A 25-year trace of methicillin-resistant Staphylococcus aureus dissemination in a geriatric hospital in Japan

Sakai, Fuminori; Hanaki, Hideaki; Barada, Kazunari; Hirao, Yuriko; Igarashi, Takashi; Nakae, Taiji; Sunakawa, Keisuke

doi:10.2147/ijgm.s14729

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…The commonest effective therapeutic option against the multi-antibiotic-resistant MRSA is VA or linezolid [6][7] . VA is a glycopeptide antibiotic that is active against Gram-positive bacteria including Staphylococci and Enterococci, however, Gram-negative bacteria are naturally resistant to it, mainly because of its outer membrane that acts as a penetration barrier 8 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Antimicrobial Susceptibility of Methicillin-Resistant Staphylococcus aureus in an Egyptian University Hospital

Taha¹,

Badr²,

El-Morsy³

et al. 2019

J Pure Appl Microbiol

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The relative high burden of morbidity and mortality caused by Staphylococcus aureus (SA) in healthcare and community settings is a major concern worldwide. It can cause invasive infections, sepsis and deaths. Despite progress in methicillin-resistant S. aureus (MRSA) prevention in healthcare settings, there is a critical need for assessment of the problem in both healthcare and community settings. This study was conducted for examining the prevalence, risk factors and antimicrobial susceptibility of MRSA in Mansoura University Hospitals (MUHs), Egypt. Samples were collected from patients in MUHs with clinically suspected nosocomial infections. MRSA isolates were identified by the standard bacteriological methods, biochemical reactions and disc diffusion method as recommended by the Clinical & Laboratory Standards Institute (CLSI), then confirmed by MecA gene PCR. A total of 2006 isolates was obtained. SA (32%) was the most frequently isolated pathogen. MRSA (130 isolates) represented 20% of SA and 6.48 % of all isolates. The mecA PCR identified SA as MRSA in 99.2% of cases. MRSA was isolated with another organism (mostly Gram-negative bacilli) from 40.8% of cases while 59.2% of MRSA was isolated alone. The most important reported risk factors for MRSA infections were prolonged hospital stays, recent antibiotic therapy, ICU admission, indwelling devices and presence of surgical sutures. MRSA was resistant to many antibiotics but sensitive to vancomycin in 99.2% of cases. Minimizing exposure to the risk factors with rapid diagnosis of MRSA infections are essential for early initiation of appropriate antibiotic treatment and limitation of the non-optimal use of glycopeptides and deaths.

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Section: Introductionmentioning

confidence: 99%

Prevalence and Antimicrobial Susceptibility of Methicillin-Resistant Staphylococcus aureus in an Egyptian University Hospital

Taha¹,

Badr²,

El-Morsy³

et al. 2019

J Pure Appl Microbiol

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“…Spread of MRSA was limited to hospital patients for a long period of time, but it has become more common in the broader community in recent years. Owing to the multi-antibiotic-resistant nature of MRSA, only a limited range of chemotherapeutic agents can be used; most commonly, vancomycin or the recently developed linezolid [ 1 - 3 ].…”

Section: Introductionmentioning

confidence: 99%

Low level β-lactamase production in methicillin-resistant staphylococcus aureus strains with β-lactam antibiotics-induced vancomycin resistance

et al. 2012

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BackgroundA class of methicillin-resistant Staphylococcus aureus (MRSA) shows resistance to vancomycin only in the presence of ß-lactam antibiotics (BIVR). This type of vancomycin resistance is mainly attributable to the rapid depletion of free vancomycin in the presence of ß-lactam antibiotics. This means that ß-lactam antibiotics remain active or intact in BIVR culture, although most MRSA cells are assumed to produce ß-lactamase. We hypothesised that the BIVR cells either did not harbour the ß-lactamase gene, blaZ, or the gene was quiescent. We tested this hypothesis by determining ß-lactamase activity and conducting PCR amplification of blaZ.ResultsFive randomly selected laboratory stock BIVR strains showed an undetectable level of ß-lactamase activity and were blaZ-negative. Five non-BIVR stock strains showed an average ß-lactamase activity of 2.59 ± 0.35 U. To test freshly isolated MRSA, 353 clinical isolates were collected from 11 regionally distant hospitals. Among 25 BIVR strains, only 16% and 8% were blaZ positive and ß-lactamase-positive, respectively. In contrast, 95% and 61% of 328 non-BIVR strains had the blaZ gene and produced active ß-lactamase, respectively. To know the mechanism of low ß-lactamase activity in the BIVR cells, they were transformed with the plasmid carrying the blaZ gene. The transformants still showed a low level of ß-lactamase activity that was several orders of magnitude lower than that of blaZ-positive non-BIVR cells. Presence of the ß-lactamase gene in the transformants was tested by PCR amplification of blaZ using 11 pairs of primers covering the entire blaZ sequence. Yield of the PCR products was consistently low compared with that using blaZ-positive non-BIVR cells. Nucleotide sequencing of blaZ in one of the BIVR transformants revealed 10 amino acid substitutions. Thus, it is likely that the ß-lactamase gene was modified in the BIVR cells to downregulate active ß-lactamase production.ConclusionsWe concluded that BIVR cells gain vancomycin resistance by the elimination or inactivation of ß-lactamase production, thereby preserving ß-lactam antibiotics in milieu, stimulating peptidoglycan metabolism, and depleting free vancomycin to a level below the minimum inhibitory concentration of vancomycin.

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“…2010; and Sakai et al, 2010). VA is a glycopeptide that binds to the D-Ala-D-Ala ends of the peptidoglycan structure and its precursors, and so blocks the action of peptidoglycan transpeptidase or penicillinbinding proteins (PBPs), so inhibiting the extension of the peptidoglycan network and bacterial growth (Perkins and Nieto, 1974).…”

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confidence: 99%

Vancomycin-Resistant MRSA Induced by β-Lactam Antibiotics in Mansoura University Hospitals, Egypt

Taha¹,

Badr²,

Morsy³

et al. 2017

Int.J.Curr.Microbiol.App.Sci

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A 25-year trace of methicillin-resistant Staphylococcus aureus dissemination in a geriatric hospital in Japan

Cited by 3 publications

References 21 publications

Prevalence and Antimicrobial Susceptibility of Methicillin-Resistant Staphylococcus aureus in an Egyptian University Hospital

Prevalence and Antimicrobial Susceptibility of Methicillin-Resistant Staphylococcus aureus in an Egyptian University Hospital

Low level β-lactamase production in methicillin-resistant staphylococcus aureus strains with β-lactam antibiotics-induced vancomycin resistance

Vancomycin-Resistant MRSA Induced by β-Lactam Antibiotics in Mansoura University Hospitals, Egypt

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