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Saha E, Khan A, Mallick AI, Mitra J. Purpose-built multicomponent supramolecular silver(I)-hydrogels as membrane-targeting broad-spectrum antibacterial agents against multidrug-resistant pathogens. J Mater Chem B 2024; 12:8767-8777. [PMID: 39140272 DOI: 10.1039/d4tb01355g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Membrane-targeting compounds are of immense interest to counter complicated multi-drug resistant infections. However, the broad-spectrum effect of such compounds is often unmet due to the surges of antibiotic resistance among majority of Gram-negative bacteria compared to Gram-positive species. Though amphiphiles, synthetic mimics of antimicrobial peptides etc, have been extensively explored for their potential to perturb bacterial membranes, small molecule-based supramolecular hydrogels have remained unexplored. The design of supramolecular hydrogels can be tuned on-demand, catering to desired applications, including facile bacterial membrane perturbation. Considering the strong biocidal properties of Ag-based systems and the bacterial membrane-targeting potential of appended primary amine groups, we designed self-assembled multicomponent supramolecular Ag(I)-hydrogels with urea and DATr (3,5-diamino-1,2,4-triazole) as ligands, which are predisposed for hydrogen bonding and interacting with negatively charged bacterial membranes at physiological pH. The synthesized supramolecular Ag(I)-hydrogels exhibited almost similar antibacterial activity against both Gram-negative (Campylobacter jejuni; C. jejuni) and Gram-positive (Staphylococcus aureus; S. aureus) bacteria, with minimal inhibitory concentration (MIC) of ∼60 μg mL-1. Ag(I)-hydrogels facilitated the disruption of the negatively charged bacterial membrane due to electrostatic interaction and complementary hydrogen bonding facilitated by DATr and urea. Sustained intracellular ROS generation in the presence of Ag(I)-hydrogel further expedited cell lysis. We envisage that the multicomponent supramolecular Ag(I)-hydrogels studied herein can be employed in designing effective antibacterial coatings on a range of medical devices, including surgical instruments. Moreover, the present form of the hydrogels has the potential to improve the antibacterial functionality of conventional antimicrobials, thus revitalizing the effective targeting of hard-to-treat multi-drug-resistant (MDR) bacterial infections in a clinical set up.
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Affiliation(s)
- Ekata Saha
- Inorganic Materials & Catalysis (IMC) Division, CSIR-Central Salt & Marine Chemicals Research Institute, Gijubhai Badheka Marg, Bhavnagar-364002, Gujarat, India.
- Academy of Scientific and Innovative Research (AcSIR), AcSIR Headquarters, CSIR-HRDC Campus, Ghaziabad-201002, UP, India
| | - Afruja Khan
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, Nadia, West Bengal-741246, India.
| | - Amirul Islam Mallick
- Department of Biological Sciences, Indian Institute of Science Education and Research Kolkata, Mohanpur, Nadia, West Bengal-741246, India.
| | - Joyee Mitra
- Inorganic Materials & Catalysis (IMC) Division, CSIR-Central Salt & Marine Chemicals Research Institute, Gijubhai Badheka Marg, Bhavnagar-364002, Gujarat, India.
- Academy of Scientific and Innovative Research (AcSIR), AcSIR Headquarters, CSIR-HRDC Campus, Ghaziabad-201002, UP, India
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Narayana Iyengar S, Dowden B, Ragheb K, Patsekin V, Rajwa B, Bae E, Robinson JP. Identifying antibiotic-resistant strains via cell sorting and elastic-light-scatter phenotyping. Appl Microbiol Biotechnol 2024; 108:406. [PMID: 38958764 PMCID: PMC11222266 DOI: 10.1007/s00253-024-13232-0] [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: 11/17/2023] [Revised: 03/04/2024] [Accepted: 03/19/2024] [Indexed: 07/04/2024]
Abstract
The proliferation and dissemination of antimicrobial-resistant bacteria is an increasingly global challenge and is attributed mainly to the excessive or improper use of antibiotics. Currently, the gold-standard phenotypic methodology for detecting resistant strains is agar plating, which is a time-consuming process that involves multiple subculturing steps. Genotypic analysis techniques are fast, but they require pure starting samples and cannot differentiate between viable and non-viable organisms. Thus, there is a need to develop a better method to identify and prevent the spread of antimicrobial resistance. This work presents a novel method for detecting and identifying antibiotic-resistant strains by combining a cell sorter for bacterial detection and an elastic-light-scattering method for bacterial classification. The cell sorter was equipped with safety mechanisms for handling pathogenic organisms and enabled precise placement of individual bacteria onto an agar plate. The patterning was performed on an antibiotic-gradient plate, where the growth of colonies in sections with high antibiotic concentrations confirmed the presence of a resistant strain. The antibiotic-gradient plate was also tested with an elastic-light-scattering device where each colony's unique colony scatter pattern was recorded and classified using machine learning for rapid identification of bacteria. Sorting and patterning bacteria on an antibiotic-gradient plate using a cell sorter reduced the number of subculturing steps and allowed direct qualitative binary detection of resistant strains. Elastic-light-scattering technology is a rapid, label-free, and non-destructive method that permits instantaneous classification of pathogenic strains based on the unique bacterial colony scatter pattern. KEY POINTS: • Individual bacteria cells are placed on gradient agar plates by a cell sorter • Laser-light scatter patterns are used to recognize antibiotic-resistant organisms • Scatter patterns formed by colonies correspond to AMR-associated phenotypes.
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Affiliation(s)
| | - Brianna Dowden
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Kathy Ragheb
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Valery Patsekin
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Bartek Rajwa
- Bindley Bioscience Center, Purdue University, West Lafayette, IN, 47907, USA
| | - Euiwon Bae
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - J Paul Robinson
- Department of Basic Medical Sciences, Purdue University, West Lafayette, IN, 47907, USA.
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA.
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Abdullahi IN, Lozano C, Ruiz-Ripa L, Fernández-Fernández R, Zarazaga M, Torres C. Ecology and Genetic Lineages of Nasal Staphylococcus aureus and MRSA Carriage in Healthy Persons with or without Animal-Related Occupational Risks of Colonization: A Review of Global Reports. Pathogens 2021; 10:1000. [PMID: 34451464 PMCID: PMC8400700 DOI: 10.3390/pathogens10081000] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 01/16/2023] Open
Abstract
In this conceptual review, we thoroughly searched for appropriate English articles on nasal staphylococci carriage among healthy people with no reported risk of colonization (Group A), food handlers (Group B), veterinarians (Group C), and livestock farmers (Group D) published between 2000 and 2021. Random-effects analyses of proportions were performed to determine the pooled prevalence of S. aureus, MRSA, MRSA-CC398, and MSSA-CC398, as well as the prevalence of PVL-positive S. aureus from all eligible studies. A total of 166 eligible papers were evaluated for Groups A/B/C/D (n = 58/31/26/51). The pooled prevalence of S. aureus and MRSA in healthy humans of Groups A to D were 15.9, 7.8, 34.9, and 27.1%, and 0.8, 0.9, 8.6, and 13.5%, respectively. The pooled prevalence of MRSA-CC398 nasal carriage among healthy humans was as follows: Group A/B (<0.05%), Group C (1.4%), Group D (5.4%); and the following among Group D: pig farmers (8.4%) and dairy farmers (4.7%). The pooled prevalence of CC398 lineage among the MSSA and MRSA isolates from studies of the four groups were Group A (2.9 and 6.9%), B (1.5 and 0.0%), C (47.6% in MRSA), and D (11.5 and 58.8%). Moreover, MSSA-CC398 isolates of Groups A and B were mostly of spa-t571 (animal-independent clade), while those of Groups C and D were spa-t011 and t034. The MRSA-CC398 was predominately of t011 and t034 in all the groups (with few other spa-types, livestock-associated clades). The pooled prevalence of MSSA and MRSA isolates carrying the PVL encoding genes were 11.5 and 9.6% (ranges: 0.0-76.9 and 0.0-28.6%), respectively. Moreover, one PVL-positive MSSA-t011-CC398 isolate was detected in Group A. Contact with livestock and veterinary practice seems to increase the risk of carrying MRSA-CC398, but not in food handlers. Thus, this emphasizes the need for integrated molecular epidemiology of zoonotic staphylococci.
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Affiliation(s)
| | | | | | | | | | - Carmen Torres
- Area of Biochemistry and Molecular Biology, University of La Rioja, Madre de Dios 53, 26006 Logroño, Spain; (I.N.A.); (C.L.); (L.R.-R.); (R.F.-F.); (M.Z.)
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Gram Positive Bacteria Carriage among Health Care Workers: An Under-Reported Source of Infections? JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.4.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Staphylococcus aureus and Streptococcus pyogenes are two highly infectious pathogens implicated in a significant percentage of healthcare associated infections. They produce wide range of infections, from mere folliculitis & furuncles, cellulitis, myositis, & glomerulonephritis to conditions with very significant morbidity such as necrotizing fasciitis & Toxic Shock syndrome, and thus represent an important subset of infections that need to be tackled urgently. To assess prevalence of nasal as well as oropharyngeal carriage of Staphylococcus aureus & Streptococcus pyogenes among health-care workers and its antimicrobial resistance pattern. One nasal swab & two oropharyngeal swabs were collected from each participant, with one nasal & oropharyngeal swab cultured on blood agar & mannitol salt agar for Staphylococcus aureus, and the second oropharyngeal swabs were cultured on Crystal violet blood agar for Streptococcus pyogenes, further subjected to susceptibility test by disc diffusion method on Muller-Hinton agar as per CLSI guidelines 2019. Prevalence of Staphylococcus aureus carriage was 9% which includes 4% It is nasal, 4.5% oropharyngeal & 0.5% both. Prevalence of MRSA, MLSB & mupirocin resistant Staphylococcus aureus was 1.5%,4% & 0%respectively. Prevalence of oropharyngeal carriage of Streptococcus pyogenes was 1.5%. This study feature the need of screening of Health-care workers for nasal as well as oropharyngeal carriage of Staphylococcus aureus & Streptococcus pyogenes & further its antimicrobial resistance pattern.
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Archana GJ, Sinha AY, Annamanedi M, Asrith KP, Kale SB, Kurkure NV, Doijad SP, Nagamani K, Hegde NR. Molecular characterisation of methicillin-resistant Staphylococcus aureus isolated from patients at a tertiary care hospital in Hyderabad, South India. Indian J Med Microbiol 2020; 38:183-191. [PMID: 32883932 DOI: 10.4103/ijmm.ijmm_20_151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Context Infections with methicillin-resistant Staphylococcus aureus (MRSA) greatly influence clinical outcome. Molecular characterisation of MRSA can help to predict their spread and to institute treatment and hospital protocols. Aim The aim of this study is to understand the diversity of MRSA in a tertiary care hospital in Hyderabad, India. Settings and Design Samples collected at Gandhi Medical College, Hyderabad, and designed to assess hospital-or community-associated MRSA (HA-MRSA or CA-MRSA). Subjects and Methods MRSA were subjected to antibiotic susceptibility testing, pulsed-field gel electrophoresis (PFGE), spa typing, multi-locus sequence typing and staphylococcal cassette chromosome-mec (SCCmec) typing. Statistical Analysis Used Discriminatory index and 95% confidence interval. Results Of the 30 MRSA, (a) 18 and 12 were HA-MRSA and CA-MRSA, respectively, and (b) 23.3% and 6.6% displayed induced clindamycin and intermediate vancomycin resistance, respectively. Genetic diversity was evident from the presence of (a) 20 pulsotypes, (b) eight spa types, with the predominance of t064 (n = 9) and (c) seven sequence types (ST), with the preponderance of ST22 and ST8 (9 each). ST22 and ST8 were the most prevalent among HA-MRSA and CA-MRSA, respectively. SCCmec type IV was the most frequent (n = 8). 44.4% of HA-MRSA belonged to SCCmec IV and V, whereas 33.3% of CA-MRSA belonged to SCCmec I and III; 33.3% (5/15) of the isolates harbouring the pvl gene belonged to SCCmec IVC/H. Conclusions ST8 was a dominant type along with other previously reported types ST22, ST239, and ST772 from India. The observations highlight the prevalence of genetically diverse clonal populations of MRSA, suggesting potential multiple origins.
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Affiliation(s)
- Ganapuram J Archana
- Department of Microbiology, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
| | - Akhauri Yash Sinha
- Ella Foundation, Genome Valley, Turkapally, Shameerpet Mandal, Telangana, India
| | | | | | - Satyajit B Kale
- Department of Veterinary Pathology, Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University, Nagpur, Maharashtra, India
| | - Nitin V Kurkure
- Department of Veterinary Pathology, Nagpur Veterinary College, Maharashtra Animal and Fishery Sciences University, Nagpur, Maharashtra, India
| | - Swapnil P Doijad
- Division of Veterinary Public Health, ICAR Research Complex for Goa, Old Goa, Goa, India
| | - Kammili Nagamani
- Department of Microbiology, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
| | - Nagendra R Hegde
- National Institute of Animal Biotechnology, Hyderabad, Telangana, India
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Gurung RR, Maharjan P, Chhetri GG. Antibiotic resistance pattern of Staphylococcus aureus with reference to MRSA isolates from pediatric patients. Future Sci OA 2020; 6:FSO464. [PMID: 32257376 PMCID: PMC7117559 DOI: 10.2144/fsoa-2019-0122] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim: The extent of methicillin-resistant Staphylococcus aureus (MRSA) infection in Nepalese children is largely unknown. Materials & methods: Six hundred and seventy-two clinical samples collected from 232 patients between June and November 2016 were processed in a microbiology laboratory. Results: Out of 300 culture-positive samples, 52 (17.3%) were S. aureus isolates. Among those 52, 39 (75.0%) were found to be MRSA. The infection rate of S. aureus was shown to be higher in inpatients (55.7%) compared with outpatients (44.3%) at p = 0.637, 95% CI. Thirteen types of antibiotics were used in the antibiotic susceptibility test. MRSA isolates showed 100 and 0% resistance to penicillin and vancomycin, respectively. The D-test showed inducible clindamycin-resistant phenotype in 15.4% of MRSA isolates. Conclusion: This demonstrates the utmost need for routine testing for MRSA in Nepalese hospitals. The problem of antibiotic resistance is rising worldwide. Methicillin antibiotic-resistant Staphylococcus aureus (i.e., MRSA) infection is one of the bacterial infections that contribute to increased health and economic burdens. An accurate understanding of the MRSA infection status in Nepalese children is not available to date. Thus, the current research was performed in a pediatric hospital. We also discovered that MRSA is not tested routinely and thus we recommend it should be monitored regularly, as with other bacterial infections.
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Affiliation(s)
- Raja Ram Gurung
- Tri-Chandra Multiple Campus affiliated to Tribhuvan University, Department of Microbiology, Kirtipur, Kathmandu 44600, Nepal.,Biotechnology Society of Nepal (BSN), Rani Devi Marg, Kathmandu 44600, Nepal
| | - Prashanna Maharjan
- Biotechnology Society of Nepal (BSN), Rani Devi Marg, Kathmandu 44600, Nepal.,Amrit Science Campus affiliated to Tribhuvan University, Department of Microbiology, Thamel, Kathmandu 44600, Nepal
| | - Ganga Gharti Chhetri
- Tri-Chandra Multiple Campus affiliated to Tribhuvan University, Department of Microbiology, Kirtipur, Kathmandu 44600, Nepal
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Ahmadi E, Khojasteh M, Mortazavi SM, Khan-Mohammadi F, Kazemnia A, Beheshtipour J, Raeeszadeh M. Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus nasal carriage in the West of Iran: a population-based cross-sectional study. BMC Infect Dis 2019; 19:899. [PMID: 31660878 PMCID: PMC6819401 DOI: 10.1186/s12879-019-4567-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 10/16/2019] [Indexed: 02/06/2023] Open
Abstract
Background Several reports designate the recent increase in community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) nasal carriage. Because of the scanty information regarding the nasal carriage sate of MRSA in the west of Iran, the purpose of the present study was to determine the frequency of CA-MRSA in Sanandaj city. Methods Swabs collected from anterior nares of 600 volunteers were analyzed for the presence of S. aureus. The isolates were further investigated for methicillin resistance by using the cefoxitin disk diffusion test, followed by PCR-amplification of the mecA gene. SCCmec types and the presence of the Panton-Valentine Leukocidin (pvl) encoding genes were determined through PCR. Finally, the antimicrobial susceptibility of the isolates was determined by the agar diffusion method. Results Nasal screening identified 181 S. aureus, of which 55 isolates were MRSA. SCCmec types IV and V were detected in MRSA at frequencies of 80 and 20%, respectively. The overall frequency of pvl genes among the MRSA isolates was 14.54%. MRSA isolates were highly susceptible (98.18%) to mupirocin, gentamicin, and fusidic acid. Conclusions The high prevalence of CA-MRSA carriage in the population could pose a serious public health concern for the region. Additionally, advent of drug-resistant pvl-positive strains demands continuous surveillance on the colonization state of CA-MRSA in order to prevent dissemination of the bacterium in the community.
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Affiliation(s)
- Elham Ahmadi
- Department of Pathobiology, Faculty of Veterinary Medicine, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran.
| | - Mohammad Khojasteh
- Department of Pathobiology, Faculty of Veterinary Medicine, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Seyed Mohammad Mortazavi
- Department of Pathobiology, Faculty of Veterinary Medicine, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Fatemeh Khan-Mohammadi
- Department of Microbiology, Faculty of Basic Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Ali Kazemnia
- Department of Microbiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Javad Beheshtipour
- Young Researchers and Elite Club, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Mahdieh Raeeszadeh
- Department of Basic Sciences, Faculty of Veterinary Medicine, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
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Lechner AM, Past E, Porsche U, Kern JM, Hoppe U, Pretsch I. Two cases of serious rhabdomyolysis during linezolid treatment. Infection 2017; 45:563-566. [PMID: 28083787 PMCID: PMC5529475 DOI: 10.1007/s15010-016-0978-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 12/29/2016] [Indexed: 11/29/2022]
Abstract
Linezolid is an oxazolidinone antibiotic with activity against gram-positive organisms, particularly methicillin-resistant Staphylococcus aureus (MRSA). To the best of our knowledge, there are only two case reports on rhabdomyolysis in patients treated with linezolid. Here, we describe two cases of serious rhabdomyolysis: one in a patient with septic community-acquired (CA)-MRSA pneumonia and a second case in a patient with suspected catheter-related blood stream infection.
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Affiliation(s)
- Arno M Lechner
- Division Medizinische Mikrobiologie, Paracelsus Medizinische Universität Salzburg, Universitätsinstitut für Medizinisch-Chemische Labordiagnostik, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.
| | - Eva Past
- Landesapotheke Salzburg, Muellner Hauptstrasse 50, 5020, Salzburg, Austria.
| | - Ulla Porsche
- Landesapotheke Salzburg, Muellner Hauptstrasse 50, 5020, Salzburg, Austria
| | - Jan M Kern
- Division Medizinische Mikrobiologie, Paracelsus Medizinische Universität Salzburg, Universitätsinstitut für Medizinisch-Chemische Labordiagnostik, Muellner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Uta Hoppe
- Paracelsus Medizinische Universität Salzburg, Universitätsklinik für Innere Medizin II, Muellner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Ingrid Pretsch
- Paracelsus Medizinische Universität Salzburg, Universitätsklinik für Innere Medizin II, Muellner Hauptstrasse 48, 5020, Salzburg, Austria
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Prevalence and genotype distribution of methicillin-resistant Staphylococcus aureus (MRSA) in India. J Glob Antimicrob Resist 2016; 7:46-52. [DOI: 10.1016/j.jgar.2016.07.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 07/14/2016] [Accepted: 07/15/2016] [Indexed: 11/18/2022] Open
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Huh K, Chung DR. Changing epidemiology of community-associated methicillin-resistant Staphylococcus aureus in the Asia-Pacific region. Expert Rev Anti Infect Ther 2016; 14:1007-1022. [PMID: 27645549 DOI: 10.1080/14787210.2016.1236684] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become an important threat to public health in the Asia-Pacific region, which is characterized by a large population and relatively insufficient resources. Better understanding on the current status of CA-MRSA in the region is of paramount importance. Areas covered: This article reviews the published literatures on the prevalence, molecular epidemiology, colonization, and hospital spread of CA-MRSA. Expert commentary: The burden of CA-MRSA has been increasing in the past two decades. The molecular epidemiology of CA-MRSA in the Asia-Pacific region shows a marked diversity in each country. Still, some strains - multilocus sequence type (MLST) ST59, ST30, ST72, ST8, and ST772 - are unique clones that have successfully established themselves as predominant, often spreading into nosocomial settings. More coordinated and comprehensive surveillance to understand the true epidemiology of CA-MRSA in the Asia-Pacific region is urgently needed.
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Affiliation(s)
- Kyungmin Huh
- a Division of Infectious Diseases, Department of Internal Medicine , Armed Forces Capital Hospital , Seongnam , Korea
| | - Doo Ryeon Chung
- b Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center , Sungkyunkwan University School of Medicine , Seoul , Korea
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Mobasherizadeh S, Shojaei H, Havaei SA, Mostafavizadeh K, Davoodabadi F, Khorvash F, Kushki AM, Daei-Naser A, Ghanbari F. Nasal carriage screening of community-associated methicillin resistant Staphylococcus aureus in healthy children of a developing country. Adv Biomed Res 2016; 5:144. [PMID: 27656613 PMCID: PMC5025912 DOI: 10.4103/2277-9175.187400] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 10/28/2015] [Indexed: 12/01/2022] Open
Abstract
Background: The rapid emergence and spread of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has raised considerable public health concern in both developed and developing countries. The current study aimed to address the extent of this phenomenon in healthy preschool children of a developing country. Materials and Methods: We conducted a prospective study from April 2013 to March 2014 on 410 healthy 2-6 years old preschool children in Isfahan, Iran. Demographic medical data and nasal samples were collected from the participating children. Isolates were identified as S. aureus and MRSA based on microbiological and molecular tests, including the presence of eap and mecA genes. Results: The overall prevalence of S. aureus and CA-MRSA nasal carriage was 28% (115/410) and 6.1% (25/410), respectively. The identity of isolates was confirmed by molecular assay. The factors that were independently associated with nasal carriage of S. aureus were: Children crowding in day-care nurseries and income level of families. A total of 20/90 (22.2%) of methicillin-susceptible S. aureus and all 25 CA-MRSA displayed multiple drug resistance to 3–8 antibiotics. Conclusions: The current report reflects issues and concerns that the high rate of colonization by CA-MRSA in Iranian healthy children provides obliging evidence that MRSA have established a foothold in the community and are emerging as important health threatening pathogens. It is suggested that we need more effective infection control measures to prevent transmission of nasal CA-MRSA in healthy preschool children.
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Affiliation(s)
- Sina Mobasherizadeh
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hasan Shojaei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Asghar Havaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kamyar Mostafavizadeh
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fazlollah Davoodabadi
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Mehrabi Kushki
- Department of Epidemiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Daei-Naser
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Ghanbari
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Devraj A, Siva Tez Pinnamaneni V, Biswal M, Ramachandran R, Jha V. Extranasal Staphylococcus aureus colonization predisposes to bloodstream infections in patients on hemodialysis with noncuffed internal jugular vein catheters. Hemodial Int 2016; 21:35-40. [PMID: 27358213 DOI: 10.1111/hdi.12450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Staphylococcal infection of endogenous origin is an important cause of morbidity and mortality in patients who receive hemodialysis (HD). The risk of such infections in nasal carriers of the organism is well defined. Extranasal carriage of the organism at extranasal sites may pose similar risks. METHODS A total of 70 patients about to undergo internal jugular vein catheterization for HD were enrolled in this prospective observational study. Swab cultures were obtained from anterior nares, posterior pharynx, axillae, toe web spaces, and vascular access sites at baseline and 1 week later. A patient was defined as a persistent carrier when the same organism was grown in both samples. Staphylococcus aureus bloodstream infections were assessed by blood and catheter tip cultures over a 90-day period. FINDINGS The mean age of the patients was 43.71 ± 16.2 years. Persistent S. aureus carriage at anterior nares, throat, axilla, toe web spaces, vascular access site, and all sites was documented in 27.9%, 11.4%, 40%, 32.9%, 4.3%, and 64.2% of patients, respectively. Fifteen patients developed S. aureus infections. Catheter related S. aureus infections (CRI) were more likely in persistent carriers than nonpersistent carriers with odds ratios (95% CI) of 10.2 (2.8-37.1), 8.6 (1.7-42.2), 17.3 (3.4-86.0), 3.0 (0.9-9.8), and 1.9 (0.2-22.4) for anterior nares, throat, axilla, toe web spaces, and vascular access site carriers, respectively. The probability of developing CRI in persistent S. aureus carriers was 55% compared to none in noncarriers at 90 days (P = 0.04). DISCUSSION Extranasal S. aureus carriage is as significant a risk factor as nasal carriage for staphylococcal infections in patients on HD through catheters. The study is limited by lack of molecular phenotyping.
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Affiliation(s)
- Anand Devraj
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Manisha Biswal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Raja Ramachandran
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivekanand Jha
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,George Institute for Global Health, New Delhi, India
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13
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Kumar H, Kaur A, Kishor N, Goutam U, Palaha R. Prevalence of Multiple Antibiotic Resistant Nasal Carriage MRSA Among Healthy Population of Border Villages in Amritsar Region, Punjab, India. J Clin Diagn Res 2016; 10:DL01-2. [PMID: 27437220 DOI: 10.7860/jcdr/2016/16131.7781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/15/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Harsh Kumar
- Faculty, Department of Microbiology, School of Biotechnology and Biosciences, Lovely Professional University , Punjab, India
| | - Amritbeer Kaur
- Post Graduate Student, Department of Microbiology, School of Biotechnology and Biosciences, Lovely Professional University , Punjab, India
| | - Nitin Kishor
- Post Graduate Student, Department of Microbiology, School of Biotechnology and Biosciences, Lovely Professional University , Punjab, India
| | - Umesh Goutam
- Faculty, Department of Microbiology, School of Biotechnology and Biosciences, Lovely Professional University , Punjab, India
| | - Rajdeep Palaha
- Food Safety Officer, Department of Health, Civil Hospital Barnala, India
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14
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George K, Abdulkader JK, Sugumar M, Rajagopal GK. Prevalence of MRSA Nasal Carriage in Patients Admitted to a Tertiary Care Hospital in Southern India. J Clin Diagn Res 2016; 10:DC11-3. [PMID: 27042461 PMCID: PMC4800526 DOI: 10.7860/jcdr/2016/18259.7262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 01/13/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Infections with MRSA, both community and hospital acquired, are well established and the source of infection is often a carrier. There are very few studies showing the magnitude of MRSA nasal colonization among healthy persons from the community. This study was conducted to detect the prevalence of MRSA nasal carriage in patients who did not have any known risk factors associated with HA- MRSA colonization, admitted to a tertiary care centre in Kerala. MATERIALS AND METHODS Nasal swabs were collected from patients within 24 hours of admission. Specimen were inoculated on chromogenic agar (HiCrome MeReSa agar-HiMedia) for MRSA screening. Isolates were then subjected to antibiotic sensitivity tests, SCCmec typing and PVL gene detection. RESULTS Out of 683 patients, 16 carried MRSA in their nares (2.3%). Of the 16 strains 13 (81.25 %) strain were SCCmec type III and one belonged to SCCmec type IV (6.25 %). Two strains failed to amplify SCCmec genes. Three strains carried genes for PVL toxin (18.75%). CONCLUSION With a better understanding of the complex epidemiology of MRSA it is increasingly apparent that demarcations between the HA and CA phenotypes are not as clear cut as previously thought. In this study of nasal carriage of MRSA in the community we have demonstrated prevalence consistent with published data. Most isolates however were shown to belong to the type conventionally assigned to HA-MRSA.
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Affiliation(s)
- Kalpana George
- Assistant Professor, Department of Microbiology, Government Medical College, Kozhikode, Kerala, India
| | | | - Madhan Sugumar
- Research Fellow, Department of Microbiology, JIPMER, Puducherry, India
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15
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Govindan S, Maroli AS, Ciraj AM, Bairy I. Molecular epidemiology of methicillin resistant staphylococcus aureus colonizing the anterior Nares of school children of Udupi Taluk. Indian J Med Microbiol 2015; 33 Suppl:129-33. [PMID: 25657131 DOI: 10.4103/0255-0857.150919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT Community associated methicillin resistant Staphylococcus aureus (CA-MRSA) cause serious skin and soft tissue infections including necrotizing fasciitis and necrotizing pneumonia. Production of Panton Valentine Leucocidine (PVL) toxin is implicated in its enhanced virulence. A variant of epidemic MRSA-15 (EMRSA-15) which produces PVL toxin has been isolated and characterized by pulsed-field gel electrophoresis (PFGE) method from the Indian population both in hospital and community settings. AIMS Identify the epidemiological type of MRSA colonizing the anterior nares of school children in Udupi taluk. SETTINGS AND DESIGN The study population included children of the age group of 5-16 years belonging to the Udupi taluk of Karnataka, India. A total of 1503 children were screened for MRSA colonization during July 2009 to December 2010. MATERIALS AND METHODS PVL assay, Staphylococcal Cassette Chromosome (SCC) mec typing and PFGE typing were carried out with all the MRSA isolates. STATISTICAL ANALYSIS USED Frequency distribution of different variables was assessed by SPSS. RESULTS Among the 1.1% of MRSA, 58.8% (10/17) of isolates were positive for pvl and 41.7% (7/17) were identified as SCC mec type IV. PFGE patterns of all the strains were identical with Indian variant EMRSA-15; however they were different from classical EMRSA-15 in 3-4 bands. CONCLUSIONS The Indian variant EMRSA-15 gains much epidemiological relevance owing to the acquisition of pvl gene. In spite of low prevalence of nasal colonization of MRSA, emergence of the virulent Indian variant EMRSA-15 in our community is a worrisome fact to be reckoned with.
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Affiliation(s)
- S Govindan
- Department of Microbiology, Melaka Manipal Medical College, Manipal, India
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16
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Abstract
Not only is Asia the most populous region in the world, but inappropriate therapy, including self-medication with over-the-counter antimicrobial agents, is a common response to infectious diseases. The high antibiotic selective pressure among the overcrowded inhabitants creates an environment that is suitable for the rapid development and efficient spread of numerous multidrug-resistant pathogens. Indeed, Asia is among the regions with the highest prevalence rates of healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) and community-associated methicillin-resistant S. aureus (CA-MRSA) in the world. Most hospitals in Asia are endemic for multidrug-resistant methicillin-resistant S. aureus (MRSA), with an estimated proportion from 28% (in Hong Kong and Indonesia) to >70% (in Korea) among all clinical S. aureus isolates in the early 2010s. Isolates with reduced susceptibility or a high level of resistance to glycopeptides have also been increasingly identified in the past few years. In contrast, the proportion of MRSA among community-associated S. aureus infections in Asian countries varies markedly, from <5% to >35%. Two pandemic HA-MRSA clones, namely multilocus sequence type (ST) 239 and ST5, are disseminated internationally in Asia, whereas the molecular epidemiology of CA-MRSA in Asia is characterized by clonal heterogeneity, similar to that in Europe. In this review, the epidemiology of S. aureus in both healthcare facilities and communities in Asia is addressed, with an emphasis on the prevalence, clonal structure and antibiotic resistant profiles of the MRSA strains. The novel MRSA strains from livestock animals have been considered to constitute a public health threat in western countries. The emerging livestock-associated MRSA strains in Asia are also included in this review.
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Affiliation(s)
- C-J Chen
- Division of Paediatric Infectious Diseases, Chang Gung Memorial Hospital and Children's Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
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