RESUMO
The widespread use of mobile phones (MP) among healthcare personnel might be considered as an important source of contamination. One of the most pathogenic bacteria to humans is Staphylococcus aureus, which can be transmitted through the constant use of MP. Nevertheless, which specific type of strains are transmitted and which are their sources have not been sufficiently studied. The aim of this study is to determine the source of contamination of MP and characterize the corresponding genotypic and phenotypic properties of the strains found. Nose, pharynx, and MP samples were taken from a group of health science students. We were able to determinate the clonality of the isolated strains by pulsed-field gel electrophoresis (PFGE) and spa gene typing (spa-type). Adhesin and toxin genes were detected, and the capacity of biofilm formation was determined. Several of the MP exhibited strains of S. aureus present in the nose and/or pharynx of their owners. methicillin-susceptible Staphylococcus aureus (MSSA), hospital-acquired methicillin-resistant S. aureus (HA-MRSA), and community-acquired methicillin-resistant S. aureus (CA-MRSA) strains were found, which indicated a variety of genotypes. This study concludes that MP can be contaminated with the strains of S. aureus present in the nose and/or pharynx of the owners; these strains can be of different types and there is no dominant genotype.
RESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Cochlospermum regium, known as "algodãozinho", is an important plant belonging to Brazilian biodiversity used in traditional medicine to treat infections, wounds and skin conditions. AIM OF THE STUDY: To assess the effects of aqueous and ethanolic extracts from C. regium leaves on methicillin-resistant Staphylococcus aureus planktonic cells and biofilm formation. MATERIAL AND METHODS: The phytochemical characterization of the extracts was carried out by quantification of flavonoids, phenols and tannins and HPLC-DAD. Minimum inhibitory concentrations, cell viability, and enzyme activity inhibition were determined in planktonic cells exposed to C. regium extracts. The effect of the extracts on biofilms was assessed by quantifying colony-forming units (CFUs) and the extracellular matrix, and by visualizing the biofilm structure using scanning electron microscopy. RESULTS: Leaf extract contents showed high concentration of phenols and the gallic and ellagic acids were identified. The extracts showed potent antimicrobial activities at concentrations ranging from 62.5-250 µg/mL, and decreased coagulase activity. In addition, the extracts prevented biofilm formation, and the aqueous extract completely inhibited its formation. CONCLUSIONS: C. regium extracts stand out as promising alternative treatments for the prevention and treatment of methicillin-resistant Staphylococcus aureus infections.
Assuntos
Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Bixaceae , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Extratos Vegetais/farmacologia , Antibacterianos/isolamento & purificação , Biofilmes/crescimento & desenvolvimento , Bixaceae/química , Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento , Staphylococcus aureus Resistente à Meticilina/ultraestrutura , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Extratos Vegetais/isolamento & purificação , Folhas de Planta/químicaRESUMO
The epidemiology and clonality of methicillin-resistant Staphylococcus aureus (MRSA) has not been investigated, as not much research or surveillance has been undertaken to identify and characterize the circulating MRSA strains in Barbados. Prevalence rates, molecular characteristics and antimicrobial susceptibility pattern of MRSA infections in hospitalized and nonhospitalized patients were investigated. A total of 293 isolates were included in the study, with 100 from the hospital and 193 from the public health laboratory. Isolates were collected over a period of 1 (2015-2016) and 3 years (2013-2016) respectively. MRSA was identified using standard microbiologic techniques and was further analysed by multiplex PCR for the presence of the spa, mec gene complex typing and PVL genes (lukS-PV and lukF-PV). A prevalence rate of 19.7% was calculated for those hospitalized. All hospital isolates were sensitive to vancomycin, rifampin, linezolid and cotrimoxazole (trimethoprim/sulfamethoxazole), whilst 82% were sensitive to clindamycin. The PVL gene was detected in 76% of hospital isolates. In the community isolates, resistance was observed in erythromycin (100%), ciprofloxacin (97.4%), clindamycin (13%) and cotrimoxazole (5.7%). There was no resistance to vancomycin. The PVL gene was detected in 97.9% of the isolates, the mecA gene in only 2.1% and the mecC gene in 0%. Most MRSA isolates were community acquired in both settings, and the antimicrobial susceptibility profile was similar, suggesting transmission of community-associated MRSA into the hospital environment. Further harmonization of antimicrobial policy for the treatment of MRSA (and by extension other pathogens) should be implemented to quell ongoing transmission. We found that 93.4% of MRSA in Barbados treated in the primary healthcare system were sensitive to cotrimoxazole. By typing MRSA isolates and drawing interferences on transmission on the basis of genetic relatedness, transmission pathways may be tracked. Further studies must be performed for this high level of comprehensiveness so that with the surveillance of MRSA, effective strategies may be developed to prevent or limit transmission.
RESUMO
This study characterized 30 MRSA isolates from intensive care unit (ICU) environment and equipment surfaces and healthy children. The SCCmec types I, IVa and V were detected in HA-MRSA isolates while CA-MRSA showed the SCCmec type IVa and V. Most isolates were classified as agr group II. All isolates presented the sei gene, and only HA-MRSA were positive for etb e tst genes. Three genotypes were related to Pediatric (ST5/SCCmecIV) and Berlin (ST45/SCCmecIV) clones. The present study showed molecular similarity between CA- and HA-MRSA isolates in hospital and community settings in a Brazilian region.
Assuntos
Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , Unidades de Terapia Intensiva/estatística & dados numéricos , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Brasil , Equipamentos e Provisões Hospitalares/microbiologia , Genótipo , Humanos , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Infecções Estafilocócicas/genética , Infecções Estafilocócicas/microbiologia , Fatores de Virulência/genética , Fatores de Virulência/isolamento & purificaçãoRESUMO
ABSTRACT This study characterized 30 MRSA isolates from intensive care unit (ICU) environment and equipment surfaces and healthy children. The SCCmec types I, IVa and V were detected in HA-MRSA isolates while CA-MRSA showed the SCCmec type IVa and V. Most isolates were classified as agr group II. All isolates presented the sei gene, and only HA-MRSA were positive for etb e tst genes. Three genotypes were related to Pediatric (ST5/SCCmecIV) and Berlin (ST45/SCCmecIV) clones. The present study showed molecular similarity between CA- and HA-MRSA isolates in hospital and community settings in a Brazilian region.
Assuntos
Humanos , Infecção Hospitalar/microbiologia , Infecções Comunitárias Adquiridas/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Staphylococcus aureus Resistente à Meticilina/genética , Unidades de Terapia Intensiva/estatística & dados numéricos , Infecções Estafilocócicas/genética , Infecções Estafilocócicas/microbiologia , Brasil , Fatores de Virulência/isolamento & purificação , Fatores de Virulência/genética , Equipamentos e Provisões Hospitalares/microbiologia , Staphylococcus aureus Resistente à Meticilina/patogenicidade , GenótipoRESUMO
OBJECTIVE: Methicillin resistant Staphylococcus aureus (MRSA) is a resistant bacteria responsible for hard-to-treat infections. To understand the primary impact of this infection in healthcare settings, a retrospective study was performed at a hospital in southern Puerto Rico. Our objectives were to classify the types of MRSA infection, identify factors associated with the infection, and evaluate the outcome of decolonization therapy after its having been implemented at the hospital. METHODS: Medical records of cases encompassing October 2009 through October 2011 were reviewed. A total of 761 MRSA-positive patients were identified and their infections classified as community-acquired MRSA (CA-MRSA), hospital-acquired MRSA (HA-MRSA), or healthcare-associated community-onset MRSA (HACO-MRSA). Basic demographics, reason for hospitalization, medical history, and culture sites, along with other information, were obtained for each case. SPSS v17 was used for statistical analysis. Fisher's exact test was used to measure the statistical significance of the crude OR, using the patients with CA-MRSA as the comparison group. HA-MRSA cases were compared before and after the intervention, using Epidat v4.0 to calculate the cumulative incidence of HA-MRSA before and after the implementation of decolonization therapy at the hospital. RESULTS: In our study, 5.0% of the patients were found to be infected with HA-MRSA, 72.8%, with CA-MRSA, and 22.2%, with HACO-MRSA. After the intervention, we found a decrease of 10.35% (p = 0.704) in HA-MRSA, of 2.6% (p = 0.791) in CA-MRSA, and of 7.0% in HACO-MRSA (p = 0.650). CONCLUSION: Our findings suggest that CA-MRSA could be responsible for the majority of the infections caused by MRSA within the hospital at which the study took place. Decolonization of MRSA is a useful tool in helping to control the spread of infection, although future studies are needed to confirm our study's findings.
Assuntos
Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecção Hospitalar/tratamento farmacológico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/tratamento farmacológico , Adolescente , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Feminino , Hospitalização , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Porto Rico/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Adulto JovemRESUMO
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important bacterial pathogens based on its incidence and the severity of its associated infections. In addition, severe MRSA infections can occur in hospitalised patients or healthy individuals from the community. Studies have shown the infiltration of MRSA isolates of community origin into hospitals and variants of hospital-associated MRSA have caused infections in the community. These rapid epidemiological changes represent a challenge for the molecular characterisation of such bacteria as a hospital or community-acquired pathogen. To efficiently control the spread of MRSA, it is important to promptly detect the mecA gene, which is the determinant of methicillin resistance, using a polymerase chain reaction-based test or other rapidly and accurate methods that detect the mecA product penicillin-binding protein (PBP)2a or PBP2’. The recent emergence of MRSA isolates that harbour a mecA allotype, i.e., the mecC gene, infecting animals and humans has raised an additional and significant issue regarding MRSA laboratory detection. Antimicrobial drugs for MRSA therapy are becoming depleted and vancomycin is still the main choice in many cases. In this review, we present an overview of MRSA infections in community and healthcare settings with focus on recent changes in the global epidemiology, with special reference to the MRSA picture in Brazil.
Assuntos
Animais , Humanos , Proteínas de Bactérias/genética , Staphylococcus aureus Resistente à Meticilina/genética , Proteínas de Ligação às Penicilinas/genética , Infecções Estafilocócicas/microbiologia , Antibacterianos/farmacologia , Proteínas de Bactérias/classificação , DNA Bacteriano/genética , Genes Bacterianos/genética , Testes de Sensibilidade Microbiana , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Reação em Cadeia da Polimerase , Proteínas de Ligação às Penicilinas/classificaçãoRESUMO
In order to obtain adequate information for the treatment of methicillin resistant Staphylococcus aureus (MRSA) infections, it is crucial to identify trends in epidemiological and antimicrobial resistance patterns of local S. aureus strains. Community and hospital acquired S. aureus isolates (n = 202) were characterized using staphylococcal cassette chromosome mec (SCCmec) typing, pulse field gel electrophoresis (PFGE) analysis, spa typing and minimal inhibitory concentration (MIC) determination. The prevalence of the Panton-Valentine leukocidine (pvl) and several antibiotic resistance genes among the isolates were also detected by PCR. All of the S. aureus isolates were susceptible to vancomycin, daptomycin and linezolid. Three hospital isolates were resistant to teicoplanin while 14 showed intermediate resistance to teicoplanin. The resistance patterns of community-acquired MRSA (CA-MRSA) isolates to other antimicrobials were similar to those of hospital-acquired MRSA (HA-MRSA) isolates except for clindamycin and gentamicin. There was excellent correlation between phenotypes and genotypes in the determination of S. aureus resistance to erythromycin, gentamicin, and tetracycline. The SCCmec type II and SCCmec type IV were the predominant types detected in hospital and community isolates, respectively. The most frequently encountered spa types were t002 and t030 both in HA-and CA-MRSA isolates. Pulsotype A was the most predominant pulsotype identified among the isolates tested, followed by pulsotype B. Seventy-two hospital isolates (19 HA-MRSA and 53 HA-MSSA) and 10 CA-MRSA were positive for the pvl gene. This study shows that the combination of susceptibility testing and various molecular methods has provided useful information on the antibiotic resistance and molecular diversity of S. aureus in a specific region of China. The high proportion of pvl positive MSSA and MRSA isolates observed in this study indicates that adequate measures are needed to curtail the spread of those MRSA and MSSA clones prevailing both in hospital and the community.
Assuntos
Humanos , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/genética , Técnicas de Tipagem Bacteriana , Proteínas de Bactérias/genética , China/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus/efeitos dos fármacosRESUMO
In order to obtain adequate information for the treatment of methicillin resistant Staphylococcus aureus (MRSA) infections, it is crucial to identify trends in epidemiological and antimicrobial resistance patterns of local S. aureus strains. Community and hospital acquired S. aureus isolates (n=202) were characterized using staphylococcal cassette chromosome mec (SCCmec) typing, pulse field gel electrophoresis (PFGE) analysis, spa typing and minimal inhibitory concentration (MIC) determination. The prevalence of the Panton-Valentine leukocidine (pvl) and several antibiotic resistance genes among the isolates were also detected by PCR. All of the S. aureus isolates were susceptible to vancomycin, daptomycin and linezolid. Three hospital isolates were resistant to teicoplanin while 14 showed intermediate resistance to teicoplanin. The resistance patterns of community-acquired MRSA (CA-MRSA) isolates to other antimicrobials were similar to those of hospital-acquired MRSA (HA-MRSA) isolates except for clindamycin and gentamicin. There was excellent correlation between phenotypes and genotypes in the determination of S. aureus resistance to erythromycin, gentamicin, and tetracycline. The SCCmec type II and SCCmec type IV were the predominant types detected in hospital and community isolates, respectively. The most frequently encountered spa types were t002 and t030 both in HA- and CA-MRSA isolates. Pulsotype A was the most predominant pulsotype identified among the isolates tested, followed by pulsotype B. Seventy-two hospital isolates (19 HA-MRSA and 53 HA-MSSA) and 10 CA-MRSA were positive for the pvl gene. This study shows that the combination of susceptibility testing and various molecular methods has provided useful information on the antibiotic resistance and molecular diversity of S. aureus in a specific region of China. The high proportion of pvl positive MSSA and MRSA isolates observed in this study indicates that adequate measures are needed to curtail the spread of those MRSA and MSSA clones prevailing both in hospital and the community.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/genética , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana , China/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Humanos , Staphylococcus aureus Resistente à Meticilina/genética , Proteínas de Ligação às Penicilinas , Staphylococcus aureus/efeitos dos fármacosRESUMO
Staphylococcus aureus es responsable de un amplio espectro de cuadros clínicos que van desde infecciones en la piel y los tejidos blandos hasta enfermedades sistémicas muy graves que amenazan la vida; tiene gran importancia en la comunidad y está comúnmente implicado en infecciones nosocomiales. Además, un alto porcentaje de individuos está colonizado por S. aureus, lo cual constituye un factor de riesgo para su diseminación. S. aureus tiene gran capacidad de adquirir resistencia a los antimicrobianos y en la actualidad se encuentran cepas resistentes a la mayoría de los antibióticos disponibles; en particular, su resistencia a la meticilina, inicialmente en el ambiente hospitalario (HA-MRSA) y posteriormente en la comunidad (CA-MRSA), ha dificultado aún más el control mundial de este microorganismo. Los estudios de epidemiología molecular han permitido entender mejor las relaciones evolutivas de las cepas y definir el origen de los clones durante brotes epidémicos. En Colombia se sabe poco sobre la epidemiología de S. aureus y aún menos sobre su comportamiento en la comunidad. Por ello, estudios de vigilancia epidemiológica que involucren la tipificación molecular de las cepas permitirán comprender mejor su epidemiología y establecer estrategias más certeras de tratamiento y control.
Staphylococcus aureus is responsible for a wide variety of clinical manifestations ranging from skin and soft tissue infections to severe systemic and life threatening diseases; it is of relevance in the community and is commonly associated with nosocomial infections. Additionally, a high percentage of the population is colonized by S. aureus, which constitutes a risk factor for its dissemination. S. aureus has great capacity to acquire antimicrobial resistance, and currently there are resistant strains to the majority of available antibiotics; in particular, its resistance to methycillin, initially in the hospital environment (Hospital associated methycillin resistant S. aureus, HA-MRSA) and later in the community (Community acquired methycillin resistant S. aureus, CA-MRSA), has made even more difficult the worldwide control of this microorganism. Molecular epidemiological studies have provided a better understanding of the evolutionary relationships of the strains, and the definition of the clonal source during epidemic outbreaks. In Colombia, very little is known about S. aureus epidemiology and even less about its behavior in the community. Therefore, studies based on epidemiological surveillance, involving molecular typing, will lead to a better understanding of its epidemiology, making it possible the design of more assertive control strategies.