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Barmettler K, Waser S, Stephan R. Microbiological Quality of Plant-based Meat-alternative Products Collected at Retail Level in Switzerland. J Food Prot 2025; 88:100402. [PMID: 39542106 DOI: 10.1016/j.jfp.2024.100402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 11/05/2024] [Accepted: 11/07/2024] [Indexed: 11/17/2024]
Abstract
As the interest in plant-based alternative food products has increased significantly in the last years, it is also important to investigate these products regarding microbiological aspects. The aim of this study was to assess the microbiological quality and the occurrence of selected foodborne pathogens in plant-based meat alternative products (PBMA) collected at retail level in Switzerland. A total of 100 PBMA (84 vegan and 16 vegetarian products) was analyzed qualitatively for the presence of Salmonella, Listeria monocytogenes and quantitatively for Staphylococcus aureus, Bacillus cereus group members, Enterobacteriaceae, and the total viable count. Furthermore, pH measurements were carried out and the aw-value was determined. Isolates were further analyzed with Whole Genome Sequencing. The total viable count before the expiration date was between <2 log and 7 log CFU/g (median: 5.97 log CFU/g). In six (6%) samples, Enterobacteriaceae with 2 log to 3 log CFU/g were detected. No Salmonella and no Listeria monocytogenes were detected. However, seven products (7%) were contaminated with other Listeria spp. (six L. innocua and one L. seeligeri). Further findings were two (2%) Staphylococcus aureus ST8 with the presence of selx and tsst-1 genes, and five (5%) Bacillus cereus group members (three B. paranthracis, one B. cereus sensu stricto, and one B. cytotoxicus) which all were diarrhea-associated strains. This study provides data that are relevant for HACCP concepts of companies that produce plant-based meat alternative products and helps to define microbiological parameters that should be included when testing such products.
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Affiliation(s)
- Karen Barmettler
- Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, Switzerland.
| | - Silja Waser
- Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Roger Stephan
- Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, Switzerland
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2
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Dianatkhah M, Davoodi ZS, Soltani R, Shafiee F, Hosseini A. Evaluation of the Antimicrobial Resistance Pattern of Nosocomial Infections in Patients Hospitalized in Chamran Heart Educational, Medical, and Research Center of Isfahan. J Res Pharm Pract 2023; 12:135-140. [PMID: 39262413 PMCID: PMC11386061 DOI: 10.4103/jrpp.jrpp_25_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/26/2024] [Accepted: 05/05/2024] [Indexed: 09/13/2024] Open
Abstract
Objective According to the importance of evaluating the antimicrobial resistance pattern in the management of nosocomial infections (NIs), we decided to investigate the prevalence of antimicrobial resistance in Chamran Heart Hospital. Methods This retrospective cross-sectional observational study was performed for 6 months from February to July 2022 at Shahid Chamran Hospital of Isfahan, Iran. All hospitalized patients with any NIs were eligible for the study. Clinical specimens were obtained from patients with NIs. All specimens underwent microbial culture, and if bacterial growth developed, differential tests were performed. Antibiotic susceptibility testing also was performed per the standards of Clinical and Laboratory Standards Institute, 2022. Findings Out of 201 examined samples, urinary infection (34.83%), pneumonia (27.86%), and sepsis (13.43%) were reported to be the most prevalent infections. Among Gram-negatives (76.12%), Citrobacter spp. (26.37%), Escherichia coli (24.87%), and Klebsiella spp. (11.44%) were the most common pathogens. About 54.9% of Citrobacter spp., 33.3% of E. coli, and 45.45% of Klebsiella spp. were resistant to carbapenems. About 1.88% and 15% of Citrobacter spp. were identified as pan-drug-resistant bacteria and extensively drug-resistant (XDR), respectively. In addition, 4.34% of Klebsiella spp. were identified as XDR. Among Gram-positives (23.88%), Enterococcus spp. (8.95%) was identified as the most common pathogen, and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) was 11.11% and 61.11%, respectively. Conclusion In our study, carbapenem-resistant Enterobacteriaceae accounts for about 50% of all NIs. Moreover, despite the low prevalence of MRSA, VRE was reported to be high in our center when compared with other studies.
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Affiliation(s)
- Mehrnoush Dianatkhah
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
- Chamran Cardiovascular Medical and Research Hospital, Isfahan, Iran
| | - Zeinab Sadat Davoodi
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Shafiee
- Department of Pharmaceutical Biotechnology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Hosseini
- Department of Cardiac Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
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3
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Bes TM, Perdigão-Neto L, Martins RR, Heijden I, Trindade PDA, Camilo G, Nagano DS, Mongelos D, Marchi AP, Tomaz M, Oliveira LMD, Rossi F, Levin AS, Costa SF. Susceptibility to chlorhexidine and mupirocin among methicillin-resistant Staphylococcus aureus clinical isolates from a teaching hospital. Rev Inst Med Trop Sao Paulo 2021; 63:e27. [PMID: 33852710 PMCID: PMC8046504 DOI: 10.1590/s1678-9946202163027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/14/2021] [Indexed: 11/21/2022] Open
Abstract
Despite the widespread use of chlorhexidine (CHX) to prevent infection, data
regarding the in vitro action of CHX against
methicillin-resistant Staphylococcus aureus(MRSA) are limited. Clinical isolates from Hospital das Clinicas,
Sao Paulo, Brazil, identified during 2002/2003 and 2012/2013 were studied to
describe the susceptibility to CHX and mupirocin, molecular characteristics, and
virulence profile of MRSA. Susceptibility test to Mupirocin was performed by the
disk diffusion method and to CHX by the agar dilution technique. PCR for
virulence genes, mecA gene and Staphylococcal Cassette
Chromosome mec (SCCmec) types were
investigated as well. Mupirocin- and CHX-resistant isolates were sequenced using
the IlluminaTM plataform. Two hundred and sixteen MRSA clinical
isolates were evaluated: 154 from infected and 62 from colonized patients.
Resistance to mupirocin was observed in four isolates assigned as
SCCmec type III and STs (ST05; ST239 and ST105) carrying
mupA and blaZ, two of them co-harboring
the ileS gene. Only one isolate assigned as
SCCmec type III was resistant to CHX (MIC of 8.0
μg.mL-1) and harbored the qacA gene. Resistance
to chlorhexidine and mupirocin were found in isolates carrying
qacA and mupA in our hospital. Since these
genes are plasmid-mediated, this finding draws attention to the potential spread
of resistance to mupirocin in our hospital.
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Affiliation(s)
- Taniela Marli Bes
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Lauro Perdigão-Neto
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Roberta Ruedas Martins
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Inneke Heijden
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Gaspar Camilo
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Debora Satie Nagano
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Diego Mongelos
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Ana Paula Marchi
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Mariama Tomaz
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Flavia Rossi
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil
| | - Anna Sara Levin
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Silvia Figueiredo Costa
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
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4
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Motallebi M, Alibolandi Z, Aghmiyuni ZF, van Leeuwen WB, Sharif MR, Moniri R. Molecular analysis and the toxin, MSCRAMM, and biofilm genes of methicillin-resistant Staphylococcus aureus strains isolated from pemphigus wounds: A study based on SCCmec and dru typing. INFECTION GENETICS AND EVOLUTION 2020; 87:104644. [PMID: 33246081 DOI: 10.1016/j.meegid.2020.104644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/30/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Pemphigus is a chronic autoimmune blistering disease. Pemphigus blisters can damage the natural skin barrier and increase the risk of life-threatening conditions. Colonization of pemphigus wounds with methicillin-resistant Staphylococcus aureus (MRSA) prolongs wound healing and increases mortality rate. Assessing MRSA prevalence, types, and toxin and adhesion genes can facilitate the detection of MRSA strains which cause infections, selection of appropriate treatments, and healing of pemphigus wounds. This study aimed to determine the SCCmec, the direct repeat unit (dru) types (dts), and the toxin, MSCRAMM, and biofilm genes of MRSA strains isolated from pemphigus wounds. METHODS In this cross-sectional study, 118 S. aureus isolates were gathered from 118 patients with pemphigus. MRSA detection was performed using the mecA gene. Using the polymerase chain reaction method, all MRSA isolates were assessed for the presence of the sea, seb, sec, tst, eta, pvl, hla, hlb, MSCRAMM, and ica genes. Typing and subtyping were performed through respectively SCCmec typing and dru typing methods. The Bionumerics software was used for analyzing the data and drawing the minimum spanning tree. FINDINGS From 118 S. aureus isolates, 51 were MRSA. SCCmec typing revealed the prevalence of SCCmec II with a prevalence of 64.7% (33 out of 51 isolates) and SCCmec III with a prevalence of 35.3% (18 out of 51 isolates). Dru typing indicated seven dts, namely dts 10a, 10g, 10m, 13i, 8h, 8i, and 9ca in two main clusters. The dt9ca was a new dru type and was registered in the dru-typing database (www.dru-typing.org). The prevalence rates of the hla, sea, and sec genes in MRSA isolates were respectively 54.9%, 27.4%, and 1.9%, while the hlb, seb, eta, and pvl genes were not detected at all. Only one MRSA with SCCmec III and dt10a carried the tst encoding gene. MSCRAMM gene analysis revealed the high prevalence of the eno (31.3%) and the fib (21.5%) genes. The prevalence rates of the icaA and icaD biofilm formation genes were 3.9% and 5.8%, respectively. There were no significant differences between the two detected SCCmec types and between the two detected dts clusters respecting the prevalence of the encoding genes of virulence factors and MSCRAMMs. CONCLUSION The toxin genes hla and sea are prevalent among MRSA strains with SCCmec II and III isolated from pemphigus wounds. The most prevalent dts are dt10a and dt10g among MRSA with SCCmec III and dt8h and dt8i among MRSA with SCCmec II.
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Affiliation(s)
- Mitra Motallebi
- Department of Immunology and Microbiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran; Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
| | - Zahra Alibolandi
- Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Zeinab Fagheei Aghmiyuni
- Institute of Immunology and Infection Diseases, Antimicrobial Resistance Research Centre, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, IR, Iran
| | - Willem B van Leeuwen
- Leiden Center for Applied Bioscience, University of Applied Sciences Leiden, Leiden, Netherlands
| | - Mohammad Reza Sharif
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Rezvan Moniri
- Department of Immunology and Microbiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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The History of Methicillin-Resistant Staphylococcus aureus in Brazil. ACTA ACUST UNITED AC 2020; 2020:1721936. [PMID: 33082892 PMCID: PMC7563066 DOI: 10.1155/2020/1721936] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/21/2020] [Accepted: 09/24/2020] [Indexed: 12/20/2022]
Abstract
Since the emergence of MRSA in the 1960s, a gradual increase in infections by resistant bacteria has been observed. Clinical manifestations may vary from brand to critical condition due to host risk factors, as well as pathogen virulence and resistance. The high adaptability and pathogenic profile of MRSA clones contributed to its spread in hospital and community settings. In Brazil, the first MRSA isolates were reported in the late 1980s, and since then different genetic profiles, such as the Brazilian epidemic clone (BEC) and other clones considered a pandemic, became endemic in the Brazilian population. Additionally, Brazil's MRSA clones were shown to be able to transfer genes involved in multidrug resistance and enhanced pathogenic properties. These events contributed to the rise of highly resistant and pathogenic MRSA. In this review, we present the main events which compose the history of MRSA in Brazil, including numbers and locations of isolation, as well as types of staphylococcal cassette chromosome mec (SCCmec) found in the Brazilian territory.
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Abbas HA, Elsherbini AM, Shaldam MA. Glyceryl trinitrate blocks staphyloxanthin and biofilm formation in Staphylococcus aureus. Afr Health Sci 2019; 19:1376-1384. [PMID: 31148964 PMCID: PMC6531949 DOI: 10.4314/ahs.v19i1.10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Staphylococcus aureus is an important nosocomial bacterium that is responsible for a number of infections that may be fatal. The treatment of such infections is limited by emergence of antibiotic resistance. Targeting virulence of Staphylococcus aureus may provide an alternative option to antibiotic that may bypass the emergence of resistant strains due to lack of stress on viability. Objectives Investigation of the ability of glyceryl trinitrate (GTN) to inhibit staphyloxanthin, biofilm and tolerance to oxidative stress. Methods The disk sensitivity method was used to detect the methicillin resistance of Staphylococcus aureus. The effect of sub-inhibitory concentration of GTN on biofilm formation, staphyloxanthin production and tolerance to oxidative stress was evaluated. Molecular docking study was used to investigate the ability of GTN to bind to dehydrosqualene synthase enzyme. Results GTN showed a significant inhibition of biofilm, staphyloxanthin and tolerance to oxidative stress. In the molecular docking study, it was found that GTN could bind to dehydrosqualene synthase enzyme by hydrogen bonding, electrostatic interaction and pi-cation interaction. Conclusion The present study revealed the ability of GTN to serve as a potential anti-virulence candidate for attenuation of S. aureus pathogenicity.
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7
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Bes TM, Martins RR, Perdigão L, Mongelos D, Moreno L, Moreno A, Oliveira GSD, Costa SF, Levin AS. Prevalence of methicillin-resistant Staphylococcus aureus colonization in individuals from the community in the city of Sao Paulo, Brazil. Rev Inst Med Trop Sao Paulo 2018; 60:e58. [PMID: 30365641 PMCID: PMC6199126 DOI: 10.1590/s1678-9946201860058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/13/2018] [Indexed: 11/25/2022] Open
Abstract
Staphylococcus aureus (SA) is a commensal habitant of nasal cavities and skin. Colonization by community-acquired methicillin-resistant SA (CA-MRSA) is associated with infections in patients who have not been recently hospitalized. The aim of this study is to determine the prevalence of MRSA colonization in an outpatient population, currently unknown in Brazil. Three-hundred patients or caregivers from two teaching hospitals were included. A questionnaire was applied and nasal swabs were obtained from patients. Swabs were inoculated in brain heart infusion (BHI) with 2.5% NaCl and seeded in mannitol. Suspicious colonies were subjected to MALDI-TOF MS Microflex™ identification. Antimicrobial susceptibility test for oxacillin was performed for SA-positive samples by microdilution. Polymerase chain-reactions for detection of mecA and coA genes were performed for resistant samples. Data about MRSA carriers were compared with non-carriers. There were 127 S. aureus isolates, confirmed by MALDI-TOF. Only seven (2.3%) were MRSA and positive for mecA and coA genes. Factors associated with MRSA carriage were African ethnicity, skin diseases or antibiotic use. The majority of them were from Dermatology clinics. Prevalence of MRSA colonization in individuals from the community was low in our study (2.3%). This finding raises the hypothesis of inter-household transmission of SA, although we did not find any association between MRSA-colonization and the shared use of personal objects. Given the low prevalence of MRSA carriers observed, empirical antimicrobial coverage for MRSA in community-acquired infections should be not necessary.
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Affiliation(s)
- Taniela Marli Bes
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Roberta Ruedas Martins
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Lauro Perdigão
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo De Controle de Infecções Hospitalares, São Paulo, São Paulo, Brazil
| | - Diego Mongelos
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Luisa Moreno
- Universidade de São Paulo, Faculdade de Medicina Veterinária e Zootecnia, São Paulo, São Paulo, Brazil
| | - Andrea Moreno
- Universidade de São Paulo, Faculdade de Medicina Veterinária e Zootecnia, São Paulo, São Paulo, Brazil
| | - Gerson Salvador de Oliveira
- Universidade de São Paulo, Faculdade de Medicina, Hospital Universitário, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Medicina Física e de Reabilitação, São Paulo, São Paulo, Brazil
| | - Silvia Figueiredo Costa
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Anna Sara Levin
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo De Controle de Infecções Hospitalares, São Paulo, São Paulo, Brazil
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8
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Cueno ME, Imai K. Network analytics approach towards identifying potential antivirulence drug targets within the Staphylococcus aureus staphyloxanthin biosynthetic network. Arch Biochem Biophys 2018; 645:81-86. [PMID: 29551420 DOI: 10.1016/j.abb.2018.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/23/2018] [Accepted: 03/11/2018] [Indexed: 11/30/2022]
Abstract
Staphylococcus aureus is associated with several clinically significant infections among humans and infections associated with antibiotic-resistant strains are growing in frequency. Antivirulence strategies shift the target of drugs from bacterial growth to the infection process resulting to milder evolutionary pressure for the development of bacterial resistant strains. Staphyloxanthin (STX) is a yellowish-orange carotenoid pigment synthesized by S. aureus and this carotenoid functions as an important virulence factor for the bacteria. In this study, we elucidated whether network analytics can be used as a viable tool to identify significant components in the STX biosynthetic network which in-turn could serve as possible antivirulence drug targets. For confirmation, we correlated our results to known drugs that were able to inhibit STX biosynthesis. Throughout this study, we established that crtN(1) activity and 4,4'-diaponeurosporene amounts are significant components in the STX biosynthetic network and, moreover, network analytics can aid in identifying antivirulence drug targets within the STX biosynthetic network. Similarly, we found that network analytics is capable of identifying multiple potential targets simultaneously. Taken together, we propose that an effective antivirulence drug against S. aureus STX biosynthesis would involve targeting crtN(1) activity, 4,4'-diaponeurosporene levels, or both components.
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Affiliation(s)
- Marni E Cueno
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, 101-8310, Japan.
| | - Kenichi Imai
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, 101-8310, Japan
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Elshabrawy WO, Zaki ME, Kamel MF. Genetic and phenotypic study of methicillin-resistant Staphylococcus aureus among patients and health care workers in Mansoura University Hospital, Egypt. IRANIAN JOURNAL OF MICROBIOLOGY 2017; 9:82-88. [PMID: 29213999 PMCID: PMC5715281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Staphylococcus aureus is common pathogen that is associated with many hospital acquired infections. The virulence of S. aureus is identified with resistance to antibiotics especially to methicillin. Therefore the aims of the present study were to detect the carrier rates of methicillin-resistant S. aureus (MRSA) among health care Workers (HCWs) and patients and to compare use of specific chromogenic agar for MRSA culture with PCR for detection of MRSA genes. MATERIALS AND METHODS Samples obtained were subjected to full microbiological laboratory studies involving culture on specific chromogenic medium and antibiotics susceptibility testing for detection of MRSA and their resistance rates to other commonly used antibiotics. Furthermore multiplex PCR was carried out to detect SCCmecA genes. RESULTS Staphylococcus aureus was isolated from 70 (29.9%) of the studied subjects. MRSA isolates (n=28) had high resistance rates for the used antibiotics and the most common resistance was for ciprofloxacin and chloramphenicol (57.1% for each). MRSA was isolated mainly from health care workers (17.02%). The frequency of SCCmecA was 60.7% for type I, 25% for type III and 14.3% for type II. Chromogenic agar identified correctly MRSA isolates in 92.9%. PCR was positive in all isolates with resistance to cefoxitin disc. CONCLUSIONS The present study highlights that MRSA carriage is common among health care workers in one Egyptian tertiary care hospital. The major genotype of MRSA is belonging to SCCmecA type I followed by type III and type II. ChromID medium is an accurrate culture method for detection of MRSA compared to molecular method.
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Affiliation(s)
- Walaa Othman Elshabrawy
- Clinical Pathology Department, Mansoura Faculty of Medicine, Mansoura, Egypt,Corresponding author: Dr. Walaa Othman Elshabrawy, Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt. Tel: +201063781102,
| | - Maysaa Elsayed Zaki
- Clinical Pathology Department, Mansoura Faculty of Medicine, Mansoura, Egypt
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10
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van der Heijden IM, de Oliveira LM, Brito GC, Abdala E, Freire MP, Rossi F, D'Albuquerque LAC, Levin ASS, Costa SF. Virulence and resistance profiles of MRSA isolates in pre- and post-liver transplantation patients using microarray. J Med Microbiol 2016; 65:1060-1073. [PMID: 27473165 DOI: 10.1099/jmm.0.000324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) screening plays a great role in preventing infections in surgical patients. This study aims to evaluate clonality, virulence and resistance of MRSA in pre- and post-liver transplantation (LT) patients. Nasal and groin swabs of 190 patients were collected. PCR for virulence genes and staphylococcal cassette chromosome mec (SCCmec) types, microarray, PFGE, multilocus sequence typing and MIC were performed. MRSA carriers were detected in 20.5 % (39/190) of the patients. However, only three colonized patients developed infections post-LT. Sixty-nine MRSA isolates were identified, and the most frequent SCCmec type was type II (29/69; 42.0 %). Most isolates (57/69; 82.6 %) were susceptible to trimethoprim-sulfamethoxazole (TMP/SMX) and harboured the lukD, lukE, clf and fnbA genes as determined by PCR. Five sequence types (ST) were identified among nine clones; 36.2 % (25/69) isolates belonged to a predominant clone (ST105 and SCCmec type II) that was susceptible to TMP/SMX, mupirocin and chlorhexidine, which had 87.9 % similarity with the New York/Japan clone. The array showed virulence difference in isolates of the same clone and patients and that colonized isolates (pre-LT patients) were less virulent than those post-LT and those infected. Therefore, despite the high frequency of MRSA colonization, infection due to MRSA was uncommon in our LT unit. MRSA isolates presented great diversity. Isolates of the same clone expressed different virulence factors by array. Colonizing isolates pre-LT expressed less virulent factors than post-LT and infecting isolates.
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Affiliation(s)
- Inneke Marie van der Heijden
- Department of Infectious Diseases, Laboratory of Medical Investigation (LIM 54), Hospital das Clínicas - FMUSP, Sao Paulo, Brazil.,Department of Infectious Diseases, FMUSP, University of Sao Paulo, Brazil.,Department of Pathology, Discipline of Microbiology and Immunology, ABC Medicine School, FMABC, Santo André, Brazil
| | - Larissa Marques de Oliveira
- Department of Infectious Diseases, FMUSP, University of Sao Paulo, Brazil.,Department of Infectious Diseases, Laboratory of Medical Investigation (LIM 54), Hospital das Clínicas - FMUSP, Sao Paulo, Brazil
| | - Glauber Costa Brito
- ICESP - Institute of Cancer of Sao Paulo, FFM, University of Sao Paulo, Brazil
| | - Edson Abdala
- Department of Infectious Diseases, FMUSP, University of Sao Paulo, Brazil
| | | | - Flavia Rossi
- Department of Pathology, Division of Microbiology of the Central Laboratory (LIM 03), Hospital das Clínicas - FMUSP, University of Sao Paulo, Brazil
| | - Luiz Augusto Carneiro D'Albuquerque
- Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, Hospital das Clínicas - FMUSP, University of Sao Paulo, Brazil
| | - Anna Sara Shafferman Levin
- Department of Infectious Diseases, FMUSP, University of Sao Paulo, Brazil.,Department of Infectious Diseases, Laboratory of Medical Investigation (LIM 54), Hospital das Clínicas - FMUSP, Sao Paulo, Brazil.,Department of Infection Control, Hospital das Clínicas - FMUSP, University of Sao Paulo, Brazil
| | - Silvia Figueiredo Costa
- Department of Infectious Diseases, FMUSP, University of Sao Paulo, Brazil.,Department of Infectious Diseases, Laboratory of Medical Investigation (LIM 54), Hospital das Clínicas - FMUSP, Sao Paulo, Brazil.,Department of Infection Control, Hospital das Clínicas - FMUSP, University of Sao Paulo, Brazil
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11
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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: 0.6] [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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12
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Davoudi A, Najafi N, Alian S, Tayebi A, Ahangarkani F, Rouhi S, Heydari A. Resistance Pattern of Antibiotics in Patient Underwent Open Heart Surgery With Nosocomial Infection in North of Iran. Glob J Health Sci 2015; 8:288-97. [PMID: 26383221 PMCID: PMC4803946 DOI: 10.5539/gjhs.v8n2p288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/20/2015] [Accepted: 07/09/2015] [Indexed: 12/18/2022] Open
Abstract
Background: Patients who undergo cardiac surgery appear to be at increased risk for the development of Nosocomial infections (NIs). The development of antibiotic-resistant infections has been associated with significantly greater hospital mortality rates compared to similar infections caused by antibiotic-sensitive pathogens. Objectives: The purpose of this study is survey of Nis and antibiotic resistance patterns of causative bacteria among patients who underwent open heart surgery in the north of Iran during a 2-year period between September 2012 and September 2014. Methods: In this cross-sectional study we evaluated 187 patients that underwent open heart surgery with NIs. Demographic feature, clinical characteristics and risk factors of each infection were recorded. The antibiotic susceptibility test was performed using the Minimum inhibitory concentration (MIC) method according to the standard protocol of Clinical & Laboratory Standards Institute (CLSI). Detection of Extended-spectrum beta-lactamase (ESBL) producing bacteria was performed by the double-disk synergy (DDS) test; also Methicillin-resistant Staphylococcus (MRSA) strains were identified by MRSA Screen Agar. The collected data were analyzed using the SPSS software (ver. 16) and, descriptive statistics were used. Results: Out Of total of 2253 hospitalized patients who underwent open heart surgery, 187(5.05%) patients had NIs. 51.9% of the patients were female. The rates of surgical site infection (SSI), respiratory tract infection, endocarditis, Urinary tract infection (UTI), blood Infection and mediastinitis were 27.80, 25.66%, 17.64, 17.11% 8.55% and 3.20% respectively. E.coli and S.aureus were the most causative agents of NIs. The rate of ESBL-producing bacteria was 14.28- 71.42% among enterobacteriaceae and the rate of MRSA was 54.2% among S.aureus strains. All isolated Acinetobacter.spp were Multi-drug resistance (MDR). Conclusions: We showed that the rate of NIs among these high-risk patients was in the average level. But the emergence of MRSA and ESBL bacteria is increasing in our region.
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Affiliation(s)
| | | | | | | | - Fatemeh Ahangarkani
- Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran university of medical sciences, Sari, Iran.
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13
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Molecular analysis and susceptibility pattern of meticillin-resistant Staphylococcus aureus strains in emergency department patients and related risk factors in Iran. J Hosp Infect 2015; 89:186-91. [DOI: 10.1016/j.jhin.2014.11.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 11/21/2014] [Indexed: 11/22/2022]
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14
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Pires FV, da Cunha MDLRDS, Abraão LM, Martins PYF, Camargo CH, Fortaleza CMCB. Nasal carriage of Staphylococcus aureus in Botucatu, Brazil: a population-based survey. PLoS One 2014; 9:e92537. [PMID: 24663818 PMCID: PMC3963891 DOI: 10.1371/journal.pone.0092537] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 02/23/2014] [Indexed: 11/29/2022] Open
Abstract
Recent increases in the incidence and severity of staphylococcal infections renewed interest in studies that assess the burden of asymptomatic carriage of Staphylococcus aureus in the community setting. We conducted a population-based survey in the city of Botucatu, Brazil (122,000 inhabitants), in order to identify the prevalence of nasal carriage of Staphylococcus aureus (including methicillin-resistant strains). Nasal swabs were obtained from 686 persons over one year of age. Resistance to methicillin was assessed through phenotypic methods, identification of the mecA gene and typing of the Staphylococcal Chromosome Cassette mec (SCCmec). Methicillin-resistant S. aureus (MRSA) isolates were characterized using Pulsed-Field Gel Electrophoresis (PFGE), Multilocus Sequence Typing (MLST) and spa typing. Polymerase chain reaction was applied to identify genes coding for Panton-Valentine Leukocidin (PVL) in isolates. The prevalence of overall S. aureus carriage was 32.7% (95%CI, 29.2%–36.2%). Carriers were significantly younger (mean age, 28.1 versus 36.3 for non-carriers; OR for age, 0.98; 95%CI, 0.97–0.99) and likely to report recent skin infection (OR, 1.85; 95%CI, 1.03–3.34). Carriage of methicillin-resistant S. aureus (MRSA) was found in 0.9% of study subjects (95%CI, 0.4%–1.8%). All MRSA isolates harbored SCCmec type IV, and belonged to spa types t002 or t021, but none among them harbored genes coding for PLV. In MLST, most isolates belonged to clones ST5 or ST1776. However, we found one subject who carried a novel clone, ST2594. Two out of six MRSA carriers had household contacts colonized with isolates similar to theirs. Our study pointed to dissemination of community-associated MRSA among the Brazilian population.
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Affiliation(s)
- Fabiana Venegas Pires
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | | | - Lígia Maria Abraão
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | - Patrícia Y. F. Martins
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
| | - Carlos Henrique Camargo
- Departamento de Microbiologia e Imunologia, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, Brazil
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Haddadin RN, Saleh SA, Ayyash MA, Collier PJ. Occupational exposure of pharmaceutical workers to drug actives and excipients and their effect on Staphylococcus spp. nasal carriage and antibiotic resistance. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2013; 19:207-14. [PMID: 23885773 DOI: 10.1179/2049396713y.0000000035] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Pharmaceutical manufacturing workers are exposed to significant amounts of product ingredients, including antibiotics. Such exposure could affect their nasal microflora. OBJECTIVE To assess the effect of exposure to various unidentified pharmaceutical ingredients in cephalosporin-manufacturing and non-cephalosporin plants on the nasal carriage of Staphylococcus spp. and their antibiotic resistance. METHODS Nasal swab samples were collected from 39 workers in both plants on three different occasions. Staphylococci were isolated and identified to genus level. Antibiotic resistance profiles were determined and subsequent identification to species level was performed. RESULTS There was complete absence of S. aureus in the samples collected from workers in both facilities. Multiple drug resistant coagulase-negative staphylococci (MDR CONS) prevalence rates were higher in the non-cephalosporin plant than in the cephalosporin plant, with resistance towards six classes of antibiotics. S. epidermidis was the prevalent species in the non-cephalosporin plant and S. haemolyticus prevailed in the cephalosporin-producing plant. CONCLUSIONS The observed prevalence of CONS in both production plants was the same. However, exposure to intermittent non-cephalosporin pharmaceuticals results in higher prevalence of MDR CONS compared to continuous exposure to cephalosporin.
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16
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Caiaffa-Filho HH, Trindade PA, Gabriela da Cunha P, Alencar CS, Prado GVB, Rossi F, Levin AS. Methicillin-resistant Staphylococcus aureus carrying SCCmec type II was more frequent than the Brazilian endemic clone as a cause of nosocomial bacteremia. Diagn Microbiol Infect Dis 2013; 76:518-20. [PMID: 23719088 DOI: 10.1016/j.diagmicrobio.2013.04.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/17/2013] [Accepted: 04/20/2013] [Indexed: 11/25/2022]
Abstract
Fifty consecutive MRSA blood isolates were evaluated: 30(60%) carried SCCmec type II (single PFGE clone; sequence type 5 or ST105); 12 (26%), IV; 5 (10%), III; 3 (6%), I. Brazilian endemic clone, carrying SCCmec type III, has been the main nosocomial clone in Brazil; however, this study showed that a clone carrying type II predominated.
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Affiliation(s)
- Helio Hehl Caiaffa-Filho
- Molecular Biology Branch, Central Laboratory Division and Medical Investigation Laboratories LIM/03, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
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17
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Methicillin-resistant Staphylococcus aureus in Rio de Janeiro hospitals: dissemination of the USA400/ST1 and USA800/ST5 SCCmec type IV and USA100/ST5 SCCmec type II lineages in a public institution and polyclonal presence in a private one. Am J Infect Control 2013; 41:e21-6. [PMID: 23261682 DOI: 10.1016/j.ajic.2012.08.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 08/20/2012] [Accepted: 08/22/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) infections have changed since certain non-multiresistant MRSA lineages have emerged in hospitals. In this study, 99 MRSA isolates, 77 from a public and 22 from a private hospital, were characterized. METHODS Isolates were tested for antimicrobial susceptibility, whereas staphylococcal chromosomal cassette mec (SCCmec) typing and Panton-Valentine leukocidin genes were assessed by polymerase chain reaction. Pulsed-field gel electrophoresis and multilocus sequence typing analyses were carried out to determine the MRSA lineages. RESULTS High rates of resistance were found to erythromycin (96%), ciprofloxacin (93%), and clindamycin (90%). The SCCmec types found were as follows: type II (14.2%), III (62.6%), and IV (23.2%). Approximately 85% of type III isolates was related to the Brazilian epidemic clone in both hospitals. For type IV isolates, 94.4% were related to both USA400/ sequence type (ST) 1 and USA800/ST5 lineages in the public hospital, whereas the USA400/ST1, USA800/ST5, USA1100/ST30, and EMRSA (Epidemic MRSA)-15/ST22 lineages were detected in the private hospital. Among the SCCmec II isolates, approximately 85% were related to the USA100/ST5 lineage. Three MRSA isolates were positive to Panton-Valentine leukocidin genes. CONCLUSION The study showed that there was an emergence of USA400/ST1, USA800/ST5 SCCmec IV, and USA100/ST5 SCCmec II MRSA lineages in both hospitals. There was a dissemination of them in the public hospital and a polyclonal presence of the MRSA isolates in the private hospital. The spread of these lineages can be facilitated by the characteristics of the health institution.
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Leejae S, Hasap L, Voravuthikunchai SP. Inhibition of staphyloxanthin biosynthesis in Staphylococcus aureus by rhodomyrtone, a novel antibiotic candidate. J Med Microbiol 2012; 62:421-428. [PMID: 23242641 DOI: 10.1099/jmm.0.047316-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Staphyloxanthin is the eponymous feature of the human pathogen Staphylococcus aureus, and the pigment promotes resistance to reactive oxygen species and host neutrophil-based killing. To probe the possible use of rhodomyrtone isolated from Rhodomyrtus tomentosa (Aiton) Hassk. leaves to inhibit pigment production in S. aureus, experiments were carried out to compare pigment production and the susceptibility of rhodomyrtone-treated S. aureus and untreated cells to oxidants in vitro. In addition, we observed the innate immune clearance of S. aureus after incubation with rhodomyrtone using an ex vivo assay system - human whole-blood survival. The results indicated that rhodomyrtone-treated S. aureus exhibited reduced pigmentation, and that rhodomyrtone treatment led to a dose-dependent increase in the susceptibility of the pathogen to H(2)O(2) and singlet oxygen killing. Consequently, the survival ability of the treated organisms decreased in freshly isolated human whole blood due to less carotenoid pigment to act as an antioxidant scavenger. Rhodomyrtone may be acting via effects on DnaK and/or σ(B), resulting in many additional effects on bacterial virulence.
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Affiliation(s)
- Sukanlaya Leejae
- Department of Microbiology and Natural Products Research Center, Faculty of Science, Prince of Songkla University, Songkhla 90112, Thailand
| | - Laila Hasap
- Department of Microbiology and Natural Products Research Center, Faculty of Science, Prince of Songkla University, Songkhla 90112, Thailand
| | - Supayang Piyawan Voravuthikunchai
- Department of Microbiology and Natural Products Research Center, Faculty of Science, Prince of Songkla University, Songkhla 90112, Thailand
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Rocha-e-Silva M. Molecular and genetic aspects of oncology and infectology in Clinics. Clinics (Sao Paulo) 2012; 67:1353-6. [PMID: 23295585 PMCID: PMC3521794 DOI: 10.6061/clinics/2012(12)01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Cursino MA, Garcia CP, Lobo RD, Salomão MC, Gobara S, Raymundo GF, Kespers T, Soares RE, Mollaco CH, Keil KG, Malieno PB, Krebs VL, Gibelli MA, Kondo MM, Zugaib M, Costa SF, Levin AS. Performance of surveillance cultures at different body sites to identify asymptomatic Staphylococcus aureus carriers. Diagn Microbiol Infect Dis 2012; 74:343-8. [PMID: 22995367 DOI: 10.1016/j.diagmicrobio.2012.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 08/06/2012] [Accepted: 08/10/2012] [Indexed: 10/27/2022]
Abstract
The objective was to evaluate the performance of surveillance cultures at various body sites for Staphylococcus aureus colonization in pregnant women and newborns (NB) and the factors associated with nasal colonization. For NB, 4 sites were evaluated: nares, oropharynx, perineum, and umbilical stump (birth, third day, and weekly). For pregnant women, 4 sites during labor: anterior nares, anus, perineum, and oropharynx. Nasally colonized patients were compared with colonized only extranasally. Colonization was 53% of 392 pregnant women (methicillin-resistant S. aureus [MRSA]: 4%) and 47% of 382 NB (MRSA: 9%). For newborn patients, the best body site was the umbilical stump (methicillin-susceptible S. aureus [MSSA]: 64%; MRSA: 68%) and the combination of nares + umbilical (MSSA: 86%; MRSA: 91%). Among pregnant women, the best body site was the anterior nares (MSSA: 59%; MRSA: 67%) and the combination of nares + oropharynx (MSSA: 83%; MRSA: 80%). A smaller number of household members were associated with MRSA carriage in pregnant women (2.2 ± 0.6 versus 3.6 ± 1.8; P = 0.04). In conclusion, multiple culture sites are needed. Control programs based on surveillance cultures may be compromised.
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Affiliation(s)
- Maria A Cursino
- Department of Infectious Diseases and LIM-54, University of São Paulo, 05403-900 São Paulo, Brazil
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