Emergence and spread of antibiotic-resistant Gram-positive bacterial pathogens

Witte, Wolfgang; Cuny, Christiane; Klare, Ingo; Nübel, Ulrich; Strommenger, Birgit; Werner, Guido

doi:10.1016/j.ijmm.2007.10.005

Cited by 95 publications

(60 citation statements)

References 108 publications

(97 reference statements)

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“…1 A). This observation reinforces the notion that health care-associated MRSA strains may be of distinct evolutionary origins from hospital strains (6), as previously suggested by MLST and/or DNA macrorestriction analysis in combination with SCCmec typing and toxin gene content (11).…”

Section: Evolutionary History Of Methicillin Resistancesupporting

confidence: 90%

“…Our ignorance on these matters is partially because S. aureus is so genetically homogeneous that MLST and other genotyping tools that currently are used for typing possess only limited discriminatory power. It already has been documented that individual MLST sequence types, including ST5, which is the subject of this report, can be heterogeneous with respect to antibiotic resistance patterns, spa type, SCCmec type, and gene content (11,12). However, deeper understanding of the speed with which mobile elements and individual genes are imported and lost from S. aureus populations will require higher-resolution phylogenetic analyses than were possible until now.…”

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confidence: 88%

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Frequent emergence and limited geographic dispersal of methicillin-resistant Staphylococcus aureus

Nübel

Filloux

Feldkamp

et al. 2008

Proc. Natl. Acad. Sci. U.S.A.

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242

181

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A small number of clonal lineages dominates the global population structure of methicillin-resistant Staphylococcus aureus (MRSA), resulting in the concept that MRSA has emerged on a few occasions after penicillinase-stable ␤-lactam antibiotics were introduced to clinical practice, followed by intercontinental spread of individual clones. We investigated the evolutionary history of an MRSA clone (ST5) by mutation discovery at 108 loci (46 kb) within a global collection of 135 isolates. The SNPs that were ascertained define a radial phylogenetic structure within ST5 consisting of at least 5 chains of mutational steps that define geographically associated clades. These clades are not concordant with previously described groupings based on staphylococcal protein A gene (spa) typing. By mapping the number of independent imports of the staphylococcal cassette chromosome methicillin-resistance island, we also show that import has occurred on at least 23 occasions within this single sequence type and that the progeny of such recombinant strains usually are distributed locally rather than globally. These results provide strong evidence that geographical spread of MRSA over long distances and across cultural borders is a rare event compared with the frequency with which the staphylococcal cassette chromosome island has been imported.antibiotic resistance ͉ evolution ͉ phylogeography ͉ SNP

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Section: Evolutionary History Of Methicillin Resistancesupporting

confidence: 90%

mentioning

confidence: 88%

Frequent emergence and limited geographic dispersal of methicillin-resistant Staphylococcus aureus

Nübel

Filloux

Feldkamp

et al. 2008

Proc. Natl. Acad. Sci. U.S.A.

Self Cite

242

181

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“…In the current study, 66.7% of the S. epidermidis isolates were multi-drug resistant and thus represent a source for possible transmission of antibiotic resistance and a challenge for eradication [25,26]. Overall, 56.6% of the S. epidermidis isolates were oxacillin-resistant and mecA-positive.…”

Section: Discussionmentioning

confidence: 64%

Slime layer formation and the prevalence of mecA and aap genes in Staphylococcus epidermidis isolates

Pourmand

Abdossamadi

Salari

et al. 2010

J Infect Dev Ctries

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Introduction: Staphylococcus epidermidis strains are frequently associated with catheter-related infection, acute bacteremia, and hospitalacquired infection. Some isolates produce an extracellular matrix called slime that may make them more resistant to antibiotics. The aim of this study was to determine antimicrobial resistance patterns, the prevalence of slime production, and the distribution of genes (mecA and aap, respectively) associated with these phenotypes in S. epidermidis nasal isolates from health-care personnel. Methodology: A descriptive cross-sectional study was performed on 163 nasal swabs from health-care staff (one swab per subject). S. epidermidis isolates were tested for slime production on congo red agar and antibiotic resistance. PCR-based screening for mecA and aap genes was performed upon the extracted DNA of S. epidermidis isolates. Results: A total of 99 S. epidermidis strains were cultured from 58.9% of the study participants (n = 96). Of these strains, 34 (34.3%) isolates produced slime. A significant relation between slime production and resistance to penicillin 32(94%) , oxacillin 30(88%),, tetracycline 20(59%), erythromycin 27(79%), and clindamycin 26(77%) was found. Respectively, 95.8% and 94.8% of all isolates were PCR-positive for mecA and aap, but only 59.8% of mecA+ strains were oxacillin-resistant and 37.3% of aap+ strains were slime producers. Conclusions: The surveillance of nasal colonization with slime-forming oxacillin-resistant S. epidermidis in health-care workers might be helpful in breaking the epidemiological chain of hospital-acquired infections.

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“…In the biofilm, bacteria can persist in a low metabolic, stationary growth phase, in which they resist killing by the host immune system and antimicrobials (14,28). Both the spread of multiresistant staphylococci and the increased use of temporary implants (vascular catheters, pins from external fixation devices) and permanent implants (e.g., joint prosthesis, breast implants, and cardiac or brain pacemakers), drive the need for new antimicrobial agents for innovative therapeutic strategies (1,7,23,29).…”

mentioning

confidence: 99%

In Vitro Activity of Gallium Maltolate against Staphylococci in Logarithmic, Stationary, and Biofilm Growth Phases: Comparison of Conventional and Calorimetric Susceptibility Testing Methods

Baldoni

Steinhuber

Zimmerli

et al. 2010

Antimicrob Agents Chemother

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Ga3؉ is a semimetal element that competes for the iron-binding sites of transporters and enzymes. We investigated the activity of gallium maltolate (GaM), an organic gallium salt with high solubility, against laboratory and clinical strains of methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), methicillin-susceptible Staphylococcus epidermidis (MSSE), and methicillin-resistant S. epidermidis (MRSE) in logarithmic or stationary phase and in biofilms. The MICs of GaM were higher for S. aureus (375 to 2000 g/ml) than S. epidermidis (94 to 200 g/ml). Minimal biofilm inhibitory concentrations were 3,000 to >6,000 g/ml (S. aureus) and 94 to 3,000 g/ml (S. epidermidis). In time-kill studies, GaM exhibited a slow and dose-dependent killing, with maximal action at 24 h against S. aureus of 1.9 log 10 CFU/ml (MSSA) and 3.3 log 10 CFU/ml (MRSA) at 3؋ MIC and 2.9 log 10 CFU/ml (MSSE) and 4.0 log 10 CFU/ml (MRSE) against S. epidermidis at 10؋ MIC. In calorimetric studies, growth-related heat production was inhibited by GaM at subinhibitory concentrations; and the minimal heat inhibition concentrations were 188 to 4,500 g/ml (MSSA), 94 to 1,500 g/ml (MRSA), and 94 to 375 g/ml (MSSE and MRSE), which correlated well with the MICs. Thus, calorimetry was a fast, accurate, and simple method useful for investigation of antimicrobial activity at subinhibitory concentrations. In conclusion, GaM exhibited activity against staphylococci in different growth phases, including in stationary phase and biofilms, but high concentrations were required. These data support the potential topical use of GaM, including its use for the treatment of wound infections, MRSA decolonization, and coating of implants.

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Emergence and spread of antibiotic-resistant Gram-positive bacterial pathogens

Cited by 95 publications

References 108 publications

Frequent emergence and limited geographic dispersal of methicillin-resistant Staphylococcus aureus

Frequent emergence and limited geographic dispersal of methicillin-resistant Staphylococcus aureus

Slime layer formation and the prevalence of mecA and aap genes in Staphylococcus epidermidis isolates

In Vitro Activity of Gallium Maltolate against Staphylococci in Logarithmic, Stationary, and Biofilm Growth Phases: Comparison of Conventional and Calorimetric Susceptibility Testing Methods

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