scholarly journals Prevalence and molecular characterization of methicillin-resistant Staphylococcus aureus with mupirocin, fusidic acid and/or retapamulin resistance

2020 ◽  
Author(s):  
Wenjing Chen ◽  
Chunyan He ◽  
Han Yang ◽  
Wen Shu ◽  
Zelin Cui ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Fusidic Acid ◽  
Resistance Mechanisms ◽  
Antibiotics Resistance ◽  
Genetic Characteristics ◽  
Methicillin Resistant ◽  
Low Level ◽  
High Level ◽  
Level Resistance

Abstract Data on the prevalence of resistance to mupirocin (MUP), fusidic acid (FA) and retapamulin (RET) in methicillin-resistant Staphylococcus aureus (MRSA) from China are still limited. In this study we examined these three antibiotics resistance pheno and geno-typically in 1206 MRSA clinical isolates. Phenotypic MUP, FA and RET resistance was determined by MICs, and genotypically by PCR and DNA sequencing examining genes mupA / B , fusB - D , cfr and vgaA / Av , and mutations in ileS , fusA / E , rplC , and 23S RNA V domain. The genetic characteristics of resistance isolates were conducted by PFGE and MLST. Overall MRSA MUP, FA and RET resistance was low (5.1%, 1.0% and 0.3%, respectively). The mupA was the mechanism of high-level MUP resistance. All low-level MUP resistance isolates possessed an equivocal mutation N213D in IleS, and 2 of them additionally had the reported V588F mutation impacting the Rossman fold. FusA mutations, such as L461K, H457Q, H457Y and V90I, were the primary FA resistance mechanisms among high-level resistance isolates, most of which contained fusC ; however, all low-level resistance strains carried fusB . No resistance mechanisms detected were found among RET resistance isolates. Genetic analysis demonstrated clone spread for MUP resistance isolates. In conclusion, MUP, FA and RET exhibited highly activity against MRSA isolates. Acquired genes and chromosome-borne genes mutations were responsible for MUP and FA resistance, and further investigation is needed to uncover the RET resistance mechanisms. Moreover, the surveillance to MUP in MRSA should be strengthened to prevent resistance increase due to the expansion of clones.

scholarly journals The Prevalence and Determinants of Fusidic Acid Resistance Among Methicillin-Resistant Staphylococcus aureus Clinical Isolates in China

2021 ◽  
Vol 8 ◽  
Author(s):  
Huilin Zhao ◽  
Xinyi Wang ◽  
Bingjie Wang ◽  
Yanlei Xu ◽  
Lulin Rao ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Fusidic Acid ◽  
Inner Mongolia ◽  
Methicillin Resistant ◽  
Autonomous Region ◽  
Low Level ◽  
Broth Microdilution Method ◽  
High Level ◽  
Inner Mongolia Autonomous Region ◽  
Level Resistance

The significant increase in resistance of methicillin-resistant Staphylococcus aureus (MRSA) to fusidic acid (FA) is a worrying public concern. However, the data on the prevalence of FA-resistant MRSA isolates in China is still limited. This study aims to investigate the prevalence of FA resistance and resistance determinants among MRSA isolates from six tertiary hospitals in different regions of China between 2016 and 2020. The antimicrobial susceptibility of MRSA isolates was performed by disk diffusion test and broth microdilution method. Whole-genome sequencing was conducted to evaluate the determinants of FA resistance and molecular characterization of FA-resistant MRSA isolates. In this study, a total of 74 (74/457, 16.2%) isolates were identified to be FA-resistant among 457 non-duplicate MRSA isolates. The prevalence of 74 FA-resistant isolates was as follows: Hubei (28/70, 40%), Shanghai (18/84, 21.4%), Jiangxi (7/58, 12.1%), Inner Mongolia Autonomous Region (6/38, 15.8%), Guangdong (12/112, 10.7%), and Sichuan (3/95, 3.2%). The mutations in fusA were present in 79.7% (59/74) of FA-resistant MRSA isolates, with 54 (54/74, 73%) having L461K mutation and conferring high-level resistance [Minimum Inhibitory Concentration (MIC)>128 μg/ml]. Acquired gene, fusB, with low-level resistance (MIC <16 μg/ml) was found in 20.3% (15/74) FA-resistant MRSA isolates. ST5-MRSA-II-t2460 was the most prevalence clone with high-level resistance, accounting for 51.4% (38/74), which was distributed in Hubei (24/28, 85.7%), Inner Mongolia Autonomous Region (4/6, 66.7%), Shanghai (7/18, 38.9%), and Guangdong (3/12, 25%). ST630-t4549 MRSA isolates with low-level resistance were the most common in Jiangxi (3/7, 42.9%) and Sichuan (2/3, 66.7%). In brief, the prevalence of FA resistance among MRSA isolates in China was relatively high with geographic differences. High-level FA resistance was associated mostly with fusA mutations, especially the L461K mutation, whereas fusB usually conferred the low-level resistance to FA. The spread of ST5-MRSA-II-t2460 clone with high-level resistance to FA contributed greatly to the increase of FA-resistant MRSA isolates in most regions, especially in Hubei.

scholarly journals Molecular Characterization of rpoBMutations Conferring Cross-Resistance to Rifamycins on Methicillin-Resistant Staphylococcus aureus

1999 ◽  
Vol 43 (11) ◽  
pp. 2813-2816 ◽  
Author(s):  
Thomas A. Wichelhaus ◽  
Volker Schäfer ◽  
Volker Brade ◽  
Boris Böddinghaus
Keyword(s):  
Staphylococcus Aureus ◽  
Amino Acid ◽  
Molecular Characterization ◽  
Amino Acid Substitution ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Cross Resistance ◽  
Methicillin Resistant ◽  
Low Level ◽  
Level Resistance

ABSTRACT Mutations of the rpoB gene conferring resistance to rifampin were analyzed in 40 methicillin-resistant Staphylococcus aureus isolates obtained from six countries. Interestingly, the majority of clinical isolates showed multiple mutations withinrpoB. The amino acid substitution 481His→Asn was the most prevalent one, capable of conferring low-level resistance on its own. Cross-resistance to rifampin, rifabutin, and rifapentine was demonstrated for all mutants identified. The level of resistance to rifamycins correlated with both the mutation position and type of amino acid substitution.

scholarly journals Fusidic Acid Resistance Determinants in Staphylococcus aureus Clinical Isolates

2010 ◽  
Vol 54 (12) ◽  
pp. 4985-4991 ◽  
Author(s):  
Hsiao-Jan Chen ◽  
Wei-Chun Hung ◽  
Sung-Pin Tseng ◽  
Jui-Chang Tsai ◽  
Po-Ren Hsueh ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Fusidic Acid ◽  
Acid Resistance ◽  
Nucleotide Sequencing ◽  
Methicillin Resistant ◽  
Resistance Determinants ◽  
High Level ◽  
Flanking Regions ◽  
First Time ◽  
Level Resistance

ABSTRACT A total of 71 fusidic acid-resistant Staphylococcus aureus (45 methicillin-resistant and 26 methicillin-susceptible) isolates were examined for the presence of resistance determinants. Among 45 fusidic acid-resistant methicillin-resistant S. aureus (MRSA), isolates, 38 (84%) had fusA mutations conferring high-level resistance to fusidic acid (the MIC was ≥128 μg/ml for 22/38), none had fusB, and 7 (16%) had fusC. For 26 fusidic acid-resistant methicillin-susceptible S. aureus (MSSA), only 3 possessed fusA mutations, but 15 (58%) had fusB and 8 (31%) had fusC. Low-level resistance to fusidic acid (MICs ≤ 32 μg/ml) was found in most fusB- or fusC-positive isolates. For 41 isolates (38 MRSA and 3 MSSA), with fusA mutations, a total of 21 amino acid substitutions in EF-G (fusA gene) were detected, of which R76C, E444K, E444V, C473S, P478S, and M651I were identified for the first time. The nucleotide sequencing of fusB and flanking regions in an MSSA isolate revealed the structure of partial IS257-aj1-LP-fusB-aj2-aj3-IS257-partial blaZ, which is identical to the corresponding region in pUB101, and the rest of fusB-carrying MSSA isolates also show similar structures. On the basis of spa and staphylococcal cassette chromosome mec element (SCCmec) typing, two major genotypes, spa type t037-SCCmec type III (t037-III; 28/45; 62%) and t002-II (13/45; 29%), were predominant among 45 MRSA isolates. By pulsed-field gel electrophoresis analysis, 45 MRSA isolates were divided into 12 clusters, while 26 MSSA isolates were divided into 15 clusters. Taken together, the distribution of fusidic acid resistance determinants (fusA mutations, fusB, and fusC) was quite different between MRSA and MSSA groups.

scholarly journals Ceftobiprole- and Ceftaroline-Resistant Methicillin-Resistant Staphylococcus aureus

2015 ◽  
Vol 59 (5) ◽  
pp. 2960-2963 ◽  
Author(s):  
Liana C. Chan ◽  
Li Basuino ◽  
Binh Diep ◽  
Stephanie Hamilton ◽  
Som S. Chatterjee ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Content Type ◽  
Low Level ◽  
Mrsa Strains ◽  
High Level ◽  
Level Resistance

ABSTRACTThe role ofmecAmutations in conferring resistance to ceftobiprole and ceftaroline, cephalosporins with anti-methicillin-resistantStaphylococcus aureus(MRSA) activity, was determined with MRSA strains COL and SF8300. The SF8300 ceftaroline-passaged mutant carried a singlemecAmutation, E447K (E-to-K change at position 447), and expressed low-level resistance. This mutation in COL conferred high-level resistance to ceftobiprole but only low-level resistance to ceftaroline. The COL ceftaroline-passaged mutant, which expressed high-level resistance to ceftobiprole and ceftaroline, had mutations inpbp2,pbp4, andgdpPbut notmecA.

Localization and Characterization of MupA Gene in High and Low-Level Mupirocin Resistant Methicillin Resistant Staphylococcus Aureus

2020 ◽  
Vol 29 (3) ◽  
pp. 171-177
Author(s):  
Marwa S. Mostaf ◽  
Alaa R. Awad
Keyword(s):  
Staphylococcus Aureus ◽  
Plasmid Dna ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Gene Location ◽  
Chromosomal Dna ◽  
Methicillin Resistant ◽  
Low Level ◽  
Mupirocin Resistance ◽  
High Level

Background: Two types of mupirocin resistance among methicillin resistant Staphylococcus aureus (MRSA) have been reported; low-level mupirocin resistance (LL-MR), and high-level mupirocin resistance (HL-MR). The mupA gene is typically located on mobile genetic elements which facilitate the resistance dissemination. Objective: The aim of this work was to identify the mupA gene location, as well as the restriction fragment length polymorphism (RFLP) patterns in high and low-level mupirocin resistant MRSA. Methodology: This study was conducted on 100 MRSA isolates; seven of them were mupirocin resistant. The E test was used to identify high and low level mupirocin resistance. Amplification of mupA gene in total and plasmid DNA was performed. We also detected the spacer region (trsLM–IS257-like–mupA) in the 7 isolates by PCR then we investigated its RFLP patterns. Results: Four MR MRSA isolates had low level resistance, their MupA gene was located on chromosomal DNA, whereas, three isolates showed high level MR, their MupA gene was located on plasmid DNA. Four types of different RFLP patterns of the spacer region were identified; type-1 included two LL-MR isolates, each of type-2 and 3 included both HL-MR and LL-MR isolates, and type-4 included one HL-MR isolate. Conclusions: Staphylococcus aureus mupA gene responsible for LL-MR is located on the chromosome while that responsible for HL-MR is plasmid-mediated. The spacer region variations appear to occur in both chromosomal and plasmid-located mupA gene regardless the type of mupirocin resistance.

scholarly journals Outbreak of Mupirocin-Resistant Staphylococci in a Hospital in Warsaw, Poland, Due to Plasmid Transmission and Clonal Spread of Several Strains

1999 ◽  
Vol 37 (9) ◽  
pp. 2781-2788 ◽  
Author(s):  
Tomasz A. Łe˛ski ◽  
Marek Gniadkowski ◽  
Anna Skoczyńska ◽  
Elz˙bieta Stefaniuk ◽  
Krzysztof Trzciński ◽  
...  
Keyword(s):  
Resistance Mechanisms ◽  
Hospital Environment ◽  
Coagulase Negative Staphylococci ◽  
Large Hospital ◽  
Methicillin Resistant ◽  
Inappropriate Use ◽  
Clonal Spread ◽  
High Level ◽  
Almost All ◽  
Level Resistance

An outbreak of mupirocin-resistant (MuR) staphylococci was investigated in two wards of a large hospital in Warsaw, Poland. Fifty-three MuR isolates of Staphylococcus aureus, S. epidermidis, S. haemolyticus, S. xylosus, and S. capitis were identified over a 17-month survey which was carried out after introduction of the drug for the treatment of skin infections. The isolates were collected from patients with infections, environmental samples, and carriers; they constituted 19.5% of all staphylococcal isolates identified in the two wards during that time. Almost all the MuR isolates were also resistant to methicillin (methicillin-resistant S. aureus and methicillin-resistant coagulase-negative staphylococci). Seven of the outbreak isolates expressed a low-level-resistance phenotype (MuL), whereas the remaining majority of isolates were found to be highly resistant to mupirocin (MuH). The mupA gene, responsible for the MuH phenotype, has been assigned to three different polymorphic loci among the strains in the collection analyzed. The predominant polymorph, polymorph I (characterized by a mupA-containingEcoRI DNA fragment of about 16 kb), was located on a specific plasmid which was widely distributed among the entire staphylococcal population. All MuR S. aureus isolates were found to represent a single epidemic strain, which was clonally disseminated in both wards. The S. epidermidis population was much more diverse; however, at least four clusters of closely related isolates were identified, which suggested that some strains of this species were also clonally spread in the hospital environment. Six isolates of S. epidermidis were demonstrated to express the MuL and MuH resistance mechanisms simultaneously, and this is the first identification of such dual MuR phenotype-bearing strains. The outbreak was attributed to a high level and inappropriate use of mupirocin, and as a result the dermatological formulation of the drug has been removed from the hospital formulary.

scholarly journals Genetic Characterization of Fluoroquinolone-Resistant Streptococcus pneumoniae Strains Isolated during Ciprofloxacin Therapy from a Patient with Bronchiectasis

2003 ◽  
Vol 47 (4) ◽  
pp. 1419-1422 ◽  
Author(s):  
Adela G. de la Campa ◽  
María-José Ferrandiz ◽  
Fe Tubau ◽  
Román Pallarés ◽  
Federico Manresa ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Genetic Characterization ◽  
Susceptible Strain ◽  
Low Level ◽  
Resistant Strains ◽  
Resistant Mutants ◽  
High Level ◽  
Level Resistance

ABSTRACT Five Spain9V-3 Streptococcus pneumoniae strains were isolated from a patient with bronchiectasis who had received long-term ciprofloxacin therapy. One ciprofloxacin-susceptible strain was isolated before treatment, and four ciprofloxacin-resistant strains were isolated during treatment. The resistant strains were derived from the susceptible strain either by a parC mutation (low-level resistance) or by parC and gyrA mutations (high-level resistance). This study shows that ciprofloxacin therapy in a patient colonized by susceptible S. pneumoniae may select fluoroquinolone-resistant mutants.

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Kyiv Surgical Hospital (Ukraine)

2017 ◽  
Vol 1 (2) ◽  
pp. 73-83
Author(s):  
A.G. Salmanov ◽  
O.M. Verner
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Fusidic Acid ◽  
The Other ◽  
Antibiotics Resistance ◽  
Methicillin Resistant ◽  
Surgical Department ◽  
Epidemiologic Surveillance ◽  
Total Prevalence ◽  
Vitek 2

Objective — to determine the prevalence of methicillin-resistant strains of Staphylococcus aureus, isolated from patients different departments in Kyiv Surgical Hospital. Materials and methods. Between June 2015 and December 2015, a total of 128 S. aureus isolates were collected from the pus samples of the patients with SSI in a surgical hospital in Kyiv, Ukraine. The identification and antimicrobial susceptibility of the cultures were determined, using automated microbiology analyzer VITEK 2 Compact (bioMerieux, France). Susceptibility to antibiotics was determined using VITEK 2 AST-P580 card (bioMerieux, France), which included 20 antibiotics (benzylpenicillin, oxacyllin, cefoxitin, gentamycin, tobramycin, levofloxacin, moxifloxacin, erythromycin, clindamycin, linezolid, teicoplanin, vancomycin, tetracycline, tigecycline, fosfomicin, nitrofurantoin, fusidic acid, mupirocin, rifampicin, and trimethoprim/ sulphamethoxazole) and a cefoxitin test, designed for detection of staphylococci resistance to methicillin. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute (CLSI). Results and discussion. Based on antimicrobial susceptibility analysis, the most active antibiotics found in the study were linezolid, tigecycline, and mupirocin, showing growth inhibition of 100 % strains tested. Susceptibility to the other antimicrobials was also on a high level: 99 % of strains were found susceptible to nitrofurantoin and trimethoprim/sulphamethoxazole, 98 % — to fusidic acid, 97 % — to moxifloxacin, 96 % — to teicoplanin, 95 % — to vancomycin and fosfomicin, 93 % — to gentamycin, and 92 % — to tobramycin. Susceptibility to levofloxacin (89 %), tetracycline (88 %), rifampin (87 %), erythromycin (84 %), and clindamycin (79 %) was observed to be some lower. Research of MRSA prevalence in Kyiv Surgical Hospital (Ukraine) shown, that 11 % of staphylococci strains, isolated from patients having nosocomial infections (SSI), had multiple resistance to antibiotics. Resistance S. aureus to oxacyllin came up to 19 %. Further, 35.7 % of MRSA strains were resistant only to the group of beta-lactamic antibiotics, while the rest — also to the other classes of antibiotics. Conclusions. MRSA in surgical hospital, being a subject of the research is considered to be a serious therapeutic and epidemiologic problem. Total prevalence of MRSA in hospital was evaluated as 19 %, varying in every surgical department studied. Antibiotics revealed the most effective for treatment of MRSA infections were linezolid, mupirocin, tigecycline, vancomycine, teicoplanin, moxifloxacin, nitrofurantoin, fusidic acid, and trimethoprim/sulphamethoxazole. Taking into account the constant changes and significant differences of the S. aureus resistance levels observed in various regions, the constant monitoring of antibiotic resistance to antimicrobials in every in-patient medical institution is required and on the base of the local obtained results to elaborate the hospital record sheets. Antibiotics application tactics should be determined in accordance with the local data of resistance to them in each surgical inpatient institution. The system of epidemiologic surveillance over microbial resistance should be established on the local, regional, and national levels.

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