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Inagawa T, Hisatsune J, Kutsuno S, Iwao Y, Koba Y, Kashiyama S, Ota K, Shime N, Sugai M. Genomic characterization of Staphylococcus aureus isolated from patients admitted to intensive care units of a tertiary care hospital: epidemiological risk of nasal carriage of virulent clone during admission. Microbiol Spectr 2024; 12:e0295023. [PMID: 38709078 DOI: 10.1128/spectrum.02950-23] [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: 07/26/2023] [Accepted: 04/05/2024] [Indexed: 05/07/2024] Open
Abstract
We conducted a molecular epidemiological study of Staphylococcus aureus using whole-genome sequence data and clinical data of isolates from nasal swabs of patients admitted to the intensive care unit (ICU) of Hiroshima University hospital. The relationship between isolate genotypes and virulence factors, particularly for isolates that caused infectious diseases during ICU admission was compared with those that did not. The nasal carriage rates of methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) in patients admitted to the ICU were 7.0% and 20.1%, respectively. The carriage rate of community-acquired (CA)-MRSA was 2.3%, accounting for 32.8% of all MRSA isolates. Whole-genome sequencing analysis of the MRSA isolates indicated that most, including CA-MRSA and healthcare-associated (HA)-MRSA, belonged to clonal complex (CC) 8 [sequence type (ST) 8] and SCCmec type IV. Furthermore, results for three disease foci (pneumonia, skin and soft tissue infection, and deep abscess) and the assessment of virulence factor genes associated with disease conditions [bacteremia, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC), and septic shock] suggested that nasal colonization of S. aureus clones could represent a risk for patients within the ICU. Particularly, MRSA/J and MSSA/J may be more likely to cause deep abscess infection; ST764 may cause ventilation-associated pneumonia, hospital-acquired pneumonia and subsequent bacteremia, and ARDS, and tst-1-positive isolates may cause DIC onset.IMPORTANCENasal colonization of MRSA in patients admitted to the intensive care unit (ICU) may predict the development of MRSA infections. However, no bacteriological data are available to perform risk assessments for Staphylococcus aureus infection onset. In this single-center 2-year genomic surveillance study, we analyzed all S. aureus isolates from nasal swabs of patients admitted to the ICU and those from the blood or lesions of in-patients who developed infectious diseases in the ICU. Furthermore, we identified the virulent clones responsible for causing infectious diseases in the ICU. Herein, we report several virulent clones present in the nares that are predictive of invasive infections. This information may facilitate the design of preemptive strategies to identify and eradicate virulent MRSA strains, reducing nosocomial infections within the ICU.
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Affiliation(s)
- Takahiro Inagawa
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Junzo Hisatsune
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Shoko Kutsuno
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yasuhisa Iwao
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yumiko Koba
- Section of Clinical Laboratory, Division of Clinical Support, Hiroshima University Hospital, Hiroshima, Japan
- Division of Laboratory Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Seiya Kashiyama
- Section of Clinical Laboratory, Division of Clinical Support, Hiroshima University Hospital, Hiroshima, Japan
- Division of Laboratory Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Kohei Ota
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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2
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Ogihara S, Yamaguchi T, Sato T, Aoki K, Komori K, Sasaki M, Murakami H, Ishii Y, Tateda K. Assessing the discriminability of PCR-based open reading frame typing versus single-nucleotide polymorphism analysis via draft whole-genome sequencing of methicillin-resistant Staphylococcus aureus in nosocomial transmission analysis. J Infect Chemother 2024:S1341-321X(24)00056-4. [PMID: 38437985 DOI: 10.1016/j.jiac.2024.02.021] [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: 01/05/2024] [Revised: 02/04/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
Phylogenetic analysis based on single-nucleotide polymorphism (SNP)-based through whole-genome sequencing is recognized as the standard method for probing nosocomial transmission. However, the application of WGS is constrained by the high cost of equipment and the need for diverse analysis tools, which limits its widespread use in clinical laboratory settings. In Japan, the prevalent use of PCR-based open reading frame typing (POT) for tracing methicillin-resistant Staphylococcus aureus (MRSA) transmission routes is attributed to its simplicity and ease of use. Although POT's discriminatory power is considered insufficient for nosocomial transmission analysis, conclusive data supporting this notion is lacking. This study assessed the discriminatory capabilities of SNP analysis and POT across 64 clinical MRSA strains. All 21 MRSA strains of ST5/SCCmec IIa, having more than 16 SNPs, demonstrated distinct clones. Conversely, two strains shared the same POT number and were identified as group A. Among the 12 MRSA strains of ST8/SCCmec IVl with over nine SNPs, five fell into POT group B, and five into POT group C. All four MRSA strains of ST8/SCCmec IVa were classified into POT group D, although they included strains with more than 30 SNPs. Among the 27 MRSA strains of ST1/SCCmec IVa, 14 were classified into POT group E. However, except for two clusters (each comprising two or three strains), all had SNP counts >10 (Fig.1-D). SNP analysis of MRSA in CC1/SCCmec IV showed that several strains had the same number of SNPs in POT number (106-183-37), even among bacteria with >100 SNPs, indicating POT's limited use in detailed nosocomial transmission analysis.
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Affiliation(s)
- Shinji Ogihara
- Department of Clinical Laboratory, Toho University Omori Medical Center, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan; Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan
| | - Tetsuo Yamaguchi
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan.
| | - Takahiro Sato
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan; Department of General Medicine and Emergency Care, Toho University Omori 12 Medical Center, Tokyo, Japan
| | - Kotaro Aoki
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan
| | - Kohji Komori
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan
| | - Masakazu Sasaki
- Department of Clinical Laboratory, Toho University Omori Medical Center, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Hinako Murakami
- Department of Clinical Laboratory, Toho University Omori Medical Center, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan
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3
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Xiao Y, Han W, Wang B, Xu Y, Zhao H, Wang X, Rao L, Zhang J, Shen L, Zhou H, Hu L, Shi J, Yu J, Guo Y, Xia H, Yu F. Phylogenetic analysis and virulence characteristics of methicillin-resistant Staphylococcus aureus ST764-SCC mec II: an emerging hypervirulent clone ST764-t1084 in China. Emerg Microbes Infect 2023; 12:2165969. [PMID: 36628606 PMCID: PMC9870001 DOI: 10.1080/22221751.2023.2165969] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Previous studies have shown that the increased prevalent ST764 clone in China, Japan, and other Asian areas. However, the knowledge of the genetic features and virulence characteristics of methicillin-resistant Staphylococcus aureus (MRSA) ST764 in China is still limited. In this study, we identified 52 ST764-SCCmec type II isolates collected from five cities in China between 2014 and 2021. Whole genome sequencing showed that the most common staphylococcal protein A (spa) types of ST764 in China were t002 (55.78%) and t1084 (40.38%). Virulence assays showed that ST764-t1084 isolates had high haemolytic activity and α-toxin levels. Of the critical regulatory factors affecting α-toxin production, only the SaeRS was highly expressed in ST764-t1084 isolates. Mouse abscess model indicated that the virulence of ST764-t1084 isolates was comparable to that of S. aureus USA300-LAC famous for its hypervirulence. Interestingly, ST764-t002 isolates exhibited stronger biofilm formation and cell adhesion capacities than ST764-t1084 isolates. This seems to explain why ST764-t002 subclone has become more prevalent in China in recent years. Phylogenetic analysis suggested that all ST764 isolates from China in Clade III were closely related to KUN1163 (an isolate from Japan). Notably, genomic analysis revealed that the 52 ST764 isolates did not carry arginine catabolic mobile element (ACME), which differed from ST764 isolates in Japan. Additionally, most ST764 isolates (69.23%) harboured an obvious deletion of approximately 5 kb in the SCCmec II cassette region compared to KUN1163. Our findings shed light on the potential global transmission and genotypic as well as phenotypic characteristics of ST764 lineage.
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Affiliation(s)
- Yanghua Xiao
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China,School of Public Health, Nanchang University, Nanchang, People’s Republic of China
| | - Weihua Han
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Bingjie Wang
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Yanlei Xu
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Huilin Zhao
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Xinyi Wang
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Lulin Rao
- Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Jiao Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Li Shen
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Hui Zhou
- Department of Bioinformatics, Hugobiotech, Beijing, People’s Republic of China
| | - Long Hu
- Department of Bioinformatics, Hugobiotech, Beijing, People’s Republic of China
| | - Junhong Shi
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Jingyi Yu
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Yinjuan Guo
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Han Xia
- Department of Bioinformatics, Hugobiotech, Beijing, People’s Republic of China, Han Xia Department of Bioinformatics, Hugobiotech, Beijing100022, People’s Republic of China; Fangyou Yu Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, People’s Republic of China
| | - Fangyou Yu
- Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China, Han Xia Department of Bioinformatics, Hugobiotech, Beijing100022, People’s Republic of China; Fangyou Yu Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433, People’s Republic of China
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4
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Mitsumoto-Kaseida F, Morinaga Y, Sasaki D, Ota K, Kaku N, Sakamoto K, Kosai K, Hasegawa H, Hayashi J, Yanagihara K. The clinical characteristics and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) among very elderly people in Japan. Geriatr Gerontol Int 2023; 23:744-749. [PMID: 37694453 DOI: 10.1111/ggi.14664] [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: 03/08/2023] [Revised: 08/02/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
AIM Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial infection-causing pathogen. The clonal shift from staphylococcal cassette chromosome mec (SCCmec) type II MRSA to SCCmec type IV MRSA has occurred rapidly in acute-care hospitals. However, the epidemiology and clinical impacts of MRSA in geriatric hospitals are poorly documented. We performed a molecular epidemiological analysis of the clinical isolates and retrospectively investigated the clinical characteristics of SCCmec type IV MRSA in elderly individuals. METHODS MRSA isolates were grouped according to the SCCmec type and virulence genes (tst, sea, seb, sec, and lukS/F-PV), and multi-locus sequence typing (MLST) was performed. RESULTS Of the 145 MRSA isolates obtained from patients with a median age of 85 years, 100 (69.0%) were obtained from sputum samples, 22 (15.2%) from skin and soft tissues, and seven (4.8%) from blood samples. The most prevalent clone was SCCmec type IV/clonal complex (CC)1/sea+ (59.3%), followed by SCCmec type I/sequence type (ST) 8 (17.3%). Of the 17 (11.7%) strains to which an anti-MRSA drug was administered by a physician, only three were SCCmec type IV/CC1/sea+ (17.6%) and five were SCCmec type I/ST8 (29.4%). SCCmec type IV/CC1/sea+ MRSA was more frequently isolated in long-term care wards than were SCCmec type I/ST8 strains (odds ratio: 2.85, 95% confidence interval: 1.08-7.54) and was less frequently treated as the cause of MRSA infections (odds ratio: 0.15, 95% confidence interval: 0.03-0.73). CONCLUSIONS SCCmec type IV/CC1/sea+ MRSA was the predominant clone and could be easily transmissible and be capable of colonization. Geriatr Gerontol Int 2023; 23: 744-749.
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Affiliation(s)
- Fujiko Mitsumoto-Kaseida
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Kyushu General Medicine Center, Haradoi Hospital, Fukuoka, Japan
| | - Yoshitomo Morinaga
- Department of Microbiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Daisuke Sasaki
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kenji Ota
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Norihito Kaku
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kei Sakamoto
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroo Hasegawa
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jun Hayashi
- Kyushu General Medicine Center, Haradoi Hospital, Fukuoka, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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5
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Interleukin-10 (IL-10) Produced by Mutant Toxic Shock Syndrome Toxin 1 Vaccine-Induced Memory T Cells Downregulates IL-17 Production and Abrogates the Protective Effect against Staphylococcus aureus Infection. Infect Immun 2019; 87:IAI.00494-19. [PMID: 31358568 DOI: 10.1128/iai.00494-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/23/2019] [Indexed: 11/20/2022] Open
Abstract
Development of long-term memory is crucial for vaccine-induced adaptive immunity against infectious diseases such as Staphylococcus aureus infection. Toxic shock syndrome toxin 1 (TSST-1), one of the superantigens produced by S. aureus, is a possible vaccine candidate against infectious diseases caused by this pathogen. We previously reported that vaccination with less toxic mutant TSST-1 (mTSST-1) induced T helper 17 (Th17) cells and elicited interleukin-17A (IL-17A)-mediated protection against S. aureus infection 1 week after vaccination. In the present study, we investigated the host immune response induced by mTSST-1 vaccination in the memory phase, 12 weeks after the final vaccination. The protective effect and IL-17A production after vaccination with mTSST-1 were eliminated because of IL-10 production. In the presence of IL-10-neutralizing monoclonal antibody (mAb), IL-17A production was restored in culture supernatants of CD4+ T cells and macrophages sorted from the spleens of vaccinated mice. Vaccinated mice treated with anti-IL-10 mAb were protected against systemic S. aureus infection in the memory phase. From these results, it was suggested that IL-10 produced in the memory phase suppresses the IL-17A-dependent vaccine effect through downregulation of IL-17A production.
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6
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Lv M, Zhang YJ, Zhou F, Ge Y, Zhao MH, Liu Y, Yang KW. Real-time monitoring of D-Ala-D-Ala dipeptidase activity of VanX in living bacteria by isothermal titration calorimetry. Anal Biochem 2019; 578:29-35. [DOI: 10.1016/j.ab.2019.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/17/2019] [Accepted: 05/03/2019] [Indexed: 02/07/2023]
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Choudhary KS, Mih N, Monk J, Kavvas E, Yurkovich JT, Sakoulas G, Palsson BO. The Staphylococcus aureus Two-Component System AgrAC Displays Four Distinct Genomic Arrangements That Delineate Genomic Virulence Factor Signatures. Front Microbiol 2018; 9:1082. [PMID: 29887846 PMCID: PMC5981134 DOI: 10.3389/fmicb.2018.01082] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/07/2018] [Indexed: 01/24/2023] Open
Abstract
Two-component systems (TCSs) consist of a histidine kinase and a response regulator. Here, we evaluated the conservation of the AgrAC TCS among 149 completely sequenced Staphylococcus aureus strains. It is composed of four genes: agrBDCA. We found that: (i) AgrAC system (agr) was found in all but one of the 149 strains, (ii) the agr positive strains were further classified into four agr types based on AgrD protein sequences, (iii) the four agr types not only specified the chromosomal arrangement of the agr genes but also the sequence divergence of AgrC histidine kinase protein, which confers signal specificity, (iv) the sequence divergence was reflected in distinct structural properties especially in the transmembrane region and second extracellular binding domain, and (v) there was a strong correlation between the agr type and the virulence genomic profile of the organism. Taken together, these results demonstrate that bioinformatic analysis of the agr locus leads to a classification system that correlates with the presence of virulence factors and protein structural properties.
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Affiliation(s)
- Kumari S Choudhary
- Systems Biology Research Group, Department of Bioengineering, University of California, San Diego, San Diego, CA, United States
| | - Nathan Mih
- Systems Biology Research Group, Department of Bioengineering, University of California, San Diego, San Diego, CA, United States.,Bioinformatics and Systems Biology Program, University of California, San Diego, San Diego, CA, United States
| | - Jonathan Monk
- Systems Biology Research Group, Department of Bioengineering, University of California, San Diego, San Diego, CA, United States
| | - Erol Kavvas
- Systems Biology Research Group, Department of Bioengineering, University of California, San Diego, San Diego, CA, United States
| | - James T Yurkovich
- Systems Biology Research Group, Department of Bioengineering, University of California, San Diego, San Diego, CA, United States.,Bioinformatics and Systems Biology Program, University of California, San Diego, San Diego, CA, United States
| | - George Sakoulas
- Department of Pediatrics, University of California, San Diego, San Diego, CA, United States
| | - Bernhard O Palsson
- Systems Biology Research Group, Department of Bioengineering, University of California, San Diego, San Diego, CA, United States.,Bioinformatics and Systems Biology Program, University of California, San Diego, San Diego, CA, United States.,Department of Pediatrics, University of California, San Diego, San Diego, CA, United States
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8
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Ogihara S, Saito R, Sawabe E, Kozakai T, Shima M, Aiso Y, Fujie T, Nukui Y, Koike R, Hagihara M, Tohda S. Molecular typing of methicillin-resistant Staphylococcus aureus: Comparison of PCR-based open reading frame typing, multilocus sequence typing, and Staphylococcus protein A gene typing. J Infect Chemother 2017; 24:312-314. [PMID: 29233460 DOI: 10.1016/j.jiac.2017.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/24/2017] [Accepted: 10/28/2017] [Indexed: 11/17/2022]
Abstract
The recently developed PCR-based open reading frame typing (POT) method is a useful molecular typing tool. Here, we evaluated the performance of POT for molecular typing of methicillin-resistant Staphylococcus aureus (MRSA) isolates and compared its performance to those of multilocus sequence typing (MLST) and Staphylococcus protein A gene typing (spa typing). Thirty-seven MRSA isolates were collected between July 2012 and May 2015. MLST, spa typing, and POT were performed, and their discriminatory powers were evaluated using Simpson's index analysis. The MRSA isolates were classified into 11, 18, and 33 types by MLST, spa typing, and POT, respectively. The predominant strains identified by MLST, spa typing, and POT were ST8 and ST764, t002, and 93-191-127, respectively. The discriminatory power of MLST, spa typing, and POT was 0.853, 0.875, and 0.992, respectively, indicating that POT had the highest discriminatory power. Moreover, the results of MLST and spa were available after 2 days, whereas that of POT was available in 5 h. Furthermore, POT is rapid and easy to perform and interpret. Therefore, POT is a superior molecular typing tool for monitoring nosocomial transmission of MRSA.
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Affiliation(s)
- Shinji Ogihara
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Ryoichi Saito
- Department of Microbiology and Immunology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
| | - Etsuko Sawabe
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan; Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Takahiro Kozakai
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Mari Shima
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Yoshibumi Aiso
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Toshihide Fujie
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Yoko Nukui
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Ryuji Koike
- Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Michio Hagihara
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Shuji Tohda
- Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
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9
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Miura Y, Yamaguchi T, Nakamura I, Koyama S, Tamai K, Okanda T, Matsumoto T. Epidemiological Trends Observed from Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Isolates from Blood Cultures at a Japanese University Hospital, 2012-2015. Microb Drug Resist 2017; 24:70-75. [PMID: 28708463 DOI: 10.1089/mdr.2017.0008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite increasing reports of skin and soft tissue infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Japan, the extent to which these strains cause nosocomial infections remains unknown, and this is especially true for bloodstream infections. In this study, we molecularly characterized MRSA isolates from Japanese blood samples. Among the 151 MRSA isolates collected from 53 medical facilities in 2011, 115 (76%) and 30 (20%) were classified as staphylococcal cassette chromosome mec (SCCmec) types II and IV, respectively, while the Panton-Valentine leukocidin (PVL) gene was detected in only two isolates. Among 66 MRSA isolates collected from Tokyo Medical University Hospital between 2012 and 2015, 43 (65%) and 20 (30%) were classifiable as SCCmec types II and IV, respectively. In 2015, highly virulent strains, such as the SCCmec type IV/PVL and SCCmec type IV/ toxic shock syndrome toxin-1 clonal types, increased in number. Therefore, the SCCmec type IV clone may cause invasive infections not only in community settings but also in healthcare settings in Japan.
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Affiliation(s)
- Yuri Miura
- 1 Department of Microbiology Laboratory, Tokyo Medical University Hospital , Tokyo, Japan
| | - Tetsuo Yamaguchi
- 2 Department of Microbiology and Infectious Diseases, Toho University School of Medicine , Tokyo, Japan .,3 Department of Microbiology, Tokyo Medical University , Tokyo, Japan
| | - Itaru Nakamura
- 4 Department of Infection Control and Prevention, Tokyo Medical University Hospital , Tokyo, Japan
| | - Shinobu Koyama
- 5 Department of Microbiology Laboratory, Miroku Medical Laboratory Co., Ltd. , Nagano, Japan
| | - Kiyoko Tamai
- 5 Department of Microbiology Laboratory, Miroku Medical Laboratory Co., Ltd. , Nagano, Japan
| | - Takashi Okanda
- 3 Department of Microbiology, Tokyo Medical University , Tokyo, Japan
| | - Tetsuya Matsumoto
- 3 Department of Microbiology, Tokyo Medical University , Tokyo, Japan .,4 Department of Infection Control and Prevention, Tokyo Medical University Hospital , Tokyo, Japan
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10
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Mitsumoto-Kaseida F, Murata M, Toyoda K, Morokuma Y, Kiyosuke M, Kang D, Furusyo N. Clinical and pathogenic features of SCCmec type II and IV methicillin-resistant Staphylococcus aureus in Japan. J Infect Chemother 2017; 23:90-95. [DOI: 10.1016/j.jiac.2016.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/23/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
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11
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Osman K, Badr J, Al-Maary KS, Moussa IMI, Hessain AM, Girah ZMSA, Abo-Shama UH, Orabi A, Saad A. Prevalence of the Antibiotic Resistance Genes in Coagulase-Positive-and Negative- Staphylococcus in Chicken Meat Retailed to Consumers. Front Microbiol 2016; 7:1846. [PMID: 27920760 PMCID: PMC5118462 DOI: 10.3389/fmicb.2016.01846] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/03/2016] [Indexed: 11/29/2022] Open
Abstract
The use of antibiotics in farm management (growing crops and raising animals) has become a major area of concern. Its implications is the consequent emergence of antibiotic resistant bacteria (ARB) and accordingly their access into the human food chain with passage of antibiotic resistance genes (ARG) to the normal human intestinal microbiota and hence to other pathogenic bacteria causative human disease. Therefore, we pursued in this study to unravel the frequency and the quinolone resistance determining region, mecA and cfr genes of methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRCNS) and methicillin-susceptible coagulase-negative staphylococci (MSCNS) isolated from the retail trade of ready-to-eat raw chicken meat samples collected during 1 year and sold across the Great Cairo area. The 50 Staphylococcus isolated from retail raw chicken meat were analyzed for their antibiotic resistance phenotypic profile on 12 antibiotics (penicillin, oxacillin, methicillin, ampicillin-sulbactam, erythromycin, tetracycline, clindamycin, gentamicin, ciprofloxacin, chloramphenicol, sulfamethoxazole-trimethoprim, and vancomycin) and their endorsement of the quinolone resistance determining region, mecA and cfr genes. The isolation results revealed 50 isolates, CPS (14) and CNS (36), representing ten species (S. aureus, S. hyicus, S. epidermedius, S. lugdunensis, S. haemolyticus, S. hominus, S. schleiferi, S. cohnii, S. intermedius, and S. lentus). Twenty seven isolates were methicillin-resistant. Out of the characterized 50 staphylococcal isolates, three were MRSA but only 2/3 carried the mecA gene. The ARG that bestows resistance to quinolones, β-lactams, macrolides, lincosamides, and streptogramin B [MLS(B)] in MRSA and MR-CNS were perceived. According to the available literature, the present investigation was a unique endeavor into the identification of the quinolone-resistance-determining-regions, the identification of MRSA and MR-CNS from retail chicken meat in Egypt. In addition, these isolates might indicate the promulgation of methicillin, oxacillin and vancomycin resistance in the community and imply food safety hazards.
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Affiliation(s)
- Kamelia Osman
- Department of Microbiology, Faculty of Veterinary Medicine, Cairo University Giza, Egypt
| | - Jihan Badr
- Department of Poultry Diseases, Animal Health Research Institute Giza, Egypt
| | - Khalid S Al-Maary
- Department of Botany and Microbiology, College of Science, King Saud University Riyadh, Saudi Arabia
| | - Ihab M I Moussa
- Department of Botany and Microbiology, College of Science, King Saud University Riyadh, Saudi Arabia
| | - Ashgan M Hessain
- Department of Health Science, College of Applied Studies and Community Service, King Saud University Riyadh, Saudi Arabia
| | | | - Usama H Abo-Shama
- Department of Microbiology, Faculty of Veterinary Medicine, Sohag University Sohag, Egypt
| | - Ahmed Orabi
- Department of Microbiology, Faculty of Veterinary Medicine, Cairo University Giza, Egypt
| | - Aalaa Saad
- Department of Poultry Diseases, Animal Health Research Institute Giza, Egypt
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Kimura Y, Morinaga Y, Akamatsu N, Matsuda J, Yamaryo T, Kawakami K, Matsuo H, Kosai K, Uno N, Hasegawa H, Yanagihara K. Antimicrobial susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus in a Japanese secondary care facility. J Infect Chemother 2015; 22:14-8. [PMID: 26617349 DOI: 10.1016/j.jiac.2015.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/06/2015] [Accepted: 08/18/2015] [Indexed: 10/22/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is prevalent in Japan, and the Staphylococcus cassette chromosome mec (SCCmec) type II is common among hospital-acquired MRSA isolates. Information pertaining to MRSA characteristics is limited, including SCCmec types, in primary or secondary care facilities. A total of 128 MRSA isolates (90 skin and soft tissue isolates and 38 blood isolates) were collected at a secondary care facility, Kawatana Medical Center, from 2005 to 2011. Antimicrobial susceptibility testing for anti-MRSA antibiotics and molecular testing for SCCmec and virulence genes (tst, sec, etb, lukS/F-PV) were performed. Strains positive for lukS/F-PV were analyzed by multilocus sequence typing and phage open-reading frame typing. SCCmec typing in skin and soft tissue isolates revealed that 65.6% had type IV, 22.2% had type II, 8.9% had type I, and 3.3% had type III. In blood isolates, 50.0% had type IV, 47.4% had type II, and 2.6% had type III. Minimum inhibitory concentrations, MIC(50)/MIC(90), against vancomycin, teicoplanin, linezolid, and arbekacin increased slightly in SCCmec II isolates from skin and soft tissue. MICs against daptomycin were similar between sites of isolation. SCCmec type II isolates possess tst and sec genes at a greater frequently than SCCmec type IV isolates. Four lukS/F-PV-positive isolates were divided into two clonal patterns and USA300 was not included. In conclusion, SCCmec type IV was dominant in blood, skin, and soft tissue isolates in a secondary care facility in Japan. Because antimicrobial susceptibility varies with the SCCmec type, SCCmec typing of clinical isolates should be monitored in primary or secondary care facilities.
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Affiliation(s)
- Yumiko Kimura
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshitomo Morinaga
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Norihiko Akamatsu
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Junichi Matsuda
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Yamaryo
- Department of Respiratory Internal Medicine, National Hospital Organization Nagasaki Kawatana Medical Center, Nagasaki, Japan
| | - Kenji Kawakami
- Department of Respiratory Internal Medicine, National Hospital Organization Nagasaki Kawatana Medical Center, Nagasaki, Japan
| | - Hidenori Matsuo
- Department of Clinical Research, National Hospital Organization Nagasaki Kawatana Medical Center, Nagasaki, Japan
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Uno
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroo Hasegawa
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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13
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de Oliveira LM, van der Heijden IM, Golding GR, Abdala E, Freire MP, Rossi F, D' alburquerque LC, Levin AS, Costa SF. Staphylococcus aureus isolates colonizing and infecting cirrhotic and liver-transplantation patients: comparison of molecular typing and virulence factors. BMC Microbiol 2015; 15:264. [PMID: 26572493 PMCID: PMC4647648 DOI: 10.1186/s12866-015-0598-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 11/03/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND S. aureus is an important agent of colonization and infection in liver transplant patients. It harbors several virulence factors that can increase its pathogenicity. However, studies of virulence and molecular typing of MRSA in cirrhotic and liver transplantation patients are scarce. RESULTS Here we use SCCmec, PFGE, spa typing, MLST and virulence factors to characterize MRSA isolates in pre and post liver transplantation patients. Sixteen (13%) of 126 cirrhotic and 15 of the 64 liver-transplanted patients (23%) were colonized by MRSA (p=0.091). SCCmec types I, II and III that are generally associated with nosocomial infections were identified in 91% of the isolates. None of the isolates carried PVL, adhesion factors and fib gene. Only three MRSA colonized isolates carried tst gene and were characterized as SCCmec type I and t149. Ten spa types and five STs were identified; t002 and ST105 were the most frequent profiles. Spa types and ST1510 never described in Brazil and a new spa type t14789 were identified. Nineteen PFGE subtypes were found and grouped into nine types. There was a predominant cluster, which was related to the New York/Japanese epidemic clone and harboured SCCmec type II identified in both cirrhotic and post-transplantation patients. Based on SCCmec and virulence factors the MRSA isolates belonged to NY/Jpn clone seen be more similar to the USA100 MRSA isolates. CONCLUSIONS Although without significance, liver-transplantation was more frequently colonized by MRSA than cirrhotic patients. The most frequent SCCmec was type II, and the predominant cluster was related to the New York/Japanese clone. A new spa t14789, and ST1510 never reported in Brazil were identified.
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Affiliation(s)
- Larissa Marques de Oliveira
- Department of Infection Control, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil. .,Laboratory of Medical Investigation 54 (LIM-54), Hospital Das Clínicas FMUSP, São Paulo, Brazil.
| | - Inneke Marie van der Heijden
- Department of Infection Control, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil. .,Laboratory of Medical Investigation 54 (LIM-54), Hospital Das Clínicas FMUSP, São Paulo, Brazil.
| | | | - Edson Abdala
- Liver Transplantation Unit, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
| | - Maristela P Freire
- Liver Transplantation Unit, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
| | - Flavia Rossi
- Laboratory of Microbiology, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
| | - Luiz C D' alburquerque
- Liver Transplantation Unit, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
| | - Anna S Levin
- Department of Infection Control, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil. .,Laboratory of Medical Investigation 54 (LIM-54), Hospital Das Clínicas FMUSP, São Paulo, Brazil.
| | - Silvia F Costa
- Laboratory of Medical Investigation 54 (LIM-54), Hospital Das Clínicas FMUSP, São Paulo, Brazil. .,Department of Infectious Diseases, LIM-54, Faculdade de Medicina, University of São Paulo, Avenida Doutor Enéas de Carvalho Aguiar, 470, São Paulo, SP, 05403-000, Brazil.
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Narita K, Hu DL, Asano K, Nakane A. Vaccination with non-toxic mutant toxic shock syndrome toxin-1 induces IL-17-dependent protection against Staphylococcus aureus infection. Pathog Dis 2015; 73:ftv023. [PMID: 25857736 DOI: 10.1093/femspd/ftv023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2015] [Indexed: 12/24/2022] Open
Abstract
Toxic shock syndrome toxin-1 (TSST-1) is one of superantigens produced by Staphylococcus aureus. We have previously demonstrated that vaccination with non-toxic mutant TSST-1 (mTSST-1) develops host protection to lethal S. aureus infection in mice. However, the detailed mechanism underlying this protection is necessary to elucidate because the passive transfer of antibodies against TSST-1 fails to provide complete protection against S. aureus infection. In this study, the results showed that interleukin-17A (IL-17A)-producing cells were increased in the spleen cells of mTSST-1-vaccinated mice. The main source of IL-17A in mTSST-1-vaccinated mice was T-helper 17 (Th17) cells. The protective effect of vaccination was induced when the vaccinated wild type but not IL-17A-deficient mice were challenged with S. aureus. Gene expression of chemokines, CCL2 and CXCL1, and infiltration of neutrophils and macrophages were increased in spleens and livers of vaccinated mice after infection. The IL-17A-dependent immune response was TSST-1 specific because TSST-1-deficient S. aureus failed to induce the response. The present study suggests that mTSST-1 vaccination is able to provide the IL-17A-dependent host defense against S. aureus infection which promotes chemokine-mediated infiltration of phagocytes into the infectious foci.
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Affiliation(s)
- Kouji Narita
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan Institute for Animal Experimentation, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
| | - Dong-Liang Hu
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan Laboratory of Zoonoses, Kitasato University School of Veterinary Medicine, Towada, Aomori 034-8628, Japan
| | - Krisana Asano
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
| | - Akio Nakane
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
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Ishihara K, Saito M, Shimokubo N, Muramatsu Y, Maetani S, Tamura Y. Methicillin-resistant Staphylococcus aureus carriage among veterinary staff and dogs in private veterinary clinics in Hokkaido, Japan. Microbiol Immunol 2014; 58:149-54. [PMID: 24397564 DOI: 10.1111/1348-0421.12128] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 11/27/2013] [Accepted: 12/24/2013] [Indexed: 10/25/2022]
Abstract
To explore the prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) in veterinary medical practices, MRSA carriage was tested among 96 veterinarians (Vets), 70 veterinary technicians (VTs) and 292 dogs with which they had contact at 71 private veterinary clinics (VCs) in Hokkaido, Japan. MRSA isolates were obtained from 22 Vets [22.9%] and 7 VTs [10%]. The prevalence of MRSA among Vets was as high as that found in an academic veterinary hospital in our previous study. In contrast, only two blood donor dogs and one dog with liver disease (1.0%, 3/292) yielded MRSA. All MRSA-positive dogs were reared or treated in different VCs, in each of which at least one veterinary staff member carrying MRSA worked. Sequence types (ST) identified by multilocus sequence typing, spa types, and SCCmec types for canine MRSA isolates (ST5-spa t002-SCCmec II [from two dogs] or ST30-spa t021-SCCmec IV [from a dog]) were concordant with those from veterinary staff members in the same clinics as the MRSA-positive dogs, with which they had potentially had contact. Most MRSA isolates from veterinary staff were the same genotype (SCCmec type II and spa type t002) as a major hospital-acquired MRSA clone in Japan. The remaining MRSA was the same genotypes as domestic and foreign community-associated MRSA. Measures against MRSA infection should be provided in private VCs.
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Affiliation(s)
- Kanako Ishihara
- Department of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan; School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido, 069-8501, Japan
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16
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Kaku N, Yanagihara K, Morinaga Y, Yamada K, Harada Y, Migiyama Y, Nagaoka K, Matsuda JI, Uno N, Hasegawa H, Miyazaki T, Izumikawa K, Kakeya H, Yamamoto Y, Kohno S. Influence of antimicrobial regimen on decreased in-hospital mortality of patients with MRSA bacteremia. J Infect Chemother 2014; 20:350-5. [PMID: 24731430 DOI: 10.1016/j.jiac.2013.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/06/2013] [Accepted: 12/09/2013] [Indexed: 11/18/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important causes of bacteremia. Recently, several epidemiological and microbiological changes have become evident in MRSA infections. The purposes of this study were to assess clinical characteristics of patients with MRSA bacteremia and microbiological changes in MRSA. We conducted a retrospective observational study on patients with MRSA bacteremia who were hospitalized between 2008 and 2011. We used univariate and multivariate analysis to evaluate the predictors associated with 30-day mortality. The 7-day and 30-day mortality rates were 12.0% and 25.3%, respectively. According to multivariate analysis, the independent predictors that associated with 30-day mortality were leukopenia, low serum albumin, high sequential organ failure assessment (SOFA) score, and quinolone use within 30 days. Compared to previous data (2003-2007), the SOFA score of the new data set remained unchanged, but in-hospital mortality decreased significantly. In particular, the mortality associated with use of vancomycin (VCM) was significantly lower. Although the minimum inhibitory concentration of VCM required to inhibit the growth of 90% of organisms (MIC90) had not changed, the trough value of VCM changed significantly; a VCM trough value of 10 or greater was significantly higher compared to previous data. Of the staphylococcal cassette chromosome mec (SCCmec) types, SCCmec II values decreased significantly, and SCCmec I and IV values increased significantly. Our results indicate that changes in VCM usage might contribute to decreased in-hospital mortality.
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Affiliation(s)
- Norihito Kaku
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Yoshitomo Morinaga
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koichi Yamada
- Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yosuke Harada
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yohei Migiyama
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kentaro Nagaoka
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jun-Ichi Matsuda
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Uno
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroo Hasegawa
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Taiga Miyazaki
- Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koichi Izumikawa
- Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Kakeya
- Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshihiro Yamamoto
- Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shigeru Kohno
- Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Surveillance of methicillin-resistant Staphylococcus aureus causing nosocomial infections in five medical centers of Monterrey, Nuevo León, México from 2005-2009. Arch Med Res 2013; 44:570-4. [PMID: 24051038 DOI: 10.1016/j.arcmed.2013.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 08/23/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Staphylococcus aureus is a principal cause of human bacterial infection worldwide. The dissemination of antibiotic resistance among S. aureus strains is very import in the treatment of Staphylococcal infections. We undertook this study to identify methicillin-resistant Staphylococcus aureus (MRSA) clones responsible for nosocomial infection in five medical centers in Monterrey, Nuevo León (N.L.), México from 2005-2009. METHODS One hundred ninety MRSA strains collected from 2005-2009 from five hospitals affiliated with the Instituto Mexicano del Seguro Social (IMSS) in Monterrey, N.L., México were characterized by antimicrobial susceptibility, pulsed field gel electrophoresis (PFGE) and Staphylococcal Cassette Chromosome mec (SCCmec) typing. RESULTS Only one clone was present in the five hospitals (clone C); this clone is strongly associated with the New York-Japan clone (SCCmec II) with a broad resistance profile. CONCLUSIONS This study clearly documented the high ability for dissemination and the persistence of the New York-Japan clone in these centers.
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Aklilu E, Zunita Z, Hassan L, Cheng CH. Molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) among veterinary students and personnel at a veterinary hospital in Malaysia. Vet Microbiol 2013; 164:352-8. [DOI: 10.1016/j.vetmic.2013.02.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 02/25/2013] [Accepted: 02/26/2013] [Indexed: 10/27/2022]
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Khokhlova O, Tomita Y, Hung WC, Takano T, Iwao Y, Higuchi W, Nishiyama A, Reva I, Yamamoto T. Elderly infection in the community due to ST5/SCCmecII methicillin-resistant Staphylococcus aureus (the New York/Japan clone) in Japan: Panton-Valentine leukocidin-negative necrotizing pneumonia. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2012. [PMID: 23201322 DOI: 10.1016/j.jmii.2012.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An 89-year-old man suffered from and died of necrotizing pneumonia with rapid progression and cavity formation due to methicillin-resistant Staphylococcus aureus (MRSA). He was at no risk for hospital-acquired MRSA infection. His MRSA exhibited genotype ST5/spa2(t002)/agr2/SCCmecII/coagulaseII and was negative for Panton-Valentine leukocidin, indicating the New York/Japan clone (the predominant epidemic hospital-acquired MRSA clone in Japan). However, this strain expressed the cytolytic peptide (phenol-soluble modulin or δ-hemolysin) genes at high level, similar to USA300 (the most common community-acquired MRSA in the United States), indicating a variant of the New York/Japan clone with an important feature of community-acquired MRSA.
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Affiliation(s)
- Olga Khokhlova
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yusuke Tomita
- Department of Respiratory Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Wei-Chun Hung
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tomomi Takano
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yasuhisa Iwao
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Wataru Higuchi
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akihito Nishiyama
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ivan Reva
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tatsuo Yamamoto
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan.
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Berktold M, Grif K, Mäser M, Witte W, Würzner R, Orth-Höller D. Genetic characterization of Panton-Valentine leukocidin-producing methicillin-resistant Staphylococcus aureus in Western Austria. Wien Klin Wochenschr 2012; 124:709-15. [PMID: 23053569 DOI: 10.1007/s00508-012-0244-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 08/08/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Community-acquired methicillin-resistant Staphylococcus aureus (caMRSA) is an emerging pathogen which causes potentially severe infections in young and healthy individuals due to the ability of most strains to produce Panton-Valentine leukocidin (PVL). The aim of this study was to evaluate the prevalence of PVL-positive (PVL(+))-MRSA strains in Western Austria in the period from December 2005 to May 2010 and to characterize the identified PVL(+)-MRSA strains. METHODS Six hundred and fifty MRSA strains from Innsbruck Medical University hospital, district hospitals, and general practitioners were investigated for the presence of lukS-lukF gene (encoding for PVL). Antimicrobial resistance testing, SCCmec-, agr-, MLST- and spa-typing, as well as arcA determination were performed on PVL(+)-MRSA. RESULTS Among 650 MRSA strains collected from various body sites from hospitalized patients and outpatients, 31 strains (4.8 %) were positive for lukS-lukF and thus identified as PVL(+)-MRSA. Agr-1 was the most common agr-type (n = 18, 58.1 %) and SCCmec-IV or variants IVa and IVc were the most common SCCmec types (n = 27, 87.1 %). All tested strains showed in-vitro susceptibility to vancomycin and rifampicin, but resistance against cotrimoxazol (6.4 %), clindamycin (9.7 %), gentamicin (9.7 %), fusidic acid (12.9 %), levofloxacin (12.9 %), and erythromycin (61.3 %) was found. Most lukS-lukF-positive MRSA detected in our survey shared ST8 and t008 and were positive for arcA. CONCLUSIONS The major lukS-lukF-positive MRSA lineage found in our population was ST8, t008 and positive for arcA which is mainly found in the USA. In contrast, ST80 strains were not found as frequently in our region as in many other European countries.
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Affiliation(s)
- Michael Berktold
- Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Fritz-Pregl-Straße 3, Innsbruck, Austria
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Hammad AM, Watanabe W, Fujii T, Shimamoto T. Occurrence and characteristics of methicillin-resistant and -susceptible Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci from Japanese retail ready-to-eat raw fish. Int J Food Microbiol 2012; 156:286-9. [DOI: 10.1016/j.ijfoodmicro.2012.03.022] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 03/17/2012] [Accepted: 03/20/2012] [Indexed: 12/01/2022]
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PAMUK SEBNEM, YILDIRIM YELIZ, SEKER ESRA, GURLER ZEKI, KARA RECEP. A survey of the occurrence and properties of methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus intermedius in water buffalo milk and dairy products in Turkey. INT J DAIRY TECHNOL 2012. [DOI: 10.1111/j.1471-0307.2012.00832.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Antimicrobial susceptibility and molecular characteristics of 857 methicillin-resistant Staphylococcus aureus isolates from 16 medical centers in Japan (2008–2009): nationwide survey of community-acquired and nosocomial MRSA. Diagn Microbiol Infect Dis 2012; 72:253-7. [DOI: 10.1016/j.diagmicrobio.2011.11.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 10/21/2011] [Accepted: 11/12/2011] [Indexed: 11/22/2022]
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24
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Iwao Y, Yabe S, Takano T, Higuchi W, Nishiyama A, Yamamoto T. Isolation and molecular characterization of methicillin-resistant Staphylococcus aureus from public transport. Microbiol Immunol 2012; 56:76-82. [DOI: 10.1111/j.1348-0421.2011.00397.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Jia C, Yang KW, Liu CC, Feng L, Xiao JM, Zhou LS, Zhang YL. Synthesis, characterization and activity of new phosphonate dipeptides as potential inhibitors of VanX. Bioorg Med Chem Lett 2012; 22:482-4. [DOI: 10.1016/j.bmcl.2011.10.094] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Revised: 10/15/2011] [Accepted: 10/28/2011] [Indexed: 10/15/2022]
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26
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Takata T, Miyazaki M, Li H, Healy M, Frye S, Tanaka K, Hara S, Kamimura H, Yoshimura H, Matsunaga A, Ohta D, Ishikura H, Tamura K, Tang YW. Methicillin-resistant Staphylococcus aureus bloodstream infections in a Japanese University Hospital between 1987 and 2004. J Infect Chemother 2011; 18:199-206. [PMID: 22009526 DOI: 10.1007/s10156-011-0313-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 09/20/2011] [Indexed: 10/16/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infections have been the most common cause of nosocomial infections in Japan, but their genetic characteristics related to bloodstream infections have not been well studied. The aim of this study was to investigate a comprehensive molecular characterization of MRSA blood isolates during the historical 18-year study period between 1987 and 2004 in a tertiary care university hospital. A total of 137 MRSA isolates recovered from the blood of inpatients at Fukuoka University Hospital were analyzed. Clinical information and antimicrobial susceptibility profiles were reviewed, and staphylococcal chromosomal cassette mec (SCCmec), accessory gene regulator (agr), and a battery of bacterial genes were tested by PCR-based assays. The relatedness of these isolates was determined by the repetitive sequence-based PCR (rep-PCR) and pulsed-field gel electrophoresis (PFGE). Although low numbers of agr type III/SCCmec type IV isolates circulated between 1987 and 1992, agr type II/SCCmec type II isolates started circulating in 1993 and were responsible for the increased MRSA isolates until 2004. The rep-PCR and PFGE identified 104 epidemic and 33 sporadic isolates. Among the 104 epidemic isolates, six major rep-PCR/PFGE types were identified, which occupied 67.3% of epidemic isolates. The SCCmec type II and agr type II isolates were observed in significantly higher proportion in epidemic isolates than in sporadic isolates (P = 0.0318, P = 0.0123, respectively). In contrast, SCCmec type IV strains were observed in significantly higher proportion in sporadic isolates than in epidemic isolates (P = 0.0494). Although isolates with sec were detected in higher rates in epidemic isolates (P = 0.0397), seh was detected in higher rates in sporadic isolates (P = 0.0350). Multivariate logistic regression analysis with forward stepping revealed that SCCmec type II was independently associated with epidemic isolates (P = 0.0067; odds ratio, 1.75; 95% confidence interval, 1.17-2.64). These data indicated that SCCmec type II MRSA isolates were responsible for the increased MRSA bloodstream infections for inpatients during the 18-year study period in the hospital.
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Affiliation(s)
- Tohru Takata
- Department of Oncology, Hematology, and Infectious Diseases, Fukuoka University School of Medicine, Fukuoka, Japan.
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Comparison of automated repetitive-sequence-based polymerase chain reaction and spa typing versus pulsed-field gel electrophoresis for molecular typing of methicillin-resistant Staphylococcus aureus. Diagn Microbiol Infect Dis 2011; 69:30-7. [PMID: 21146711 DOI: 10.1016/j.diagmicrobio.2010.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 09/03/2010] [Accepted: 09/09/2010] [Indexed: 11/23/2022]
Abstract
Automated repetitive polymerase chain reaction (PCR) (DiversiLab, bioMérieux, St. Laurent, Quebec, Canada) and single locus sequence typing of the Staphylococcus protein A (spa) gene with spa-type assignment by StaphType RIDOM software were compared to pulsed-field gel electrophoresis (PFGE) as the "gold standard" method for methicillin-resistant Staphylococcus aureus (MRSA) typing. Fifty-four MRSA isolates were typed by all methods: 10 of known PFGE CMRSA type and 44 clinical isolates. Correct assignment of CMRSA type or cluster occurred for 47 of 54 (87%) of the isolates when using a rep-PCR similarity index (SI) of ≥95%. Rep-PCR gave 7 discordant results [CMRSA1 (3), CMRSA2 (1), CMRSA4 (1), and CMRSA10 (2)], and some CMRSA clusters were not distinguished (CMRSA10/5/9, CMRSA 7/8, and CMRSA3/6). Several spa types occurred within a single PFGE or repetitive PCR types among the 19 different spa types found. spa type t037 was shared by CMRSA3 and CMRSA6 strains, and CMRSA9 and most CMRSA10 strains shared spa type t008. Time to results for PFGE, repetitive PCR, and spa typing was 3-4 days, 24 h, and 48 h, respectively. The annual costs of using spa or repetitive PCR were 2.4× and 1.9× higher, respectively, than PFGE but routine use of spa typing would lower annual labor costs by 0.10 full-time equivalents compared to PFGE. Repetitive PCR is a good method for rapid outbreak screening, but MRSA isolates that share the same repetitive PCR or PFGE patterns can be distinguished by spa typing.
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Yamada K, Yanagihara K, Hara Y, Araki N, Harada Y, Morinaga Y, Matsuda J, Izumikawa K, Seki M, Kakeya H, Yamamoto Y, Kohno S, Kamihira S. Clinical Features of Bacteremia Caused by Methicillin-Resistant Staphylococcus aureus in a Tertiary Hospital. TOHOKU J EXP MED 2011; 224:61-7. [DOI: 10.1620/tjem.224.61] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Koichi Yamada
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
- Second Department of Internal Medicine Nagasaki University Graduate School of Biomedical Sciences
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
- Second Department of Internal Medicine Nagasaki University Graduate School of Biomedical Sciences
| | - Yukiko Hara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Nobuko Araki
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Yousuke Harada
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Yoshitomo Morinaga
- Second Department of Internal Medicine Nagasaki University Graduate School of Biomedical Sciences
| | - Junichi Matsuda
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Koichi Izumikawa
- Second Department of Internal Medicine Nagasaki University Graduate School of Biomedical Sciences
| | - Masafumi Seki
- Second Department of Internal Medicine Nagasaki University Graduate School of Biomedical Sciences
| | - Hiroshi Kakeya
- Second Department of Internal Medicine Nagasaki University Graduate School of Biomedical Sciences
| | - Yoshihiro Yamamoto
- Second Department of Internal Medicine Nagasaki University Graduate School of Biomedical Sciences
| | - Shigeru Kohno
- Second Department of Internal Medicine Nagasaki University Graduate School of Biomedical Sciences
- Global COE Program, Nagasaki University
| | - Shimeru Kamihira
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
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29
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Hu DL, Maina EK, Omoe K, Inoue F, Yasujima M, Nakane A. Superantigenic Toxin Genes Coexist with Specific Staphylococcal Cassette Chromosome mec Genes in Methicillin-Resistant Staphylococcus aureus. TOHOKU J EXP MED 2011; 225:161-9. [DOI: 10.1620/tjem.225.161] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Dong-Liang Hu
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine
| | - Edward K Maina
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine
| | - Katsuhiko Omoe
- Department of Veterinary Medicine, Faculty of Agriculture, Iwate University
| | - Fumio Inoue
- Department of Clinical Laboratory, Hirosaki University Hospital
| | - Minoru Yasujima
- Department of Clinical Laboratory, Hirosaki University Hospital
- Department of Laboratory Medicine, Hirosaki University Graduate School of Medicine
| | - Akio Nakane
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine
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Isolation of meticillin-resistant Staphylococcus aureus (MRSA) from swine in Japan. Int J Antimicrob Agents 2010; 36:352-4. [DOI: 10.1016/j.ijantimicag.2010.06.040] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 06/22/2010] [Indexed: 11/17/2022]
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Yamamoto T, Nishiyama A, Takano T, Yabe S, Higuchi W, Razvina O, Shi D. Community-acquired methicillin-resistant Staphylococcus aureus: community transmission, pathogenesis, and drug resistance. J Infect Chemother 2010; 16:225-54. [PMID: 20336341 PMCID: PMC7088255 DOI: 10.1007/s10156-010-0045-9] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Indexed: 11/29/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is able to persist not only in hospitals (with a high level of antimicrobial agent use) but also in the community (with a low level of antimicrobial agent use). The former is called hospital-acquired MRSA (HA-MRSA) and the latter community-acquired MRSA (CA-MRSA). It is believed MRSA clones are generated from S. aureus through insertion of the staphylococcal cassette chromosome mec (SCCmec), and outbreaks occur as they spread. Several worldwide and regional clones have been identified, and their epidemiological, clinical, and genetic characteristics have been described. CA-MRSA is likely able to survive in the community because of suitable SCCmec types (type IV or V), a clone-specific colonization/infection nature, toxin profiles (including Pantone-Valentine leucocidin, PVL), and narrow drug resistance patterns. CA-MRSA infections are generally seen in healthy children or young athletes, with unexpected cases of diseases, and also in elderly inpatients, occasionally surprising clinicians used to HA-MRSA infections. CA-MRSA spreads within families and close-contact groups or even through public transport, demonstrating transmission cores. Re-infection (including multifocal infection) frequently occurs, if the cores are not sought out and properly eradicated. Recently, attention has been given to CA-MRSA (USA300), which originated in the US, and is growing as HA-MRSA and also as a worldwide clone. CA-MRSA infection in influenza season has increasingly been noted as well. MRSA is also found in farm and companion animals, and has occasionally transferred to humans. As such, the epidemiological, clinical, and genetic behavior of CA-MRSA, a growing threat, is focused on in this study.
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Affiliation(s)
- Tatsuo Yamamoto
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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Occurrence and molecular characteristics of methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus pseudintermedius in an academic veterinary hospital. Appl Environ Microbiol 2010; 76:5165-74. [PMID: 20543040 DOI: 10.1128/aem.02780-09] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Recently, methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus pseudintermedius (MRSP) have been increasingly isolated from veterinarians and companion animals. With a view to preventing the spread of MRSA and MRSP, we evaluated the occurrence and molecular characteristics of each in a veterinary college. MRSA and MRSP were isolated from nasal samples from veterinarians, staff members, and veterinary students affiliated with a veterinary hospital. Using stepwise logistic regression, we identified two factors associated with MRSA carriage: (i) contact with an identified animal MRSA case (odds ratio [OR], 6.9; 95% confidence interval [95% CI], 2.2 to 21.6) and (ii) being an employee (OR, 6.2; 95% CI, 2.0 to 19.4). The majority of MRSA isolates obtained from individuals affiliated with the veterinary hospital and dog patients harbored spa type t002 and a type II staphylococcal cassette chromosome mec (SCCmec), similar to the hospital-acquired MRSA isolates in Japan. MRSA isolates harboring spa type t008 and a type IV SCCmec were obtained from one veterinarian on three different sampling occasions and also from dog patients. MRSA carriers can also be a source of MRSA infection in animals. The majority of MRSP isolates (85.2%) carried hybrid SCCmec type II-III, and almost all the remaining MRSP isolates (11.1%) carried SCCmec type V. MRSA and MRSP were also isolated from environmental samples collected from the veterinary hospital (5.1% and 6.4%, respectively). The application of certain disinfection procedures is important for the prevention of nosocomial infection, and MRSA and MRSP infection control strategies should be adopted in veterinary medical practice.
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Motoshima M, Yanagihara K, Morinaga Y, Matsuda J, Sugahara K, Yamada Y, Kohno S, Kamihira S. Genetic diagnosis of community-acquired MRSA: a multiplex real-time PCR method for Staphylococcal cassette chromosome mec typing and detecting toxin genes. TOHOKU J EXP MED 2010; 220:165-70. [PMID: 20139668 DOI: 10.1620/tjem.220.165] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) causes a wide range of infections in health care settings and community environments. In particular, community-acquired MRSA (CA-MRSA) is important for clinicians because many fatal cases in healthy populations have been reported. Staphylococcal cassette chromosome mec (SCCmec) is a mobile genetic element and carries the central determinant for broad-spectrum beta-lactam resistance encoded by the mecA gene. The emergence of MRSA is due to the acquisition and insertion of the SCCmec element into the chromosome. CA-MRSA is characterized as SCCmec type IV. Thus, we aimed to establish a novel multiplex real-time PCR method to distinguish SCCmec type, which enables us to evaluate the pathogenicity of MRSA. A total of 778 MRSA were isolated at Nagasaki University Hospital from 2000 to 2007. All isolates were subjected to minimal inhibitory concentration testing and PCR for SCCmec typing and detecting genes of toxins: tst (toxic shock syndrome toxin 1), sec (encoded enterotoxin type c), etb (exfoliative toxin type b), and lukS/F-PV (Panton-Valentine leukocidin). PCR was performed to amplify a total of 10 genes in the same run. The 667 MRSA clones detected from pus in 778 clones were classified as SCCmec type II (77.7%), type IV (19.2%), and type I (3.0%). 87.5% of SCCmec type II clone had tst and sec genes. No isolate was lukS/F-PV positive. The present study indicates the high rate of lukS/F-PV-negative SCCmec type IV in Nagasaki. Our PCR method is convenient for typing MRSA and detecting toxins in Japan.
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Affiliation(s)
- Maiko Motoshima
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University Hospital, Nagasaki, Japan
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Ohkura T, Yamada K, Okamoto A, Baba H, Ike Y, Arakawa Y, Hasegawa T, Ohta M. Nationwide epidemiological study revealed the dissemination of meticillin-resistant Staphylococcus aureus carrying a specific set of virulence-associated genes in Japanese hospitals. J Med Microbiol 2009; 58:1329-1336. [PMID: 19528142 DOI: 10.1099/jmm.0.010173-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
To study comprehensive toxin profiles and the chromosomal diversity of current Japanese hospital-associated meticillin-resistant Staphylococcus aureus (HA-MRSA) strains, we conducted PCR-based identification of 28 toxin genes, and staphylococcal cassette chromosome mec (SCCmec) typing and PFGE analysis of 208 MRSA strains isolated from 100 hospitals throughout Japan. Of the tested HA-MRSA strains, 80.3 % were tst-positive. The most frequent toxin gene profile was characterized by the carriage of 13 genes, tst, sec, seg, sei, sel, sem, sen, seo, lukED, hla, hlb, hld and hlg-2. Ninety of the 208 strains had this profile, which was named pattern A. Among the 118 non-pattern A strains, 100 had similar toxin gene profiles, the concordance rates to pattern A of which were more than 80 %. Consequently, 91.3 % of the examined HA-MRSA strains carried similar toxin profiles, although PFGE patterns showed a wide variation. These strains belonged to SCCmec type II, agr II and coagulase type II. We concluded that, unlike MRSA from many other countries, most of the Japanese HA-MRSA strains belonged to, or were related to, a specific group carrying the set of 13 toxin genes, irrespective of chromosomal diversity. In addition, among the 13 toxin genes, the coexistence rates of tst, sec and sel, and those of seg, sei, sem, sen and seo, were higher than for the other toxin genes. High coexistence rates of tst, sec and sel genes suggested the presence of the pathogenicity island SaPIn1 in these strains.
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Affiliation(s)
- Teruko Ohkura
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Keiko Yamada
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Akira Okamoto
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hisashi Baba
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yasuyoshi Ike
- Department of Bacteriology and Bacterial Infection Control, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Yoshichika Arakawa
- Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Tadao Hasegawa
- Department of Bacteriology, Nagoya City University, School of Medical Sciences, Nagoya, Aichi, Japan
| | - Michio Ohta
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Pereira V, Lopes C, Castro A, Silva J, Gibbs P, Teixeira P. Characterization for enterotoxin production, virulence factors, and antibiotic susceptibility of Staphylococcus aureus isolates from various foods in Portugal. Food Microbiol 2009; 26:278-82. [DOI: 10.1016/j.fm.2008.12.008] [Citation(s) in RCA: 165] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Revised: 12/22/2008] [Accepted: 12/29/2008] [Indexed: 11/29/2022]
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Ozaki K, Takano M, Higuchi W, Takano T, Yabe S, Nitahara Y, Nishiyama A, Yamamoto T. Genotypes, intrafamilial transmission, and virulence potential of nasal methicillin-resistant Staphylococcus aureus from children in the community. J Infect Chemother 2009; 15:84-91. [PMID: 19396517 DOI: 10.1007/s10156-009-0668-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 01/14/2009] [Indexed: 10/20/2022]
Abstract
Pediatric outpatients and healthy children in the community were examined for nasal methicillin-resistant Staphylococcus aureus (MRSA) in Japan. MRSA isolation frequencies were 0.7% (3/426) and 3.7% (5/136), respectively, in pediatric outpatients and healthy children in the community (overall frequency, 1.4%). The frequency of MRSA isolation was higher in children 5-9 years of age compared with the other age groups. All eight MRSA strains isolated were Panton-Valentine leukocidin-negative. Of these, three with the genotype multilocus sequence type (ST) 8/spa606/SCCmecIV (2 cases) and ST88/spa999/SCCmecIV/exfoliative toxin A gene (eta) were identical or similar to MRSA from bullous impetigo, determined by pulsed-field gel electrophoresis. One strain with ST764 (ST5 variant)/spa2/SCCmecII/staphylococcal enterotoxin B gene seb2 (seb variant) was similar to MRSA from bacteremia, and one with ST5/spa2/SCCmecII was the Pandemic New York/Japan clone. The remaining three strains, with ST22/spa998/SCCmecI, ST380/spa799/SCCmecIV, and ST857/spa416/SCCmecII, have not been identified. All MRSA strains were resistant to one or more non-beta-lactam antibiotics, and the ST5 and ST764 strains were multidrug-resistant. Family analysis demonstrated parent-to-child transmission (for ST8 and ST764), as well as acquisition from outside the family (for ST8 and ST380). The data suggest that young school-age children have a higher carriage rate of nasal MRSA than children of other ages, and that not only community-acquired MRSA strains but also MRSA strains with characteristics of hospital-acquired MRSA are spreading in the community.
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Affiliation(s)
- Kyoko Ozaki
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibanchou, Asahimachidori, Niigata, 951-8510, Japan
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37
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Silva-Carvalho MC, Teixeira LA, Ferreira FA, Ribeiro A, Ferreira-Carvalho BT, Figueiredo AMS. Comparison of different methods for detecting methicillin resistance in MRSA isolates belonging to international lineages commonly isolated in the American continent. Microbiol Immunol 2009; 53:117-22. [PMID: 19291096 DOI: 10.1111/j.1348-0421.2008.00096.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of the present paper was to compare different methods for detecting methicillin resistance in Staphylococcus aureus. Among the isolates analyzed, 52 belonged to MRSA international lineages commonly detected in the American continent and 14 to sporadic MRSA clones. Both 30 microg-cefoxitin disk and PBP2a had 100% sensibility/specificity when the low-level heterogeneous isolates were tested and, thus, are highly recommended.
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Affiliation(s)
- Maria Cícera Silva-Carvalho
- Federal University of Rio de Janeiro, Institute of Microbiology Professor Paulo de Góes, Center for Health Science, University City, Rio de Janeiro, Brazil
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38
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Takano T, Higuchi W, Yamamoto T. Superior in vitro activity of carbapenems over anti-methicillin-resistant Staphylococcus aureus (MRSA) and some related antimicrobial agents for community-acquired MRSA but not for hospital-acquired MRSA. J Infect Chemother 2009; 15:54-7. [PMID: 19280303 DOI: 10.1007/s10156-008-0665-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Accepted: 12/26/2008] [Indexed: 11/24/2022]
Abstract
Eighty-eight strains of Panton-Valentine leukocidin (PVL)-positive and -negative community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) and 152 strains of hospital-acquired MRSA (HA-MRSA) were examined for susceptibility to carbapenems, oxacillin, and other antimicrobial agents. CA-MRSA strains were more susceptible to carbapenems (MIC(90), 1-4 microg/ml) than HA-MRSA strains (MIC(90), 32-64 microg/ml). Among the carbapenems examined, CA-MRSA strains were most susceptible to imipenem (MIC(50), 0.12 microg/ml; MIC(90), 1 microg/ml). A similar tendency was observed with oxacillin, but less markedly (MIC(90): 32 microg/ml for CA-MRSA and > or =256 microg/ml for HA-MRSA). This difference was also observed between CA-MRSA and HA-MRSA in susceptibility levels to cephems, erythromycin, clindamycin, and levofloxacin, but not to ampicillin, vancomycin, teicoplanin, linezolid, and arbekacin. The data indicate that, in terms of MIC(50) or MIC(90) values, CA-MRSA is 64-256 times more susceptible to imipenem than HA-MRSA, and for CA-MRSA, some carbapenems, e.g., imipenem, show better in vitro activity than anti-MRSA or some related agents.
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Affiliation(s)
- Tomomi Takano
- Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8520, Japan
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39
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Hu DL, Omoe K, Inoue F, Kasai T, Yasujima M, Shinagawa K, Nakane A. Comparative prevalence of superantigenic toxin genes in meticillin-resistant and meticillin-susceptible Staphylococcus aureus isolates. J Med Microbiol 2008; 57:1106-1112. [PMID: 18719180 DOI: 10.1099/jmm.0.2008/002790-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A total of 118 meticillin-resistant Staphylococcus aureus (MRSA) and 140 meticillin-susceptible S. aureus (MSSA) isolates from different patients in the same time period were comprehensively searched using a multiplex PCR for the classical and recently described superantigenic toxin gene family comprising the staphylococcal enterotoxin genes sea to ser and the toxic shock syndrome toxin 1 gene, tst-1. Both MRSA and MSSA isolates carried a number of superantigenic toxin genes, but the MRSA isolates harboured more superantigenic toxin genes than the MSSA isolates. The most frequent genotype of the MRSA isolates was sec, sell and tst-1 together with the gene combination seg, sei, selm, seln and selo, which was found strictly in combination in 69.5% of the isolates tested. In contrast, possession of the sec, sell and tst-1 genes in MSSA isolates was significantly less than in MRSA (2.1 vs 77.1%, respectively), although they also often contained the combination genes (25.0%). This notable higher prevalence in MRSA isolates indicated that possession of the sec, sell and tst-1 genes in particular appeared to be a habitual feature of MRSA. Moreover, these were mainly due to the fixed combinations of the mobile genetic elements type I nuSa4 encoding sec, sell and tst-1, and type I nuSabeta encoding seg, sei, selm, seln and selo. Analysis of the relationship between toxin genotypes and the toxin gene-encoding profiles of mobile genetic elements has a possible role in determining superantigenic toxin genotypes in S. aureus.
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Affiliation(s)
- Dong-Liang Hu
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Katsuhiko Omoe
- Department of Veterinary Microbiology, Faculty of Agriculture, Iwate University, 3-18-8 Ueda, Morioka, Iwate 020-8550, Japan
| | - Fumio Inoue
- Department of Clinical Laboratory, Hirosaki University Hospital, 53 Hon-cho, Hirosaki, Aomori 036-8563, Japan
| | - Takesi Kasai
- Department of Clinical Laboratory, Hirosaki University Hospital, 53 Hon-cho, Hirosaki, Aomori 036-8563, Japan
| | - Minoru Yasujima
- Department of Clinical Laboratory Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.,Department of Clinical Laboratory, Hirosaki University Hospital, 53 Hon-cho, Hirosaki, Aomori 036-8563, Japan
| | - Kunihiro Shinagawa
- Department of Veterinary Microbiology, Faculty of Agriculture, Iwate University, 3-18-8 Ueda, Morioka, Iwate 020-8550, Japan
| | - Akio Nakane
- Department of Microbiology and Immunology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
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Sivaraman K, Venkataraman N, Tsai J, Dewell S, Cole AM. Genome sequencing and analysis reveals possible determinants of Staphylococcus aureus nasal carriage. BMC Genomics 2008; 9:433. [PMID: 18808706 PMCID: PMC2566312 DOI: 10.1186/1471-2164-9-433] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Accepted: 09/22/2008] [Indexed: 02/05/2023] Open
Abstract
Background Nasal carriage of Staphylococcus aureus is a major risk factor in clinical and community settings due to the range of etiologies caused by the organism. We have identified unique immunological and ultrastructural properties associated with nasal carriage isolates denoting a role for bacterial factors in nasal carriage. However, despite extensive molecular level characterizations by several groups suggesting factors necessary for colonization on nasal epithelium, genetic determinants of nasal carriage are unknown. Herein, we have set a genomic foundation for unraveling the bacterial determinants of nasal carriage in S. aureus. Results MLST analysis revealed no lineage specific differences between carrier and non-carrier strains suggesting a role for mobile genetic elements. We completely sequenced a model carrier isolate (D30) and a model non-carrier strain (930918-3) to identify differential gene content. Comparison revealed the presence of 84 genes unique to the carrier strain and strongly suggests a role for Type VII secretion systems in nasal carriage. These genes, along with a putative pathogenicity island (SaPIBov) present uniquely in the carrier strains are likely important in affecting carriage. Further, PCR-based genotyping of other clinical isolates for a specific subset of these 84 genes raise the possibility of nasal carriage being caused by multiple gene sets. Conclusion Our data suggest that carriage is likely a heterogeneic phenotypic trait and implies a role for nucleotide level polymorphism in carriage. Complete genome level analyses of multiple carriage strains of S. aureus will be important in clarifying molecular determinants of S. aureus nasal carriage.
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Affiliation(s)
- Karthikeyan Sivaraman
- Department of Molecular Biology & Microbiology, Biomolecular Science Center, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, USA.
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Staphylococcus aureus in dermatology outpatients with special emphasis on community-associated methicillin-resistant strains. J Invest Dermatol 2008; 128:2655-2664. [PMID: 18596827 DOI: 10.1038/jid.2008.133] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) emerged as a community-associated pathogen (CA-MRSA) in the past 6 years. This prospective study investigated dermatology outpatients with inflammatory skin diseases, leg ulcers, and skin infections for Panton-Valentine leukocidin (PVL)-positive S. aureus, often associated with deep skin infection. In case of PVL positivity, molecular typing and PCR demonstration of resistance genes were performed. Out of 248 patients, 130 carried S. aureus, 24 being lukS-PV lukF-PV positive. Eighteen were MRSA, 11 of them belonging to the multilocus sequence typing clonal complex (CC)5, 1 to CC45, and 2/18 to CC8. Out of 18 patients, 4 were CA-MRSA containing lukS-PV lukF-PV as an important trait of CA-MRSA. Out of four CA-MRSA isolates, two were of type ST080 containing far-1 coding for fusidic acid (FUS) resistance and two were FUS sensitive (ST152 and ST001). The FUS-sensitive CA-MRSA, which corresponded to the CA-MRSA of ST001 from the United States, was detected in Germany for the first time, indicating that dermatologists are first in line to detect CA-MRSA. In contrast to CA-MRSA from other continents, far-1-coded FUS resistance represents a typical marker for the widespread CA-MRSA ST080 in Europe, especially in Germany. The significant risk factor for the acquisition of CA-MRSA was visits to foreign countries and/or professional or private contacts with foreigners.
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Ho PL, Lai EL, Chow KH, Chow LSM, Yuen KY, Yung RWH. Molecular epidemiology of methicillin-resistant Staphylococcus aureus in residential care homes for the elderly in Hong Kong. Diagn Microbiol Infect Dis 2008; 61:135-42. [PMID: 18272314 DOI: 10.1016/j.diagmicrobio.2007.12.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Revised: 12/12/2007] [Accepted: 12/16/2007] [Indexed: 10/22/2022]
Abstract
This territory-wide study evaluated the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in residential care homes for elderly (RCHEs) in Hong Kong. MRSA colonization was assessed by taking swab culture from anterior nares and active skin lesions. Of 487 RCHEs surveyed, 80 MRSA strains were recovered from 1563 residents, giving a prevalence of 5.1%. Twenty-four isolates had SCCmec II, 2 had SCCmec III, 17 had SCCmec IV, 36 had SCCmec V, and 1 had a composite SCCmec type. Pulsed-field gel electrophoresis typing clustered 75 isolates into 7 clones (HKU10 to 50, HKU80, and HKU90). Two predominant types, HKU30 and HKU50, which together account for 75% of all MRSA strains, were found in 13 and 15 of the 18 geographic districts in Hong Kong, respectively. The main features for HKU50 strains were spa t1081/ST45-IV or V, capsular type 8, agrIV, and hla, seg, sei positive. On the other hand, HKU30 strains had spa t002/ST5-II, capsular type 5, agrII, and were hla, seg, sei positive. HKU30 strains were often multidrug resistant (MDR, involving ciprofloxacin, erythromycin, gentamicin, and tetracycline). In contrast, HKU50 strains exhibit both multidrug resistance (MDR) (involving ciprofloxacin, erythromycin, and tetracycline, but not gentamicin) and non-MDR patterns.
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Affiliation(s)
- Pak-Leung Ho
- Division of Infectious Diseases, Department of Microbiology and Centre of Infection, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
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