Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia

Sit, Pik San; Teh, Cindy Shuan Ju; Idris, Nuryana; Ponnampalavanar, Sasheela

doi:10.1016/j.meegid.2018.01.031

Cited by 17 publications

(19 citation statements)

References 28 publications

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“…However, high resistance rates were reported for ampicillinsulbactam, erythromycin, ciprofloxacin, clindamycin, and pipercacillin-tazobactam. These findings are similar to those of the previously reported studies (23,30,31). Common prescription of these drugs against a variety of bacterial infections might also be a contributing factor.…”

Section: Discussionsupporting

confidence: 93%

Predominance of ST22-MRSA-IV Clone and Emergence of Clones for Methicillin-Resistant <i>Staphylococcus aureus</i> Clinical Isolates Collected from a Tertiary Teaching Hospital Over a Two-Year Period

et al. 2019

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INTRODUCTION Methicillin-resistant Staphylococcus aureus (MRSA) is an established nosocomial pathogen that causes infections, such as bacteremia, respiratory tract infections, skin and soft tissue infections (SSTIs), bone and joint infections, and urinary tract infections (1, 2). The prevalence rate of hospital-acquired MRSA infections was the highest (＞50) in Asia, South America, and Malta, followed by lower prevalence rates (25-50) in Australia, China, Africa, Romania, Greece, Italy, and Portugal (3). The prevalence rate of MRSA in Malaysia has been reported to increase from 17 in 1986 (4) to 44 in 2007 (5). To date, healthcare-associated MRSA (HA-MRSA) remains a global healthcare concern; however, the emergence of community-associated MRSA (CA-MRSA) since the 1990s poses significant risks and threats to both hospital and community populations. The current modality of treatment for MRSA infections is prescribing antibiotics, such as vancomycin, linezolid, rifampicin, and fusidic acid (2,6). The molecular epidemiology of MRSA can be studied using different typing methods, such as staphylococcal cassette chromosomal mec (SCCmec) typing, multilocus sequence typing (MLST), and pulsed

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Section: Discussionsupporting

confidence: 93%

Predominance of ST22-MRSA-IV Clone and Emergence of Clones for Methicillin-Resistant <i>Staphylococcus aureus</i> Clinical Isolates Collected from a Tertiary Teaching Hospital Over a Two-Year Period

et al. 2019

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“…In terms of antibiotic resistance, 58.4% of all ESKAPE isolates are resistant towards penicillin V. Beta-lactams are the most widely-used antibiotic to treat bacterial infections, where penicillins are among the most common beta-lactams prescribed for upper respiratory tract infections (URTIs) by both public and private primary care providers (Teng et al, 2011;Pandey and Cascella, 2019). Generally, the prevalence of methicillin-resistant S. aureus (MRSA) among the S. aureus isolates in the present study (5.6%, n=5/89) is still lower than the 19.4% reported in the latest NSAR report (Ministry of Health, 2019) and the 9% reported by Sit et al (2018). Nonetheless, we present the first report of MRSA isolated from community-based throat swabs.…”

Section: Discussioncontrasting

confidence: 69%

Antibiotic resistance of ESKAPE bacteria in acute pharyngitis patients from private clinics in central Malaysia

Chong

Tan

et al. 2020

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Worldwide, the ESKAPE group of pathogens - Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species - are emerging as important pathogens which have acquired resistance towards different classes of antibiotics. Malaysia has also reported high levels of antibiotic resistance among these pathogens, based on prevalence data from hospital patients. However, the prevalence and antibiotic resistance rates of ESKAPE group members in the community are largely unknown. Therefore, this study focuses on acute pharyngitis (AP) patients from private primary care clinics in the Klang Valley, central Malaysia, as AP is the most common infection-associated reason for contact with private primary healthcare providers. Out of 205 patients, 119 were found to harbor ESKAPE group bacteria, where a total of 175 isolates were subjected to antibiotic susceptibility testing. Our results show that the most prevalent ESKAPE group member in this cohort is S. aureus, with one isolate found to be multidrug-resistant towards penicillin V, cefoxitin, erythromycin and azithromycin. We also report the first finding of community acquired resistance to cefotaxime in K. pneumoniae, imipenem in Enterobacter spp. and tetracycline, also in Enterobacter spp., in Malaysia, which were not derived from samples from a hospital setting. In conclusion, this study, which describes antibiotic resistance of community acquired ESKAPE pathogens in the Malaysian private primary healthcare setting highlights the need for a comprehensive centralized reporting system for community acquired antibiotic resistance to complement the Malaysian National Surveillance of Antibiotic Resistance.

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“…Subgroup founder was defined as a diversified SLV of the primary founder. Singleton was the ST that did not correspond to any clonal group …”

Section: Methodsmentioning

confidence: 99%

“…Cluster analyses were performed using BioNumerics 7.6 (Applied Math) with dice correlation for band matching at a 1.5% position tolerance and the unweighted pair group method with an arithmetic average (UPGMA) and similarity coefficient of 80% …”

Section: Methodsmentioning

confidence: 99%

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Molecular epidemiology and virulence factors of methicillin‐resistant Staphylococcus aureus isolated from patients with bacteremia

Kim

Choi

Kwon

et al. 2019

Clinical Laboratory Analysis

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Background The various virulence factors of methicillin‐resistant Staphylococcus aureus bacteremia (MRSAB) are associated with a high mortality rate worldwide. Further studies are warranted to confirm the significant relationship between the strains and virulence genes. Here, we prospectively investigated the molecular characteristics underlying the genotypes and virulence factors of MRSA isolated from patients with bacteremia. Methods We collected 59 MRSA isolates from adult patients with bacteremia. Antimicrobial susceptibility results were obtained with the Vitek2 automated system. Genotypes were identified with multi‐locus sequence typing (MLST) and pulse‐field gel electrophoresis (PFGE), and 21 virulence genes were detected with polymerase chain reaction (PCR). Results The 59 MRSA isolates mainly comprised ST5 (n = 31, 52.5%) and ST72 (n = 22, 37.2%). Most ST5 isolates and all ST72 isolates were clustered into one and two PFGE groups, respectively. The mean number of virulence genes was higher in ST5 than in ST72. Sel was more frequently detected in ST5 than in ST72, whereas sec and sed were found only in ST5. ST5 had significantly higher resistance against many antibiotics than ST72. Conclusion Most MRSA isolates causing bacteremia were ST5 (CC5) and ST72 (CC8), and those belonging to the same STs were divided into only a few PFGE groups. ST5 was associated with higher antibiotic resistance and staphylococcal superantigen toxin genes, than ST72, which may be related to its higher virulence.

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Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia

Cited by 17 publications

References 28 publications

Predominance of ST22-MRSA-IV Clone and Emergence of Clones for Methicillin-Resistant <i>Staphylococcus aureus</i> Clinical Isolates Collected from a Tertiary Teaching Hospital Over a Two-Year Period

Predominance of ST22-MRSA-IV Clone and Emergence of Clones for Methicillin-Resistant <i>Staphylococcus aureus</i> Clinical Isolates Collected from a Tertiary Teaching Hospital Over a Two-Year Period

Antibiotic resistance of ESKAPE bacteria in acute pharyngitis patients from private clinics in central Malaysia

Molecular epidemiology and virulence factors of methicillin‐resistant Staphylococcus aureus isolated from patients with bacteremia

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