Epidemiology of methicillin-resistant Staphylococcus aureus carrying the novel mecC gene in Denmark corroborates a zoonotic reservoir with transmission to humans

Petersen, Andreas; Stegger, Marc; Heltberg, Ole; Christensen, Judit Marta; Zeuthen, Anne Bak; Knudsen, Lisbet Krause; Urth, Tinna Ravnholt; Sørum, Marit; Schouls, Leo M.; Larsen, Jesper; Skov, Robert; Larsen, Anders Rhod

doi:10.1111/1469-0691.12036

Cited by 165 publications

(197 citation statements)

References 23 publications

(25 reference statements)

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“…In contrast to these findings, the prevalence of MRSA containing the mecC gene seems to be increasing in Denmark, indicating the need to screen for the mecC gene (36).…”

Section: Discussionmentioning

confidence: 63%

A Rapid and High-Throughput Screening Approach for Methicillin-Resistant Staphylococcus aureus Based on the Combination of Two Different Real-Time PCR Assays

et al. 2014

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b Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that has been responsible for major nosocomial epidemics worldwide. For infection control programs, rapid and adequate detection of MRSA is of great importance. We developed a rapid and high-throughput molecular screening approach that consists of an overnight selective broth enrichment, followed by mecA, mecC, and S. aureus-specific (SA442 gene) real-time PCR assays, with subsequent confirmation using a staphylococcal cassette chromosome mec element (SCCmec)-orfX-based real-time PCR assay (GeneOhm MRSA assay) and culture. Here, the results of the screening approach over a 2-year period are presented. During this period, a total of 13,387 samples were analyzed for the presence of MRSA, 2.6% of which were reported as MRSA positive. No MRSA isolates carrying the mecC gene were detected during this study. Based on the results of the real-time PCR assays only, 95.2% of the samples could be reported as negative within 24 h. Furthermore, the performance of these real-time PCR assays was evaluated using a set of 104 assorted MRSA isolates, which demonstrated high sensitivity for both the combination of mecA and mecC with SA442 and the BD GeneOhm MRSA assay (98.1% and 97.1%, respectively). This molecular screening approach proved to be an accurate method for obtaining reliable negative results within 24 h after arrival at the laboratory and contributes to improvement of infection control programs, especially in areas with a low MRSA prevalence.

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“…In contrast to these findings, the prevalence of MRSA containing the mecC gene seems to be increasing in Denmark, indicating the need to screen for the mecC gene (36).…”

Section: Discussionmentioning

confidence: 63%

A Rapid and High-Throughput Screening Approach for Methicillin-Resistant Staphylococcus aureus Based on the Combination of Two Different Real-Time PCR Assays

et al. 2014

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“…aureus isolates may show phenotypical resistance against cefoxitin and oxacillin, despite the absence of the mecA gene. This resistance may be regulated by newly described mecA homologue mecC gene or other factors such as overproduction of betalactamase and mutations that occur in the structure of PBP (Garcia-Alvarez et al, 2011;Petersen et al, 2013). Lee (2003) found 12 MRSA strains isolated from bovine milk samples that were resistant to oxacillin, penicillin, and ampicillin; six of the 12 MRSA isolates were resistant to cefoxitin; three were resistant to ciprofloxacin; eight to erythromycin; 11 to gentamicin; and five to tetracycline.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence and Antibiotic Resistance of Methicillin-Resistant Staphylococcus aureus (MRSA) in Milk and Dairy Products in Balikesir, Turkey

Ektik

Gökmen

Cibik

2018

J Hellenic Vet Med Soc

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ABSTRACT. Methicillin-ResistantStaphylococcus aureus is an important pathogen that causes severe infections in humans and animals. The aim of this study was to determine the prevalence and the antimicrobial profile of methicillin-resistant S. aureus (MRSA) in cow bulk tank milk and dairy products in the region of Balikesir in Turkey. Of 175 milk and dairy products' samples, 26 were found to be positive for coagulase-positive staphylococci and 3 (2 samples from cow bulk tank milk and 1 sample from tulum cheese) were MRSA phenotypically being resistant against both oxacillin and cefoxitin. Among these, 17 were confirmed as S. aureus by the detection of nuc gene and one as MRSA carrying the mecA gene. All MRSA isolates were found to be also resistant against ampicillin, penicillin and sulfamethoxazole-trimethoprim. Consequently, even though the prevalence of MRSA in cow bulk tank milk and dairy products was relatively low (1.70%), it may pose serious risks in terms of food safety and public health. In order to prevent the prevalence of MRSA in dairy products, hygienic measures, especially in terms of personal hygiene and disinfection of equipment in all stages of dairy production, should be taken, and HACCP and GMP regulations should be implemented.

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“…Furthermore, only about one-third of our isolates were classified as colonizing. While isolates carrying the novel gene (mecC) were rare prior to 2003, their frequency appears to be increasing (10). Therefore, ongoing surveillance for MRSA isolates with the mecC homologue among U.S. military personnel should continue, especially given their frequent downrange exposure to livestock.…”

mentioning

confidence: 99%

Evaluation for a Novel Methicillin Resistance ( mecC ) Homologue in Methicillin-Resistant Staphylococcus aureus Isolates Obtained from Injured Military Personnel

et al. 2013

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A total of 102 methicillin-resistant Staphylococcus aureus (MRSA) isolates collected from 50 injured service members (June 2009 to December 2011) at U.S. military treatment facilities were analyzed for the conventional mecA gene and mecC homologue by using standard PCR-based methods. The prevalence of the mecC homologue was zero. Management and prevention of infections due to multidrugresistant organisms, including methicillin-resistant Staphylococcus aureus (MRSA), are critical components of combat care. Among deployed military personnel, skin and soft tissue infections due to MRSA are widespread, resulting in significant morbidity and affecting the operational readiness of the troops (1-3). The control and prevention of MRSA infections require reliable identification of the organism and subsequent isolation of infected/ colonized individuals (4). Rapid screening for MRSA using PCRbased assays has led to faster detection of MRSA and, consequently, earlier isolation of patients colonized with MRSA (5). Hence, some major U.S. military treatment facilities (MTFs), including Walter Reed National Military Medical Center (WRNMMC) and San Antonio Military Medical Center (SAMMC), have switched from standard culture techniques to the use of the Xpert MRSA PCR assay (Cepheid) for identifying MRSA colonization. Injured service members are either screened at hospital admission (WRNMMC) or upon admission to the intensive care unit (SAMMC) for nasal MRSA carriage using the Xpert MRSA assay.The Xpert MRSA assay is a real-time PCR assay that detects the staphylococcal cassette chromosome mec element (SCCmec)-orfX junction. The SCCmec is a transposon-encoded genetic region that carries the mecA gene. The mecA gene confers methicillin resistance among S. aureus isolates (6) by encoding an altered penicillin binding protein (PBP), specifically PBP2a, that confers reduced affinity to all ␤-lactams. In recent years, however, a novel MRSA isolate carrying a novel mecA gene (mecC or mecA LGA 251 ) has been identified (7). While MRSA isolates with this novel gene are phenotypically PBP2a positive, they are not detected by the Xpert (Cepheid) assay used for the identification of MRSA (8). Therefore, the exclusive use of the Xpert MRSA assay (Cepheid) method to screen injured service members for MRSA carriage could result in the misclassification of an S. aureus isolate as susceptible to methicillin, when it actually is not, thereby raising questions about the adequacy of the current infection control policies at two of the major U.S. MTFs. Thus, to evaluate the appropriateness of our current infection control measures, we examined all MRSA isolates collected from U.S. service members injured during deployment and transitioned through Germany for the presence of the novel mecA homologue.Since June 2009, U.S. military personnel injured during deployment to Iraq and Afghanistan and admitted to a participating U.S. MTF (WRNMMC and SAMMC), after receiving initial care at Landstuhl Regional Medical Center (Germany), have had their data (e.g....

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Epidemiology of methicillin-resistant Staphylococcus aureus carrying the novel mecC gene in Denmark corroborates a zoonotic reservoir with transmission to humans

Cited by 165 publications

References 23 publications

A Rapid and High-Throughput Screening Approach for Methicillin-Resistant Staphylococcus aureus Based on the Combination of Two Different Real-Time PCR Assays

A Rapid and High-Throughput Screening Approach for Methicillin-Resistant Staphylococcus aureus Based on the Combination of Two Different Real-Time PCR Assays

The Prevalence and Antibiotic Resistance of Methicillin-Resistant Staphylococcus aureus (MRSA) in Milk and Dairy Products in Balikesir, Turkey

Evaluation for a Novel Methicillin Resistance ( mecC ) Homologue in Methicillin-Resistant Staphylococcus aureus Isolates Obtained from Injured Military Personnel

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