Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Isolated from Children in a Community with Low Antimicrobial Pressure in Japan

Otsuka, Taketo; Zaraket, Hassan; Fujii, Koyata; Masuda, Yasuko; Komiyama, Kenichi; Ishikawa, Yukio; Shirai, Takatoshi; Iwaya, Atsushi; Okazaki, Masanori

doi:10.7883/yoken.65.483

Cited by 11 publications

(8 citation statements)

References 23 publications

(33 reference statements)

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“…This factor was included as an indicator of inpatients’ age adjustment because patients in this ward were 15 years old or younger. The reason why the MRSA ratio for outpatients ≤ 15 years old was fluctuating whereas the ratio for outpatients > 15 years old decreased might derive from increased antimicrobial use and pediatrics MRSA reservoir in regional practitioners 17. Future research may clarify age-specific mechanisms for MRSA surveillance in our region.…”

Section: Discussionmentioning

confidence: 92%

Association between ward-specific antimicrobial use density and methicillin-resistant Staphylococcus aureus surveillance: a 60-month study

Yoshida¹,

Kikuchi²,

Matsubara³

et al. 2013

IDR

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It is not known whether or not ward-specific antimicrobial use density (AUD) affects the ratio of methicillin-resistant Staphylococcus aureus (MRSA) in culture-positive S. aureus. A 60-month study was attempted to ascertain the association between inpatient MRSA ratio and ward-specific AUDs as well as the former and latter study intervals, specimen types, and ward specialty. During the study, the professionals in infection control regulated the use of broad-spectrum antimicrobials and those for MRSA. By both month and ward, the ratio of inpatients positive for MRSA to those positive for S. aureus was calculated. Factors associated with MRSA ratio included AUDs averaged for the sampling month and its previous month, outpatient MRSA ratio by age, ward specialty, specimen type, and half intervals to represent historical changes. Of a total of 4,245 strains of S. aureus isolated during the 5-year study, 2,232 strains (52.6%) were MRSA. By year, outpatient MRSA ratio at age ≥15 decreased in later years, as did inpatient MRSA ratio. Multivariate analysis for inpatient MRSA ratio revealed a positive risk in AUDs for meropenem (odds ratio [OR] 1.761; 95% confidence interval [CI] 1.761–2.637, P = 0.01), imipenem-cilastatin (OR 1.583; 95% CI 1.087–2.306, P = 0.02), ampicillin-sulbactam (OR 1.623; 95% CI 1.114–2.365, P = 0.01), and minocycline (OR 1.680; CI 1.135–2.487, P = 0.01), respiratory care ward (OR 2.292; 95% CI 1.085–4.841, P = 0.03), and outpatient MRSA ratio (OR 1.536; 95% CI 1.070–2.206, P = 0.02). Use of broad-spectrum antimicrobials, such as meropenem, imipenem-cilastatin, and ampicillin-sulbactam may increase inpatient MRSA ratio. Ward factor should be included in MRSA surveillance because of the possible effect on AUD and considering patients’ backgrounds.

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Section: Discussionmentioning

confidence: 92%

Association between ward-specific antimicrobial use density and methicillin-resistant Staphylococcus aureus surveillance: a 60-month study

Yoshida¹,

Kikuchi²,

Matsubara³

et al. 2013

IDR

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“…In the current study, we also found a cfr -positive ST398 MRSA strain isolated from a duck indicating a possibility of widespread dissemination of the cfr -harboring ST398 LA-MRSA clone in China. In addition, all of the three cfr -positive MRSA isolates from patients were identified as ST764, the increased prevalent hybrid variant of the ST5 HA-MRSA lineage with the arginine catabolic mobile element (ACME) in China, Japan, and other Asian areas ( Otsuka et al, 2012 ; Nakaminami et al, 2014 ; Wang et al, 2016 ). These results indicated that cfr -positive MRSA isolates from animals and humans belonged to different ST types and were probably from epidemiologically unrelated MRSA clones.…”

Section: Discussionmentioning

confidence: 99%

Characterization of the Multi-Drug Resistance Gene cfr in Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Isolated From Animals and Humans in China

Zhou

et al. 2018

Front. Microbiol.

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We investigated cfr-positive and -negative MRSA strains isolated from animals and humans in different geographical areas of China, from 2011 to 2016. Twenty cfr-positive strains (15.6%) were identified from 128 MRSA strains including 17 from food animals and three from humans. The resistance rates and prevalence of the tested antibiotic resistance genes (ARGs) in the cfr-positive MRSA isolates were higher than that in the cfr-negative MRSA isolates. All cfr-positive MRSA isolates were co-carrying fexA and ermC, and had significantly higher optrA incidence rate vs. the cfr-negative isolates (P < 0.05). In addition, multilocus sequence typing (MLST) assays showed that ST9 and spa-type t899 were the most prevalent ST and spa types in the study strains. However, all of the 20 cfr-positive and 10 randomly selected cfr-negative MRSA isolates were clonally unrelated as determined by pulsed-field gel electrophoresis (PFGE) analyses. Importantly, the cfr gene was successfully transferred to a recipient Staphylococcus aureus strain RN4220 from 13 of the 20 cfr-positive MRSA isolates by electroporation. Among these 13 cfr-positive MRSA isolates, two different genetic contexts surrounding cfr were determined and each was associated with one type of cfr-carrying plasmids. Of note, the predominant genetic context of cfr was found to be a Tn558 variant and locate on large plasmids (∼50 kb) co-harboring fexA in 11 of the 13 MRSA isolates. Furthermore, the cfr gene was also identified on small plasmids (∼ 7.1 kb) that co-carried ermC in two of the 13 MRSA isolates. Our results demonstrated a high occurrence of multi-drug resistance in cfr-positive MRSA isolates, and the spread of cfr might be attributed to horizontal dissemination of similar cfr-carrying transposons and plasmids.

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“…This can be partially explained by the fact that MRSA prevalence might be affected by the previous use of antibiotics (20)(21)(22)(23) . In our study endophthalmitis cases were frequently associated with surgery, and the prophylactic regimens used in the perioperative period could cause the selection of resistant strains.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus in ocular infections

Vola¹,

Moriyama²,

Lisboa³

et al. 2013

Arq. Bras. Oftalmol.

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Purpose: To study the prevalence of methicillin-resistant Staphylococcus aureus among S. aureus ocular infections in a tertiary health center in Brazil and compare antibiotic susceptibility patterns between MRSA and methicillin-susceptible S. aureus isolates. Methods: Electronic records from the ocular microbiology laboratory of the Universidade Federal de São Paulo were retrospectively reviewed. During a 10-year period (between January 2000 and December 2009) all conjunctivitis, keratitis, and endophthalmitis cases with a positive culture for S. aureus were identified. Antibiotic susceptibility was determined using the Kirby-Bauer disk diffusion method. Results: Five hundred sixty-six S. aureus isolates were identified; of those, 56 (9.9%) were resistant to methicillin. Throughout the 10-year period, Staphylococcus aureus showed a significant increasing trend from 7.55% to 16.18% among overall S. aurues infections (p=0.001) and from 3.7% to 13.16% in conjunctivitis (p=0.001). Conversely, we did not observe the same trend among those with keratitis (p=0.38). Staphylococcus aureus isolates showed higher resistance rates to tobramycin, gentamicin, ciprofloxacin, gatifloxacin, and moxifloxacin when compared with S. aureus isolates (p< 0.001). All cases were susceptible to vancomycin. Conclusion:We observed an increasing trend in the overall prevalence of Staphylococcus aureus ocular infections and statistically significant higher resistance rates to commonly used antibiotics compared to Staphylococcus aureus. Our data supports the need for constant bacterial surveillance and should be taken into consideration before initiating empiric treatment of ocular infections. Keywords

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Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Isolated from Children in a Community with Low Antimicrobial Pressure in Japan

Cited by 11 publications

References 23 publications

Association between ward-specific antimicrobial use density and methicillin-resistant Staphylococcus aureus surveillance: a 60-month study

Association between ward-specific antimicrobial use density and methicillin-resistant Staphylococcus aureus surveillance: a 60-month study

Characterization of the Multi-Drug Resistance Gene cfr in Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Isolated From Animals and Humans in China

Prevalence and antibiotic susceptibility of methicillin-resistant Staphylococcus aureus in ocular infections

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