isolates of Staphylococcus sp. and sixty-three of Enterococcus sp. persisted during WWTP treatments. Thirteen species of staphylococci and seven species of enterococci were identified. Thirty-one isolates of Staphylococcus sp. and ninety-four of Enterococcus sp. were multidrug-resistant. Resistance to vancomycin (1.1%), linezolid (2.7%), and daptomycin (8.2%/10.9%%), and a lower susceptibility to tigecycline (2.7%), was observed. This study evidences the presence of Staphylococcus sp. and Enterococcus sp. resistant to antibiotics of last choice of clinical treatment, in community and hospital wastewater and their ability to survive WWTP treatment systems.
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Affiliation(s)
- Maria Elena Velazquez-Meza
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca City 62100, Mexico; (M.E.V.-M.); (M.G.-L.); (B.A.C.-Q.)
| | - Miguel Galarde-López
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca City 62100, Mexico; (M.E.V.-M.); (M.G.-L.); (B.A.C.-Q.)
| | - Patricia Cornejo-Juárez
- Departamento de Infectología, Instituto Nacional de Cancerología, Mexico City 14080, Mexico; (P.C.-J.); (C.V.-A.)
| | - Berta Alicia Carrillo-Quiroz
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca City 62100, Mexico; (M.E.V.-M.); (M.G.-L.); (B.A.C.-Q.)
| | - Consuelo Velázquez-Acosta
- Departamento de Infectología, Instituto Nacional de Cancerología, Mexico City 14080, Mexico; (P.C.-J.); (C.V.-A.)
| | - Miriam Bobadilla-del-Valle
- Laboratorio Nacional de Máxima Seguridad para el Estudio de Tuberculosis y Enfermedades Emergentes, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City 14080, Mexico; (M.B.-d.-V.); (A.P.-d.-L.)
| | - Alfredo Ponce-de-León
- Laboratorio Nacional de Máxima Seguridad para el Estudio de Tuberculosis y Enfermedades Emergentes, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City 14080, Mexico; (M.B.-d.-V.); (A.P.-d.-L.)
| | - Celia Mercedes Alpuche-Aranda
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca City 62100, Mexico; (M.E.V.-M.); (M.G.-L.); (B.A.C.-Q.)
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Guest JD, Luo Z, Liu Y, Gao H, Wang D, Xu XM, Zhu H. Acute penetrating injury of the spinal cord by a wooden spike with delayed surgery: a case report. Neural Regen Res 2023; 18:2781-2784. [PMID: 37449645 DOI: 10.4103/1673-5374.373668] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Rarely, penetrating injuries to the spinal cord result from wooden objects, creating unique challenges to mitigate neurological injury and high rates of infection and foreign body reactions. We report a man who sustained a penetrating cervical spinal cord injury from a sharpened stick. While initially tetraparetic, he rapidly recovered function. The risks of neurological deterioration during surgical removal made the patient reluctant to consent to surgery despite the impalement of the spinal cord. A repeat MRI on day 3 showed an extension of edema indicating progressive inflammation. On the 7th day after injury, fever and paresthesias occurred with a large increase in serum inflammatory indicators, and the patient agreed to undergo surgical removal of the wooden object. We discuss the management nuances related to wood, the longitudinal evolution of MRI findings, infection risk, surgical risk mitigation and technique, an inflammatory marker profile, long-term recovery, and the surprisingly minimal neurological deficits associated with low-velocity midline spinal cord injuries. The patient had an excellent clinical outcome. The main lessons are that a wooden penetrating central nervous system injury has a high risk for infection, and that surgical removal from the spinal cord should be performed soon after injury and under direct visualization.
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Affiliation(s)
- James D Guest
- Neurological Surgery, and the Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Zhuojing Luo
- Department of Orthopedic Spinal Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Yansheng Liu
- Department of Neurosurgery, Kunming Tongren Hospital, Kunming, Yunnan Province, China
| | - Hongkun Gao
- Kunming International Spine, and Spinal Cord Injury Treatment Center, Kunming Tongren Hospital, Kunming, Yunnan Province, China
| | - Dianchun Wang
- Kunming International Spine, and Spinal Cord Injury Treatment Center, Kunming Tongren Hospital, Kunming, Yunnan Province, China
| | - Xiao-Ming Xu
- Indiana University School of Medicine, Stark Neurosciences Research Institute, Indianapolis, IN, USA
| | - Hui Zhu
- Kunming International Spine, and Spinal Cord Injury Treatment Center, Kunming Tongren Hospital, Kunming, Yunnan Province, China
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Watkin S, Ciric L, Kiernan M, Cloutman-Green E. A proposed classification system for opportunistic pathogens for improved healthcare infection prevention and control risk assessments. J Hosp Infect 2023; 135:206-207. [PMID: 36948226 DOI: 10.1016/j.jhin.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 03/24/2023]
Affiliation(s)
- Sam Watkin
- Healthy Infrastructure Research Group, University College London, London, UK.
| | - Lena Ciric
- Healthy Infrastructure Research Group, University College London, London, UK
| | | | - Elaine Cloutman-Green
- Healthy Infrastructure Research Group, University College London, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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7
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Szemraj M, Lisiecki P, Glajzner P, Szewczyk EM. Vancomycin heteroresistance among methicillin-resistant clinical isolates S. haemolyticus, S. hominis, S. simulans, and S. warneri. Braz J Microbiol 2023; 54:159-167. [PMID: 36374479 PMCID: PMC9944261 DOI: 10.1007/s42770-022-00870-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/01/2022] [Indexed: 11/15/2022] Open
Abstract
Besides being an essential part of the skin microbiome, coagulase-negative staphylococci are the etiological factors of serious infections. The aim of the study was to evaluate the heteroresistance to vancomycin and the potential antimicrobial efficacy of teicoplanin and daptomycin against the multiresistant strains of S. haemolyticus, S. hominis, S. warneri, and S. simulans. The study covered 80 clinical coagulase-negative staphylococci. Teicoplanin, vancomycin, and daptomycin MICs for the tested strains were determined according to EUCAST recommendation. The vanA and vanB genes were searched. The brain heart infusion screen agar method detected vancomycin heteroresistance. The population analysis profile method and analysis of autolytic activity were applied for the strains growing on BHI containing 4 mg/L vancomycin. Seven S. haemolyticus, two S. hominis, and two S. warneri strains presented a heterogeneous resistance to vancomycin. Their subpopulations were able to grow on a medium containing 4-12 mg/L of vancomycin. Monitoring heteroresistance to peptide antibiotics, which are often the last resort in staphylococcal infections, is essential due to the severe crisis in antibiotic therapy and the lack of alternatives to treat infections with multiresistant strains. Our work highlights the selection of resistant strains and the need for more careful use of peptide antibiotics.
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Affiliation(s)
- Magdalena Szemraj
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszyńskiego 1, 90-235, Łódź, Poland.
| | - Paweł Lisiecki
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszyńskiego 1, 90-235, Łódź, Poland
| | - Paulina Glajzner
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszyńskiego 1, 90-235, Łódź, Poland
| | - Eligia M Szewczyk
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszyńskiego 1, 90-235, Łódź, Poland
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Ferreira M, Santos M, Rodrigues J, Diogo C, Resende C, Baptista C, Faria C. Epidemiology of bacteremia in a pediatric population - A 10-year study. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:85-91. [PMID: 36759058 DOI: 10.1016/j.eimce.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/05/2021] [Indexed: 02/09/2023]
Abstract
INTRODUCTION With the widespread introduction of conjugate meningococcal and pneumococcal vaccines, the prevalence and etiology of invasive bacterial infections have changed. We aimed to review all cases of bacteremia in a level II pediatric department over a ten-year period in the post-pneumococcal conjugate vaccine era. METHODS We reviewed all positive blood cultures (BC) obtained in our department between 2007 and 2016. Results were classified as contaminants, potential pathogens or confirmed pathogens, based on species, number of positive BC in the episode and the patients' medical history. Demographic and clinical data were collected for patients with identified pathogens. RESULTS A total of 638 positive BC were identified (6.6% of total BC); 120 (1.2%) were considered to represent true bacteremia. The most frequently identified microorganism was Streptococcus pneumoniae (29.2%), with a decrease in the number of cases between 2008 and 2015. Staphylococcus aureus was the second most common organism (19.2%) being 21.7% of these methicillin-resistant. Escherichia coli was the most common isolate in children aged less than three months. CONCLUSION We found a rate of true bacteremia in children similar to recent studies. Although Streptococcus pneumoniae remains the most common microorganism, its prevalence may be declining. Monitoring microbiological data in children has implications in practice, particularly in local antibiotic prescription.
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Affiliation(s)
- Mariana Ferreira
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
| | - Mafalda Santos
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Jorge Rodrigues
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Clara Diogo
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Catarina Resende
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Cristina Baptista
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Cristina Faria
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
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Gisriel SD, Jacobs JW. The first reported case of Staphylococcus pettenkoferi prosthetic joint infection. Microbes Infect 2022; 24:104978. [PMID: 35421570 DOI: 10.1016/j.micinf.2022.104978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
Abstract
Staphylococcus aureus and Staphylococcus epidermidis are among the most frequent causes of prosthetic joint infections (PJIs). Staphylococcus pettenkoferi, a coagulase-negative Staphylococcal species first described in 2002, has been detected in fewer than 20 patients with true infection (15 cases of bacteremia and 1 case of osteomyelitis). This organism has never been implicated in a PJI, likely owing in part to the difficulty in identification via biochemical methods. S. pettenkoferi is almost universally reported to be a contaminant when detected. We report the first case of a PJI caused by S. pettenkoferi, highlighting its infectious potential in specific patient populations.
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Affiliation(s)
- Savanah D Gisriel
- Departments of Laboratory Medicine and Pathology, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA.
| | - Jeremy W Jacobs
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.
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Kierzkowska M, Markowska K, Majewska A. Knowledge, Attitude and Practice Regarding Staphylococcus pettenkoferi. Infect Dis Rep 2022; 14:112-120. [PMID: 35200442 PMCID: PMC8872105 DOI: 10.3390/idr14010015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023] Open
Abstract
Staphylococcus pettenkoferi is a coagulase-negative staphylococcus, first described in 2002. Using medical databases, i.e., Scopus, Web of Science, Pubmed, and Embase, we identified and analysed research, reports, and opinions dealing with S. pettenkoferi. Published data allow us to conclude that S. pettenkoferi is a human commensal, opportunistic bacterium and may be isolated from the environment and animals. The involvement of S. pettenkoferi in bloodstream infection and osteomyelitis has been described, but its clinical relevance is not fully understood, so far. This work summarizes knowledge about S. pettenkoferi and reveals the difficulties and rules for interpreting the results of microbiological tests, when S. pettenkoferi has been identified in the blood sample. Clinical and laboratory criteria, recommended by Centers for Disease Control and Prevention (CDC) and the third international consensus definitions of sepsis and septic shock (Sepsis-3), are important to determine whether the presence of bacteria in the sample is a consequence of an infection, contamination from the environment, or translocation of the bacteria outside the place of its natural existence. The precise identification of bacteria from the blood sample and recognizing the true bacteraemia are critical to implement the appropriate procedures and make decisions concerning the patient’s medical care.
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The clinical significance of staphylococcus pettenkoferi: a retrospective review at a tertiary care medical center. Diagn Microbiol Infect Dis 2021; 102:115592. [PMID: 34839128 DOI: 10.1016/j.diagmicrobio.2021.115592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022]
Abstract
Staphylococcus pettenkoferi is a recently described coagulase-negative staphylococcal pathogen. We retrospectively reviewed 25 cases in which S. pettenkoferi was identified in routine cultures (12 blood, 13 other). Most were found with commensal flora and considered clinically insignificant, but its significance was uncertain in two cases from non-healing, deep foot wounds.
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12
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Staphylococcus pettenkoferi Bacteremia in an American Intensive Care Unit. Case Rep Infect Dis 2021; 2021:5235691. [PMID: 34631179 PMCID: PMC8494585 DOI: 10.1155/2021/5235691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/21/2021] [Indexed: 11/18/2022] Open
Abstract
Coagulase-negative staphylococci (CoNS) are considered the most common cause of nosocomial bloodstream infections; yet, these species are frequently designated as contaminants in the absence of systemic signs and symptoms of infection. Immunocompromised patients or those with prosthetic devices are at increased risk for clinically significant bacteremia. With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) in clinical practice, there has been improved specificity of CoNS isolate identification and further elucidation of underrecognized pathogenic species. Staphylococcus pettenkoferi was a novel CoNS species first identified in 2002 and thought to be misdiagnosed as other CoNS due to limitations in biochemical identification. There is increasing identification of S. pettenkoferi isolates; however, there are limited case reports of clinically significant S. pettenkoferi bacteremia and no reported cases within the United States. We present the first known case of S. pettenkoferi from an American intensive care unit.
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Ferreira M, Santos M, Rodrigues J, Diogo C, Resende C, Baptista C, Faria C. Epidemiology of bacteremia in a pediatric population - A 10-year study. Enferm Infecc Microbiol Clin 2021; 41:S0213-005X(21)00207-X. [PMID: 34275687 DOI: 10.1016/j.eimc.2021.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/28/2021] [Accepted: 06/05/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION With the widespread introduction of conjugate meningococcal and pneumococcal vaccines, the prevalence and etiology of invasive bacterial infections have changed. We aimed to review all cases of bacteremia in a level II pediatric department over a ten-year period in the post-pneumococcal conjugate vaccine era. METHODS We reviewed all positive blood cultures (BC) obtained in our department between 2007 and 2016. Results were classified as contaminants, potential pathogens or confirmed pathogens, based on species, number of positive BC in the episode and the patients' medical history. Demographic and clinical data were collected for patients with identified pathogens. RESULTS A total of 638 positive BC were identified (6.6% of total BC); 120 (1.2%) were considered to represent true bacteremia. The most frequently identified microorganism was Streptococcus pneumoniae (29.2%), with a decrease in the number of cases between 2008 and 2015. Staphylococcus aureus was the second most common organism (19.2%) being 21.7% of these methicillin-resistant. Escherichia coli was the most common isolate in children aged less than three months. CONCLUSION We found a rate of true bacteremia in children similar to recent studies. Although Streptococcus pneumoniae remains the most common microorganism, its prevalence may be declining. Monitoring microbiological data in children has implications in practice, particularly in local antibiotic prescription.
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Affiliation(s)
- Mariana Ferreira
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
| | - Mafalda Santos
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Jorge Rodrigues
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Clara Diogo
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Catarina Resende
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Cristina Baptista
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Cristina Faria
- Department of Pediatrics, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
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Michels R, Last K, Becker SL, Papan C. Update on Coagulase-Negative Staphylococci-What the Clinician Should Know. Microorganisms 2021; 9:microorganisms9040830. [PMID: 33919781 PMCID: PMC8070739 DOI: 10.3390/microorganisms9040830] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 02/07/2023] Open
Abstract
Coagulase-negative staphylococci (CoNS) are among the most frequently recovered bacteria in routine clinical care. Their incidence has steadily increased over the past decades in parallel to the advancement in medicine, especially in regard to the utilization of foreign body devices. Many new species have been described within the past years, while clinical information to most of those species is still sparse. In addition, interspecies differences that render some species more virulent than others have to be taken into account. The distinct populations in which CoNS infections play a prominent role are preterm neonates, patients with implanted medical devices, immunodeficient patients, and those with other relevant comorbidities. Due to the property of CoNS to colonize the human skin, contamination of blood cultures or other samples occurs frequently. Hence, the main diagnostic hurdle is to correctly identify the cases in which CoNS are causative agents rather than contaminants. However, neither phenotypic nor genetic tools have been able to provide a satisfying solution to this problem. Another dilemma of CoNS in clinical practice pertains to their extensive antimicrobial resistance profile, especially in healthcare settings. Therefore, true infections caused by CoNS most often necessitate the use of second-line antimicrobial drugs.
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Sader HS, Carvalhaes CG, Streit JM, Arends SJR, Mendes RE. Antimicrobial activity of dalbavancin against clinical isolates of coagulase-negative staphylococci from the USA and Europe stratified by species. J Glob Antimicrob Resist 2020; 24:48-52. [PMID: 33285311 DOI: 10.1016/j.jgar.2020.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/16/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES To evaluate the in vitro activity of dalbavancin compared with vancomycin, daptomycin and other agents against a large collection of coagulase-negative staphylococci (CoNS) isolates. METHODS A total of 5088 CoNS causing clinically significant infection were consecutively collected from 122 medical centres in the USA and Europe over 6 years (2014-2019). Isolates were tested for susceptibility by the reference broth microdilution method. Species identification was confirmed by MALDI-TOF. Most isolates were from bloodstream infections (BSIs) (53.5%) or skin/skin structure infections (28.5%). RESULTS Staphylococcus epidermidis was the most common species overall (54.6%) and for BSI (61.3%). The second most common species were Staphylococcus lugdunensis overall (12.3%) and Staphylococcus hominis for BSI (14.7%). Dalbavancin (MIC50/90, 0.03/0.06 mg/L) inhibited >99.9% of CoNS isolates at ≤0.25 mg/L (susceptible breakpoint for Staphylococcus aureus per CLSI). All species were inhibited at ≤0.25 mg/L dalbavancin, except some S. epidermidis (>99.9%) and Staphylococcus warneri (98.9%) isolates. Staphylococcus capitis and Staphylococcus simulans exhibited the lowest dalbavancin MIC50/90 values (0.015/0.03 mg/L) and Staphylococcus haemolyticus and Staphylococcus saprophyticus the highest (MIC50/90, 0.06/0.12 mg/L); 47.8% of S. epidermidis and 34.7% of S. haemolyticus exhibited decreased susceptibility to vancomycin (MIC ≥ 2 mg/L) and 23.2% of S. capitis and 28.4% of S. warneri showed decreased susceptibility to daptomycin (MIC ≥ 1 mg/L). CONCLUSION Antimicrobial susceptibility varied widely among CoNS species. Dalbavancin inhibited >99.9% and 99.1% of isolates at the US-FDA and EUCAST breakpoints, respectively. Clinical studies of dalbavancin for treatment of CoNS infections should be considered based on these in vitro data.
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16
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Power N, Calisti G, Price F, Watt V, Gamlin W, Dobson L, Ray S. Staphylococcus simulans endocarditis of native aortic and mitral valves. Case report and literature review. CLINICAL INFECTION IN PRACTICE 2020. [DOI: 10.1016/j.clinpr.2020.100044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Staphylococcus saccharolyticus: An Overlooked Human Skin Colonizer. Microorganisms 2020; 8:microorganisms8081105. [PMID: 32718033 PMCID: PMC7465461 DOI: 10.3390/microorganisms8081105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 01/04/2023] Open
Abstract
Coagulase-negative staphylococcal species constitute an important part of the human skin microbiota. In particular, facultative anaerobic species such as Staphylococcus epidermidis and Staphylococcus capitis can be found on the skin of virtually every human being. Here, we applied a culture-independent amplicon sequencing approach to identify staphylococcal species on the skin of healthy human individuals. While S. epidermidis and S. capitis were found as primary residents of back skin, surprisingly, the third most abundant member was Staphylococcus saccharolyticus, a relatively unstudied species. A search of skin metagenomic datasets detected sequences identical to the genome of S. saccharolyticus in diverse skin sites, including the back, forehead, and elbow pit. Although described as a slow-growing anaerobic species, a re-evaluation of its growth behavior showed that S. saccharolyticus can grow under oxic conditions, and, in particular, in a CO2-rich atmosphere. We argue here that S. saccharolyticus was largely overlooked in previous culture-dependent and -independent studies, due to its requirement for fastidious growth conditions and the lack of reference genome sequences, respectively. Future studies are needed to unravel the microbiology and host-interacting properties of S. saccharolyticus and its role as a prevalent skin colonizer.
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18
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Zheng G, Li S, Zhao M, Yang X, Zhang Y, Deng J, Luo Y, Lv H, Zhang G. Time to positive culture can differentiate post-neurosurgical coagulase-negative Staphylococci other than S epidermidis meningitis from contamination: A case-control observational study. J Clin Lab Anal 2020; 34:e23447. [PMID: 32638442 PMCID: PMC7595912 DOI: 10.1002/jcla.23447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/09/2020] [Accepted: 05/26/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To explore the characteristics of coagulase‐negative Staphylococci other than Staphylococci epidermidis (Nse‐CoNS) meningitis and to apply cerebrospinal fluid (CSF) times to positivity culture (TTPC) for the precise differentiation of meningitis from contamination. Methods We conducted a case‐control study to accomplish the following: First, we retrospectively reviewed records of post‐neurosurgical patients’ CSF that yielded Nse‐CoNS from January to October 2019 at the Beijing Tiantan Hospital; 17 clinical and 12 laboratory characteristics were reviewed. Second, we investigated the TTPC of the Nse‐CoNS, the cutoffs, and corresponding parameters to differentiate Nse‐CoNS meningitis from contamination. Results In this study, a total of 146 patients with Nse‐CoNS CSF culture positive were enrolled. The average TTPC in the Nse‐CoNS meningitis group was significantly shorter than in the contamination group (20.2 ± 5.0 hours and 30.2 ± 12.6 hours, respectively, P < .05). The area under curve (AUC) of the model was 0.802. A TTPC of 20.0 hours had 94.3% sensitivity and a negative value of 90.2% for predicting Nse‐CoNS meningitis. Conclusions Nse‐CoNS meningitis often causes confusion in clinical diagnosis. In this study, we evaluated the clinical predictive factors of Nse‐CoNS meningitis and confirmed that the median TTPC in the Nse‐CoNS meningitis group was significantly shorter than in the contamination group. A TTPC shorter than 20.0 hours was associated with Nse‐CoNS meningitis, while a TTPC longer than 20.0 hours was associated with Nse‐CoNS contamination. This information will be helpful for the rapid diagnosis of Nse‐CoNS meningitis.
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Affiliation(s)
- Guanghui Zheng
- Department of Clinical Diagnosis, Laboratory of Beijing Tiantan Hospital and Capital Medical University, Beijing, China
| | - Siwen Li
- Department of Clinical Diagnosis, Laboratory of Beijing Tiantan Hospital and Capital Medical University, Beijing, China
| | - Minghui Zhao
- Department of Clinical Laboratory Diagnostics, Capital Medical University, Beijing, China
| | - Xinrui Yang
- Department of Clinical Laboratory Diagnostics, Capital Medical University, Beijing, China
| | - Yumeng Zhang
- Department of Clinical Laboratory Diagnostics, Capital Medical University, Beijing, China
| | - Jia Deng
- Department of Clinical Laboratory Diagnostics, Capital Medical University, Beijing, China
| | - Yu Luo
- Department of Clinical Laboratory Diagnostics, Capital Medical University, Beijing, China
| | - Hong Lv
- Department of Clinical Diagnosis, Laboratory of Beijing Tiantan Hospital and Capital Medical University, Beijing, China
| | - Guojun Zhang
- Department of Clinical Diagnosis, Laboratory of Beijing Tiantan Hospital and Capital Medical University, Beijing, China
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19
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Abstract
BACKGROUND Staphylococcus saccharolyticus is a rare cause of human infectious disease. The clinical characteristics and treatment of patients with S saccharolyticus infections remain largely unknown. OBJECTIVES We present the first reported case of empyema due to S saccharolyticus. In addition, a systematic review and pooled analysis of all S saccharolyticus cases were done to summarize the clinical and microbiological characteristics and treatment of this rare pathogen. METHODS A case of empyema caused by S saccharolyticus diagnosed in study hospital was reported. This case and those identified from PubMed, EMBASE, and Web of Science were analyzed. RESULTS In total, 8 patients were reviewed. The averages of the white blood cell count, sedimentation rate, and C-reactive protein were 16.8 × 10/L, 72 mm/h, and 176 mg/L, respectively. The average time-to-positivity of the anaerobic cultures was 5 days. The S saccharolyticus was resistant to metronidazole, but susceptible to fluoroquinolones, clindamycin, and vancomycin in all the cases with drug sensitivity tests available for these antibiotics. Two of 7 patients showed resistance to all β-lactams. Both of those patients finally died. CONCLUSIONS S saccharolyticus should be added to the list of anaerobic microorganisms that are able to cause empyema. A prolonged anaerobic culture is critical to improve the yield of this possibly underestimated pathogen. The time to positive culture of S saccharolyticus may not help to distinguish true-positive growth from contaminated growth. Acute or subacute courses and systemic evidence of infection may contribute to judge the clinical significance of positive cultures and avoid unnecessary antibiotic treatment. β-Lactam agents plus fluoroquinolones or vancomycin/teicoplanin or clindamycin may be appropriate to achieve full coverage of the β-lactam resistant bacteria.
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Affiliation(s)
- Ping Wang
- Department of Respiratory and Critical Care Medicine
| | - Yali Liu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yingchun Xu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zuojun Xu
- Department of Respiratory and Critical Care Medicine
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20
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Qu Y, Li Y, Cameron DR, Easton CD, Zhu X, Zhu M, Salwiczek M, Muir BW, Thissen H, Daley A, Forsythe JS, Peleg AY, Lithgow T. Hyperosmotic Infusion and Oxidized Surfaces Are Essential for Biofilm Formation of Staphylococcus capitis From the Neonatal Intensive Care Unit. Front Microbiol 2020; 11:920. [PMID: 32477314 PMCID: PMC7237634 DOI: 10.3389/fmicb.2020.00920] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/17/2020] [Indexed: 11/20/2022] Open
Abstract
Staphylococcus capitis is an opportunistic pathogen often implicated in bloodstream infections in the neonatal intensive care unit (NICU). This is assisted by its ability to form biofilms on indwelling central venous catheters (CVC), which are highly resistant to antibiotics and the immune system. We sought to understand the fundamentals of biofilm formation by S. capitis in the NICU, using seventeen clinical isolates including the endemic NRCS-A clone and assessing nine commercial and two modified polystyrene surfaces. S. capitis clinical isolates from the NICU initiated biofilm formation only in response to hyperosmotic conditions, followed by a developmental progression driven by icaADBC expression to establish mature biofilms, with polysaccharide being their major extracellular polymer substance (EPS) matrix component. Physicochemical features of the biomaterial surface, and in particular the level of the element oxygen present on the surface, significantly influenced biofilm development of S. capitis. A lack of highly oxidized carbon species on the surface prevented the immobilization of S. capitis EPS and the formation of mature biofilms. This information provides guidance in regard to the preparation of hyperosmolar total parenteral nutrition and the engineering of CVC surfaces that can minimize the risk of catheter-related bloodstream infections caused by S. capitis in the NICU.
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Affiliation(s)
- Yue Qu
- The Neonatal Intensive Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Infection and Immunity Theme, Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia.,Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Yali Li
- The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Clayton, VIC, Australia.,Department of Materials Science and Engineering, Monash Institute of Medical Engineering, Monash University, Clayton, VIC, Australia
| | - David R Cameron
- Infection and Immunity Theme, Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
| | - Christopher D Easton
- The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Clayton, VIC, Australia
| | - Xuebo Zhu
- The Neonatal Intensive Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Minli Zhu
- The Neonatal Intensive Care Unit, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mario Salwiczek
- Infection and Immunity Theme, Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia.,The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Clayton, VIC, Australia
| | - Benjamin W Muir
- The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Clayton, VIC, Australia
| | - Helmut Thissen
- The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Clayton, VIC, Australia
| | - Andrew Daley
- Department of Microbiology, The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - John S Forsythe
- Department of Materials Science and Engineering, Monash Institute of Medical Engineering, Monash University, Clayton, VIC, Australia
| | - Anton Y Peleg
- Infection and Immunity Theme, Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia.,Department of Infectious Diseases, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Trevor Lithgow
- Infection and Immunity Theme, Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, Australia
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21
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Coagulase-negative staphylococci in outpatient routines: the implications of switching from CLSI to BrCAST/EUCAST guidelines. Braz J Microbiol 2020; 51:1071-1078. [PMID: 32328965 DOI: 10.1007/s42770-020-00278-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/16/2020] [Indexed: 12/20/2022] Open
Abstract
Coagulase-negative staphylococci (CoNS) are frequently isolated in clinical specimens and are important reservoirs of resistance genes. In 2019, the Brazilian government set the BrCAST/EUCAST (Brazilian Committee on Antimicrobial Susceptibility Testing) guidelines as the national standard, resulting in changes in the interpretation of CoNS susceptibility tests. From outpatients, disk-diffusion susceptibility of 65 CoNS cultures were evaluated and compared using classification criteria from both CLSI and BrCAST/EUCAST. The isolates were identified using matrix assisted laser desorption ionization-time of flight (MALDI-TOF), and the presence of the mecA gene was determined. The most prevalent species were Staphylococcus saprophyticus (32.3%), S. haemolyticus (18.5%), and S. epidermidis (9.2%). Almost perfect agreement was seen between the guidelines, except concerning oxacillin and gentamicin, and the prevalence of multidrug resistant isolates increased with the use of BrCAST/EUCAST. Of all, 15 (23.1%) isolates, mainly S. epidermidis and S. haemolyticus, were positive for the mecA gene, and only three were detected when using CLSI or BrCAST/EUCAST disk-diffusion screening. This, using either guideline, could reveal the difficulty of determining oxacillin resistance. Using warning zones or molecular methods might well be indicated for CoNS. In conclusion, adoption of the BrCAST/EUCAST guidelines will result in certain artificial changes in epidemiological susceptibility profiles, and clinicians and institutions should be aware of the possible implications.
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22
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Asai N, Sakanashi D, Suematsu H, Kato H, Hagihara M, Watanabe H, Shiota A, Koizumi Y, Yamagishi Y, Mikamo H. Clinical characteristics and relevance of coagulase-negative Staphylococci other than S. epidermidis by positive blood culture. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 54:632-638. [PMID: 32299785 DOI: 10.1016/j.jmii.2020.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/21/2020] [Accepted: 03/03/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Staphylococci is the most commonly isolated bacteria in blood cultures (BC), and is mostly regarded as contamination. However, the clinical relevance and characteristics of CNS other than Staphylococcus epidermidis (Non-SE-CNS) is still unknown. METHODS For the purpose of clarifying the epidemiology and clinical significance of Non-Se-CNS infections, we retrospectively evaluated BC isolates of Non-Se-CNS at our institute from May 2013 to March 2017. Infections were defined as true bacteremia if (1) two or more positive BCs of the same species were present (or detection of the same species in another clinically relevant sample), (2) the patient had clinical symptoms as outlined in the Centers for Disease Control and Prevention's definition of primary blood stream infection8 and the symptoms or markers of inflammation (e.g., fever, symptoms, white cell counts, C-reactive protein, or procalcitonin) were improved after pathogen-directed therapy (e.g. either antibiotic therapy and/or removal of the foreign body in the case of catheter-related blood stream infections suspected) and (3) without any other infection. RESULTS During the period, 279 patients with BC positive for Non Se-CNS were identified. 44 patients were excluded, either due to missing data or multiple pathogens in the same BC. Among the remaining 235 patients, 67 (29%) were categorized as true bacteremia (n = 43) or possible infections (n = 24). Resistance rate to methicillin among Non-SE-CNS is about 60%, which is lower than those among S. epidermidis of 78%. CONCLUSION About 30% of Non-Se-CNS isolates were clinically relevant in our study. Antibiotic susceptibility of Non-SE-CNS is quite different than those of S. epidermidis.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Szemraj M, Grazul M, Balcerczak E, Szewczyk EM. Staphylococcal species less frequently isolated from human clinical specimens - are they a threat for hospital patients? BMC Infect Dis 2020; 20:128. [PMID: 32046678 PMCID: PMC7014773 DOI: 10.1186/s12879-020-4841-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/31/2020] [Indexed: 11/23/2022] Open
Abstract
Background Coagulase-negative staphylococci belonging to S. haemolyticus, S. hominis subsp. hominis, S. simulans, and S. warneri are often described as etiological factors of infections. Staphylococci are a phylogenetically coherent group; nevertheless, there are differences among the species which may be important to clinicians. Methods We investigated selected virulence factors and antibiotic resistance that were phenotypically demonstrated, the presence and expression of genes encoding the virulence factors, and the type of the SCCmec cassette. Results The differences between the tested species were revealed. A great number of isolates produced a biofilm and many of them contained single icaADBC operon genes. Clear differences between species in the lipolytic activity spectrum could be related to their ability to cause various types of infections. Our studies also revealed the presence of genes encoding virulence factors homologous to S. aureus in the analysed species such as enterotoxin and pvl genes, which were also expressed in single isolates of S. simulans and S. warneri. S. haemolyticus and S. hominis subsp. hominis isolates were resistant to all clinically important antibiotics including ß-lactams. The identified SCCmec cassettes belonged to IV, V, VII, and IX type but most of the detected cassettes were non-typeable. Among the investigated species, S. hominis subsp. hominis isolates accumulated virulence genes typical for S. aureus in the most efficient way and were widely resistant to antibiotics. Conclusions Our results clearly indicated significant differences between the tested species, which might be a result of the horizontal gene transfer (HGT) and can lead to the formation and selection of multi-drug resistant strains as well as strains with new virulence features. Such strains can have a new clinical relevance.
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Affiliation(s)
- Magdalena Szemraj
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Pomorska 137, 90-235, Łódź, Poland.
| | - Magdalena Grazul
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Pomorska 137, 90-235, Łódź, Poland
| | - Ewa Balcerczak
- Department of Pharmaceutical Biochemistry and Molecular Diagnostic, Laboratory of Molecular Diagnostic and Pharmacogenomics, Medical University of Lodz, Łódź, Poland
| | - Eligia M Szewczyk
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Pomorska 137, 90-235, Łódź, Poland
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Tran P, Dowell E, Hamilton S, Dolan SA, Messacar K, Dominguez SR, Todd J. Two Blood Cultures With Age-Appropriate Volume Enhance Suspected Sepsis Decision-Making. Open Forum Infect Dis 2020; 7:ofaa028. [PMID: 32055641 PMCID: PMC7009551 DOI: 10.1093/ofid/ofaa028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 01/24/2020] [Indexed: 11/14/2022] Open
Abstract
Background Multiple blood cultures have been shown to improve pathogen yield and antimicrobial stewardship for adult patients with suspected serious bacterial infection (SBI). For children, the use of multiple blood cultures is less common and volume recommendations are more complicated, often resulting in single cultures with low volume. Methods In 2010, Children’s Hospital Colorado instituted electronic medical record (EMR) decision support to recommend collection of 2 blood cultures before administration of antibiotics for suspected SBI. Recommended blood culture volumes were calculated by age rather than weight. We evaluated all children admitted to inpatient units between 2008 and 2009 (pre-intervention) and 2011 and 2013 (postintervention) who received antibiotics in the hospital after having blood cultures drawn in the emergency department, excluding those with a length of stay >8 days. We compared blood culture yield, isolate classification (pathogen vs contaminant), and antimicrobial modifications before and after the interventions. Results A total of 3948 children were included in the study. EMR guidelines were associated with a significantly higher number of children with multiple blood cultures drawn before antibiotic administration (88.0% vs 12.3%; P < .001) and an increased percentage of blood cultures with the recommended volume (74.3% vs 15.2%; P < .001), resulting in a significantly higher pathogen isolation rate and improved antimicrobial decisions. Multiple cultures helped define the role of common contaminants in the clinical decision process. Conclusions Multiple blood cultures with age-based volumes taken before starting antibiotics increase pathogen isolation rates and appropriate modification of antimicrobial treatment in children.
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Affiliation(s)
- Paul Tran
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Elaine Dowell
- Department of Pathology, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Stacey Hamilton
- Department of Pathology, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Susan A Dolan
- Department of Infectious Diseases and Epidemiology, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Kevin Messacar
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Samuel R Dominguez
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.,Department of Pathology, Children's Hospital Colorado, Aurora, Colorado, USA.,Department of Infectious Diseases and Epidemiology, Children's Hospital Colorado, Aurora, Colorado, USA
| | - James Todd
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.,Department of Infectious Diseases and Epidemiology, Children's Hospital Colorado, Aurora, Colorado, USA
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25
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Oladipo AO, Oladipo OG, Bezuidenhout CC. Multi-drug resistance traits of methicillin-resistant Staphylococcus aureus and other Staphylococcal species from clinical and environmental sources. JOURNAL OF WATER AND HEALTH 2019; 17:930-943. [PMID: 31850900 DOI: 10.2166/wh.2019.177] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Multi-drug resistance traits of Staphylococcus species especially methicillin-resistant Staphylococcus aureus (MRSA) in the clinical settings are well established. Of environmental concern is hospital effluents discharging into wastewaters. This article investigated the prevalence and detection of antibiotic resistance genes in Staphylococcus species from clinical and environmental sources in Ile-Ife, Nigeria. Standard culture-based and molecular protocols were used. Seventy-six (27 clinical, 14 hospital effluent and 35 environmental) Staphylococcus isolates were recovered: 56.58% were coagulase-negative and 43.42% coagulase-positive (S. aureus). For the clinical isolates, 10, 6, 4, 4 and 1 were isolated from urine, skin, wounds, blood and pus, respectively. Isolates were resistant to methicillin and amoxycillin (91.7%), cloxacillin (88.0%), ciprofloxacin (84.0%), ofloxacin (83.3%), azithromycin (78.0%), ceftazidime (76.0%), gentamycin (75.0%), cefuroxime (75.0%) and erythromycin (72.0%). Nearly, all isolates (90.8%) had multiple antibiotic resistance (MAR) index >0.2. Overall MAR indices for Staphylococcus species isolated from the clinical, hospital effluent and environmental wastewaters were relatively similar (0.482; 0.500; 0.435). mecA, nuc and luk-pvl genes were detected in S. aureus, while mecA was detected in S. arlettae, S. sciuri, S. cohnii, S. epidermidis and S. saprophyticus. This study informs on the potential contamination of environmental waters downstream from hospitals and possible impacts that this could have on human and animal health.
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Affiliation(s)
- Adegboyega O Oladipo
- Unit for Environmental Sciences and Management: Microbiology, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa E-mail: ; Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), P.M.B 5538, Ile-Ife, Nigeria
| | - Oluwatosin G Oladipo
- Unit for Environmental Sciences and Management: Microbiology, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa E-mail:
| | - Cornelius C Bezuidenhout
- Unit for Environmental Sciences and Management: Microbiology, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa E-mail:
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Chen S, Liu S, Yuan X, Mai H, Lin J, Wen F. Etiology, drug sensitivity profiles and clinical outcome of bloodstream infections: A retrospective study of 784 pediatric patients with hematological and neoplastic diseases. Pediatr Hematol Oncol 2019; 36:482-493. [PMID: 31718370 DOI: 10.1080/08880018.2019.1667462] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Bloodstream infections (BSI) represent one of the most serious complications in patients in the hematology-oncology unit. In this study, the prevalence, distribution, drug sensitivity profiles, and clinical outcome of BSI were analyzed in pediatric patients with hematological malignancies. Patients admitted to the pediatric hematology-oncology unit at Shenzhen Children's Hospital (Shenzen, China) between January 2016 and December 2017 were enrolled. Their medical records, including gender, age, primary diseases, and microbiology results of all clinical specimens, were reviewed. The incidence of BSI, microbiology characteristics, and effectiveness of antimicrobial therapy were analyzed. A total of 125 BSI cases in 108 patients (mean age, 5.5 years) were recorded, of which 69 (55.2%) were nosocomial BSI cases. The overall rate of BSI was 18.8% in the hematology-oncology unit, of which 75 (75.2%) episodes were neutropenic patients. Patients with nosocomial BSIs and the neutropenic group were older (p#.02, p#.03). HSCTs and AML were more often observed in nosocomial BSIs, while solid tumors were more found in nonnosocomial and non-neutropenic BSIs. BSIs were dominated by Gram-negative pathogens (49.6%) in the hematology-oncology unit compared with Gram-positive pathogens (39.2%). The most common pathogens were coagulase-negative Staphylococcus (24.2%) followed by Klebsiella pneumonia (15.2%), Escherichia coli (12.5%), viridans streptococci (8.2%), and Candida species (7.8%). The antibiotic therapy success rate in patients was 93.5%. Based on our center's experience, Gram-negative pathogens were commonly observed among pediatric hematology-oncology patients with BSI. Coagulase-negative Staphylococcus and K. pneumoniae predominated and antibiotic therapy was effective in these patients.
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Affiliation(s)
- Senmin Chen
- Department of Pediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China.,Hematology and Oncology Department, Shenzhen Children's Hospital, Shenzhen, China
| | - Sixi Liu
- Hematology and Oncology Department, Shenzhen Children's Hospital, Shenzhen, China
| | - Xiuli Yuan
- Hematology and Oncology Department, Shenzhen Children's Hospital, Shenzhen, China
| | - Huirong Mai
- Hematology and Oncology Department, Shenzhen Children's Hospital, Shenzhen, China
| | - Junrong Lin
- Hematology and Oncology Department, Shenzhen Children's Hospital, Shenzhen, China
| | - Feiqiu Wen
- Department of Pediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China.,Hematology and Oncology Department, Shenzhen Children's Hospital, Shenzhen, China
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Honkanen M, Jämsen E, Karppelin M, Huttunen R, Eskelinen A, Syrjänen J. Periprosthetic Joint Infections as a Consequence of Bacteremia. Open Forum Infect Dis 2019; 6:ofz218. [PMID: 31214625 PMCID: PMC6565379 DOI: 10.1093/ofid/ofz218] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/06/2019] [Indexed: 01/17/2023] Open
Abstract
Background The risk for developing a periprosthetic joint infection (PJI) during bacteremia is unclear, except for Staphylococcus aureus bacteremia. The aim of this study was to examine the risk for developing a PJI during bacteremia and to identify possible risk factors leading to it. Methods Patients with a primary knee or hip joint replacement performed in a tertiary care hospital between September 2002 and December 2013 were identified (n = 14 378) and followed up until December 2014. Positive blood culture results during the study period and PJIs were recorded. PJIs associated with an episode of bacteremia were identified and confirmed from patient records. Potential risk factors for PJI among those with bacteremia were examined using univariate logistic regression. Results A total of 542 (3.8%) patients had at least 1 episode of bacteremia. Seven percent (47/643) of the bacteremias resulted in a PJI. Development of a PJI was most common for Staphylococcus aureus (21% of bacteremias led to a PJI) and beta-hemolytic streptococci (21%), whereas it was rare for gram-negative bacteria (1.3%). Having ≥2 bacteremias during the study period increased the risk for developing a PJI (odds ratio, 2.29; 95% confidence interval, 1.17–4.50). The risk for developing a PJI was highest for bacteremias occurring within a year of previous surgery. Chronic comorbidities did not affect the risk for PJI during bacteremia. Conclusions The development of a PJI during bacteremia depends on the pathogen causing the bacteremia and the timing of bacteremia with respect to previous joint replacement surgery. However, significant patient-related risk factors for PJI during bacteremia could not be found.
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Affiliation(s)
- Meeri Honkanen
- Department of Internal Medicine, Tampere University Hospital, Tampere University, Tampere, Finland
| | - Esa Jämsen
- Coxa Hospital for Joint Replacement, Tampere and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Matti Karppelin
- Department of Internal Medicine, Tampere University Hospital, Tampere University, Tampere, Finland
| | - Reetta Huttunen
- Department of Internal Medicine, Tampere University Hospital, Tampere University, Tampere, Finland
| | - Antti Eskelinen
- Coxa Hospital for Joint Replacement, Tampere and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jaana Syrjänen
- Department of Internal Medicine, Tampere University Hospital, Tampere University, Tampere, Finland
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Brüggemann H, Poehlein A, Brzuszkiewicz E, Scavenius C, Enghild JJ, Al-Zeer MA, Brinkmann V, Jensen A, Söderquist B. Staphylococcus saccharolyticus Isolated From Blood Cultures and Prosthetic Joint Infections Exhibits Excessive Genome Decay. Front Microbiol 2019; 10:478. [PMID: 30915059 PMCID: PMC6423177 DOI: 10.3389/fmicb.2019.00478] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 02/25/2019] [Indexed: 12/27/2022] Open
Abstract
The slow-growing, anaerobic, coagulase-negative species Staphylococcus saccharolyticus is found on human skin and in clinical specimens but its pathogenic potential is unclear. Here, we investigated clinical isolates and sequenced the genomes of seven strains of S. saccharolyticus. Phylogenomic analyses showed that the closest relative of S. saccharolyticus is Staphylococcus capitis with an average nucleotide identity of 80%. Previously sequenced strains assigned to S. saccharolyticus are misclassified and belong to S. capitis. Based on single nucleotide polymorphisms of the core genome, the population of S. saccharolyticus can be divided into two clades that also differ in a few larger genomic islands as part of the flexible genome. An unexpected feature of S. saccharolyticus is extensive genome decay, with over 300 pseudogenes, indicating ongoing reductive evolution. Many genes of the core metabolism are not functional, rendering the species auxotrophic for several amino acids, which could explain its slow growth and need for fastidious growth conditions. Secreted proteins of S. saccharolyticus were determined; they include stress response proteins such as heat and oxidative stress-related factors, as well as immunodominant staphylococcal surface antigens and enzymes that can degrade host tissue components. The strains secrete lipases and a hyaluronic acid lyase. Hyaluronidase as well as urease activities were detected in biochemical assays, with clade-specific differences. Our study revealed that S. saccharolyticus has adapted its genome, possibly due to a recent change of habitat; moreover, the data imply that the species has tissue-invasive potential and might cause prosthetic joint infections.
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Affiliation(s)
| | - Anja Poehlein
- Department of Genomic and Applied Microbiology, Institute of Microbiology and Genetics, University of Göttingen, Göttingen, Germany
| | - Elzbieta Brzuszkiewicz
- Department of Genomic and Applied Microbiology, Institute of Microbiology and Genetics, University of Göttingen, Göttingen, Germany
| | - Carsten Scavenius
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus, Denmark
| | - Jan J Enghild
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus, Denmark
| | - Munir A Al-Zeer
- Department of Applied Biochemistry, Institute of Biotechnology, Technical University of Berlin, Berlin, Germany
| | - Volker Brinkmann
- Microscopy Core Facility, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Anders Jensen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Bo Söderquist
- Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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29
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Dutta TK, Chakraborty S, Das M, Mandakini R, Vanrahmlimphuii, Roychoudhury P, Ghorai S, Behera SK. Multidrug-resistant Staphylococcus pettenkoferi isolated from cat in India. Vet World 2018; 11:1380-1384. [PMID: 30532490 PMCID: PMC6247871 DOI: 10.14202/vetworld.2018.1380-1384] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/21/2018] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Coagulase-negative staphylococci (CoNS) are considered to be one of the emerging pathogens in human and animals in recent times. Staphylococcus pettenkoferi, a novel pathogen under CoNS, is discovered in 2002 in humans with multiple clinical manifestations in various patients. To date, the pathogens have not yet been reported from any animals. The present study reported the first ever isolation, identification, and characterization of multidrug-resistant S. pettenkoferi from a cat with peritonitis in India. Materials and Methods: Peritoneal fluid was collected aseptically from 3 years old cat processed for bacteriological culture by standard techniques. Isolates were confirmed by BD Phoenix™ automated bacterial identification system and were subjected to plate and tube coagulase tests. All the isolates were tested for antimicrobial sensitivity profile by disc diffusion assay, extended-spectrum β-lactamase production by double disc diffusion assay, in vitro biofilm production ability by microtiter plate assay, and detection of virulence genes and mecA gene by polymerase chain reaction assay. Results: A total of five clonally expanded isolates of S. pettenkoferi were isolated from peritoneal fluid of the affected cat. All the isolates were resistant against 36 antimicrobial agents and were also methicillin-resistant staphylococci. Phenotypically, all the isolates were negative for biofilm production but were carrying multiple biofilm-producing genes (icaA, IS257, nuc, and mecA). Conclusion: Although S. pettenkoferi was previously reported once from animal (cat) environment, this is probably the first ever report of isolation of the organism directly from any animals. This is also probably the first report from any species in India.
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Affiliation(s)
- Tapan Kumar Dutta
- Department of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl - 796 014, Mizoram, India
| | - Satyaki Chakraborty
- Department of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl - 796 014, Mizoram, India
| | - Malay Das
- Department of Veterinary Public Health and Epidemiology, Central Agricultural University-Imphal, Selesih, Aizawl - 796 014, Mizoram, India
| | - Rajkumari Mandakini
- Department of Veterinary Microbiology, Central Agricultural University-Imphal, Jalukie, Nagaland-India
| | - Vanrahmlimphuii
- Department of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl - 796 014, Mizoram, India
| | - Parimal Roychoudhury
- Department of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl - 796 014, Mizoram, India
| | - Santanu Ghorai
- Department of Veterinary Medicine, Central Agricultural University-Imphal, Selesih, Aizawl - 796 014, Mizoram, India
| | - Suvendu Kumar Behera
- Department of Veterinary Medicine, Central Agricultural University-Imphal, Selesih, Aizawl - 796 014, Mizoram, India
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Pindar C, Viau RA. Staphylococcus haemolyticus epididymo-orchitis and bacteraemia: a case report. JMM Case Rep 2018; 5:e005157. [PMID: 30275960 PMCID: PMC6159547 DOI: 10.1099/jmmcr.0.005157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/08/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Although more often recognized as a culprit in female urinary tract infection, coagulase-negative staphylococci (CoNS) can cause severe genitourinary infections in men. While positive blood cultures with CoNS are usually thought to be contaminants, in the setting of a severe genito-urinary infection they can represent true infection. Case presentation We present the case of a 70-year-old male without a central venous catheter or urinary catheter who developed Staphylococcus haemolyticus bloodstream infection secondary to epididymo-orchitis. Conclusion This case highlights the importance of prompt recognition of serious CoNS infections, including bacteraemia, in the setting of CoNS genitourinary tract infections.
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Affiliation(s)
- Christina Pindar
- Case Western Reserve, University School of Medicine, Cleveland, OH 44106, USA
| | - Roberto A Viau
- Case Western Reserve, University School of Medicine, Cleveland, OH 44106, USA.,Department of Medicine, Case Western Reserve University, Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA
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Dargère S, Cormier H, Verdon R. Contaminants in blood cultures: importance, implications, interpretation and prevention. Clin Microbiol Infect 2018; 24:964-969. [DOI: 10.1016/j.cmi.2018.03.030] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 03/17/2018] [Accepted: 03/20/2018] [Indexed: 11/24/2022]
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Frickmann H, Hahn A, Skusa R, Mund N, Viehweger V, Köller T, Köller K, Schwarz NG, Becker K, Warnke P, Podbielski A. Comparison of the etiological relevance of Staphylococcus haemolyticus and Staphylococcus hominis. Eur J Clin Microbiol Infect Dis 2018; 37:1539-1545. [PMID: 29777490 DOI: 10.1007/s10096-018-3282-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/10/2018] [Indexed: 01/19/2023]
Abstract
The study was performed to assess potential differences in the etiological relevance of two coagulase-negative staphylococci (CoNS), Staphylococcus haemolyticus and Staphylococcus hominis, in an observational single-center study. Over a 5-year interval, patients in whom there was detected S. haemolyticus or S. hominis of presumed etiological relevance were assessed for the primary endpoint death during hospital stay and the secondary endpoint transfer to an intensive care unit (ICU) after the detection of S. haemolyticus or S. hominis. Patients with S. haemolyticus or S. hominis died in 11.3% (50 out of 444) and 9.5% (60 out of 631) of cases, respectively, and were transferred to ICU after S. haemolyticus and S. hominis detection in 8.7% (19 out of 219) and 11.7% (44 out of 377) of cases, respectively. There was no significance for species-related influence on the primary outcome parameter (P > 0.1), while ICU transfers were more likely for patients with S. hominis detections (P = 0.016). Delayed diagnosis of both CoNS species was associated with an increased probability of death (P = 0.009). The study revealed comparable morbidity caused by S. haemolyticus and S. hominis identified in a clinically relevant context.
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Affiliation(s)
- Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Bernhard Nocht Str. 74, 20359, Hamburg, Germany. .,Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany.
| | - Andreas Hahn
- Institute for Microbiology, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Romy Skusa
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
| | - Nils Mund
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
| | - Vivian Viehweger
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
| | - Thomas Köller
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
| | - Kerstin Köller
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
| | - Norbert Georg Schwarz
- Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine Hamburg, Bernhard Nocht Str. 74, 20359, Hamburg, Germany
| | - Karsten Becker
- Institute of Medical Microbiology, University Hospital Münster, Domagkstraße 10, 48149, Münster, Germany
| | - Philipp Warnke
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
| | - Andreas Podbielski
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Schillingallee 70, 18057, Rostock, Germany
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Pedroso SHSP, Sandes SHC, Filho RAT, Nunes AC, Serufo JC, Farias LM, Carvalho MAR, Bomfim MRQ, Santos SG. Coagulase-Negative Staphylococci Isolated from Human Bloodstream Infections Showed Multidrug Resistance Profile. Microb Drug Resist 2018; 24:635-647. [PMID: 29683776 DOI: 10.1089/mdr.2017.0309] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Coagulase-negative staphylococci (CNS) are important pathogens causing nosocomial infections worldwide with increasing resistance to antimicrobials. The aim of this study was to characterize resistance aspects of CNS isolated from patients with bloodstream infections acquired in hospitals in Belo Horizonte, MG, Brazil. Staphylococcus strains were characterized using repetitive sequence-based polymerase chain reaction (rep-PCR) fingerprinting with (GTG)5 primer. Phenotypic resistance was analyzed using AST-P5085 card (bioMérieuxVitek®). PCR was used to detect mecA, vanA, blaZ, ermA/B/C, aac-aphD, and SCC-mec. For statistical analyses, we used hierarchical cluster, chi-square test (χ2), and correspondence. Several clusters were formed within the same species using (GTG)5 primer, and strains showed resistance to the following antimicrobials: benzylpenicillin (100%); oxacillin (93.1%); gentamicin (36.3%); ciprofloxacin (63.7%); moxifloxacin (32.7%); norfloxacin (81.0%); erythromycin (86.2%); clindamycin (75.8%); linezolid, teicoplanin and vancomycin (1.7%); tigecycline (0%); fusidic acid (10.35%); rifampicin (13.7%); and trimethoprim/sulfamethoxazole (46.5%). Regarding genotypic analyses, 40%, 0%, 78%, 42%, 100%, 24%, and 30% were positive for mecA, vanA, blaZ, ermA, ermB, ermC, and aac-aphD, respectively. Regarding staphylococcal cassette mec (SCCmec) type, 3.4% presented type I; 5.0% type II; 27.1% type III; 20.3% type IIIA; and 32.2% type IIIB. Six clusters were formed and frequency distributions of resistant strains to oxacillin, gentamicin, ciprofloxacin, moxifloxacin, norfloxacin, erythromycin, clindamycin, linezolid, teicoplanin, vancomycin, fusidic acid, rifampicin, and trimethoprim/sulfamethoxazole, and mecA, blaZ, ermC, aac-aphD, and SCCmec type differed (p < 0.001). In conclusion, the strains investigated in this study were multidrug resistant and carried multiple antibiotic resistance genes.
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Affiliation(s)
- Silvia H S P Pedroso
- 1 Departamento de Microbiologia, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Savio H C Sandes
- 2 Departamento de Biologia Geral, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Robledo A T Filho
- 3 Departamento de Engenharia de Alimentos, Universidade Federal de Viçosa , Florestal, Brasil
| | - Alvaro C Nunes
- 2 Departamento de Biologia Geral, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Jose C Serufo
- 4 Departamento de Clínica Médica, Faculdade de Medicina, UFMG, Universidade Federal de Minas Gerais , Belo Horizonte, Brasil
| | - Luiz M Farias
- 1 Departamento de Microbiologia, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Maria A R Carvalho
- 1 Departamento de Microbiologia, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Maria R Q Bomfim
- 5 Departamento de Parasitologia e Biologia, Centro Universitário do Maranhão , São Luís, Brasil
| | - Simone G Santos
- 1 Departamento de Microbiologia, Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Hong SB, Baek YH. Study on the Contamination of Methicillin-Resistant Staphylococcus(MRS) in a High School Environment. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2017. [DOI: 10.15324/kjcls.2017.49.4.420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Seung Bok Hong
- Department of Clinical Laboratory Science, Chungbuk Health & Science University, Cheongju, Korea
| | - Yun Hee Baek
- Department of Microbiology, Chungbuk National University College of Medicine, Cheongju, Korea
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Da F, Joo HS, Cheung GYC, Villaruz AE, Rohde H, Luo X, Otto M. Phenol-Soluble Modulin Toxins of Staphylococcus haemolyticus. Front Cell Infect Microbiol 2017; 7:206. [PMID: 28596942 PMCID: PMC5442197 DOI: 10.3389/fcimb.2017.00206] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/08/2017] [Indexed: 12/12/2022] Open
Abstract
Coagulase-negative staphylococci (CoNS) are important nosocomial pathogens and the leading cause of sepsis. The second most frequently implicated species, after Staphylococcus epidermidis, is Staphylococcus haemolyticus. However, we have a significant lack of knowledge about what causes virulence of S. haemolyticus, as virulence factors of this pathogen have remained virtually unexplored. In contrast to the aggressive pathogen Staphylococcus aureus, toxin production has traditionally not been associated with CoNS. Recent findings have suggested that phenol-soluble modulins (PSMs), amphipathic peptide toxins with broad cytolytic activity, are widespread in staphylococci, but there has been no systematic assessment of PSM production in CoNS other than S. epidermidis. Here, we identified, purified, and characterized PSMs of S. haemolyticus. We found three PSMs of the β-type, which correspond to peptides that before were described to have anti-gonococcal activity. We also detected an α-type PSM that has not previously been described. Furthermore, we confirmed that S. haemolyticus does not produce a δ-toxin, as results from genome sequencing had indicated. All four S. haemolyticus PSMs had strong pro-inflammatory activity, promoting neutrophil chemotaxis. Notably, we identified in particular the novel α-type PSM, S. haemolyticus PSMα, as a potent hemolysin and leukocidin. For the first time, our study describes toxins of this important staphylococcal pathogen with the potential to have a significant impact on virulence during blood infection and sepsis.
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Affiliation(s)
- Fei Da
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesda, MD, United States.,Department of Pharmacology, School of Pharmacy, Fourth Military Medical UniversityXi'an, China
| | - Hwang-Soo Joo
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesda, MD, United States
| | - Gordon Y C Cheung
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesda, MD, United States
| | - Amer E Villaruz
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesda, MD, United States
| | - Holger Rohde
- Institute of Medical Microbiology, Virology, and Hygiene, University Hospital Hamburg-EppendorfHamburg, Germany
| | - Xiaoxing Luo
- Department of Pharmacology, School of Pharmacy, Fourth Military Medical UniversityXi'an, China
| | - Michael Otto
- Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesda, MD, United States
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