27 research outputs found
Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus Associated with Pediatric Infection in Cambodia
BACKGROUND: The incidence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is rising in the developed world but appears to be rare in developing countries. One explanation for this difference is that resource poor countries lack the diagnostic microbiology facilities necessary to detect the presence of CA-MRSA carriage and infection. METHODOLOGY AND PRINCIPAL FINDINGS: We developed diagnostic microbiology capabilities at the Angkor Hospital for Children, Siem Reap, western Cambodia in January 2006 and in the same month identified a child with severe community-acquired impetigo caused by CA-MRSA. A study was undertaken to identify and describe additional cases presenting between January 2006 and December 2007. Bacterial isolates underwent molecular characterization using multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec) typing, and PCR for the presence of the genes encoding Panton-Valentine Leukocidin (PVL). Seventeen children were identified with CA-MRSA infection, of which 11 had skin and soft tissue infection and 6 had invasive disease. The majority of cases were unrelated in time or place. Molecular characterization identified two independent MRSA clones; fifteen isolates were sequence type (ST) 834, SCCmec type IV, PVL gene-negative, and two isolates were ST 121, SCCmec type V, PVL gene-positive. CONCLUSIONS: This represents the first ever report of MRSA in Cambodia, spread of which would pose a significant threat to public health. The finding that cases were mostly unrelated in time or place suggests that these were sporadic infections in persons who were CA-MRSA carriers or contacts of carriers, rather than arising in the context of an outbreak
Fusidic acid and clindamycin resistance in community-associated, methicillin-resistant Staphylococcus aureus infections in children of Central Greece
<p>Abstract</p> <p>Introduction</p> <p>In Greece, fusidic acid and clindamycin are commonly used for the empiric therapy of suspected staphylococcal infections.</p> <p>Methods</p> <p>The medical records of children examined at the outpatient clinics or admitted to the pediatric wards of the University General Hospital of Larissa, Central Greece, with community-associated staphylococcal infections from January 2003 to December 2009 were reviewed.</p> <p>Results</p> <p>Of 309 children (0-14 years old), 21 (6.8%) had invasive infections and 288 (93.2%) skin and soft tissue infections (SSTIs). Thirty-five patients were ≤30 days of age. The proportion of staphylococcal infections caused by a community-associated methicillin-resistant <it>Staphylococcus aureus </it>(CA-MRSA) isolate increased from 51.5% (69 of 134) in 2003-2006 to 63.4% (111 of 175) in 2007-2009 (<it>P </it>= 0.037). Among the CA-MRSA isolates, 88.9% were resistant to fusidic acid, 77.6% to tetracycline, and 21.1% to clindamycin. Clindamycin resistance increased from 0% (2003) to 31.2% (2009) among the CA-MRSA isolates (<it>P </it>= 0.011). Over the 7-year period, an increase in multidrug-resistant CA-MRSA isolates was observed (<it>P </it>= 0.004). One hundred and thirty-one (93.6%) of the 140 tested MRSA isolates were Panton-Valentine leukocidin-positive. Multilocus sequence typing of 72 CA-MRSA isolates revealed that they belonged to ST80 (n = 61), ST30 (n = 6), ST377 (n = 3), ST22 (n = 1), and ST152 (n = 1). Resistance to fusidic acid was observed in ST80 (58/61), ST30 (1/6), and ST22 (1/1) isolates.</p> <p>Conclusion</p> <p>In areas with high rate of infections caused by multidrug-resistant CA-MRSA isolates, predominantly belonging to the European ST80 clone, fusidic acid and clindamycin should be used cautiously as empiric therapy in patients with suspected severe staphylococcal infections.</p
A Field Guide to Pandemic, Epidemic and Sporadic Clones of Methicillin-Resistant Staphylococcus aureus
In recent years, methicillin-resistant Staphylococcus aureus
(MRSA) have become a truly global challenge. In addition to the long-known
healthcare-associated clones, novel strains have also emerged outside of the
hospital settings, in the community as well as in livestock. The emergence and
spread of virulent clones expressing Panton-Valentine leukocidin (PVL) is an
additional cause for concern. In order to provide an overview of pandemic,
epidemic and sporadic strains, more than 3,000 clinical and veterinary isolates
of MRSA mainly from Germany, the United Kingdom, Ireland, France, Malta, Abu
Dhabi, Hong Kong, Australia, Trinidad & Tobago as well as some reference
strains from the United States have been genotyped by DNA microarray analysis.
This technique allowed the assignment of the MRSA isolates to 34 distinct
lineages which can be clearly defined based on non-mobile genes. The results
were in accordance with data from multilocus sequence typing. More than 100
different strains were distinguished based on affiliation to these lineages,
SCCmec type and the presence or absence of PVL. These
strains are described here mainly with regard to clinically relevant
antimicrobial resistance- and virulence-associated markers, but also in relation
to epidemiology and geographic distribution. The findings of the study show a
high level of biodiversity among MRSA, especially among strains harbouring
SCCmec IV and V elements. The data also indicate a high
rate of genetic recombination in MRSA involving SCC elements, bacteriophages or
other mobile genetic elements and large-scale chromosomal replacements
A Field Guide to Pandemic, Epidemic and Sporadic Clones of Methicillin-Resistant Staphylococcus aureus
In recent years, methicillin-resistant Staphylococcus aureus
(MRSA) have become a truly global challenge. In addition to the long-known
healthcare-associated clones, novel strains have also emerged outside of the
hospital settings, in the community as well as in livestock. The emergence and
spread of virulent clones expressing Panton-Valentine leukocidin (PVL) is an
additional cause for concern. In order to provide an overview of pandemic,
epidemic and sporadic strains, more than 3,000 clinical and veterinary isolates
of MRSA mainly from Germany, the United Kingdom, Ireland, France, Malta, Abu
Dhabi, Hong Kong, Australia, Trinidad & Tobago as well as some reference
strains from the United States have been genotyped by DNA microarray analysis.
This technique allowed the assignment of the MRSA isolates to 34 distinct
lineages which can be clearly defined based on non-mobile genes. The results
were in accordance with data from multilocus sequence typing. More than 100
different strains were distinguished based on affiliation to these lineages,
SCCmec type and the presence or absence of PVL. These
strains are described here mainly with regard to clinically relevant
antimicrobial resistance- and virulence-associated markers, but also in relation
to epidemiology and geographic distribution. The findings of the study show a
high level of biodiversity among MRSA, especially among strains harbouring
SCCmec IV and V elements. The data also indicate a high
rate of genetic recombination in MRSA involving SCC elements, bacteriophages or
other mobile genetic elements and large-scale chromosomal replacements
Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis
Background
Mupirocin is widely used for nasal decolonization of Staphylococcus aureus to prevent subsequent staphylococcal infection in patients and healthcare personnel. However, the prolonged and unrestricted use has led to the emergence of mupirocin-resistant (mupR) S. aureus. The aim of this systematic review was to investigate the prevalence, phenotypic and molecular characteristics, and geographic spread of mupR S. aureus in Africa.
Methods
We examined five electronic databases (EBSCOhost, Google Scholar, ISI Web of Science, MEDLINE, and Scopus) for relevant English articles on screening for mupR S. aureus from various samples in Africa. In addition, we performed random effects meta-analysis of proportions to determine the pooled prevalence of mupR S. aureus in Africa. The search was conducted until 3 August 2016.
Results
We identified 43 eligible studies of which 11 (26%) were obtained only through Google Scholar. Most of the eligible studies (28/43; 65%) were conducted in Nigeria (10/43; 23%), Egypt (7/43; 16%), South Africa (6/43; 14%) and Tunisia (5/43; 12%). Overall, screening for mupR S. aureus was described in only 12 of 54 (22%) African countries. The disk diffusion method was the widely used technique (67%; 29/43) for the detection of mupR S. aureus in Africa. The mupA-positive S. aureus isolates were identified in five studies conducted in Egypt (n = 2), South Africa (n = 2), and Nigeria (n = 1). Low-level resistance (LmupR) and high-level resistance (HmupR) were both reported in six human studies from South Africa (n = 3), Egypt (n = 2) and Libya (n = 1). Data on mupR-MRSA was available in 11 studies from five countries, including Egypt, Ghana, Libya, Nigeria and South Africa. The pooled prevalence (based on 11 human studies) of mupR S. aureus in Africa was 14% (95% CI =6.8 to 23.2%). The proportion of mupA-positive S. aureus in Africa ranged between 0.5 and 8%. Furthermore, the frequency of S. aureus isolates that exhibited LmupR, HmupR and mupR-MRSA in Africa were 4 and 47%, 0.5 and 38%, 5 and 50%, respectively.
Conclusions
The prevalence of mupR S. aureus in Africa (14%) is worrisome and there is a need for data on administration and use of mupirocin. The disk diffusion method which is widely utilized in Africa could be an important method for the screening and identification of mupR S. aureus. Moreover, we advocate for surveillance studies with appropriate guidelines for screening mupR S. aureus in Africa
Demonstration and Modeling of the Coupling of a Heat Pump and Hybrid PV-T Panels Integrated into a Building
International audienc
Proyecto Utica. Informe de los trabajos arqueológicos efectuados en la ciudad fenicio-púnica de Utica (Túnez). Campaña de 2010
Se presentan los resultados obtenidos en la prospección
geofísica efectuada en la ciudad fenicio-púnica y
romana de Utica (Túnez). La prospección utilizó los
métodos de magnetometría y radar de subsuelo en
tres zonas del yacimiento arqueológico, sumando una
superficie total de 4.065 m2. En dos de las tres zonas
exploradas, la importante contaminación férrica en
superficie limitó los resultados de la magnetometría,
aunque los resultados del georrádar ofrecen interesantes
imágenes en la detección de complejos sistemas
de construcción, algunas de las cuales pueden
atribuirse a las fases fenicio-púnicas de Utica, como
en la denominada Zona I