A prospective cohort study of &lt;em&gt;Staphylococcus aureus &lt;/em&gt;and methicillin-resistant &lt;em&gt;Staphylococcus aureus &lt;/em&gt;carriage in neonates: the role of maternal carriage and phenotypic and molecular characteristics

Lin, Jialing; Wu, Chuan An; Yan, Chen; Ou, Qianting; Lin, Dongxin; Zhou, Jian; Ye, Xiaohua; Yao, Zhenjiang

doi:10.2147/idr.s157522

Cited by 23 publications

(32 citation statements)

References 43 publications

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“…The proportions of antibiotic resistance were higher in MRSA isolates than MSSA isolates, which is also observed in other studies [8,17]. Teicoplanin has been widely used as an anti-MRSA agent in infectious patients in the past decades [18,19], which can partially explain the high The results of CCs and STs for S. aureus isolates could demonstrate the multiple transmissions among human beings, livestock and environment, which are similar to previous studies [6,23]. We found high proportions of ST5 and ST59 in this study and these STs were also globally reported in communities [26].…”

Section: Discussionsupporting

confidence: 87%

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Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

Wang

Lin

Zhou

et al. 2019

Preprint

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Background: Staphylococcus aureus (S. aureus), particularly methicillin-resistant Staphylococcus aureus (MRSA), remains the predominant cause of infections in drug users. The cross-sectional study aims to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus carriage among community-based drug users.Methods: All eligible drug users, both intravenous and oral drug users, were asked to complete questionnaires and collect nasal swabs during the period between May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus. Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus carriage.Results: Overall, 353 drug users were included in the study and the prevalence of S. aureus carriage was 15.01% (53/353). The prevalence of MRSA carriage was 6.80% (24/353). Cohabitation was a risk factor for S. aureus (adjusted OR=8.80, 95% CI: 1.89-40.99). The proportion of multidrug resistance was 54.72% for S. aureus isolates and most of these isolates were resistant to penicillin, erythromycin and clindamycin. Seventeen MRSA isolates were multidrug resistant. The results of clonal complexes (CCs) and sequence types (STs) for S. aureus were diverse. The three predominant types for CCs were CC5 (64.15%, 34/53), CC59 (11.32%, 6/53), and CC7 (7.55%, 4/53); and for STs were ST188 (20.75%, 11/53), ST5 (11.32%, 6/53), and ST59 (11.32%, 6/53). Conclusion: The prevalence of S. aureus nasal carriage was lower when the prevalence of MRSA carriage was moderate. Phenotypic and molecular characteristics of S. aureus isolates, particularly MRSA isolates, revealed serious antibiotic resistance, indicating the existence of cross-circulation, and implying high opportunity of virulence-related diseases. Decolonization might be considered for drug users with MRSA carriage.

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Section: Discussionsupporting

confidence: 87%

“…. The proportions of virulence genes for MRSA isolates were higher than the observed studies[6,[23][24][25]. The results implied that drug users with MRSA carriage harbouring virulence associated genes, might have higher risks for relevant disease and should draw more attention.…”

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confidence: 70%

Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

Wang

Lin

Zhou

et al. 2019

Preprint

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“…A meta-analysis of risk factors for MRSA colonization in the NICU showed no relationship between colonization and sex,[3] while another study reported male neonates were at increased risk of both MRSA and MSSA colonization. [22] However, our admission patterns did not elucidate an explanation for this finding nor were female neonates older than male neonates on admission. We found vaginal delivery to be a risk factor for MSSA, but not for MRSA colonization.…”

Section: Discussionmentioning

confidence: 74%

“…In Shenzhen China, 7.3% vs. 1.7% of pre-partum women were colonized with MSSA and MRSA, respectively, and vaginal delivery was associated with neonatal MSSA, but not with MRSA colonization. [22] Similarly, Top et al reported MSSA and MRSA anovaginal colonization rates of 11.8% and 0.6%, respectively, in pre-partum women, although neonatal colonization was not assessed. [23] These findings suggest that vertical transmission of S. aureus occurs, but is more relevant for MSSA than MRSA, presumably because fewer women are colonized with MRSA.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology ofStaphylococcus aureusin Neonates on Admission to a Chinese Neonatal Intensive Care Unit

Geng

et al. 2019

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25Purpose: Little is known about the molecular epidemiology of Staphylococcus aureus in 26 Chinese neonatal intensive care units (NICUs). We describe the molecular epidemiology of S. 27 aureus isolated from neonates on admission to Beijing Children's Hospital. 28 29 Methods: From May 2015-March 2016, nasal swabs were obtained on admission from 536 30 neonates. Cultures were also obtained from body sites with suspected infections. S. aureus 31 isolates were characterized by staphylococcal chromosomal cassette (SCCmec) type, 32 staphylococcal protein A (spa) type, multilocus sequence type (MLST), sasX gene, antimicrobial 33 susceptibility and cytotoxicity. Logistic regression assessed risk factors for colonization. 34 35Results: Overall, 92 (18%) infants were colonized with S. aureus and 23 (4%) were diagnosed 36 with culture-positive S. aureus infection. Of the colonized infants, 72% harbored MSSA, while 37 74% of infected infants were culture-positive for MRSA. Risk factors for colonization included 38 female sex, age 7-28 days, birthweight and vaginal delivery. The most common MRSA and 39 MSSA clones were community-associated ST59-SCCmecIVa-t437 (60%) and ST188-t189 40 (15%), respectively. The sasX gene was not detected. Some MSSA isolates (16%) were 41 penicillin-susceptible and some MRSA isolates (18%) were oxacillin-susceptible. MRSA and 42 MSSA had similar cytotoxicity, but colonizing strains were less cytotoxic than strains associated 43 with infections. 44 45 Conclusions: S. aureus colonization was common in infants admitted to our NICU and two 46 community-associated clones predominated. Several non-modifiable risk factors for S. aureus 50 51 Key words: Staphylococcus aureus, neonatal intensive care unit, colonization, MRSA, MSSA 52 4 53 54 Staphylococcus aureus infections represent a significant clinical burden for infants worldwide 55 and were recently found to be the second most common cause of late-onset sepsis in very-low 56 birth weight (VLBW) infants admitted to neonatal intensive care units (NICU) in the United 57 States and United Kingdom.[1, 2] Preterm infants are also at high risk for S. aureus 58 colonization[3], a potential risk factor for subsequent infection. In a recent meta-analysis 59 involving patients admitted to NICUs and ICUs, methicillin-resistant S. aureus (MRSA) 60 colonization was associated with a 24.2 times increased MRSA infection risk.[4] Endemic 61 transmission and outbreaks due to MRSA and methicillin-susceptible S. aureus (MSSA) occur 62 frequently in NICUs.[5] Studying the molecular epidemiology and virulence factors of S. aureus 63 in the NICU population can promote an increased understanding of pathogenesis and ultimately 64 guide preventive strategies. 65 66 While the molecular characteristics of and risk factors for S. aureus colonization and infection 67 have been described for NICU populations across the globe and have increased our knowledge of 68 the global burden,[3, 6] no previous reports have described the molecular characteristics of S. 69 aureus strains...

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“…[21][22][23]. The proportions of virulence genes for MRSA isolates were higher than the observed studies [6,[24][25][26]. The results implied that drug users with MRSA carriage harboring virulence associated genes, might have higher risks for relevant disease and should draw more attention.…”

Section: Discussionmentioning

confidence: 88%

Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

Wang

Lin

Zhou

et al. 2020

Antimicrob Resist Infect Control

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Background: Staphylococcus aureus (S. aureus), particularly methicillin-resistant Staphylococcus aureus (MRSA), remains the predominant cause of infections in drug users. This cross-sectional study aims to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus carriage among community-based drug users. Methods: All eligible drug users, with both injection and non-injection route of drug administration, were asked to complete questionnaires and collect nasal swabs by trained personal during the period between May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus. Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus carriage. Results: Overall, 353 drug users were included in the study and the prevalence of S. aureus carriage was 15.01% (53/353). The prevalence of MRSA carriage was 6.80% (24/353). Cohabitation was a risk factor for S. aureus (adjusted OR = 8.80, 95% CI: 1.89-40.99). The proportion of multidrug resistance was 54.72% for S. aureus isolates and most of these isolates were resistant to penicillin, erythromycin and clindamycin. Seventeen MRSA isolates were multidrug resistant. The results of clonal complexes (CCs) and sequence types (STs) for S. aureus were diverse. The three predominant types for CCs were CC5 (64.15%, 34/53), CC59 (11.32%, 6/53), and CC7 (7.55%, 4/53); and for STs were ST188 (20.75%, 11/53), ST5 (11.32%, 6/53), and ST59 (11.32%, 6/53). Conclusion: The prevalence of S. aureus nasal carriage was lower while the prevalence of MRSA carriage was moderate compared to previous studies. Phenotypic and molecular characteristics of S. aureus isolates, particularly MRSA isolates, revealed high proportions of antibiotic resistance, indicating the existence of cross-circulation, and implying high opportunity of virulence-related diseases. Decolonization and antibiotic stewardship might be implemented for drug users with MRSA carriage.

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A prospective cohort study of <em>Staphylococcus aureus </em>and methicillin-resistant <em>Staphylococcus aureus </em>carriage in neonates: the role of maternal carriage and phenotypic and molecular characteristics

Cited by 23 publications

References 43 publications

Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

Epidemiology ofStaphylococcus aureusin Neonates on Admission to a Chinese Neonatal Intensive Care Unit

Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

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