Methicillin-Resistant Staphylococcus aureus Recovered from Healthcare- and Community-Associated Infections in Egypt

Background. Methicillin-resistant Staphylococcus aureus (MRSA) has created significant epidemiological, infection-control, and therapeutic management challenges during the past three decades. Aim. To analyze the pattern of resistance of healthcare- and community-associated MRSA in Egypt and the trend of resistance of HA-MRSA over time (2005–2013). Methods. MRSA isolates were recovered from healthcare-associated (HA) and community-associated (CA) Staphylococcus aureus (S. aureus) infections. They were tested against 11 antimicrobial discs and the minimal inhibitory concentration (MIC) of vancomycin was determined. Inducible clindamycin resistance (iMLSB) was also screened using D-test. Findings. Of 631 S. aureus, MRSA was identified in 343 (76.6%) and 21 (11.5%) of HA and CA S. aureus isolates, respectively. The proportion of HA-MRSA increased significantly from 48.6% in 2005 to 86.8% in 2013 (p value < 0.001). Multidrug resistance (MDR) was observed in 85.8% of HA-MRSA and 48.6% of CA-MRSA. Vancomycin intermediate resistant S. aureus (VISA) was detected in 1.2% of HA-MRSA and none was detected in CA-MRSA. Among HA-MRSA strains, 5.3% showed iMLSB compared to 9.5% among CA-MRSA. Conclusion. The upsurge of the prevalence rates of HA-MRSA over time is alarming and urges for an effective infection control strategy and continuous monitoring of antimicrobial use.

Download Full-text

CIRCULATING CLONES OF COMMUNITY-ACQUIRED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (CA-MRSA) IN WESTERN AUSTRALIA IN THE PAST 11 YEARS (2002-2013)

Jurnal Teknologi ◽

10.11113/jt.v78.8329 ◽

2016 ◽

Vol 78 (5) ◽

Author(s):

A. M. Setiawan

Keyword(s):

Public Health ◽

Staphylococcus Aureus ◽

Disease Prevention ◽

Infection Control ◽

Western Australia ◽

Methicillin Resistant Staphylococcus Aureus ◽

Methicillin Resistant ◽

Health Concerns ◽

The Past ◽

Mrsa Strains

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most complicated problems in infection control and disease prevention. Imported strains or group of similar strains called clones were introduced from other states within Australia and also from other countries. Western Australia (WA) MRSA clones known to be the most predominant clones circulating in Western Australia (WA). However, MRSA strains originally from other states and countries outside Australia (imported) have increased in number in the last decades. The aim of this study was to examine the epidemiology of CA MRSA clones in Western Australia for the past 11 year’s period (2003-2013). There were 10 predominant clones of CA-MRSA circulating in WA with WA MRSA-1 (32,82%), Queensland (22,67 %) and WA MRSA-2 (22,67 %) clones as the top three predominant clones. The percentage of PVL positive CA-MRSA clones such as Queensland (Qld) clone has been increasing significantly (R2=0,67) from 2,38 % in 2002 to 25,69% in 2013. In contrast, the percentages of two major PVL negative clones, WA MRSA-1 and WA MRSA 2, have been decreasing nearly by half from 52,38 % to 27,71 % and 30,95 % to 16,59 % respectively in the last 11 years. PVL positive clones have been introduced in WA from other states and overseas in the last eleven years. Due to the virulence factor of PVL toxin, the emergence of PVL positive CA-MRSA should be considered as public health concerns.

Download Full-text

Virulence characteristics of community-associated Staphylococcus aureus and in vitro activities of moxifloxacin alone and in combination against community-associated and healthcare-associated meticillin-resistant and -susceptible S. aureus

Journal of Medical Microbiology ◽

10.1099/jmm.0.47580-0 ◽

2008 ◽

Vol 57 (4) ◽

pp. 452-456 ◽

Cited By ~ 11

Author(s):

Ellie J. C. Goldstein ◽

Diane M. Citron ◽

Yumi A. Warren ◽

Kerin L. Tyrrell ◽

Michael J. Rybak

Keyword(s):

Staphylococcus Aureus ◽

Inhibitory Concentration ◽

Inducible Clindamycin Resistance ◽

Mrsa Strains ◽

Healthcare Associated ◽

Concentration Indices ◽

Panton Valentine Leukocidin

The increasing prevalence of community-associated meticillin-resistant Staphylococcus aureus (CA-MRSA) poses a challenge for antimicrobial therapy of skin and soft tissue infections (SSTIs). To determine whether another antimicrobial agent might enhance the activity of moxifloxacin against CA-MRSA, this study analysed its activity alone and in chequerboard combination with doxycycline, rifampicin, clindamycin, trimethoprim, sulfamethoxazole/trimethoprim (SXT) and vancomycin against recent SSTI clinical isolates, and also characterized the isolates for Panton–Valentine leukocidin (PVL), agr groups, staphylococcal cassette chromosome mec (SSCmec) types and δ-haemolysin production. For comparison, 25 strains of outpatient meticillin-susceptible S. aureus (MSSA), 24 strains of healthcare-associated (HA)-MRSA and six historical strains of vancomycin-intermediate S. aureus (VISA) were included. It was found that 21/25 CA-MRSA strains tested were PVL-positive, SSCmec type 4 and agr type 1, whilst 4/25 were PVL-negative, SSCmec type 2 and agr type 2. Two of the agr type 2 strains were negative for δ-haemolysin but all other strains were positive. Moxifloxacin MIC50/90 values (μg ml−1) were 1/8 for CA-MRSA, 4/32 for HA-MRSA and ≤0.03/1 for MSSA and MIC50 of 2 for VISA. The D-test for inducible clindamycin resistance was positive for 3/27 CA-MRSA, 5/14 HA-MRSA and none of the MSSA isolates. In chequerboard studies, fractional inhibitory concentration indices (FICIs) showed that most interactions were additive or indifferent (FICI value >0.5 to ≤2) as follows: rifampicin 43/52 strains, clindamycin 44/44, SXT 44/47, trimethoprim 41/42 and vancomycin 37/43. The FICI values for doxycycline were 3–6 for 32/34 strains, indicating antagonism, suggesting that it should not be used in combination with moxifloxacin.

Download Full-text

Characterization and Proposed Nomenclature of Epidemic Strains of MRSA in Canada

Canadian Journal of Infectious Diseases ◽

10.1155/1999/769601 ◽

1999 ◽

Vol 10 (5) ◽

pp. 333-336 ◽

Cited By ~ 6

Author(s):

AE Simor ◽

D Boyd ◽

L Louie ◽

A McGeer ◽

M Mulvey ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant ◽

The Past ◽

Geographic Regions ◽

Mrsa Strains ◽

Genotypic Characteristics

The incidence of methicillin-resistantStaphylococcus aureus(MRSA) has been increasing in many Canadian hospitals over the past few years. Some strains may be considered ‘epidemic’, in that they are clinically or epidemiologically significant, and have been identified in patients from multiple hospitals and geographic regions across the country. This paper describes phenotypic and genotypic characteristics of four epidemic MRSA strains in Canada and proposes standardized nomenclature.

Download Full-text

Methicillin Resistant Staphylococcus aureus: Prevalence And Antibiogram In A Tertiary Care Hospital in Western Nepal

The Journal of Infection in Developing Countries ◽

10.3855/jidc.86 ◽

2009 ◽

Vol 3 (09) ◽

pp. 681-684 ◽

Cited By ~ 31

Author(s):

Hare Krishna Tiwari ◽

Ayan Kumar Das ◽

Darshan Sapkota ◽

Kunjukunju Sivrajan ◽

Vijay Kumar Pahwa

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant Staphylococcus Aureus ◽

Inhibitory Concentration ◽

Tertiary Care ◽

Care Hospital ◽

Methicillin Resistant ◽

Mrsa Strains ◽

Susceptibility Tests ◽

Rational Use Of Antibiotics ◽

Hospital Acquired

Background: Methicillin resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial and community infections. Its prevalence varies with country and with hospitals within a country. The current study estimates the prevalence of MRSA strains and investigates their antibiogram in western Nepal. Methodology: A total of 162 S. aureus strains were isolated from various clinical specimens, and antibiotic susceptibility tests were performed using disc diffusion, growth on oxacillin screen agar, and oxacillin minimum inhibitory concentration (MIC). Results: One hundred and twelve (69.1%) strains were found to be MRSA, of which 37 (33.1%) were community acquired and 75 (66.9%) were hospital acquired. Of 112 MRSA strains, 45 (40.1%) were multi-drug resistant. All MRSA strains were found resistant to penicillin, and 91.9%, 87.4%, 77%, and 55.5% were resistant to amoxicillin, ampicillin, trimethoprim/sulfamethoxazole, and cephalexin, respectively. However, low resistance was observed with amikacin (19%), ciprofloxacin (26.5%), and norfloxacin (30.6%). All strains were sensitive to vancomycin. Conclusion: The reported rate of MRSA prevalence is alarming. Given the ability of MRSA to spread from person to person, it is necessary to adhere to rational use of antibiotics and to raise awareness among the concerned communities and tourists who visit this area.

Download Full-text

Methicillin-resistant Staphylococcus aureus nasal cariage among hospitalized patients and healthcare workers in the Clinical center of Serbia

Archives of Biological Sciences ◽

10.2298/abs1401087c ◽

2014 ◽

Vol 66 (1) ◽

pp. 87-92 ◽

Cited By ~ 4

Author(s):

Ivana Cirkovic ◽

Slobodanka Djukic ◽

Biljana Carevic ◽

Natasa Mazic ◽

Vesna Mioljevic ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Healthcare Workers ◽

Methicillin Resistant Staphylococcus Aureus ◽

Healthcare Facility ◽

Comprehensive Analysis ◽

Hospitalized Patients ◽

Methicillin Resistant ◽

Clinical Center ◽

Mrsa Strains ◽

Healthcare Associated

The aim of the present study was to provide the first comprehensive analysis of methicillin-resistant Staphylococcus aureus (MRSA) carriage among patients and healthcare workers (HCWs) in the largest healthcare facility in Serbia. Specimens from anterior nares obtained from 195 hospitalized patients and 105 HCWs were inoculated after broth enrichment onto chromogenic MRSA-ID medium. In total, 21 of 300 specimens yielded MRSA. Among hospitalized patients, 7.7% were colonized with MRSA, and 5.7% HCWs were colonized with MRSA. Five out of 21 (23.8%) tested MRSA strains were classified as community-associated MRSA (CA-MRSA), and four of them were isolated from HCWs. The remaining 16 MRSA strains had characteristics of healthcare-associated MRSA (HA-MRSA), and two of them were isolated from HCWs. The HA-MRSA strains isolated from HCWs were indistinguishable from HA-MRSA of the same cluster isolated from patients. This finding reveals the circulation of HA-MRSA strains between patients and HCWs in the Clinical Center of Serbia.

Download Full-text

The Decrease in Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Infections and Savings From Glycopeptide Use

Infection Control and Hospital Epidemiology ◽

10.1086/507969 ◽

2006 ◽

Vol 27 (10) ◽

pp. 1131-1132 ◽

Cited By ~ 3

Author(s):

Diler Coşkun ◽

Jale Aytaç

Keyword(s):

Staphylococcus Aureus ◽

Infection Control ◽

Methicillin Resistant Staphylococcus Aureus ◽

Medical Center ◽

Methicillin Resistant ◽

Healthcare Associated

We evaluated changes in the rate of healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) infections and healthcare-associated S. aureus infections after implementation of infection control precautions and the effect of this on glycopeptide use and expenditures for glycopeptides in a private medical center in Turkey in the years 2000-2005. A striking decrease was obtained in the number of MRSA infections, and the expenditure for glycopeptide use also decreased

Download Full-text

Methicillin-resistant Staphylococcus aureus in veterinary professionals in 2017 in the Czech Republic

BMC Veterinary Research ◽

10.1186/s12917-019-2223-z ◽

2020 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Katerina Neradova ◽

Vladislav Jakubu ◽

Katarina Pomorska ◽

Helena Zemlickova

Keyword(s):

Staphylococcus Aureus ◽

Czech Republic ◽

Nasal Carriage ◽

The Czech Republic ◽

Methicillin Resistant ◽

Nasal Swabs ◽

Mrsa Strains ◽

Healthcare Associated ◽

Mrsa Colonization ◽

Animal Strains

Abstract Background Cases of colonization or infection caused by Methicillin-resistant Staphylococcus aureus (MRSA) are frequently reported in people who work with animals, including veterinary personnel. The aim of this study was to determine the prevalence of MRSA colonization among veterinary professionals. A total of 134 nasal swabs from healthy attendees of a veterinary conference held in the Czech Republic were tested for presence of MRSA. The stains were further genotypically and phenotypically characterized. Results Nine isolated MRSA strains were characterized with sequence type (ST), spa type (t) and Staphylococcal Cassette Chromosome mec type. Five different genotypes were described, including ST398-t011-IV (n = 5), ST398-t2330-IV (n = 1), ST398-t034-V (n = 1), ST225-t003-II (n = 1) and ST4894-t011-IV (n = 1). The carriage of the animal MRSA strain was confirmed in 8 cases, characteristics of one strain corresponded to the possible nosocomial origin. Among animal strains were described three spa types (t011, t034, t2330) belonging into one dominating clonal complex spa-CC11. Conclusion According to our results, the prevalence of nasal carriage of MRSA in veterinary personnel is 6.72%. Although we described an increase compared to the results of previous study (year 2008), the prevalence in the Czech Republic is still remaining lower than reported from neighboring countries. Our results also indicate that healthcare - associated MRSA strains are still not spread among animals.

Download Full-text

Synthesis and Antimicrobial Studies of Coumarin-Substituted Pyrazole Derivatives as Potent Anti-Staphylococcus aureus Agents

Molecules ◽

10.3390/molecules25122758 ◽

2020 ◽

Vol 25 (12) ◽

pp. 2758 ◽

Cited By ~ 3

Author(s):

Rawan Alnufaie ◽

Hansa Raj KC ◽

Nickolas Alsup ◽

Jedidiah Whitt ◽

Steven Andrew Chambers ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Minimum Inhibitory Concentration ◽

Methicillin Resistant Staphylococcus Aureus ◽

Inhibitory Concentration ◽

Fatality Rate ◽

Pyrazole Derivatives ◽

Methicillin Resistant ◽

Antimicrobial Studies ◽

Mrsa Strains

In this paper, synthesis and antimicrobial studies of 31 novel coumarin-substituted pyrazole derivatives are reported. Some of these compounds have shown potent activity against methicillin-resistant Staphylococcus aureus (MRSA) with minimum inhibitory concentration (MIC) as low as 3.125 µg/mL. These molecules are equally potent at inhibiting the development of MRSA biofilm and the destruction of preformed biofilm. These results are very significant as MRSA strains have emerged as one of the most menacing pathogens of humans and this bacterium is bypassing HIV in terms of fatality rate.

Download Full-text

Control of Methicillin-Resistant Staphylococcus aureus Strains Associated With a Hospital Outbreak Involving Contamination From Anesthesia Equipment Using UV-C

Frontiers in Microbiology ◽

10.3389/fmicb.2020.600093 ◽

2020 ◽

Vol 11 ◽

Author(s):

Sara A. Ochoa ◽

Ariadnna Cruz-Córdova ◽

Jetsi Mancilla-Rojano ◽

Gerardo Escalona-Venegas ◽

Veronica Esteban-Kenel ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Opportunistic Pathogen ◽

Type Ii ◽

Methicillin Resistant ◽

Hospital Outbreak ◽

Anesthesia Equipment ◽

Mrsa Strains ◽

Healthcare Associated ◽

Uv C ◽

Sequence Types

Methicillin-resistant Staphylococcus aureus (MRSA) is considered an opportunistic pathogen in humans and is mainly associated with healthcare-associated infections (HCAIs). This bacterium colonizes the skin and mucous membranes of healthy people and causes frequent hospital outbreaks. The aim of this study was to perform molecular typing of the staphylococcal cassette chromosome mec (SCCmec) and agr loci as wells as to establish the pulsotypes and clonal complexes (CCs) for MRSA and methicillin-sensitive S. aureus (MSSA) outbreaks associated with the operating room (OR) at a pediatric hospital. Twenty-five clinical strains of S. aureus (19 MRSA and 6 MSSA strains) were recovered from the outbreak (patients, anesthesia equipment, and nasopharyngeal exudates from external service anesthesia technicians). These clinical S. aureus strains were mainly resistant to benzylpenicillin (100%) and erythromycin (84%) and were susceptible to vancomycin and nitrofurantoin. The SCCmec type II was amplified in 84% of the S. aureus strains, and the most frequent type of the agr locus was agrII, which was amplified in 72% of the strains; however, the agrI and agrIII genes were mainly detected in MSSA strains. A pulsed-field gel electrophoresis (PFGE) analysis grouped the 25 strains into 16 pulsotypes (P), the most frequent of which was P1, including 10 MRSA strains related to the anesthesia equipment, external service anesthesia technicians, and hospitalized patients. Multilocus sequence typing (MLST) identified 15 sequence types (STs) distributed in nine CCs. The most prevalent ST was ST1011, belonging to CC5, which was associated with the SCCmec type II and agrII type. We postulate that the external service anesthesia technicians were MRSA carriers and that these strains were indirectly transmitted from the contaminated anesthesia equipment that was inappropriately disinfected. Finally, the MRSA outbreak was controlled when the anesthesia equipment disinfection was improved and hand hygiene was reinforced.

Download Full-text

Inducible Clindamycin Resistance Among the Staphylococcus aureus Colonizing the Anterior Nares of School Children of Udupi Taluk

Nepal Journal of Epidemiology ◽

10.3126/nje.v4i1.10136 ◽

2014 ◽

Vol 4 (1) ◽

pp. 337-340 ◽

Cited By ~ 2

Author(s):

S Govindan ◽

C A Mohammed ◽

I Bairy

Keyword(s):

Staphylococcus Aureus ◽

Infection Control ◽

Methicillin Resistance ◽

Control Strategies ◽

Nasal Carriage ◽

Paediatric Population ◽

Inducible Clindamycin Resistance ◽

Health Authorities ◽

Public Health Authorities ◽

Mrsa Strains

Clindamycin is one of the preferred antibiotics in the treatment of Staphylococcus aureus (SA) skin and soft tissue infections. However the emergence of inducible clindamycin resistant SA is a major concern for clinicians in the management of such infections. Information about such resistant strains of SA colonizing the anterior nares is very important in planning infection control strategies. The objective of the current study was to assess the proportion of SA showing inducible clindamycin resistance and also to know their association with methicillin resistance. Among the isolates, 11.6% (44/378) strains were showing positive D test which indicates inducible clindamycin resistance and a highly significant 71% (12/17) inducible clindamycin resistance was also noticed in the case of MRSA. The nasal carriage of inducible clindamycin resistant SA showing a significant association with MRSA strains by the paediatric population from this area warrants the inclusion of D test in the routine antibiotic susceptibility testing of SA isolates. Information about the MLSBi status among the colonizing strains would also help the public health authorities to plan and implement infection control strategies at the community level.DOI: http://dx.doi.org/10.3126/nje.v4i1.10136 Nepal Journal of Epidemiology 2014;4 (1): 337-340

Download Full-text