MRSA infections among patients in the emergency department: a European multicentre study

Bouchiat, Coralie; Curtis, Stephanie J.; Spiliopoulou, Iris; Bes, Michèle; Cocuzza, C; Codiţă, Irina; Dupieux, Céline; Giormezis, Nikolaos; Kearns, Angela; Laurent, François; Molinos, Sònia; Musumeci, Rosario; Prat, Cristina; Saadatian‐Elahi, Mitra; Tacconelli, Evelina; Tristan, Anne; Schulte, Berit; Vandenesch, F.

doi:10.1093/jac/dkw431

Cited by 51 publications

(40 citation statements)

References 14 publications

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“…Thus, there is an urgent need for new drugs specific for MRSA infections. USA300, a representative MRSA strain (van der Mee-Marquet et al 2015;Bouchiat et al 2017;Immergluck et al 2017), was chosen as the strain of interest in this study.…”

Section: Introductionmentioning

confidence: 99%

The antibacterial mechanism of oridonin against methicillin-resistant Staphylococcus aureus (MRSA)

Ouyang

Rehman

et al. 2019

Pharmaceutical Biology

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Context: Methicillin-resistant Staphylococcus aureus (MRSA) is a very harmful bacterium. Oridonin, a component in Rabdosia rubescens (Hemsl.) Hara (Lamiaceae), is widely used against bacterial infections in China. Objective: We evaluated oridonin effects on MRSA cell membrane and wall, protein metabolism, lactate dehydrogenase (LDH), DNA and microscopic structure. Materials and methods: Broth microdilution and flat colony counting methods were used to measure oridonin minimal inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against USA300 strain. Electrical conductivity and DNA exosmosis were analysed to study oridonin effects (128 lg/mL) on cell membrane and wall for 0, 1, 2, 4 and 6 h. Sodium dodecyl sulphate polyacrylamide gel electrophoresis was used to detect effects on soluble protein synthesis after 6, 10 and 16 h. LDH activity was examined with an enzyme-linked immunosorbent assay. Effects of oridonin on USA300 DNA were investigated with DAPI staining. Morphological changes in MRSA following oridonin treatment were determined with scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Results: Oridonin MIC and MBC values against USA300 were 64 and 512 lg/mL, respectively. The conductivity and DNA exosmosis level of oridonin-treated USA300 improved by 3.20±0.84% and increased by 58.63 ± 1.78 lg/mL, respectively. LDH and soluble protein levels decreased by 30.85±7.69% and 27.51 ± 1.39%, respectively. A decrease in fluorescence intensity was reported with time. Oridonin affected the morphology of USA300. Conclusions: Oridonin antibacterial mechanism was related to changes in cell membrane and cell wall permeability, disturbance in protein and DNA metabolism, and influence on bacterial morphology. Thus, oridonin may help in treating MRSA infection.

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Section: Introductionmentioning

confidence: 99%

The antibacterial mechanism of oridonin against methicillin-resistant Staphylococcus aureus (MRSA)

Ouyang

Rehman

et al. 2019

Pharmaceutical Biology

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“…22 Some studies have reported high rates of MRSA in SSSI or similar infections, both CA-MRSA and HA-MRSA, ranging from 22.4% to 74.8%, 1,12 but with important geographic variations. 23 In Portugal CA-MRSA has already been reported, 24 but HA-MRSA clearly predominates.…”

Section: Discussionmentioning

confidence: 99%

Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study

et al. 2019

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Introduction: Skin and skin structure infections are an increasing cause of hospitalization. Although mortality is relatively low, skin and skin structure infections are associated with prolonged hospital length of stay and high costs. Oxazolidinones have been suggested as a tool to treat infected patients in the ambulatory setting in order to decrease hospital length of stay. We wanted to address the evidence associated with the use of oxazolidinones in the treatment of skin and skin structure infections.Material and Methods: In this observational retrospective study we analyzed the anonymized diagnosis related group coded information from the Portuguese database for hospital admissions, that included all adult patients with a diagnosis of oxazolidinone use and a SSSI, discharged between 2010 and 2015.Results: During the study period, a total of 5518 patients had a diagnosis of oxazolidinone treatment. We selected 483 of those who were also diagnosed with a skin and skin structure infections. Their mean age was 64.9 years and 62.7% were male. The median hospital length of stay was 27 days (Inter quartile range 13 – 56) and the mortality rate was 12.6%. The prevalence of secondary anemia and of thrombocytopenia in the whole group treated with oxazolidinones was 2.5% and 3%, respectively.Discussion: Despite the high bioavailability of oxazolidinones, we were not able to find evidence that its use was associated with a decrease of mortality or hospital length of stay (due to early discharge) of patients with skin and skin structure infections.Conclusion: In this study we were not able to find evidence that oxazolidinones had any clinically significant benefit. A structured approach, including antibiotics with favorable pharmacokinetic and safety profile as well as a carefully planned ambulatory follow up may be needed.

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“…A striking feature of these CA-MRSA clones was their emergence and spread in the community and their high epidemic success, notably that of the ST80 clone in North Africa, 7 Greece, 8,9 and the middle Est 10 and that of the USA300 clone in the American continent. 11 Knowledge on the underlying driving forces that rule the expansion of these clones is still limited; several non-exclusive contributing factors could be at play.…”

Section: Introductionmentioning

confidence: 99%

Panton Valentine leucocidin enhances community-acquired methicillin-resistantStaphylococcus aureuscolonisation of the gut

Couzon

Bourgeois-Nicolaos

Bénito

et al. 2020

Preprint

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Objective Community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) independently emerged and became epidemic at the end of the 20th century. Since gut carriage was reported for CA-MRSA and since the common feature of historical CA-MRSA is to harbour Panton Valentine leucocidin (PVL), the question of the possible involvement of this toxin in gut carriage was investigated in mice and cellular models. Methods CA-MRSA of three lineages (USA300, USA1100, and ST80) and their isogenic delta-pvl derivatives, were tested in competition for gut colonisation in mice and in a model of bacterial adhesion to mucus-producing intestinal epithelial cells. Results Mice inoculated with CA-MRSA and their delta-pvl derivatives had their gut successfully colonised by the three lineages regardless of the presence of PVL; however, the wild type (WT) CA-MRSA outcompeted the delta-pvl derivatives by at least 3 log after 40 days for all lineages tested. In vitro competition of CA-MRSA with their delta-pvl derivatives showed no fitness disequilibrium after 6 weeks, ensuring that the results obtained in mice did not result from direct bacterial interference. Direct fluorescence assay of mice intestine showed S. aureus localised at the mucosal surface of the intestine and within the intestinal crypts, but not within epithelial cells, suggesting a bacterial tropism for the mucus layer. Significant difference in adhesion to intestinal epithelial cells between WT and pvl knockout was only observed on mucus-producing cells, and not on non-producing ones. Conclusion PVL enhances CA-MRSA gut colonisation in mice by a mechanism involving adhesion-colonisation of the mucus layer.

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MRSA infections among patients in the emergency department: a European multicentre study

Abstract: This original prospective multicentre study highlights stark differences in European MRSA epidemiology compared with the USA, and that the USA300 CA-MRSA clone is not predominant among community-infected patients in Europe.

Cited by 51 publications

References 14 publications

The antibacterial mechanism of oridonin against methicillin-resistant Staphylococcus aureus (MRSA)

The antibacterial mechanism of oridonin against methicillin-resistant Staphylococcus aureus (MRSA)

Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study

Panton Valentine leucocidin enhances community-acquired methicillin-resistantStaphylococcus aureuscolonisation of the gut

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