Is methicillin-resistant Staphylococcus aureus involved in community acquired skin and soft tissue infections?

Phakade, RS; Nataraj, Gita; Kuyare, SK; Khopkar, US; Mehta, PR

doi:10.4103/0022-3859.93245

Cited by 15 publications

(5 citation statements)

References 13 publications

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“…One study from Ghana in the 1970s with a similar tropical climate found impetigo to be dominated by Lancefield groups C and G streptococci [ 30 ]. These findings were not reproduced in our study and have not been confirmed in other published microbiology studies from our region [ 18 ] or other tropical contexts [ 31 ]. Non-group A streptococci do not appear to play a significant role in the pathogenesis of impetigo.…”

Section: Discussioncontrasting

confidence: 93%

“…Both S. pyogenes and S. aureus have been reported as key impetigo pathogens, however the reported relative contributions of each have fluctuated over time and region. Previous microbiology studies of impetigo in both urban and remote Australian Indigenous children have shown high rates of co-infection [ 17 ],[ 18 ]. Valery et al detected co-infection with skin pathogens in 54% of urban Indigenous children.…”

Section: Discussionmentioning

confidence: 99%

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The microbiology of impetigo in Indigenous children: associations between Streptococcus pyogenes, Staphylococcus aureus,scabies, and nasal carriage

et al. 2014

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BackgroundImpetigo is caused by both Streptococcus pyogenes and Staphylococcus aureus; the relative contributions of each have been reported to fluctuate with time and region. While S. aureus is reportedly on the increase in most industrialised settings, S. pyogenes is still thought to drive impetigo in endemic, tropical regions. However, few studies have utilised high quality microbiological culture methods to confirm this assumption. We report the prevalence and antimicrobial resistance of impetigo pathogens recovered in a randomised, controlled trial of impetigo treatment conducted in remote Indigenous communities of northern Australia.MethodsEach child had one or two sores, and the anterior nares, swabbed. All swabs were transported in skim milk tryptone glucose glycogen broth and frozen at –70°C, until plated on horse blood agar. S. aureus and S. pyogenes were confirmed with latex agglutination.ResultsFrom 508 children, we collected 872 swabs of sores and 504 swabs from the anterior nares prior to commencement of antibiotic therapy. S. pyogenes and S. aureus were identified together in 503/872 (58%) of sores; with an additional 207/872 (24%) sores having S. pyogenes and 81/872 (9%) S. aureus, in isolation. Skin sore swabs taken during episodes with a concurrent diagnosis of scabies were more likely to culture S. pyogenes (OR 2.2, 95% CI 1.1 – 4.4, p = 0.03). Eighteen percent of children had nasal carriage of skin pathogens. There was no association between the presence of S. aureus in the nose and skin. Methicillin-resistance was detected in 15% of children who cultured S. aureus from either a sore or their nose. There was no association found between the severity of impetigo and the detection of a skin pathogen.ConclusionsS. pyogenes remains the principal pathogen in tropical impetigo; the relatively high contribution of S. aureus as a co-pathogen has also been confirmed. Children with scabies were more likely to have S. pyogenes detected. While clearance of S. pyogenes is the key determinant of treatment efficacy, co-infection with S. aureus warrants consideration of treatment options that are effective against both pathogens where impetigo is severe and prevalent.Trial registrationThis trial is registered; ACTRN12609000858291.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0727-5) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

The microbiology of impetigo in Indigenous children: associations between Streptococcus pyogenes, Staphylococcus aureus,scabies, and nasal carriage

et al. 2014

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“…Phakade found no MRSA in 619 cases of CA-SAP in a study conducted at KEM Hospital, Mumbai, India, whereas 45% of HA-SAP was methicillinresistant. [41] The prevalence of HA-MRSA in our study was found to be lower than other reports, but that of CA-MRSA was found concordant with reported series [Table 7]. Tiwari reported a prevalence of HA-MRSA isolated from tissue fluids in a tertiary hospital in Bhubaneshwar, India, the maximum 45% was from pus.…”

Section: Discussionsupporting

confidence: 91%

The clinical spectrum and antibiotic sensitivity patterns of staphylococcal pyodermas in the community and hospital

et al. 2014

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Context:The uncontrolled use of antibiotics has resulted in a relentless spread of multiresistant strains of Staphylococcus aureus. There are studies conducted in medical colleges in Chandigarh, Chennai, Mumbai and Vellore comparing pyodermas in the community and hospital setting based on clinical and bacteriological parameters.Aims:This study, conducted over 1½ years from March 2009 to August 2010, aimed at analyzing the clinical spectrum and antibiotic sensitivity pattern of community and hospital-associated (HA) staphylococcal pyoderma. It also assessed the prevalence of methicillin-resistant S. aureus (MRSA) in the community and hospital cohort settings.Subjects and Methods:The study comprised of 200 cases of staphylococcal pyodermas, derived from the community (150 cases) and hospital (50 cases). Patients were evaluated based on their clinical presentation; antibiotic susceptibility was tested using the Kirby-Bauer disk diffusion method.Statistical Analysis Used:Statistical significance between individual attributes between the community and HA staphylococcal pyoderma groups was analyzed using Chi-square test and mean differences using student's t-test.Results:Factors associated with community-associated (CA) pyodermas were young age (P = 0.0021), primary pyodermas, and involvement of extremities, while those with HA pyodermas were middle age, secondary pyodermas, and significantly increased body surface involvement (P = 0.041). Incidence of CA-MRSA was 11.3%, while that of HA-MRSA was 18%.Conclusions:A high level of resistance to first-line drugs such as penicillin, ciprofloxacin and cotrimoxazole was observed, more so in the hospital strain than in the community strain. S. aureus demonstrated good susceptibility to cephalosporins. Though the two strains of MRSA differed clinically, they showed 100% sensitivity to vancomycin and linezolid.

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“…In clinics, E, MUP, and FD are mainly used to treat SSTI infections. Previous studies have shown that these antibiotic agents have high rates of resistance to staphylococci [ 16 , 17 ]. The remarkable characteristic of presenting high rates of antimicrobial resistance makes S. haemolyticus an emerging threat to human health.…”

Section: Introductionmentioning

confidence: 99%

Antibacterial activity and antibacterial mechanism of flavaspidic acid BB against Staphylococcus haemelyticus

Liu,

Deng

et al. 2023

BMC Microbiol

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Background Staphylococcus haemolyticus (S. haemolyticus) is the main etiological factor in skin and soft tissue infections (SSTI). S. haemolyticus infections are an important concern worldwide, especially with the associated biofilms and drug resistance. Herein, we investigated the inhibitory effect of Flavaspidic acid BB obtained from plant extractions on clinical S. haemolyticus strains and their biofilms. Moreover, we predicted its ability to bind to the protein-binding site by molecular simulation. Since the combination of Hsp70 and RNase P synthase after molecular simulation with flavaspidic acid BB is relatively stable, enzyme-linked immunosorbent assay (ELISA) was used to investigate Hsp70 and RNase P synthase to verify the potential antimicrobial targets of flavaspidic acid BB. Results The minimum inhibitory concentrations (MIC) of flavaspidic acid BB on 16 clinical strains of S. haemolyticus was 5 ~ 480 µg/mL, and BB had a slightly higher inhibitory effect on the biofilm than MUP. The inhibitory effect of flavaspidic acid BB on biofilm formation was better with an increase in the concentration of BB. Molecular simulation verified its ability to bind to the protein-binding site. The combination of ELISA kits showed that flavaspidic acid BB promoted the activity of Hsp70 and inhibited the activity of RNase P, revealing that flavaspidic acid BB could effectively inhibit the utilization and re-synthesis of protein and tRNA synthesis, thus inhibiting bacterial growth and biofilm formation to a certain extent. Conclusions This study could potentially provide a new prospect for the development of flavaspidic acid BB as an antibacterial agent for resistant strains.

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Is methicillin-resistant Staphylococcus aureus involved in community acquired skin and soft tissue infections?

Cited by 15 publications

References 13 publications

The microbiology of impetigo in Indigenous children: associations between Streptococcus pyogenes, Staphylococcus aureus,scabies, and nasal carriage

The microbiology of impetigo in Indigenous children: associations between Streptococcus pyogenes, Staphylococcus aureus,scabies, and nasal carriage

The clinical spectrum and antibiotic sensitivity patterns of staphylococcal pyodermas in the community and hospital

Antibacterial activity and antibacterial mechanism of flavaspidic acid BB against Staphylococcus haemelyticus

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