BACKGROUND: Susceptibility testing of Staphylococcus aureus often requires cumbersome supplementary tests. MicroScan Pos Breakpoint Combo Panel Type 28 (PBC28) (Siemens, USA) includes cefoxitin screening to detect methicillin-resistant Staphylococcus aureus (MRSA), inducible clindamycin resistance detection (ICD), and determination of low-range minimum inhibitory concentration of vancomycin (0.5-16 microgram/mL). The purpose of this study was to evaluate the performance of PBC28 in comparison with that of Pos Combo Type 1A (PC1A) (Siemens). METHODS: From December 2009 to March 2010, 500 non-duplicate clinical isolates of S. aureus were tested with PC1A and PBC28. Categorical agreements (CA) between the interpretations of the 2 panels were estimated. The presence of the mecA gene was determined by PCR, and double-disk diffusion test (D-test) was performed on the isolates resistant to erythromycin but susceptible or intermediately resistant to clindamycin. Ninety-six isolates representing various vancomycin minimum inhibitory concentrations (MICs) were tested in parallel with repeat PBC28, broth macrodilution, and epsilometer test (E test). RESULTS: The CA was 99.3% with a very major error (VME) of 0.2%, major error (ME) of 0.1%, and minor error (mE) of 0.4% in total. PBC28 showed 100% CA for 1 isolate with vancomycin MIC of 4 microgram/mL and 35 isolates (7.0%) with MIC of 2 microgram/mL. However, only 15, 27, and 35 isolates with vancomycin MIC of 2 microgram/mL showed 100% CA in repeat PBC28, broth macrodilution, and E test, respectively. PC1A and PBC28 detected all 314 mecA-positive isolates. Among the 63 isolates tested with the D-test, 58 (92.1%) were positive, and the results were 100% concordant with those of ICD. CONCLUSIONS: PBC28 can be appropriate susceptibility testing of S. aureus, including MRSA detection and ICD. However, the lower-range vancomycin MIC test was not reproducible enough to reliably differentiate MIC of 2 microgram/mL from MIC< or =1 microgram/mL.
Anti-Bacterial Agents/*pharmacology ; Bacterial Proteins/genetics ; Cefoxitin/*pharmacology ; Clindamycin/*pharmacology ; Drug Resistance, Bacterial ; Methicillin-Resistant Staphylococcus aureus/genetics/isolation & purification ; *Microbial Sensitivity Tests ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Staphylococcus aureus/*drug effects/genetics/isolation & purification ; Vancomycin/*pharmacology

OBJECTIVETo analyze the epidemiology of methicillin resistant Staphylococcus aureus (MRSA) in molecular level in burn centre of Shanghai Ruijin hospital.

METHODSThe vicissitude of Staphylococcus aureus in the burn centre from 2003 to 2005 was analyzed with software WHONET5. Multiprimer random amplified polymorphic DNA(RAPD) was used to analyze the homology of 17 MRSA strains.

RESULTSRAPD analysis (primer ERIC2 and RAPD7) showed that all 17 MRSA strains were identical (Burn-A type).

CONCLUSIONMRSA with same RAPD type is prevalent in our burn centre for many years, so emphasis should be laid on the anti-infection therapy and its cross infection control. Staphylococcus aureus;

Burn Units ; Humans ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; genetics ; isolation & purification ; Microbial Sensitivity Tests ; Random Amplified Polymorphic DNA Technique ; Sequence Homology ; Staphylococcal Infections ; drug therapy ; microbiology

OBJECTIVETo study the resistance of staphylococcus aureus (S. aureus) isolated from children in Hangzhou to antibiotics and analyze the clinical value of mecA-PCR in determining oxacillin-resistant isolates.

METHODSS. aureus isolates were screened by using latex agglutination test and identified with GPI card of Vitek system. Antibiotics sensitivity tests were performed using disk diffusion methods and tests for sensitivity to oxacillin and vancomycin were performed with a further E-test method. The mecA gene was detected with polymerase-chain reaction (PCR).

RESULTSOf all 259 S. aureus strains, 185 from clinical specimens in inpatients and 74 from pharyngeal swabs in healthy children, 247 strains (95.8%) were beta-lactamase-positive and resistant to penicillin, while 91.1% of all strains were sensitive to oxacillin. All the strains were sensitive to vacomycin and 91.9% of all the strains were susceptible to cefotaxime and ceftriaxone. Resistance to erythromycin, tetracycline, clindamycin, trimethoprim-sulfamethoxazole, chloramphenicol, ofloxacin and rifampin were 48.3%, 30.9%, 21.6%, 11.2%, 10.0%, 2.3% and 1.5%, respectively. The resistance rate to oxacillin, cefotaxime, and ceftriaxone in clinical strains were significantly higher than that in carried strains (P < 0.05), while erythromycin-resistance rate was significantly higher in carried strains than that in clinical isolates (P < 0.05). The mecA-PCR showed that the control strain ATCC25923 and all oxacillin-sensitive S. aureus were mecA-negative, while all oxacillin-resistant strains were mecA-positive instead. Only one strain was mecA-positive in 7 oxacillin-intermediate S. aureus strains.

CONCLUSIONOxacillin-resistance in S. aureus isolates was low, and mecA-PCR method is a good choice for rapid examination oxacillin-resistant strains.

Anti-Bacterial Agents ; pharmacology ; Bacterial Proteins ; genetics ; isolation & purification ; Cefotaxime ; pharmacology ; Ceftriaxone ; pharmacology ; Child ; Child, Preschool ; China ; Drug Resistance, Bacterial ; genetics ; Erythromycin ; pharmacology ; Humans ; Latex Fixation Tests ; Methicillin Resistance ; genetics ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Microbial Sensitivity Tests ; Oxacillin ; pharmacology ; Penicillin-Binding Proteins ; Penicillins ; pharmacology ; Polymerase Chain Reaction ; Staphylococcal Infections ; drug therapy ; microbiology ; Staphylococcus aureus ; drug effects ; genetics ; isolation & purification ; Vancomycin ; pharmacology

BACKGROUND: We evaluated the performance of the BD MAX StaphSR Assay (SR assay; BD, USA) for direct detection of Staphylococcus aureus and methicillin resistance not only in S. aureus but also in coagulase-negative Staphylococci (CNS) from positive blood cultures. METHODS: From 228 blood culture bottles, 103 S. aureus [45 methicillin-resistant S. aureus (MRSA), 55 methicillin-susceptible S. aureus (MSSA), 3 mixed infections (1 MRSA+Enterococcus faecalis, 1 MSSA+MRCNS, 1 MSSA+MSCNS)], and 125 CNS (102 MRCNS, 23 MSCNS) were identified by Vitek 2. For further analysis, we obtained the cycle threshold (Ct) values from the BD MAX system software to determine an appropriate cutoff value. For discrepancy analysis, conventional mecA/mecC PCR and oxacillin minimum inhibitory concentrations (MICs) were determined. RESULTS: Compared to Vitek 2, the SR assay identified all 103 S. aureus isolates correctly but failed to detect methicillin resistance in three MRSA isolates. All 55 MSSA isolates were correctly identified by the SR assay. In the concordant cases, the highest Ct values for nuc, mecA, and mec right-extremity junction (MREJ) were 25.6, 22, and 22.2, respectively. Therefore, we selected Ct values from 0-27 as a range of positivity, and applying this cutoff, the sensitivity/specificity of the SR assay were 100%/100% for detecting S. aureus, and 97.9%/98.1% and 99.0%/95.8% for detecting methicillin resistance in S. aureus and CNS, respectively. CONCLUSIONS: We propose a Ct cutoff value for nuc/mec assay without considering MREJ because mixed cultures of MSSA and MRCNS were very rare (0.4%) in the positive blood cultures.
Anti-Bacterial Agents/pharmacology ; Bacteremia/diagnosis/microbiology ; Coagulase/metabolism ; Humans ; Methicillin-Resistant Staphylococcus aureus/drug effects/genetics/*isolation & purification ; Microbial Sensitivity Tests ; Oxacillin/pharmacology ; Reagent Kits, Diagnostic ; Staphylococcus/drug effects/enzymology/genetics/isolation & purification ; Staphylococcus aureus/drug effects/genetics/*isolation & purification

OBJECTIVETo investigate the spread and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) at hospital.

METHODSTotally 110 strains of Staphylococcus aureus (SA) were isolated from the clinical samples of patients in 4 hospitals and 30 strains of SA were isolated from the hospital environment and personnel in Xiangya Hospital. MRSA was detected using oxacillin disk diffusion test, cefoxitin disk diffusion test and MecA, FemA gene PCR assay. Beta-lactamase was detected using nitrocephin sticks. The antimicrobial susceptibility of MRSA was tested by K-B disk diffusion test.

RESULTSAmong the 140 strains, 89 were MRSA, accounting for 63.57% of the total SA. The isolation rates of MRSA in clinical strains and environment strains were 64.55% and 60.00% (P > 0.05). All MRSA strains were sensitive to vancomycin and linezolid, 87 MRSA strains (97.75%) were sensitive to teicoplanin, most of which, however, were resistant to other antibiotics. Among the 89 strains, 85 MRSA strains (95.51% ) expressed beta-lactamase.

CONCLUSIONSMRSA is highly prevalent in hospitals. Most MRSA strains are multi-drug resistant, but are still sensitive to vancomycin, linezolid, and teicoplanin.

Anti-Bacterial Agents ; pharmacology ; Cross Infection ; microbiology ; Drug Resistance, Multiple, Bacterial ; Hospitalization ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; genetics ; isolation & purification ; Microbial Sensitivity Tests ; Staphylococcal Infections ; microbiology

OBJECTIVETo investigate the genotype of staphylococcal chromosomal cassette mec (SCCmec) in methicillin-resistant Staphylococcus aureus (MRSA) isolated from burn wards and its current status of drug resistance.

METHODSOne hundred and seventy-nine strains of Staphylococcus aureus were isolated from wound excretion, blood, and sputum samples of patients that were admitted to ICU or public wards of our Department of Burns and Plastic Surgery from September 2012 to September 2013. Among them, 68 strains were from ICU and 111 strains from public wards. The MRSA phenotype of Staphylococcus aureus was detected with cefoxitin K-B disk diffusion method, and the isolation rates of MRSA in ICU and public wards were compared. Genotyping of SCCmec was performed by PCR in strains of MRSA. In the meantime, the identification result of MRSA by K-B method was verified through detecting methicillin-resistant determinant mecA. The antimicrobial resistance of MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) to 23 kinds of commonly used antibiotics in clinic were detected by K-B disk diffusion method. Except for the antibiotics to which the resistant rates of MRSA were 100.0% or 0, the resistant rates of SCCmecIII MRSA and non-SCCmec III MRSA to the rest of antibiotics were compared. Data were processed with Pearson chi-square test or corrected chi-square test.

RESULTSOne hundred and forty-eight strains out of the 179 Staphylococcus aureus were identified as MRSA (accounting for 82.7%), among which 62 were originated from ICU and 86 from public wards. The rest 31 strains of Staphylococcus aureus were MSSA, accounting for 17.3%. The percentage of MRSA in the isolated Staphylococcus aureus was 91.2% (62/68) in ICU, which was significantly higher than that in the public wards [77.5% (86/111), χ2 = 5.526, P = 0.019]. PCR detection showed that the 148 strains of MRSA harbored the mecA gene, out of which 106 strains were SCCmec III positive, accounting for 71.6%. The percentages of SCCmec III type MRSA in MRSA isolated from ICU and public wards were respectively 72.6% (45/62) and 70.9% (61/86), showing no statistically significant difference (χ2 = 0.048, P = 0.826). The 148 strains of MRSA were 100.0% resistant to a total of 8 kinds of antibiotics including penicillin and cephalosporins, but it was 0 for vancomycin, teicoplanin, linezolid, tigecycline, nitrofurantoin, and quinupristin/dalfopristin. Except for the 6 kinds of antibiotics to which the resistant rates of MRSA and MSSA were 0, resistant rates of MRSA to the remaining 17 kinds of antibiotics were significantly higher than those of MSSA (with χ2 values from 4.091 to 138.546, P < 0.05 or P < 0.01). Resistant rates of the 106 strains of SCCmecIII type MRSA to levofloxacin, ciprofloxacin, rifampicin, tetracycline, erythrocin, lincomycin, gentamicin, clindamycin were respectively 56.6% (60/106), 85.8% (91/106), 89.6% (95/106), 86.8% (92/106), 84.9% (90/106), 78.3% (83/106), 92.5% (98/106), 74.5% (79/106), and they were significantly higher than those of the 42 strains of non-SCCmec III type MRSA [33.3% (14/42), 61.9% (26/42), 71.4% (30/42), 66.7% (28/42), 69.0% (29/42), 57.1% (24/42), 71.4% (30/42), 52.4% (22/42), with χ2 values from 4.801 to 11.377, P < 0.05 or P < 0.01].

CONCLUSIONSIsolation rate of MRSA from burn wards in our hospital is high, and drug resistance status of this strain against antibiotics is very serious. SCCmec III is the major genotype of the isolated MRSA, but no strains resistant to the glycopeptide antibiotics are found.

Anti-Bacterial Agents ; pharmacology ; Burns ; microbiology ; Drug Resistance, Bacterial ; genetics ; Drug Resistance, Multiple ; Genes, Bacterial ; genetics ; Genotype ; Humans ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; genetics ; isolation & purification ; Microbial Sensitivity Tests ; Staphylococcal Infections ; drug therapy ; epidemiology

Staphylococcus aureus, or methicillin-resistant S. aureus (MRSA), is a significant pathogen in both nosocomial and community infections. Community-associated MRSA (CA-MRSA) strains tend to be multi-drug resistant and to invade hospital settings. This study aimed to assess the antimicrobial resistance and molecular characteristicsof nasal S. aureus among newlyadmitted inpatients.In the present study, 66 S. aureus isolates, including 10 healthcare-associated MRSA (HA-MRSA), 8 CA-MRSA, and 48 methicillin-sensitive S. aureus (MSSA) strains, were found in the nasal cavities of 62 patients by screening 292 newlyadmitted patients. Antimicrobial resistance and molecular characteristics of these isolates, including spa-type, sequence type (ST) and SCCmec type, were investigated. All isolates were sensitive to linezolid, teicoplanin, and quinupristin/dalfopristin, but high levels of resistance to penicillin and erythromycin were detected. According to D-test and erm gene detection results, the cMLSB and iMLSB phenotypes were detected in 24 and 16 isolates, respectively. All 10 HA-MRSA strains displayed the cMLSB phenotypemediated by ermA or ermA/ermC, while the cMLSB CA-MRSA and MSSA strains carried the ermB gene. Molecular characterization revealedall 10 HA-MRSA strains were derived from the ST239-SCCmec III clone, and four out of eight CA-MRSA strains were t437-ST59-SCCmec V. The results suggest that patients play an indispensable role in transmitting epidemic CA-MRSA and HA-MRSA strains.
Anti-Bacterial Agents/*pharmacology ; Bacterial Proteins/genetics ; Drug Resistance, Multiple, Bacterial/genetics ; Humans ; Inpatients ; Methicillin-Resistant Staphylococcus aureus/*drug effects/genetics/isolation & purification ; Methyltransferases/genetics ; Microbial Sensitivity Tests ; Nasal Cavity/*microbiology ; Staphylococcal Infections/diagnosis/microbiology ; Staphylococcus aureus/*drug effects/genetics/isolation & purification

OBJECTIVETo investigate the SCCmec genotyping, subtype and antimicrobial susceptibility tests in methicillin resistant staphylococcus aureus to guide the clinical treatment and provide the proof for molecular epidemiology.

METHODSTo detect mecA gene and SCCmec genetyping and subtype in 50 MRSA by PCR. According to CLSI's guideline, antimicrobial susceptibility tests were performed with disk diffusion.

RESULTSAll 50 MRSA had mecA genes. 45 strains were SCCmec III types; 3 strains were SCCmec III A types; 2 strains were SCCmec II types. There were no SCCmec I and SCCmec IV types. SCCmec II, SCCmec III and SCCmec III A type strains were all multiresistant.

CONCLUSION50 MRSA are all multiresistant. SCCmec III are the main types.

Anti-Bacterial Agents ; pharmacology ; Bacterial Proteins ; genetics ; China ; epidemiology ; Drug Resistance, Multiple, Bacterial ; Genotype ; Humans ; Methicillin-Resistant Staphylococcus aureus ; classification ; drug effects ; genetics ; isolation & purification ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins ; Phylogeny ; Staphylococcal Infections ; epidemiology ; microbiology

The crude extracts of the fermentation broth from a marine sediment-derived actinomycete strain, Saccharothrix sp. 10-10, showed significant antibacterial activities against drug-resistant pathogens. A genome-mining PCR-based experiment targeting the genes encoding key enzymes involved in the biosynthesis of secondary metabolites indicated that the strain 10-10 showed the potential to produce tetracenomycin-like compounds. Further chemical investigation of the cultures of this strain led to the identification of two antibiotics, including a tetracenomycin (Tcm) analogs, Tcm X (1), and a tomaymycin derivative, oxotomaymycin (2). Their structures were identified by spectroscopic data analysis, including UV, 1D-NMR, 2D-NMR and MS spectra. Tcm X (1) showed moderate antibacterial activities against a number of drug-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) pathogens, with the MIC values in the range of 32-64 microg x mL(-1). In addition, 1 also displayed significant cytotoxic activities against human cancer cell lines, including HL60 (leukemia), HepG2 (liver), and MCF-7 (breast) with the IC 50 values of 5.1, 9.7 and 18.0 micromol x L(-1), respectively. Guided by the PCR-based gene sequence analysis, Tcm X (1) and oxotomaymycin (2) were identified from the genus of Saccharothrix and their 13C NMR data were correctly assigned on the basis of 2D NMR spectroscopic data analysis for the first time.
Actinomycetales ; chemistry ; genetics ; Anti-Bacterial Agents ; chemistry ; isolation & purification ; pharmacology ; Antineoplastic Agents ; chemistry ; isolation & purification ; pharmacology ; Benzodiazepinones ; chemistry ; isolation & purification ; pharmacology ; Cell Line, Tumor ; Data Mining ; methods ; Drug Resistance, Bacterial ; Enterococcus faecalis ; drug effects ; Fermentation ; Genomics ; Humans ; Inhibitory Concentration 50 ; Marine Biology ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Microbial Sensitivity Tests ; Molecular Structure ; Naphthacenes ; chemistry ; isolation & purification ; pharmacology ; Phylogeny ; Staphylococcus epidermidis ; drug effects