No abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterial pathogen capable of causing human diseases, such as soft tissue infection, bacteremia, endocarditis, toxic shock syndrome, pneumonia, and sepsis. Although the incidence rate of diseases caused by MRSA has declined in recent years, these diseases still pose a clinical threat due to their consistently high morbidity and mortality rates. However, the role of virulence factors in staphylococcal infections remains incompletely understood. Methicillin resistance, which confers resistance to all β-lactam antibiotics in cellular islets, is mediated by the mecA gene in the staphylococcal cassette chromosome mec (SCCmec). Differences in SCCmec types and differences in their sizes and structures serve epidemiological purposes and are used to differentiate between hospital-associated (HA)-MRSA and community-associated (CA)-MRSA. Some virulence factors of S. aureus are also providing a distinction between HA-MRSA and CA-MRSA. These factors vary depending on the presence of toxins, adhesion, immune evasion, and other virulence determinants. In this review, we summarized an overview of MRSA such as resistance mechanisms, SCCmec types, HA-and CA-MRSA, and virulence factors that enhance pathogenicity or MRSA epidemiology, transmission, and genetic diversity.

Recent years have seen an increase in the incidence of candidiasis caused by non-albicans Candida (NAC) species. In fact, C. glabrata is now second only to C. albicans as the most common cause of invasive candidiasis. Therefore, the rapid genotyping specifically for C. glabrata is required for early diagnosis and treatment of candidiasis. A number of genotyping assays have been developed to differentiate C. glabrata sequence types (STs), but they have several limitations. In the previous study, multi-locus sequence typing (MLST) has performed with a total of 101 C. glabrata clinical isolates to analyze the prevalent C. glabrata STs in Korea. A total of 11 different C. glabrata STs were identified and, among them, ST-138 was the most commonly classified. Thus, a novel probe-based quantitative PCR (qPCR) assay was developed and evaluated for rapid and accurate identification of the predominant C. glabrata ST-138 in Korea. Two primer pairs and hybridization probe sets were designed for the amplification of internal transcribed spacer 1 (ITS1) region and TRP1 gene. Analytical sensitivity of the probe-based qPCR assay was 100 ng to 10 pg and 100 ng to 100 pg (per 1 μL), which target ITS1 region and TRP1 gene, respectively. This assay did not react with any other Candida species and bacteria except C. glabrata. Of the 101 clinical isolates, 99 cases (98%) were concordant with MLST results. This novel probebased qPCR assay proved to be rapid, sensitive, highly specific, reproducible, and cost-effective than other genotyping assay for C. glabrata ST-138 identification.