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Patil G, Agarwala P, Das P, Pathak S. Rise in the Pathogenic Status of Coagulase-Negative Staphylococci Causing Bloodstream Infection. Cureus 2024; 16:e57250. [PMID: 38686262 PMCID: PMC11056806 DOI: 10.7759/cureus.57250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Coagulase-negative staphylococci (CoNS) are one of the frequently isolated bacteria from blood cultures. Since they are part of the normal skin flora, they were previously considered contaminants. But now, they can be considered as established pathogens causing bloodstream infection (BSI). This study aims to estimate the prevalence of CoNS in BSI cases. METHODS This study was conducted at the Microbiology Department, All India Institute of Medical Sciences (AIIMS), Raipur, India, for eight months (January 2022 to August 2022). Data were collected retrospectively from medical and laboratory records. Paired blood cultures from 5085 clinically suspected sepsis cases were subjected to aerobic culture for five days in the BacT ALERT 3D system. Pathogenicity was established after recovery of CoNS from paired blood cultures of symptomatic patients. RESULTS CoNS were isolated from 2.35% of patients, the most common species being Staphylococcus haemolyticus (51.67%). About 90% of isolates were methicillin-resistant. All the isolates were susceptible to linezolid, teicoplanin, and vancomycin, except one isolate of S. haemolyticus which was intermediate to vancomycin. Minimum inhibitory concentration (MIC) 50 and MIC 90 for vancomycin were 1 ug/ml and 2 ug/ml, respectively. Conclusion: Paired blood cultures are necessary to determine the pathogenicity of CoNS in BSI cases. A high prevalence of methicillin resistance, accompanied by high resistance rates to other non-beta lactam antibiotics, warrants the strict implementation of antimicrobial stewardship practices.
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Affiliation(s)
- Girish Patil
- Microbiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Pragya Agarwala
- Microbiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Padma Das
- Microbiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Swati Pathak
- Microbiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
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2
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Kim S, Choi JP, Oh DH, Ahn MY, Yang E. Increased incidence of teicoplanin-non-susceptible Staphylococcus epidermidis strains: a 6-year retrospective study. Sci Rep 2023; 13:12582. [PMID: 37537250 PMCID: PMC10400644 DOI: 10.1038/s41598-023-39666-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023] Open
Abstract
Glycopeptide antibiotics (vancomycin and teicoplanin) are usually used for the treatment of Staphylococcus epidermidis infections owing to their increased oxacillin resistance. However, S. epidermidis strains with decreased susceptibility to teicoplanin have become increasingly incident in recent years. We aimed to identify the characteristics of teicoplanin-non-susceptible (Teico-NS) S. epidermidis isolated at our hospital and analyze its relationship with teicoplanin usage. We retrospectively evaluated 328 S. epidermidis strains isolated from clinical isolates between January 2016 and December 2021. All strains were susceptible to vancomycin (minimal inhibitory concentration (MIC) ≤ 4 mg/L). The annual incidence for S. epidermidis strains with an elevated teicoplanin MIC of 8 mg/L ranged from 22.2 to 28.9%. In addition, in 2021, the number of S. epidermidis strains with teicoplanin MIC ≥ 16 mg/L rapidly increased (n = 13, 32.5%). Furthermore, teicoplanin use increased annually until 2019; however, in 2020, it decreased abruptly due to the COVID 19 pandemic. Thus, we could not confirm the existence of a clear correlation between teicoplanin usage and increased incidence of S. epidermidis with reduced teicoplanin-susceptibility. We showed the increased incidence of Teico-NS S. epidermidis in recent years. Further studies are needed to identify the mechanisms and risk factors for teicoplanin-resistance in S. epidermidis.
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Affiliation(s)
- Subin Kim
- Division of Infectious Disease, Seoul Medical Center, 156, Sinnae-ro, Jungnang-gu, Seoul, 05505, Republic of Korea
| | - Jae-Phil Choi
- Division of Infectious Disease, Seoul Medical Center, 156, Sinnae-ro, Jungnang-gu, Seoul, 05505, Republic of Korea
| | - Dong Hyun Oh
- Division of Infectious Disease, Seoul Medical Center, 156, Sinnae-ro, Jungnang-gu, Seoul, 05505, Republic of Korea
| | - Mi Young Ahn
- Division of Infectious Disease, Seoul Medical Center, 156, Sinnae-ro, Jungnang-gu, Seoul, 05505, Republic of Korea
| | - Eunmi Yang
- Division of Infectious Disease, Seoul Medical Center, 156, Sinnae-ro, Jungnang-gu, Seoul, 05505, Republic of Korea.
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Szemraj M, Lisiecki P, Glajzner P, Szewczyk EM. Vancomycin heteroresistance among methicillin-resistant clinical isolates S. haemolyticus, S. hominis, S. simulans, and S. warneri. Braz J Microbiol 2023; 54:159-167. [PMID: 36374479 PMCID: PMC9944261 DOI: 10.1007/s42770-022-00870-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/01/2022] [Indexed: 11/15/2022] Open
Abstract
Besides being an essential part of the skin microbiome, coagulase-negative staphylococci are the etiological factors of serious infections. The aim of the study was to evaluate the heteroresistance to vancomycin and the potential antimicrobial efficacy of teicoplanin and daptomycin against the multiresistant strains of S. haemolyticus, S. hominis, S. warneri, and S. simulans. The study covered 80 clinical coagulase-negative staphylococci. Teicoplanin, vancomycin, and daptomycin MICs for the tested strains were determined according to EUCAST recommendation. The vanA and vanB genes were searched. The brain heart infusion screen agar method detected vancomycin heteroresistance. The population analysis profile method and analysis of autolytic activity were applied for the strains growing on BHI containing 4 mg/L vancomycin. Seven S. haemolyticus, two S. hominis, and two S. warneri strains presented a heterogeneous resistance to vancomycin. Their subpopulations were able to grow on a medium containing 4-12 mg/L of vancomycin. Monitoring heteroresistance to peptide antibiotics, which are often the last resort in staphylococcal infections, is essential due to the severe crisis in antibiotic therapy and the lack of alternatives to treat infections with multiresistant strains. Our work highlights the selection of resistant strains and the need for more careful use of peptide antibiotics.
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Affiliation(s)
- Magdalena Szemraj
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszyńskiego 1, 90-235, Łódź, Poland.
| | - Paweł Lisiecki
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszyńskiego 1, 90-235, Łódź, Poland
| | - Paulina Glajzner
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszyńskiego 1, 90-235, Łódź, Poland
| | - Eligia M Szewczyk
- Department of Pharmaceutical Microbiology and Microbiological Diagnostic, Medical University of Lodz, Muszyńskiego 1, 90-235, Łódź, Poland
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Xu P, Yang H, Tian L, Guo Q, Chen H, Wei X, Liu Y, He Z, Zhang J, Luo J, Li D, Guan T. Function and safety evaluation of Staphylococcus epidermidis with high esterase activity isolated from strong flavor Daqu. Lebensm Wiss Technol 2023. [DOI: 10.1016/j.lwt.2023.114534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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5
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Woreta AN, Kebede HB, Tilahun Y, Teklegiorgis SG, Abegaz WE. Antibiotic Susceptibility Pattern and Bacterial Spectrum Among Patients with External Eye Infections at Menelik II Referral Hospital in Addis Ababa, Ethiopia. Infect Drug Resist 2022; 15:765-779. [PMID: 35264860 PMCID: PMC8901190 DOI: 10.2147/idr.s352098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/22/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Asmamaw Nitsuh Woreta
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Microbiology Unit, Department of Laboratory Sciences, Menelik II Referral Hospital, Addis Ababa, Ethiopia
| | - Habtamu Biazin Kebede
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Habtamu Biazin Kebede, Email
| | - Yonas Tilahun
- Department of Ophthalmology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Woldaregay Erku Abegaz
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Lisowska-Łysiak K, Lauterbach R, Międzobrodzki J, Kosecka-Strojek M. Epidemiology and Pathogenesis of Staphylococcus Bloodstream Infections in Humans: a Review. Pol J Microbiol 2021; 70:13-23. [PMID: 33815523 PMCID: PMC8330453 DOI: 10.33073/pjm-2021-005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/18/2021] [Accepted: 01/12/2021] [Indexed: 01/19/2023] Open
Abstract
Staphylococci are among the most frequent human microbiota components associated with the high level of bloodstream infection (BSI) episodes. In predisposed patients, there is a high risk of transformation of BSI episodes to sepsis. Both bacterial and host factors are crucial for the outcomes of BSI and sepsis. The highest rates of BSI episodes were reported in Africa, where these infections were up to twice as high as the European rates. However, there remains a great need to analyze African data for comprehensive quantification of staphylococcal BSI prevalence. The lowest rates of BSI exist in Australia. Asian, European, and North American data showed similar frequency values. Worldwide analysis indicated that both Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are the most frequent BSI agents. In the second group, the most prevalent species was Staphylococcus epidermidis, although CoNS were not identified at the species level in many studies. The lack of a significant worldwide decrease in BSI episodes indicates a great need to implement standardized diagnostic methods and research etiological factors using advanced genetic methods.
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Affiliation(s)
- Klaudia Lisowska-Łysiak
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Ryszard Lauterbach
- Department of Neonatology, Collegium Medicum, Jagiellonian University, Kraków, Poland
| | - Jacek Międzobrodzki
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Maja Kosecka-Strojek
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
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Asante J, Hetsa BA, Amoako DG, Abia ALK, Bester LA, Essack SY. Multidrug-Resistant Coagulase-Negative Staphylococci Isolated from Bloodstream in the uMgungundlovu District of KwaZulu-Natal Province in South Africa: Emerging Pathogens. Antibiotics (Basel) 2021; 10:antibiotics10020198. [PMID: 33670659 PMCID: PMC7922184 DOI: 10.3390/antibiotics10020198] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 01/09/2023] Open
Abstract
Coagulase-negative staphylococci (CoNS) are increasingly associated with nosocomial infections, especially among the immunocompromised and those with invasive medical devices, posing a significant concern. We report on clinical multidrug-resistant CoNS from the uMgungundlovu District, KwaZulu-Natal Province, South Africa, as emerging pathogens. One hundred and thirty presumptive CoNS were obtained from blood cultures. Culture, biochemical tests, and the Staphaurex™ Latex Agglutination Test were used for the initial identification of CoNS isolates; confirmation and speciation were undertaken by the VITEK 2 system. Susceptibilities of isolates against a panel of 20 antibiotics were determined using the Kirby-Bauer disk diffusion method, and the multiple antibiotic resistance (MAR) indices of the isolates were determined. The polymerase chain reaction (PCR) was used to amplify the mecA gene to confirm methicillin resistance. Overall, 89/130 presumptive CoNS isolates were confirmed as CoNS by the VITEK 2 system. Of these, 68 (76.4%) isolates were putatively methicillin-resistant by the phenotypic cefoxitin screen test and 63 (92.6%) were mecA positive. Staphylococcus epidermidis (19.1%), S. hominis ssp. hominis (15.7%), and S. haemolyticus (16.9%) were the most common CoNS species. Isolates showed high percentage resistance against penicillin (100.0%), erythromycin (74.2%), and azithromycin (74.2%) while displaying high susceptibilities to linezolid (95.5%), gentamicin (95.5%), and tigecycline (94.4%). Multidrug resistance (MDR) was observed in 76.4% of isolates. MAR index calculation revealed 71.9% of isolates with MAR index >0.2 and 20.2% >0.5. Isolates with the highest MAR indices (0.7 and 0.8) were recovered from the neonatal intensive care unit. Fifty-one MDR antibiograms were observed. The high prevalence of methicillin resistance and multidrug resistance in several species of CoNS necessitates surveillance of this emerging pathogen, currently considered a contaminant of microbial cultures.
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Affiliation(s)
- Jonathan Asante
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (B.A.H.); (D.G.A.); (A.L.K.A.); (S.Y.E.)
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
- Correspondence:
| | - Bakoena A. Hetsa
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (B.A.H.); (D.G.A.); (A.L.K.A.); (S.Y.E.)
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Daniel G. Amoako
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (B.A.H.); (D.G.A.); (A.L.K.A.); (S.Y.E.)
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg 2131, South Africa
| | - Akebe Luther King Abia
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (B.A.H.); (D.G.A.); (A.L.K.A.); (S.Y.E.)
| | - Linda A. Bester
- Biomedical Research Unit, University of KwaZulu-Natal, Durban 4000, South Africa;
| | - Sabiha Y. Essack
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (B.A.H.); (D.G.A.); (A.L.K.A.); (S.Y.E.)
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Asadollahi P, Farzan B, Rezaei F, Delfani S, Ashrafi B, Soroush S. First Report on the Characteristics of Methicillin-Resistant Staphylococcus Capitis Isolates and an NRCS-A-clone Related Isolate Obtained from Iranian Children. Infect Disord Drug Targets 2021; 21:459-463. [PMID: 32389116 DOI: 10.2174/1871526520666200511011309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Methicillin-resistant staphylococcus capitis (MRSC) NRCS-A clone (Multi- resistant and vancomycin-non susceptible) has been recently described as an emerging cause of nosocomial bacteremia, especially in neonatal intensive-care units (NICUs). OBJECTIVE The objective of this study was to evaluate the antibiotic and antiseptic resistance patterns, biofilm-producing ability and the prevalence of SCCmec and ACME types among MRSC isolates as well as to check the possible presence of NRCS-A clone at Tehran's Children's Medical Center, Iran. METHODS A total of 256 coagulase-negative Staphylococcal isolates were collected, of which 10 S. capitis isolates were obtained and tested for susceptibility against 13 antimicrobial and 3 antiseptic agents, as well as biofilm production. The presence of 15 distinct resistance genes, staphylococcal cassette chromosome mec (SCCmec), and arginine catabolic mobile elements (ACMEs) were tracked. RESULTS Seven out of 10 S. capitis isolates were MRSC (MIC90 van=8μg/mL) and resistant to trimethoprim/sulfamethoxazole, produced biofilm, (3 as strong biofilm producers) and carried ACME types I and II. Despite the identification of mec and ccr complexes in some isolates, all the SCCmec cassettes were untypeable (UT). CONCLUSION According to the studied features, only one isolate belonged to the NRSC-A clone. The results indicate that MRSC with high antibiotic resistance and unknown SCCmec might become a serious problem in the future for the treatment of patients, particularly children.
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Affiliation(s)
- Parisa Asadollahi
- Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Behrooz Farzan
- Department of Anesthesiology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Faranak Rezaei
- Department of Microbiology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Somayeh Delfani
- Department of Microbiology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Behnam Ashrafi
- Department of Microbiology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Setareh Soroush
- Department of Microbiology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran
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9
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Barış A, Malkoçoğlu G, Büyükyanbolu E, Aslan FM, Bayraktar B, Aktaş E. Evaluation of Teicoplanin Resistance Detected by Automated System in Coagulase Negative Staphylococci: A Comparison with Gradient Test and Broth Microdilution Methods. Curr Microbiol 2020; 77:3355-3360. [PMID: 32754852 DOI: 10.1007/s00284-020-02144-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/22/2020] [Indexed: 11/28/2022]
Abstract
Upon the observation of an increase in teicoplanin resistance rates in coagulase negative staphylococci (CoNS) isolates determined by the automated system, we aimed to compare the automated system and gradient test methods with the gold standard broth microdilution method. In addition, the effect of standard antimicrobial susceptibility guidelines on teicoplanin susceptibility test results in CoNS was investigated. A total of 81 CoNS isolates, 52 resistant and 29 susceptible to teicoplanin determined by automated system (Phoenix, Becton Dickinson, USA), were tested. The minimum inhibitory concentration (MIC) values were determined by gradient test (M.I.C. Evaluators, OXOID, UK) and broth microdilution methods. Susceptibility categories were determined according to EUCAST and CLSI criteria and the results were compared. Among 29 isolates found to be susceptible by automated system, one isolate was found resistant by gradient and broth microdilution tests. Of the 52 resistant isolates determined by automated system, 12 (23%) were found to be resistant by gradient test and 22 (42.3%) were resistant by broth microdilution. According to CLSI criteria, no resistant isolates were detected by broth microdilution and six isolates were intermediately susceptible while, two isolates were detected to be resistant and five isolates were found to be intermediately susceptible by the gradient test. In conclusion, compared to microdilution, teicoplanin resistance was detected at a higher rate in CoNS isolates by the automated system used. On the other hand, the gradient test method which is frequently used for confirmation was not reliable in MIC values close to the EUCAST breakpoint values (4 μg/mL). In addition, lower resistance rates were observed when the CLSI breakpoints were used in gradient test and broth microdilution methods.
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Affiliation(s)
- Ayşe Barış
- Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Research and Training Hospital, Halaskargazi, Etfal Street, 34371, Sisli/İstanbul, Turkey. .,Department of Medical Microbiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
| | | | - Ecem Büyükyanbolu
- Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Research and Training Hospital, Halaskargazi, Etfal Street, 34371, Sisli/İstanbul, Turkey
| | - Feride Merve Aslan
- Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Research and Training Hospital, Halaskargazi, Etfal Street, 34371, Sisli/İstanbul, Turkey
| | - Banu Bayraktar
- Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Research and Training Hospital, Halaskargazi, Etfal Street, 34371, Sisli/İstanbul, Turkey
| | - Elif Aktaş
- Department of Medical Microbiology, University of Health Sciences, Sisli Hamidiye Etfal Research and Training Hospital, Halaskargazi, Etfal Street, 34371, Sisli/İstanbul, Turkey
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Heo S, Lee JH, Jeong DW. Food-derived coagulase-negative Staphylococcus as starter cultures for fermented foods. Food Sci Biotechnol 2020; 29:1023-1035. [PMID: 32670656 PMCID: PMC7347722 DOI: 10.1007/s10068-020-00789-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 02/07/2023] Open
Abstract
Food safety is of significant concern to consumers and is a major issue for the food industry. As such, the industry is aware of the importance of safety assessments of starters used in the production of fermented foods. Coagulase-negative staphylococci (CNS) are the predominant bacteria found in fermented foods worldwide. Because of this, food-derived CNS are used as starters for cheese and meat fermentation, and have been investigated for use as starters in soybean fermentation. Although food-derived CNS are generally considered non-pathogenic, their safety remains uncertain following the isolation of CNS from skin infections in humans and animals, and because they belong to the same genus as the highly pathogenic species Staphylococcus aureus. This review explores what is known about the safety of food-derived CNS, focusing on antibiotic resistance, enterotoxin genes, and biogenic amine production, to aid in the selection of starter candidates.
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Affiliation(s)
- Sojeong Heo
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, Republic of Korea
| | - Jong-Hoon Lee
- Department of Food Science and Biotechnology, Kyonggi University, Suwon, Republic of Korea
| | - Do-Won Jeong
- Department of Food and Nutrition, Dongduk Women’s University, Seoul, Republic of Korea
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Raina D, Chandola I, Negi N, Kataria V, Roy R. Prevalence of Coagulase Negative Staphylococcus and their Antibiotic Sensitivity Pattern from Various Clinical Samples. J Pure Appl Microbiol 2020; 14:1255-1262. [DOI: 10.22207/jpam.14.2.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Heo S, Lee JS, Lee JH, Jeong DW. Comparative Genomic Analysis of Food-Originated Coagulase-Negative Staphylococcus: Analysis of Conserved Core Genes and Diversity of the Pan-Genome. J Microbiol Biotechnol 2020; 30:341-351. [PMID: 31847510 PMCID: PMC9728283 DOI: 10.4014/jmb.1910.10049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
To shed light on the genetic differences among food-originated coagulase-negative Staphylococcus (CNS), we performed pan-genome analysis of five species: Staphylococcus carnosus (two strains), Staphylococcus equorum (two strains), Staphylococcus succinus (three strains), Staphylococcus xylosus (two strains), and Staphylococcus saprophyticus (one strain). The pan-genome size increases with each new strain and currently holds about 4,500 genes from 10 genomes. Specific genes were shown to be strain dependent but not species dependent. Most specific genes were of unknown function or encoded restriction-modification enzymes, transposases, or prophages. Our results indicate that unique genes have been acquired or lost by convergent evolution within individual strains.
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Affiliation(s)
- Sojeong Heo
- Department of Food and Nutrition, Dongduk Women’s University, Seoul 02748, Republic of Korea
| | - Jung-Sug Lee
- Department of Food and Nutrition, Kookmin University, Seoul 0707, Republic of Korea
| | - Jong-Hoon Lee
- Department of Food Science and Biotechnology, Kyonggi University, Suwon 16227, Republic of Korea
| | - Do-Won Jeong
- Department of Food and Nutrition, Dongduk Women’s University, Seoul 02748, Republic of Korea,Corresponding author Phone: +82-2-940-4463 Fax: +82-2-940-4610 E-mail :
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Affiliation(s)
- Karsten Becker
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Anna Both
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Samira Weißelberg
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Heilmann
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
- Interdisciplinary Center for Clinical Research (IZKF), University of Münster, Münster, Germany
| | - Holger Rohde
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Pereira VC, Romero LC, Pinheiro-Hubinger L, Oliveira A, Martins KB, Cunha MDLRDSD. Coagulase-negative staphylococci: a 20-year study on the antimicrobial resistance profile of blood culture isolates from a teaching hospital. Braz J Infect Dis 2020; 24:160-169. [PMID: 32084346 PMCID: PMC9392043 DOI: 10.1016/j.bjid.2020.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/14/2020] [Accepted: 01/27/2020] [Indexed: 10/28/2022] Open
Abstract
The increasing rates of nosocomial infection associated with coagulase-negative staphylococci (CoNS) were the rationale for this study, aiming to categorize oxacillin-resistant CoNS species recovered from blood culture specimens of inpatients at the UNESP Hospital das Clínicas in Botucatu, Brazil, over a 20-year period, and determine their sensitivity to other antimicrobial agents. The mecA gene was detected in 222 (74%) CoNS samples, and the four types of staphylococcal chromosomal cassette mec (SCCmec) were characterized in 19.4%, 3.6%, 54.5%, and 14.4% of specimens, respectively, for types I, II, III, and IV. Minimal inhibitory concentration (MIC) values to inhibit 50% (MIC50) and 90% (MIC90) of specimens were, respectively, 2 and >256μL/mL for oxacillin, 1.5 and 2μL/mL for vancomycin, 0.25 and 0.5μL/mL for linezolid, 0.094 and 0.19μL/mL for daptomycin, 0.19 and 0.5μL/mL for quinupristin/dalfopristin, and 0.125 and 0.38μL/mL for tigecycline. Resistance to oxacillin and tigecycline and intermediate resistance to quinupristin/dalfopristin were observed. Eight (2.7%) of all 300 CoNS specimens studied showed reduced susceptibility to vancomycin. Results from this study show high resistance rates of CoNS to antimicrobial agents, reflecting the necessity of using these drugs judiciously and controlling nosocomial dissemination of these pathogens.
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Affiliation(s)
- Valéria Cataneli Pereira
- UNESP-Universidade Estadual Paulista, Instituto de Biociências de Boucatu, Departamento de Microbiologia e Imunologia, São Paulo, SP, Brazil; UNOESTE-Universidade Oeste Paulista, Departamento de Microbiologia, São Paulo, SP, Brazil.
| | - Letícia Calixto Romero
- UNESP-Universidade Estadual Paulista, Instituto de Biociências de Boucatu, Departamento de Microbiologia e Imunologia, São Paulo, SP, Brazil
| | - Luiza Pinheiro-Hubinger
- UNESP-Universidade Estadual Paulista, Instituto de Biociências de Boucatu, Departamento de Microbiologia e Imunologia, São Paulo, SP, Brazil
| | - Adilson Oliveira
- UNESP-Universidade Estadual Paulista, Instituto de Biociências de Boucatu, Departamento de Microbiologia e Imunologia, São Paulo, SP, Brazil
| | - Katheryne Benini Martins
- UNESP-Universidade Estadual Paulista, Instituto de Biociências de Boucatu, Departamento de Microbiologia e Imunologia, São Paulo, SP, Brazil
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15
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Asante J, Amoako DG, Abia ALK, Somboro AM, Govinden U, Bester LA, Essack SY. Review of Clinically and Epidemiologically Relevant Coagulase-Negative Staphylococci in Africa. Microb Drug Resist 2020; 26:951-970. [PMID: 32043916 DOI: 10.1089/mdr.2019.0381] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Coagulase-negative staphylococci (CoNS) have engendered substantial interest in recent years as pathogenic causes of infections in both human and veterinary medicine, especially in the immunocompromised, critically ill, long-term hospitalized and in those harboring invasive medical devices such as catheters. They have been implicated in infections such as urinary tract infections, bloodstream infections, and invasive device-related infections, and are responsible for substantial economic losses in livestock production. The advancement of diagnostic techniques has increased our understanding of their molecular mechanisms of pathogenicity, even though distinguishing between innocuousness and pathogenicity is still challenging. The incidence of CoNS varied across the continent in humans and animals (mainly cattle), ranging from 6% to 68% in suspected human infections and from 3% to 61.7% in suspected animal infections, distributed across different geographic locations. Furthermore, there were varying antibiotic resistance patterns observed in CoNS isolates, with high methicillin resistance in some cases, leading to crossresistance against many antibiotics. Staphylococcus epidermidis, Staphylococcus haemolyticus, and Staphylococcus xylosus were most commonly reported in studies herein reviewed, while the enterotoxin C gene, atl E gene, ica gene, and hemolysin virulence factors were linked with enhanced pathogenicity. Advancement in identification and typing methods, including whole genome sequencing, virulence screening, and the assessment of the immune status of subjects in studies will help to thoroughly assess the true pathogenic potential of isolated CoNS species in developing countries. Careful antibiotic stewardship guidelines should be followed due to the ability of CoNS to develop multidrug resistance.
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Affiliation(s)
- Jonathan Asante
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa.,School of Laboratory Medicine and Medical Sciences and University of KwaZulu Natal, Durban, South Africa
| | - Daniel G Amoako
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Akebe L K Abia
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Anou M Somboro
- School of Laboratory Medicine and Medical Sciences and University of KwaZulu Natal, Durban, South Africa.,Biomedical Research Unit, University of KwaZulu Natal, Durban, South Africa
| | - Usha Govinden
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Linda A Bester
- Biomedical Research Unit, University of KwaZulu Natal, Durban, South Africa
| | - Sabiha Y Essack
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
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16
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Noshak MA, Ahangarzadeh Rezaee M, Hasani A, Mirzaii M, Memar MY. Biofilm formation capacity in common SCCmec types of coagulase-negative staphylococci isolated from hospitalized patients and health-care workers in northwest of Iran. Gene Reports 2019. [DOI: 10.1016/j.genrep.2019.100531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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El-Zamkan MA, Mubarak AG, Ali AO. Prevalence and phylogenetic relationship among methicillin- and vancomycin-resistant Staphylococci isolated from hospital's dairy food, food handlers, and patients. J Adv Vet Anim Res 2019; 6:463-473. [PMID: 31819873 PMCID: PMC6882726 DOI: 10.5455/javar.2019.f369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 01/21/2023] Open
Abstract
Objective: The aim of the present work was to investigate the mutual role that may be played by the served dairy food and food handlers in the transmission of methicillin- and vancomycin-resistant Staphylococcus aureus and coagulase-negative Staphylococci to patients who were hospitalized in Qena City, Egypt. Materials and Methods: A total of 210 samples including 90 dairy food samples which offered to the patients in the hospital, 60 nasal and hand swabs from food handlers working in the hospital, and 60 nasal and diarrheal swabs from patients suffering from diarrhea were investigated for the presence of coagulase-positive S. aureus and coagulase-negative Staphylococci, then isolates were screened for methicillin and vancomycin resistance phenotypically and genotypically. 16s rRNA gene sequencing was employed to construct the neighbor-joining tree. Results: Unlike food samples, both coagulase-positive S. aureus and coagulase-negative Staphylococci occurred in human samples. Methicillin- and vancomycin-resistant coagulase-negative Staphylococci could be detected in 41.7% & 20.8%, 68% & 31.9%, and 81.3% & 55.2% of isolates obtained from dairy food, food handlers, and patients’ samples, respectively. Whereas 81% & 64.3%, and 75.4% & 38.6% of coagulase-positive S. aureus obtained from food handlers and patients’ samples exhibited resistance to methicillin and vancomycin, respectively. Phenotypic resistance was confirmed molecularly through detection of mecA and vanA genes. Conclusion: A significant role can be played by food and food handlers in the transmission of methicillin- and vancomycin-resistant Staphylococci to patients, which has been proved in this study through the close phylogenetic relation between S. epidermidis isolated from food, food handlers, and patients’ diarrheal samples.
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Affiliation(s)
- Mona Ahmed El-Zamkan
- Department of Food Hygiene and Control, Faculty of Veterinary Medicine, South Valley University, Qena 83523, Egypt
| | - Asmaa Gaber Mubarak
- Department of Zoonoses, Faculty of Veterinary Medicine, South Valley University, Qena 83523, Egypt
| | - Alsagher Omran Ali
- Division of Infectious Diseases, Animal Medicine Department, Faculty of Veterinary Medicine, South Valley University, Qena 83523, Egypt
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18
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Conner JG, Smith J, Erol E, Locke S, Phillips E, Carter CN, Odoi A. Temporal trends and predictors of antimicrobial resistance among Staphylococcus spp. isolated from canine specimens submitted to a diagnostic laboratory. PLoS One 2018; 13:e0200719. [PMID: 30067775 PMCID: PMC6070192 DOI: 10.1371/journal.pone.0200719] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 07/02/2018] [Indexed: 01/22/2023] Open
Abstract
Background Resistance to commonly used antimicrobials is a growing concern in both human and veterinary medicine. Understanding the temporal changes in the burden of the problem and identifying its determinants is important for guiding control efforts. Therefore, the objective of this study was to investigate temporal patterns and predictors of antimicrobial resistance among Staphylococcus spp. isolated from canine specimens submitted to the University of Kentucky Veterinary Diagnostic Laboratory (UKVDL) between 1993 and 2009. Methods Retrospective data of 4,972 Staphylococcus isolates assessed for antimicrobial susceptibility using the disk diffusion method at the UKVDL between 1993 and 2009 were included in the study. Temporal trends were assessed for each antimicrobial using the Cochran-Armitage trend test. Logistic regression models were used to investigate predictors of antimicrobial resistance (AMR) and multidrug resistance (MDR). Results A total of 68.2% (3,388/4,972) Staphylococcus isolates were S. intermedius group (SIG), 18.2% (907/4,972) were coagulase-negative staphylococci (CoNS), 7.6% (375/4,972) were S. aureus, 5.8% (290/4,972) were S. hyicus, and S. schleiferi subsp. coagulans comprised 0.2% (12/4,972) of the isolates. The overall percentage of AMR and MDR were 77.2% and 25.6%, respectively. The highest levels of AMR were seen in CoNS (81.3%; 737/907), S. aureus (80.5%; 302/375), and SIG (77.6%; 2,629/3388). The lowest levels of AMR were observed in S. hyicus (57.9%; 168/290) and S. schleiferi subsp. coagulans (33.3%; 4/12). Overall, AMR and MDR showed significant (p<0.001) decreasing temporal trends. Significant temporal trends (both increasing and decreasing) were observed among 12 of the 16 antimicrobials covering 6 of the 9 drug classes assessed. Thus, significant increasing temporal trends in resistance were observed to β-lactams (p<0.001) (oxacillin, amoxicillin-clavulanate, cephalothin, and penicillin (p = 0.024)), aminoglycosides (p<0.001) (gentamicin, and neomycin), bacitracin (p<0.001), and enrofloxacin (p<0.001). In contrast, sulfonamide (p<0.001) (sulfadiazin) and tetracycline (p = 0.010) resistant isolates showed significant decreasing temporal trends in AMR. Staphylococcus spp., geographic region, and specimen source were significant predictors of both AMR and MDR. Conclusions Although not unexpected nor alarming, the high levels of AMR to a number of antimicrobial agents and the increasing temporal trends are concerning. Therefore, continued monitoring of AMR among Staphylococcus spp. is warranted. Future studies will need to identify local factors responsible for the observed geographic differences in risk of both AMR and MDR.
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Affiliation(s)
- Julia G. Conner
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Jackie Smith
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, Kentucky, United States of America
| | - Erdal Erol
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, Kentucky, United States of America
| | - Stephan Locke
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, Kentucky, United States of America
| | - Erica Phillips
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, Kentucky, United States of America
| | - Craig N. Carter
- Veterinary Diagnostic Laboratory, University of Kentucky, Lexington, Kentucky, United States of America
| | - Agricola Odoi
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, United States of America
- * E-mail:
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Ghaznavi-Rad E, Fard-Mousavi N, Shahsavari A, Japoni-Nejad A, Van Belkum A. Distribution of staphylococcal cassette chromosome mec types among methicillin-resistant coagulase negative staphylococci in central Iran. Iran J Microbiol 2018; 10:7-13. [PMID: 29922413 PMCID: PMC6004636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Methicillin-resistant coagulase-negative staphylococci (MR-CoNS) are important nosocomial pathogens. They may serve as a reservoir of SCCmec, the genomic island encoding amongst other methicillin resistance. This study was designed to determine the distribution of different SCCmec types from MR-CoNS isolated from clinical specimens in a tertiary hospital in central Iran, having high frequency of nosocomial methicillin-resistant staphylococcal infections. MATERIALS AND METHODS We evaluated isolates from patients attending the Vali-Asr Hospital located in the center of Iran, from February to December 2012. Multiplex PCR was performed for SCCmec typing. For isolates in which SCCmec could not be typed directly, additional ccr and mec complex analyses were performed. RESULTS Totally, 70 MR-CoNS isolates, comprising of 47 S. epidermidis strains (67%), 10 S. saprophyticus (14.3%), 9 S. hemolyticus (13%) and 4 S. lugdunensis (5.7%) were identified. Thirty-nine were characterized as type IVa 19 (27%), type III 11 (16%), type II 7 (10%) and type V 2 (3%). Only 20 isolates (28.6%) carried the ccr complex, while the current methods could not characterize the 11 remaining isolates. CONCLUSION A high level of SCCmec genetic diversity was found among MR-CoNS isolates. MR-CoNS may act as a reservoir of SCCmec IV for MRSA. This issue should be taken into consideration seriously.
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Affiliation(s)
- Ehsanollah Ghaznavi-Rad
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran,Department of Microbiology and Immunology, School of Medicine, Arak University of Medical Sciences, Arak, Iran,Corresponding author: Ehsanollah Ghaznavi-Rad, PhD, Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran; Department of Microbiology and Immunology, School of Medicine, Arak University of Medical Sciences, Arak, Iran. Tel: +98 8634173526, Fax: +98 8614173526,
| | - Nasimeh Fard-Mousavi
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Ali Shahsavari
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Ali Japoni-Nejad
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Alex Van Belkum
- Scientific Office, BioMérieux, Route de Port Michaud, La Balme Les Grottes 38390, France,Erasmus MC, Department of Medical Microbiology and Infectious Diseases, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
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20
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Mashaly GES, El-Mahdy RH. Vancomycin heteroresistance in coagulase negative Staphylococcus blood stream infections from patients of intensive care units in Mansoura University Hospitals, Egypt. Ann Clin Microbiol Antimicrob 2017; 16:63. [PMID: 28927452 PMCID: PMC5606075 DOI: 10.1186/s12941-017-0238-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 09/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vancomycin heteroresistance in coagulase negative Staphylococci (CoNS) is a recent health concern especially in serious infections like bloodstream infections as it may lead to failure of therapy. Little information is available about the prevalence vancomycin heteroresistance in CoNS causing bloodstream infections in intensive care units (ICUs) patients of Mansoura University Hospitals (MUHs). METHODS This prospective study enrolled 743 blood samples collected from ICUs patients presented with clinical manifestations of bloodstream infections over the period extending from January 2014 to March 2016. Samples were processed, coagulase negative Staphylococci were identified by routine microbiological methods and the absence of coagulase activity. Species were identified by API Staph 32. Oxacillin resistant CoNS were identified by cefoxitin disc diffusion method. Susceptibility testing of isolated CoNS to vancomycin was carried out using vancomycin agar dilution method. Mec A gene detection by PCR was done for oxacillin resistant isolates. Screening for vancomycin heteroresistance was done on brain heart infusion (BHI) agar containing 4 μg/mL vancomycin. Confirmation of vancomycin heteroresistance was carried out by population analysis profile (PAP). RESULTS A total of 58 isolates were identified as CoNS from patients of clinically suspected bloodstream infections. The identified species were 33 (56.9%) Staphylococcus epidermidis, 12 (20.7%) Staphylococcus capitis, 7 (12.1%) Staphylococcus haemolyticus, and 3 isolates (5.2%) Staphylococcus lugdunesis. Three isolates were unidentified by API Staph 32. Forty-four (75.9%) isolates were oxacillin resistant. Mec A gene was detected in all oxacillin resistant isolates. All isolates had susceptible vancomycin MICs by agar dilution. Nine isolates (15.5%) could grow on BHI agar containing 4 μg/mL vancomycin. These isolates showed heterogeneous profile of resistance to vancomycin by population analysis profile. CONCLUSIONS Vancomycin heteroresistant CoNS causing bloodstream infections is growing unrecognized health hazard in ICUs patients. These isolates have susceptible vancomycin MICs. Screening methods are recommended and should be considered to improve clinical outcome in these high risk patients.
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Affiliation(s)
- Ghada El-Saeed Mashaly
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Rasha Hassan El-Mahdy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
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Shrestha LB, Bhattarai NR, Khanal B. Antibiotic resistance and biofilm formation among coagulase-negative staphylococci isolated from clinical samples at a tertiary care hospital of eastern Nepal. Antimicrob Resist Infect Control 2017; 6:89. [PMID: 28883911 PMCID: PMC5579930 DOI: 10.1186/s13756-017-0251-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/25/2017] [Indexed: 11/23/2022] Open
Abstract
Background Coagulase negative staphylococci were long regarded non-pathogenic as they are the commensals of human skin and mucosa but the recent changes in the medical practice and changes in underlying host populations, they are being considered significant pathogens associated with number of nosocomial infections. The objective of the study was to determine the species, antimicrobial susceptibility pattern, biofilm forming ability of the clinically significant CoNS isolates and to compare the different methods for the detection of biofilm formation. Methods A total of 52 clinically significant CoNS isolates obtained from different units during a year period were studied. Characterization was done using standard microbiological guidelines and antimicrobial susceptibility was done following CLSI guidelines. Biofilm formation was detected by using three methods i.e. tissue culture plate method, congo red agar method and tube adherence method. Results Among 52 isolates, S. epidermidis (52%) was the most common species which was followed by S. saprophyticus (18%) and S. haemolyticus (14%). Antimicrobial susceptibility pattern of CoNS documented resistance of 80% to ampicillin. Resistance to cefoxitin and ceftriaxone was observed in 58% of the isolates. Biofilm formation was observed in 65.38% of the isolates. The accuracy of Congo red agar and tube adherence method for the detection of biofilm formation was 82% and 76% respectively. Conclusion CoNS isolates obtained from clinical samples should be processed routinely and antimicrobial susceptibility testing should be performed. Multidrug-resistant CoNS are prevalent. All the three methods i.e. tissue culture plate, Congo red agar and tube adherence method can be used in detecting biofilm formation.
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Affiliation(s)
- Lok Bahadur Shrestha
- Microbiology & Infectious Diseases, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Narayan Raj Bhattarai
- Microbiology & Infectious Diseases, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Basudha Khanal
- Microbiology & Infectious Diseases, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
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Soroush S, Jabalameli F, Taherikalani M, Eslampour MA, Beigverdi R, Emaneini M. Characterization of biofilm formation, antimicrobial resistance, and staphylococcal cassette chromosome mec analysis of methicillin resistant Staphylococcus hominis from blood cultures of children. Rev Soc Bras Med Trop 2017; 50:329-333. [PMID: 28700050 DOI: 10.1590/0037-8682-0384-2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 04/27/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Methicillin resistant Staphylococcus hominis (MRSHo) has been recognized as an important human pathogen, particularly in immunocompromised patients. METHODS: A total of 19 S. hominis isolates were collected from children at the Children's Medical Centre, Tehran, Iran, from March 2012 to February 2013. MRSHo susceptibility against 13 antimicrobial and 3 antiseptic agents was determined using disk diffusion (DAD) and minimum inhibitory concentration (MIC), respectively. All isolates were subjected to polymerase chain reaction (PCR) assay for 15 distinct resistance genes, staphylococcal cassette chromosome mec (SCCmec), and arginine catabolic mobile elements (ACMEs). Biofilm production of the isolates was determined using a colorimetric microtiter plate assay. RESULTS: Of the 19 isolates, 16 were resistant to oxacillin and harbored mecA. High resistance was also observed against trimethoprim/sulfamethoxazole (81.2%). All MRSHo isolates were susceptible to the three disinfectants tested (Septicidine-PC, Septi turbo, and Sayacept-HP). In total, 15 (78.9%) isolates produced biofilms. Three isolates had SCCmec types (V and VIII), 13 were untypable (UT), and 5 had ACME type II. CONCLUSIONS: The results indicate that MRSHo with high antibiotic resistance and unknown SCCmec might become a serious problem in the future for the treatment of patients such as children.
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Affiliation(s)
- Setareh Soroush
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Jabalameli
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Morovat Taherikalani
- Department of Microbiology, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Mohammad Amin Eslampour
- Department of Theriogenology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Reza Beigverdi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Mello PL, Pinheiro L, Martins LDA, Brito MAVP, Ribeiro de Souza da Cunha MDL. Short communication: β-Lactam resistance and vancomycin heteroresistance in Staphylococcus spp. isolated from bovine subclinical mastitis. J Dairy Sci 2017. [PMID: 28624285 DOI: 10.3168/jds.2016-12329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The use of antimicrobial agents has led to the emergence of resistant bacterial strains over a relatively short period. Furthermore, Staphylococcus spp. can produce β-lactamase, which explains the survival of these strains in a focus of infection despite the use of a β-lactam antibiotic. The aim of this study was to evaluate the resistance of Staphylococcus spp. isolated from bovine subclinical mastitis to oxacillin and vancomycin (by minimum inhibitory concentration) and to detect vancomycin heteroresistance by a screening method. We also evaluated β-lactamase production and resistance due to hyperproduction of this enzyme and investigated the mecA and mecC genes and performed staphylococcal cassette chromosome mec typing. For this purpose, 181 Staphylococcus spp. isolated from mastitis subclinical bovine were analyzed. Using the phenotypic method, 33 (18.2%) of Staphylococcus spp. were resistant to oxacillin. In contrast, all isolates were susceptible to vancomycin, and heteroresistance was detected by the screening method in 13 isolates. Production of β-lactamase was observed in 174 (96%) of the Staphylococcus spp. isolates. The mecA gene was detected in 8 isolates, all of them belonging to the species Staphylococcus epidermidis, and staphylococcal cassette chromosome mec typing revealed the presence of type I and type IV isolates.
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Affiliation(s)
- Priscila Luiza Mello
- Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, Universidade Estadual Paulista (UNESP), Botucatu 18618-970, Brazil.
| | - Luiza Pinheiro
- Department of Microbiology and Immunology, Institute of Biosciences of Botucatu, Universidade Estadual Paulista (UNESP), Botucatu 18618-970, Brazil; Department of Anatomic Pathology, Instituto Lauro de Souza Lima, Bauru, 17034-971, Brazil
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Jeong DW, Lee B, Her JY, Lee KG, Lee JH. Safety and technological characterization of coagulase-negative staphylococci isolates from traditional Korean fermented soybean foods for starter development. Int J Food Microbiol 2016; 236:9-16. [PMID: 27427871 DOI: 10.1016/j.ijfoodmicro.2016.07.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 06/10/2016] [Accepted: 07/09/2016] [Indexed: 12/18/2022]
Abstract
To select starters for the production of meju and doenjang, traditional Korean fermented soybean foods, we assessed the safety and technological properties of their predominant isolates, Staphylococcus saprophyticus, Staphylococcus succinus and Staphylococcus xylosus. Phenotypic antibiotic resistance, hemolysis and biofilm formation were strain-specific. None of the S. succinus isolates exhibited antibiotic resistance or hemolytic activities. Thirty-three selected strains, identified through safety assessments of 81 coagulase-negative staphylococci (CNS) isolates, produced cadaverine, putrescine, and tyramine, but not histamine in the laboratory setting. The production of these three biogenic amines may, however, be insignificant considering the high levels of tyramine produced by the control, Enterococcus faecalis. The 33 CNS strains could grow on tryptic soy agar containing 21% NaCl (w/v), exhibited acid producing activity at 15% NaCl, and expressed strain-specific protease and lipase activities. S. succinus 14BME1, the selected starter candidate, produced significant amounts of benzeneacetic acid, 2,3-butanediol, trimethylpyrazine, and tetramethylpyrazine through soybean fermentation.
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Affiliation(s)
- Do-Won Jeong
- Department of Bio and Fermentation Convergence Technology, Kookmin University, Seoul 02707, Republic of Korea
| | - Bitnara Lee
- Department of Food Science and Biotechnology, Kyonggi University, Suwon 16227, Republic of Korea
| | - Jae-Young Her
- Department of Food Science and Biotechnology, Dongguk University, Ilsan 10326, Republic of Korea
| | - Kwang-Geun Lee
- Department of Food Science and Biotechnology, Dongguk University, Ilsan 10326, Republic of Korea
| | - Jong-Hoon Lee
- Department of Food Science and Biotechnology, Kyonggi University, Suwon 16227, Republic of Korea.
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Montúfar Andrade FE, Madrid Muñoz CA, Villa Franco JP, Diaz Correa LM, Vélez Rivera JD, Vega Miranda J, Bedoya Londoño AM, Zuleta Tobón JJ, Montufar Pantoja MC. Bacteremia por Staphylococcus coagulasa negativo con concentración inhibitoria mínima para vancomicina ≥ 2. Infectio 2016. [DOI: 10.1016/j.infect.2015.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
BACKGROUND Identification of coagulase-negative staphylococci (CoNS) as nosocomial pathogens or contaminants is significant for microbiologists and clinicians. This study aimed to determine the frequency of isolation and antimicrobial resistance patterns of CoNS isolates from nosocomial bloodstream infections (BSIs) and to identify risk factors associated with true bacteremia caused by these emerging pathogens in a Saudi tertiary care hospital. METHODS All CoNS-positive cultures from inpatients were identified using the standard methods during a 10-month period. Antimicrobial susceptibility testing was done using the reference broth microdilution method. RESULTS A total of 208 isolates were identified; of these 75 (32.2%) were considered infection associated, and 133 (67.8%) were considered contamination. S. epidermidis accounted for 34.7% of bacteremia cases, followed by S. hominis (21.3%), S. haemolyticus (16%), and S. saprophyticus (12%). Central venous catheters (p ≤ 0.0001), prior antibiotic therapy (p ≤ 0.0001), the occurrence of more than one positive blood culture (p ≤ 0.0001), and intensive care unit (ICU) admission (p = 0.007) were all independently associated with CoNS bacteremia. Overall, all isolates were highly resistant to penicillin (94.7%), oxacillin (90.7%), and erythromycin (85.3%). The rates of susceptibility to vancomycin, daptomycin, and teicoplanin were 98.7%, 98.7%, and 93.3%, respectively. CONCLUSIONS Our results further highlight that accurate identification and susceptibility testing of CoNS isolates from nosocomial BSIs are crucial to minimize excessive antibiotic use and unnecessary catheter removal. In addition, daptomycin may be an efficient alternative therapeutic option for CoNS resistant to oxacillin and other commonly used antibiotics.
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Affiliation(s)
- Ahmed Morad Asaad
- a Department of Microbiology, College of Medicine , Najran University , Najran
| | | | - Syed Mujeeb Hasan
- c Laboratories Department , King Khalid Hospital , Najran , Saudi Arabia
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Pinheiro L, Brito CI, Pereira VC, Oliveira A, Bartolomeu AR, Camargo CH, Cunha MLRS. Susceptibility Profile of Staphylococcus epidermidis and Staphylococcus haemolyticus Isolated from Blood Cultures to Vancomycin and Novel Antimicrobial Drugs over a Period of 12 Years. Microb Drug Resist 2015; 22:283-93. [PMID: 26623676 DOI: 10.1089/mdr.2015.0064] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to evaluate the antimicrobial susceptibility profile of 85 Staphylococcus epidermidis and 84 Staphylococcus haemolyticus strains isolated from blood cultures to oxacillin, vancomycin, tigecycline, linezolid, daptomycin, and quinupristin/dalfopristin over a period of 12 years. S. epidermidis and S. haemolyticus isolated from blood cultures of inpatients, attended at a teaching hospital, were analyzed for the presence of the mecA gene and by SCCmec typing. The minimum inhibitory concentration (MIC) values of tigecycline, linezolid, daptomycin, quinupristin/dalfopristin, and vancomycin were determined. Isolates exhibiting vancomycin MICs of ≥2 μg/ml were typed by pulsed-field gel electrophoresis (PFGE). The rate of mecA positivity was 92.9% and 100% in S. epidermidis and S. haemolyticus, respectively. The most frequent SCCmec types were type III (53.2%) in S. epidermidis and type I (32.1%) in S. haemolyticus. All isolates were susceptible to linezolid and daptomycin, but 7.1% of S. haemolyticus and 2.3% of S. epidermidis isolates were resistant to tigecycline, and 1.2% each of S. haemolyticus and S. epidermidis were resistant and intermediately resistant to quinupristin/dalfopristin, respectively. S. epidermidis exhibited higher vancomycin MICs (40% with MIC of ≥2 μg/ml). Clonal typing of strains with vancomycin MIC of ≥2 μg/ml revealed the presence of different PFGE types of S. epidermidis and S. haemolyticus over a period of up to 4 years (2002-2004, 2005-2008, 2006-2009, 2010-2011). Despite the observation of a high prevalence of mecA, the clinical strains were fully susceptible to vancomycin and to the new drugs linezolid, daptomycin, tigecycline, and quinupristin/dalfopristin. The PFGE types with vancomycin MIC of ≥2 μg/ml exhibited a great diversity of SCCmec cassettes, demonstrating that S. epidermidis and S. haemolyticus may easily acquire these resistance-conferring genetic elements.
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Affiliation(s)
- Luiza Pinheiro
- 1 Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista (UNESP) , Botucatu, São Paulo, Brazil
| | - Carla Ivo Brito
- 1 Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista (UNESP) , Botucatu, São Paulo, Brazil
| | - Valéria Cataneli Pereira
- 1 Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista (UNESP) , Botucatu, São Paulo, Brazil
| | - Adilson Oliveira
- 1 Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista (UNESP) , Botucatu, São Paulo, Brazil
| | - Ariane Rocha Bartolomeu
- 1 Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista (UNESP) , Botucatu, São Paulo, Brazil
| | - Carlos Henrique Camargo
- 1 Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista (UNESP) , Botucatu, São Paulo, Brazil .,2 Núcleo de Doenças Entéricas e Infecções por Patógenos Especiais, Centro de Bacteriologia, Instituto Adolfo Lutz , São Paulo, São Paulo, Brazil
| | - Maria Lourdes Ribeiro Souza Cunha
- 1 Departamento de Microbiologia e Imunologia, Instituto de Biociências, Universidade Estadual Paulista (UNESP) , Botucatu, São Paulo, Brazil
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Czekaj T, Ciszewski M, Szewczyk EM. Staphylococcus haemolyticus - an emerging threat in the twilight of the antibiotics age. Microbiology (Reading) 2015; 161:2061-8. [PMID: 26363644 DOI: 10.1099/mic.0.000178] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Staphylococcus haemolyticus is one of the most frequent aetiological factors of staphylococcal infections. This species seems to lack the important virulence attributes described in other staphylococci. However, studies have shown that the presence of various enzymes, cytolysins and surface substances affects the virulence of S. haemolyticus. Nevertheless, none of them has been identified as crucial and determinative. Despite this, S. haemolyticus is, after Staphylococcus epidermidis, the second most frequently isolated coagulase-negative staphylococcus from clinical cases, notably from blood infections, including sepsis. This raises the question of what is the reason for the increasing clinical significance of S. haemolyticus? The most important factor might be the ability to acquire multiresistance against available antimicrobial agents, even glycopeptides. The unusual genome plasticity of S. haemolyticus strains manifested by a large number of insertion sequences and identified SNPs might contribute to its acquisition of antibiotic resistance. Interspecies transfer of SCCmec cassettes suggests that S. haemolyticus might also be the reservoir of resistance genes for other staphylococci, including Staphylococcus aureus. Taking into consideration the great adaptability and the ability to survive in the hospital environment, especially on medical devices, S. haemolyticus becomes a crucial factor in nosocomial infections caused by multiresistant staphylococci.
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Affiliation(s)
- Tomasz Czekaj
- Department of Pharmaceutical Microbiology and Microbiological Diagnostics, Medical University of Łódź, Pomorska 137, 90-235 Łódź, Poland
| | - Marcin Ciszewski
- Department of Pharmaceutical Microbiology and Microbiological Diagnostics, Medical University of Łódź, Pomorska 137, 90-235 Łódź, Poland
| | - Eligia M Szewczyk
- Department of Pharmaceutical Microbiology and Microbiological Diagnostics, Medical University of Łódź, Pomorska 137, 90-235 Łódź, Poland
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Sousa B, Furlanetto J, Hutka M, Gouveia P, Wuerstlein R, Mariz JM, Pinto D, Cardoso F. Central venous access in oncology: ESMO Clinical Practice Guidelines. Ann Oncol 2015; 26 Suppl 5:v152-68. [PMID: 26314776 DOI: 10.1093/annonc/mdv296] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Affiliation(s)
- B Sousa
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
| | | | - M Hutka
- St George's University Hospitals, NHS Foundation Trust, London, UK
| | - P Gouveia
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
| | - R Wuerstlein
- CCC of LMU, Breast Center, University Hospital Munich, Munich, Germany
| | - J M Mariz
- Department of Haematology, Instituto Português de Oncologia do Porto- Francisco Gentil, Oporto, Portugal
| | - D Pinto
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
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Zhang R, Wang F, Kang J, Wang X, Yin D, Dang W, Duan J. Prevalence of multidrug resistant Gram-positive cocci in a Chinese hospital over an 8-year period. Int J Clin Exp Med 2015; 8:9462-9469. [PMID: 26309609 PMCID: PMC4538018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/26/2015] [Indexed: 06/04/2023]
Abstract
Gram-positive cocci are common causes of bloodstream and nosocomial infections, and their multi-drug resistance is an increasingly serious problem. The present study aimed to assess the prevalence of multi-drug-resistant Gram-positive cocci in a Chinese population. In this retrospective study, data about Gram-positive cocci from in-patients (January 2006 and December 2013) at the Second Hospital of Shanxi Medical University, Taiyuan, China, were reviewed. Antimicrobial susceptibility profile of the isolated Gram-positive cocci was evaluated using the disk diffusion method. Antibiotic resistance was determined according to the Clinical and Laboratory Standards Institute 2009 guidelines. The prevalence of drug resistance was determined, as well as correlation coefficients for various drugs between the resistance rate and year of sample collection. A total of 7789 Gram-positive cocci isolates were found, including 2576 (33%) coagulase-negative Staphylococci, 1477 (19%) Staphylococci aureus, 1343 (17%) Enterococcus faecalis, and 1139 (15%) Enterococcus faecium. The proportions of methicillin-resistant Staphylococci aureus (MRSA) and methicillin-resistant Staphylococci (MRS) were 31.5% (465/1477) and 61.6% (1587/2576), respectively. Among all isolates, MRS had much higher drug resistance rate than methicillin-sensitive Staphylococci (P<0.05). E. faecalis had a higher multi-drug resistance rate than E. faecium (P<0.01). Interestingly, MRSA resistance rates declined over the years, showing a negative correlation coefficient for all drugs, with significance for levofloxacin, azithromycin, erythromycin, and clindamycin (P<0.05), but not sulphamethoxazole/trimethoprim (P=0.057) and gentamicin (P=0.186). These results indicated that Staphylococci were the predominant Gram-positive cocci isolated. There was a trend of decreasing MRSA in the population studied.
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Affiliation(s)
- Ruiqin Zhang
- Department of Pharmacy, The Second Hospital of Shanxi Medical UniversityTaiyuan 030000, Shanxi Province, China
| | - Fengzhi Wang
- Department of Medicine, The Second Hospital of Shanxi Medical UniversityTaiyuan 030000, Shanxi Province, China
| | - Jianbang Kang
- Department of Pharmacy, The Second Hospital of Shanxi Medical UniversityTaiyuan 030000, Shanxi Province, China
| | - Xinchun Wang
- Department of Pharmacy, The Second Hospital of Shanxi Medical UniversityTaiyuan 030000, Shanxi Province, China
| | - Donghong Yin
- Department of Pharmacy, The Second Hospital of Shanxi Medical UniversityTaiyuan 030000, Shanxi Province, China
| | - Wen Dang
- Department of Pharmacy, The Second Hospital of Shanxi Medical UniversityTaiyuan 030000, Shanxi Province, China
| | - Jinju Duan
- Department of Pharmacy, The Second Hospital of Shanxi Medical UniversityTaiyuan 030000, Shanxi Province, China
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García de la Mària C, Cervera C, Pericàs JM, Castañeda X, Armero Y, Soy D, Almela M, Ninot S, Falces C, Mestres CA, Gatell JM, Moreno A, Marco F, Miró JM. Epidemiology and prognosis of coagulase-negative staphylococcal endocarditis: impact of vancomycin minimum inhibitory concentration. PLoS One 2015; 10:e0125818. [PMID: 25961578 PMCID: PMC4427314 DOI: 10.1371/journal.pone.0125818] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 03/18/2015] [Indexed: 11/18/2022] Open
Abstract
This study describes coagulase-negative staphylococcal (CoNS) infective endocarditis (IE) epidemiology at our institution, the antibiotic susceptibility profile, and the influence of vancomycin minimum inhibitory concentration (MIC) on patient outcomes. One hundred and three adults with definite IE admitted to an 850-bed tertiary care hospital in Barcelona from 1995-2008 were prospectively included in the cohort. We observed that CoNS IE was an important cause of community-acquired and healthcare-associated IE; one-third of patients involved native valves. Staphylococcus epidermidis was the most frequent species, methicillin-resistant in 52% of patients. CoNS frozen isolates were available in 88 patients. Vancomycin MICs of 2.0 μg/mL were common; almost all cases were found among S. epidermidis isolates and did not increase over time. Eighty-five patients were treated either with cloxacillin or vancomycin: 38 patients (Group 1) were treated with cloxacillin, and 47 received vancomycin; of these 47, 27 had CoNS isolates with a vancomycin MIC <2.0 μg/mL (Group 2), 20 had isolates with a vancomycin MIC ≥ 2.0 μg/mL (Group 3). One-year mortality was 21%, 48%, and 65% in Groups 1, 2, and 3, respectively (P = 0.003). After adjusting for confounders and taking Group 2 as a reference, methicillin-susceptibility was associated with lower 1-year mortality (OR 0.12, 95% CI 0.02-0.55), and vancomycin MIC ≥ 2.0 μg/mL showed a trend to higher 1-year mortality (OR 3.7, 95% CI 0.9-15.2; P=0.069). Other independent variables associated with 1-year mortality were heart failure (OR 6.2, 95% CI 1.5-25.2) and pacemaker lead IE (OR 0.1, 95%CI 0.02-0.51). In conclusion, methicillin-resistant S.epidermidis was the leading cause of CoNS IE, and patients receiving vancomycin had higher mortality rates than those receiving cloxacillin; mortality was higher among patients having isolates with vancomycin MICs ≥ 2.0 μg/mL.
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Affiliation(s)
- Cristina García de la Mària
- Infectious Diseases Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Carlos Cervera
- Infectious Diseases Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Juan M. Pericàs
- Infectious Diseases Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Ximena Castañeda
- Infectious Diseases Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Yolanda Armero
- Infectious Diseases Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Dolors Soy
- Pharmacy Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Manel Almela
- Microbiology Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Salvador Ninot
- Department of Cardiovascular Surgery, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Carlos Falces
- Cardiology Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Carlos A. Mestres
- Department of Cardiovascular Surgery, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Jose M. Gatell
- Infectious Diseases Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Asuncion Moreno
- Infectious Diseases Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - Francesc Marco
- Microbiology Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
| | - José M. Miró
- Infectious Diseases Service, The Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona School of Medicine, Barcelona, Spain
- * E-mail:
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Affiliation(s)
- N H Ahmed
- Department of Microbiology, Delhi State Cancer Institute, New Delhi, India. E-mail:
| | - F K Baruah
- Department of Microbiology, Delhi State Cancer Institute, New Delhi, India. E-mail:
| | - R K Grover
- Department of Clinical Oncology, Delhi State Cancer Institute, New Delhi, India
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Valencia-Rey P, Weinberg J, Miller NS, Barlam TF. Coagulase-negative staphylococcal bloodstream infections: Does vancomycin remain appropriate empiric therapy? J Infect 2015; 71:53-60. [PMID: 25725152 DOI: 10.1016/j.jinf.2015.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/16/2015] [Accepted: 02/19/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES It is unknown if vancomycin minimal inhibitory concentrations (MICs) have increased in coagulase-negative staphylococci (CoNS) or whether vancomycin remains appropriate empiric therapy. METHODS We performed a retrospective study at a single tertiary care center over 8 years. Adult inpatients with ≥2 positive blood cultures for CoNS within a 48-h period were eligible. Susceptibilities were performed by automated broth based-microdilution. Changes in antimicrobial susceptibility were analyzed using logistic regression. The clinical characteristics and outcomes of patients with bloodstream infections (BSI) were compared by MIC. RESULTS Of 308 episodes of possible CoNS bacteremia, the vancomycin MIC was ≤1 μg/mL in 80 (26%) isolates, 2 μg/mL in 223 (72.4%) isolates and 4 μg/mL in 5 (1.6%) isolates. No isolates were resistant. We observed an 11-fold increased chance of having an isolate with a vancomycin MIC ≤1 μg/mL in 2009-2011 compared with 2004-2008 (OR 10.8, 95% CI 6.0-19.5, p < 0.05). In 152 patients with BSI, the median days of bacteremia, hospital mortality and readmissions at 30 days were similar in BSI caused by isolates with high vancomycin MICs (2-4 μg/mL) and low vancomycin MICs (≤1 μg/mL). CONCLUSIONS We conclude vancomycin is still appropriate empiric therapy for CoNS BSIs. CoNS vancomycin MICs decreased over the study period despite widespread use of vancomycin.
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Affiliation(s)
- Paula Valencia-Rey
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, 771 Albany Street, Dowling Building 3N, Boston, MA 02118, USA.
| | - Janice Weinberg
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA 02118, USA.
| | - Nancy S Miller
- Section of Microbiology, Department of Pathology and Laboratory Medicine, Boston Medical Center, 670 Albany Street, Suite 733, Boston, MA 02118, USA.
| | - Tamar F Barlam
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, 771 Albany Street, Dowling Building 3N, Boston, MA 02118, USA.
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Tekin A, Dal T, Deveci Ö, Tekin R, Özcan N, Atmaca S, Dayan S. In vitro susceptibility to methicillin, vancomycin and linezolid of staphylococci isolated from bloodstream infections in eastern Turkey. Braz J Microbiol 2014; 45:829-33. [PMID: 25477914 PMCID: PMC4204965 DOI: 10.1590/s1517-83822014000300010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 12/13/2013] [Indexed: 12/02/2022] Open
Abstract
Staphylococcus species are one of the major causes of bacterial bloodstream infections. Multi-resistant staphylococci infections are major therapeutic problems. This study was aimed to detect methicillin, linezolid and vancomycin susceptibilities of Staphylococcus isolates. A total of 870 Staphylococcus strains isolated from blood cultures of hospitalized patients with BSI. Antimicrobial susceptibilities of methicillin, linezolid and vancomycin were detected according to the Clinical and Laboratory Standards Institute (CLSI). A total of 771 (88.6%) isolates were coagulase-negative staphylococci (CoNS). 700 (80.5%) isolates were methicillin-resistant (MR) and 170 (19.5%) were methicillin-susceptible (MS). All the MS isolates were also susceptible to linezolid. However 15 (1.7%) of MR strains were resistant to linezolid. The minimum inhibitory concentration range for the linezolid-resistant isolates by Etest was 6–32 μg/mL. The difference between linezolid susceptibilities for MS and MR staphylococci was not quite statistically significant (p = 0.052). There was no statistically significant difference between S. aureus and CoNS isolates for linezolid susceptibility. All of the isolates were susceptible to vancomycin. In conclusion, linezolid is currently an efficient option for the treatment of methicillin-resistant staphylococci infections.
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Affiliation(s)
- Alicem Tekin
- Department of Microbiology and Clinical Microbiology Medical Faculty Dicle University Diyarbakir Turkey Department of Microbiology and Clinical Microbiology, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Tuba Dal
- Department of Microbiology and Clinical Microbiology Medical Faculty Dicle University Diyarbakir Turkey Department of Microbiology and Clinical Microbiology, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Özcan Deveci
- Department of Clinical Microbiology and Infectious Diseases Medical Faculty Dicle University Diyarbakir Turkey Department of Clinical Microbiology and Infectious Diseases, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Recep Tekin
- Department of Clinical Microbiology and Infectious Diseases Medical Faculty Dicle University Diyarbakir Turkey Department of Clinical Microbiology and Infectious Diseases, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Nida Özcan
- Department of Microbiology and Clinical Microbiology Medical Faculty Dicle University Diyarbakir Turkey Department of Microbiology and Clinical Microbiology, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Selahattin Atmaca
- Department of Microbiology and Clinical Microbiology Medical Faculty Dicle University Diyarbakir Turkey Department of Microbiology and Clinical Microbiology, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Saim Dayan
- Department of Clinical Microbiology and Infectious Diseases Medical Faculty Dicle University Diyarbakir Turkey Department of Clinical Microbiology and Infectious Diseases, Medical Faculty, Dicle University, Diyarbakir, Turkey
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Abstract
The definition of the heterogeneous group of coagulase-negative staphylococci (CoNS) is still based on diagnostic procedures that fulfill the clinical need to differentiate between Staphylococcus aureus and those staphylococci classified historically as being less or nonpathogenic. Due to patient- and procedure-related changes, CoNS now represent one of the major nosocomial pathogens, with S. epidermidis and S. haemolyticus being the most significant species. They account substantially for foreign body-related infections and infections in preterm newborns. While S. saprophyticus has been associated with acute urethritis, S. lugdunensis has a unique status, in some aspects resembling S. aureus in causing infectious endocarditis. In addition to CoNS found as food-associated saprophytes, many other CoNS species colonize the skin and mucous membranes of humans and animals and are less frequently involved in clinically manifested infections. This blurred gradation in terms of pathogenicity is reflected by species- and strain-specific virulence factors and the development of different host-defending strategies. Clearly, CoNS possess fewer virulence properties than S. aureus, with a respectively different disease spectrum. In this regard, host susceptibility is much more important. Therapeutically, CoNS are challenging due to the large proportion of methicillin-resistant strains and increasing numbers of isolates with less susceptibility to glycopeptides.
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Affiliation(s)
- Karsten Becker
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Christine Heilmann
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Georg Peters
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
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Sundarrajan S, Raghupatil J, Vipra A, Narasimhaswamy N, Saravanan S, Appaiah C, Poonacha N, Desai S, Nair S, Bhatt RN, Roy P, Chikkamadaiah R, Durgaiah M, Sriram B, Padmanabhan S, Sharma U. Bacteriophage-derived CHAP domain protein, P128, kills Staphylococcus cells by cleaving interpeptide cross-bridge of peptidoglycan. Microbiology (Reading) 2014; 160:2157-2169. [DOI: 10.1099/mic.0.079111-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
P128 is an anti-staphylococcal protein consisting of the Staphylococcus aureus phage-K-derived tail-associated muralytic enzyme (TAME) catalytic domain (Lys16) fused with the cell-wall-binding SH3b domain of lysostaphin. In order to understand the mechanism of action and emergence of resistance to P128, we isolated mutants of Staphylococcus spp., including meticillin-resistant Staphylococcus aureus (MRSA), resistant to P128. In addition to P128, the mutants also showed resistance to Lys16, the catalytic domain of P128. The mutants showed loss of fitness as shown by reduced rate of growth in vitro. One of the mutants tested was found to show reduced virulence in animal models of S. aureus septicaemia suggesting loss of fitness in vivo as well. Analysis of the antibiotic sensitivity pattern showed that the mutants derived from MRSA strains had become sensitive to meticillin and other β-lactams. Interestingly, the mutant cells were resistant to the lytic action of phage K, although the phage was able to adsorb to these cells. Sequencing of the femA gene of three P128-resistant mutants showed either a truncation or deletion in femA, suggesting that improper cross-bridge formation in S. aureus could be causing resistance to P128. Using glutathione S-transferase (GST) fusion peptides as substrates it was found that both P128 and Lys16 were capable of cleaving a pentaglycine sequence, suggesting that P128 might be killing S. aureus by cleaving the pentaglycine cross-bridge of peptidoglycan. Moreover, peptides corresponding to the reported cross-bridge of Staphylococcus haemolyticus (GGSGG, AGSGG), which were not cleaved by lysostaphin, were cleaved efficiently by P128. This was also reflected in high sensitivity of S. haemolyticus to P128. This showed that in spite of sharing a common mechanism of action with lysostaphin, P128 has unique properties, which allow it to act on certain lysostaphin-resistant Staphylococcus strains.
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Affiliation(s)
- Sudarson Sundarrajan
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Junjappa Raghupatil
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Aradhana Vipra
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Nagalakshmi Narasimhaswamy
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Sanjeev Saravanan
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Chemira Appaiah
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Nethravathi Poonacha
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Srividya Desai
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Sandhya Nair
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Rajagopala Narayana Bhatt
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Panchali Roy
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Ravisha Chikkamadaiah
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Murali Durgaiah
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Bharathi Sriram
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Sriram Padmanabhan
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
| | - Umender Sharma
- GangaGen Biotechnologies Pvt. Ltd, No. 12 5th cross, Raghavendra layout, Tumkur road, Yeshwantpur, Bangalore 560022, India
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Tashiro M, Izumikawa K, Ashizawa N, Narukawa M, Yamamoto Y. Clinical significance of methicillin-resistant coagulase-negative staphylococci obtained from sterile specimens. Diagn Microbiol Infect Dis 2015; 81:71-5. [PMID: 25312009 DOI: 10.1016/j.diagmicrobio.2014.09.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 09/10/2014] [Accepted: 09/21/2014] [Indexed: 11/23/2022]
Abstract
Distinguishing true coagulase-negative staphylococci bacteremia from contamination remains a challenge. We conducted a retrospective analysis of 183 patients with methicillin-resistant coagulase-negative staphylococci (MR-CoNS)-positive and methicillin-resistant Staphylococcus aureus-positive cultures obtained from sterile sites such as blood, synovial fluid, ascitic fluid, and cerebrospinal fluid. Of the 209 MR-CoNS isolates, 83 (39.7%) were considered infection associated, and 126 (60.3%) were considered contamination. MR-CoNS isolates cultured from synovial fluid were more likely to be infection associated (P = 0.009). The median interval from insertion of a central venous catheter to onset of infection tended to be longer in MR-CoNS infection cases than in methicillin-resistant S. aureus infection cases (41 days versus 14 days, P = 0.055). In conclusion, our results suggest that the proportion of cases of true MR-CoNS infection may be higher than previously reported.
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Essa Abdullah F, Irfan Khan M, Waheed S. Current pattern of antibiotic resistance of clinical isolates among conjunctival swabs. Pak J Med Sci 2013; 29:81-4. [PMID: 24353513 PMCID: PMC3809201 DOI: 10.12669/pjms.291.2566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 10/03/2012] [Accepted: 10/05/2012] [Indexed: 11/15/2022] Open
Abstract
Objectives: To identify the etiological agent in bacterial conjunctivitis and to determine the antibiogram of bacterial isolates. Methodology: This observational study was conducted at Dr. Essa’s Laboratory over a period of 12 months ending in March 2012. Two hundred samples taken from conjunctiva of patients with conjunctivitis were cultured on routine medium and the antibiograms of bacterial isolates were determined by Kirby- Bauer disc diffusion method. Results: The analysis of the culture showed that 41% were cultured positive with gram positive bacteria Staphylococcus aureus 52.5% and Staphylococcus epidermidis 30.1% and Micrococci 8.3%. However, 9.1% were gram negatives with Klebsiella pneumoniae 5.14% and Pseudomonas aeruginosa 2.6% and 1.36% were others (Acinetobacter, Haemophilus , E.coli and Moraxella) keeping in view the increasing use of contact lens and unclean fingers. The overall antibiograms of bacterial isolates indicate aminoglycosides (gentamicin, tobramicin) and the newer quinolones as apparent drug of choice for empirical therapy, followed by chloramphenicol, since drug fussy gram-negatives such as Pseudomonas, Acinetobacter and E.coli were among the conjunctival isolates. Resistance profile of gram positive isolates shows cefixime 91.4%, doxycycline 57.9%, cotrimoxazole 29.3%, ampicillin 22.9%, ciprofloxacin 13.4%, cephradine 8.3%, cefuroxime 7.1%, fosfomycin 4.7%, ceftriaxone 3.6%, co-amoxiclav 3.6%, cefotaxime 3.5%, vancomycin 2.6%. Conclusion: Resistance to all conventionally used antibiotics is increasing, therefore identification of etiological agent and antibiogram is important to treat conjunctivitis and to avoid complications.
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Affiliation(s)
- Farhan Essa Abdullah
- Farhan Essa Abdullah, MBBS, MPhil, PhD (Microbiology), Assistant Professor of Microbiology and Immunology, Dr. Essa's Laboratory & Diagnostic Center, Karachi
| | - Mariya Irfan Khan
- Mariya Irfan Khan, Final Year MBBS, Sindh Medical College, Karachi, Pakistan
| | - Sadia Waheed
- Sadia Waheed, Final Year MBBS, Sindh Medical College, Karachi, Pakistan
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Jain N, Mathur P, Misra M. Trend of vancomycin susceptibility of staphylococci at a level 1 trauma centre of India. Indian J Med Res 2013; 138:1022-4. [PMID: 24521652 PMCID: PMC3978957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Neetu Jain
- Department of Microbiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences New Delhi 110 029, India
| | - Purva Mathur
- Department of Laboratory Medicine Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences New Delhi 110 029, India,For correspondence:
| | - M.C. Misra
- Department of Microbiology, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences New Delhi 110 029, India
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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. Int J Occup Environ Health 2013; 19:207-14. [PMID: 23885773 DOI: 10.1179/2049396713y.0000000035] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Jeong DW, Kim HR, Han S, Jeon CO, Lee JH. A proposal to unify two subspecies of Staphylococcus equorum: Staphylococcus equorum subsp. equorum and Staphylococcus equorum subsp. linens. Antonie Van Leeuwenhoek 2013; 104:1049-62. [PMID: 24057981 DOI: 10.1007/s10482-013-0025-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/03/2013] [Indexed: 11/29/2022]
Abstract
Twelve isolates from jeotgal, a Korean high-salt-fermented seafood, identified as Staphylococcus equorum were compared by phenotypic and genotypic methods to determine their precise taxonomic identities at the subspecies level. Four strains and three strains had complete 16S rRNA gene sequence matches with S. equorum subsp. equorum DSM 20674(T) and S. equorum subsp. linens DSM 15097(T), respectively. Five strains showed 99.9 % identity with the sequences of both type strains. In our DNA-DNA hybridization analyses among two type strains and two isolates, the similarities were over 72 % and were higher than the similarities presented at the subspecies proposal. Physiological characteristics such as sugar utilization, β-galactosidase activity, novobiocin resistance and salt tolerance, which were adopted for subspecies separation, could not be applied to assign the isolates to a taxonomic unit. Antibiotic susceptibility, hemolytic activity, biofilm formation and protein profiles did not present markers to divide the isolates into either of the subspecies. Multilocus sequence typing of the sequences of the 16S rRNA gene and five housekeeping genes did not produce any coherent relationship among the isolates and type strains. Repetitive element-PCR fingerprinting using ERIC (enterobacterial repetitive intergenic consensus) primers classified 12 isolates to three genotypes, and the genotypes of both type strains coincided with two isolates expressing different characteristics. Based on these phenotypic and genotypic analyses results, we propose to unify the present two subspecies of S. equorum into one species, S. equorum.
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Affiliation(s)
- Do-Won Jeong
- Department of Food Science and Biotechnology, Kyonggi University, Suwon, 443-760, South Korea
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Martins A, Riboli DFM, Camargo CH, Pereira VC, de Almeida Sampaio R, de Souza da Cunha MDLR. Antimicrobial resistance and persistence of Staphylococcus epidermidis clones in a Brazilian university hospital. Diagn Microbiol Infect Dis 2013; 77:164-8. [PMID: 23906562 DOI: 10.1016/j.diagmicrobio.2013.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 05/24/2013] [Accepted: 06/01/2013] [Indexed: 11/27/2022]
Abstract
Oxacillin is an alternative for the treatment of Staphylococcus spp. infections; however, resistance to this drug has become a major problem over recent decades. The main objective of this study was to epidemiologically characterize coagulase-negative staphylococci (CoNS) strains recovered from blood of patients hospitalized in a Brazilian teaching hospital. Oxacillin resistance was analyzed in 160 strains isolated from blood culture samples by phenotypic methods, detection of the mecA gene, and determination of intermediate sensitivity to vancomycin on brain heart infusion agar supplemented with 4 and 6 μg/mL vancomycin. In addition, characterization of the epidemiological profile by staphylococcal cassette chromosome mec (SCCmec) typing and clonal analysis by pulsed-field gel electrophoresis (PFGE) were performed. The mecA gene was detected in 72.5% of the isolates. Methicillin-resistant CoNS isolates exhibited the highest minimum inhibitory concentrations and multiresistance when compared to methicillin-susceptible CoNS strains. Typing classified 32.8% of the isolates as SCCmec I and 50% as SCCmec III. PFGE typing of the SCCmec III Staphylococcus epidermidis isolates identified 6 clones disseminated in different wards that persisted from 2002 to 2009. The high oxacillin resistance rates found in this study and clonal dissemination in different wards highlight the importance of good practices in nosocomial infection control and of the rational use of antibiotic therapy in order to prevent the dissemination of these clones.
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Affiliation(s)
- André Martins
- Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, UNESP - Univ Estadual Paulista, City of Botucatu, Brazil; Department of Microbiology and Immunology, Biosciences Institute, UNESP - Univ Estadual Paulista, City of Botucatu, Brazil
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Pandey N, Chittams JL, Trerotola SO. Outpatient Placement of Subcutaneous Venous Access Ports Reduces the Rate of Infection and Dehiscence Compared with Inpatient Placement. J Vasc Interv Radiol 2013; 24:849-54. [DOI: 10.1016/j.jvir.2013.02.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 01/18/2013] [Accepted: 01/22/2013] [Indexed: 11/19/2022] Open
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Acquah SEK, Quaye L, Sagoe K, Ziem JB, Bromberger PI, Amponsem AA. Susceptibility of bacterial etiological agents to commonly-used antimicrobial agents in children with sepsis at the Tamale Teaching Hospital. BMC Infect Dis 2013; 13:89. [PMID: 23419199 PMCID: PMC3598494 DOI: 10.1186/1471-2334-13-89] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 02/07/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bloodstream infections in neonates and infants are life-threatening emergencies. Identification of the common bacteria causing such infections and their susceptibility patterns will provide necessary information for timely intervention. This study is aimed at determining the susceptibilities of bacterial etiological agents to commonly-used antimicrobial agents for empirical treatment of suspected bacterial septicaemia in children. METHODS This is a hospital based retrospective analysis of blood cultures from infants to children up to 14 years of age with preliminary diagnosis of sepsis and admitted to the Neonatal Intensive Care Unit (NICU) and Paediatric Wards of the Teaching Hospital Tamale from July 2011 to January 2012. RESULTS Out of 331 blood specimens cultured, the prevalence of confirmed bacterial sepsis was 25.9% (86/331). Point prevalence for confirmed cases from NICU was 44.4% (28/63) and 21.6% (58/268) from the Paediatric ward. Gram positive cocci (GPC) were the predominant isolates with Coagulase positive (32.2%) and Coagulase-negative (28.7%) Staphylococci accounting for 60.9% of the total isolates. Gram negative rods (GNR) comprised 39.1% of all isolates with Klebsiella, E.coli and Salmonella being the most common organisms isolated. Klebsiella was the most frequent GNR from the NICU and Salmonella typhi was predominantly isolated from the paediatric ward. Acinetobacter showed 100.0% susceptibility to Ceftriaxone and Cefotaxime but was resistant (100.0%) to Ampicillin, Tetracycline and Cotrimoxazole. Escherichia coli and Klebsiella were 80.0% and 91.0% susceptible to Ceftriaxone and Cefotaxime respectively. Klebsiella species showed 8.3% susceptibility to Tetracycline but was resistant to Ampicillin and Cotrimoxazole. Escherichia coli showed 40.0% susceptibility to Ampicillin, Chloramphenicol and Cotrimoxazole; 20.0% susceptibility to Tetracycline and 80.0% susceptible to Gentamicin and Cefuroxime. Coagulase negative Staphylococci was susceptible to Gentamicin (72.0%) but Coagulase positive Staphylococci showed intermediate sensitivity to Gentamicin (42.9%). CONCLUSION Coagulase Negative, Coagulase Positive Staphylococci, Salmonella and Klebsiella were the aetiological agents of bloodstream infection among children at TTH. While gram-positive and gram-negative bacteria showed low susceptibility to Ampicillin, Tetracycline and Cotrimoxazole, the GNR were susceptible to Gentamicin and third-generation cephalosporins.
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Affiliation(s)
| | - Lawrence Quaye
- Department of Medical Laboratory Services, School of Medicine and Health Sciences University for Development Studies, Tamale, Ghana
| | | | - Juventus B Ziem
- School of Medicine and Health Sciences University for Development Studies, Tamale, Ghana
| | - Patricia I Bromberger
- Department of Neonatology, Southern California Kaiser Permanente Medical Group, San Diego, CA, USA
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Dubée V, Zeller V, Lhotellier L, Kitzis MD, Ziza JM, Mamoudy P, Desplaces N. Continuous high-dose vancomycin combination therapy for methicillin-resistant staphylococcal prosthetic hip infection: a prospective cohort study. Clin Microbiol Infect 2013; 19:E98-105. [DOI: 10.1111/1469-0691.12071] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 09/07/2012] [Accepted: 10/10/2012] [Indexed: 11/27/2022]
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Cremniter J, Sivadon-Tardy V, Caulliez C, Bauer T, Porcher R, Lortat-Jacob A, Piriou P, Judet T, Aegerter P, Herrmann JL, Gaillard JL, Rottman M. Genetic analysis of glycopeptide-resistant Staphylococcus epidermidis strains from bone and joint infections. J Clin Microbiol 2013; 51:1014-9. [PMID: 23269734 DOI: 10.1128/JCM.02608-12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Glycopeptide-resistant Staphylococcus epidermidis (GRSE) strains are of increasing concern in bone and joint infections (BJIs). Using multilocus sequence typing and multilocus variable-number tandem repeat analysis, we show that BJI-associated GRSE strains are genetically diverse but arise from related, multiresistant hospital sequence types (STs), mostly ST2, ST5, and ST23.
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Sujatha S, Praharaj I. Glycopeptide resistance in gram-positive cocci: a review. Interdiscip Perspect Infect Dis 2012; 2012:781679. [PMID: 22778729 DOI: 10.1155/2012/781679] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 04/16/2012] [Accepted: 04/30/2012] [Indexed: 02/01/2023] Open
Abstract
Vancomycin-resistant enterococci (VRE) have emerged as important nosocomial pathogens in the past two decades all over the world and have seriously limited the choices available to clinicians for treating infections caused by these agents. Methicillin-resistant Staphylococcus aureus, perhaps the most notorious among the nosocomial pathogens, was till recently susceptible to vancomycin and the other glycopeptides. Emergence of vancomycin nonsusceptible strains of S. aureus has led to a worrisome scenario where the options available for treating serious infections due to these organisms are very limited and not well evaluated. Vancomycin resistance in clinically significant isolates of coagulase-negative staphylococci is also on the rise in many setups. This paper aims to highlight the genetic basis of vancomycin resistance in Enterococcus species and S. aureus. It also focuses on important considerations in detection of vancomycin resistance in these gram-positive bacteria. The problem of glycopeptide resistance in clinical isolates of coagulase-negative staphylococci and the phenomenon of vancomycin tolerance seen in some strains of Streptococcus pneumoniae has also been discussed. Finally, therapeutic options available and being developed against these pathogens have also found a mention.
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Sader HS, Jones RN. Antimicrobial activity of daptomycin in comparison to glycopeptides and other antimicrobials when tested against numerous species of coagulase-negative Staphylococcus. Diagn Microbiol Infect Dis 2012; 73:212-4. [DOI: 10.1016/j.diagmicrobio.2012.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
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Loonen AJ, Jansz AR, Bergland JN, Valkenburg M, Wolffs PF, van den Brule AJ. Comparative study using phenotypic, genotypic, and proteomics methods for identification of coagulase-negative staphylococci. J Clin Microbiol 2012; 50:1437-9. [PMID: 22238435 DOI: 10.1128/JCM.06746-11] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Five methods were compared to determine the most accurate method for identification of coagulase-negative staphylococci (CoNS) (n = 142 strains). Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) showed the best results for rapid and accurate CoNS differentiation (99.3% of strains correctly identified). An alternative to this approach could be Vitek2 combined with partial tuf gene sequencing (100% of strains correctly identified when both methods are performed simultaneously).
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Ma XX, Wang EH, Liu Y, Luo EJ. Antibiotic susceptibility of coagulase-negative staphylococci (CoNS): emergence of teicoplanin-non-susceptible CoNS strains with inducible resistance to vancomycin. J Med Microbiol 2011; 60:1661-1668. [DOI: 10.1099/jmm.0.034066-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Xiao Xue Ma
- Department of Medical Microbiology and Parasitology, College of Basic Medical Sciences, China Medical University, Shenyang, PR China
| | - En Hua Wang
- Institute of Pathology and Pathophysiology, China Medical University, Shenyang, PR China
| | - Yong Liu
- Department of Clinical Microbiology, Second Affiliated Hospital of China Medical University, Shenyang, PR China
| | - En Jie Luo
- Department of Medical Microbiology and Parasitology, College of Basic Medical Sciences, China Medical University, Shenyang, PR China
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