Treatment of Skin and Soft Tissue Infections Due to Community-Associated Methicillin-Resistant Staphylococcus aureus in Europe: The Role of Trimethoprim-sulfamethoxazole

Angelis, Giulia De; Cipriani, Michela; Cauda, Roberto; Tacconelli, Evelina

doi:10.1093/cid/cir247

Cited by 12 publications

(8 citation statements)

References 8 publications

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“…The dominant resistance gene mediating trimethoprim resistance in MRSA and MSSA in Namibia was dfrG , similar to reports in other Africa countries . Moreover, dfrG was frequently detected in S. aureus from SSTIs in travelers returning from other African countries, suggesting that dfrG can be transmitted in populations with low antifolate resistance, such as found in North America and Europe …”

Section: Resultssupporting

confidence: 81%

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Sekyere

Mensah

2019

Annals of the New York Academy of Sciences

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A systematic review of antibiotic‐resistant Gram‐positive bacteria in Africa from a One Health perspective is lacking. Here, we report result from a search for English‐language articles on the resistance mechanisms and clonality of Gram‐positive bacteria in Africa between 2007 and 2019 reported in PubMed, Web of Science, ScienceDirect, and African Journals OnLine; 172 studies from 22 different African countries were identified. Resistance genes, such as mecA, erm(B), erm(C), tet(M), tet(K), tet(L), vanB, vanA, vanC, and tet(O), were found to be common. Staphylococcus spp., Enterococcus spp., and Streptococcus spp. were the main species reported by the studies, with clones such as Staphylococcus aureus ST5 (n = 218 isolates), ST8 (n = 127 isolates), ST80 (n = 133 isolates), and ST88 (n = 117 isolates), and mobile genetic elements such as IS16 (n = 28 isolates), IS256 (n = 96), Tn916 (n = 107 isolates), and SCCmec (n = 4437 isolates) identified. SCCmec IV (n = 747 isolates) was predominant, followed by SCCmec III (n = 305 isolates), SCCmec II (n = 163 isolates), SCCmec V (n = 135 isolates), and SCCmec I (n = 79 isolates). Resistance to penicillin (n = 5926 isolates), tetracycline (n = 5300 isolates), erythromycin (n = 5151 isolates), rifampicin (n = 3823 isolates), gentamycin (n = 3494 isolates), sulfamethoxazole/trimethoprim (n = 3089 isolates), and ciprofloxacin (n = 2746 isolates) was common in most reports from 22 countries. Clonal dissemination of resistance across countries and between humans, animals, and the environment was observed. Resistance rates ranged from 1.4% to 100% for 15 of the studies; 10 were One Health–related studies. Strict infection control measures, antimicrobial stewardship, and periodic One Health epidemiological surveillance studies are needed to monitor and contain the threat of increasing antibiotic resistance in Africa.

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Section: Resultssupporting

confidence: 81%

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Sekyere

Mensah

2019

Annals of the New York Academy of Sciences

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“…In Europe, clindamycin is also recommended as the only treatment for SSTIs (De Angelis et al, 2011). The results of the current study showed that clindamycin resistance in CA-MRSA strains was high (92 %).…”

Section: Disscussionmentioning

confidence: 53%

Multidrug-resistant clones of community-associated meticillin-resistant Staphylococcus aureus isolated from Chinese children and the resistance genes to clindamycin and mupirocin

Wang

Liu

Yang

et al. 2012

Journal of Medical Microbiology

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This study aimed to correlate the multidrug resistance (MDR) and sequence type (ST) clones of community-associated (CA) meticillin-resistant Staphylococcus aureus (MRSA) to identify the genes responsible for clindamycin and mupirocin resistance in S. aureus isolates from paediatric hospitals in mainland China. A total of 435 S. aureus isolates were collected. Compared with CA meticillinsusceptible S. aureus (MSSA), the resistance rates of CA-MRSA to ciprofloxacin, chloramphenicol, gentamicin and tetracycline were higher (19.0 vs 2.6 %, P,0.001; 14.7 vs 3.1 %, P,0.001; 14.7 vs 3.1 %, P,0.01; and 46.0 vs 13.3 %, P,0.001, respectively). Compared with hospital-associated (HA)-MRSA, the resistance rates of CA-MRSA to ciprofloxacin, gentamicin, rifampicin, tetracycline and trimethoprim-sulfamethoxazole were lower (19 vs 94.8 %, P,0.001; 14.7 vs 84.4 %, P,0.001; 5.5 vs 88.3 %, P,0.001; 46 vs 94.8 %, P,0.001; and 1.8 vs 9.1 %, P,0.01, respectively). The resistance rates of CA-MRSA, HA-MRSA and CA-MSSA to clindamycin (92.0, 77.9 and 64.1 %, respectively) and erythromycin (85.9, 77.9 and 63.1 %, respectively) were high. The MDR rates (resistance to three or more non-b-lactams) were 49.6, 100 and 14 % in the CA-MRSA, HA-MRSA and CA-MSSA isolates, respectively. Five of seven ST clones in the CA-MRSA isolates, namely ST59, ST338, ST45, ST910 and ST965, had MDR rates of .50 % (67.9, 87.5, 100, 50 and 83.3 %, respectively). The constitutive phenotype of macrolide-lincosamide-streptogramin B (MLS B ) resistance (69 %) and the ermB gene (38.1 %) predominated among the MLS B -resistant CA S. aureus strains. The resistance rate to mupirocin was 2.3 % and plasmids carrying the mupA gene varied in size between 23 and 54.2 kb in six strains with high-level resistance as determined by Southern blot analysis. The present study showed that resistance to non-b-lactams, especially to clindamycin, is high in CA-MRSA isolates from Chinese children and that the profile of resistance is related to clonal type. This study revealed distinctive patterns of MLS B -resistant genes among CA S. aureus isolates.

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“…Some guidelines advocate SXT as the compound of choice for empirical treatment of skin and soft-tissue infections caused by S. aureus [11,12] with the aim of reducing failure of empirical antibiotic treatment in the MRSA era. Based on the presented results and existing knowledge on SXT resistance in clinical isolates [6][7][8], however, this approach may require modification for African patients as well as travellers that have acquired S. aureus infections on the African continent [13].…”

Section: Discussionmentioning

confidence: 99%

Clonal expansion accounts for an excess of antimicrobial resistance in Staphylococcus aureus colonising HIV-positive individuals in Lagos, Nigeria

Olalekan¹,

Schaumburg²,

Nurjadi³

et al. 2012

International Journal of Antimicrobial Agents

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Treatment of Skin and Soft Tissue Infections Due to Community-Associated Methicillin-Resistant Staphylococcus aureus in Europe: The Role of Trimethoprim-sulfamethoxazole

Cited by 12 publications

References 8 publications

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Multidrug-resistant clones of community-associated meticillin-resistant Staphylococcus aureus isolated from Chinese children and the resistance genes to clindamycin and mupirocin

Clonal expansion accounts for an excess of antimicrobial resistance in Staphylococcus aureus colonising HIV-positive individuals in Lagos, Nigeria

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