• Title/Summary/Keyword: Methicillin resistant Staphylococcal aureus

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Aggravation and Relief after Surgical Resection of Post Infectious Pneumatocele in Very Low Birth Weight Infant

  • Min, Dong-Eun;Choi, Yong-Sung;Kim, Soo-Cheol
    • Perinatology
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    • v.29 no.4
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    • pp.175-179
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    • 2018
  • Pneumatocele (PC) is a thin-walled cyst of the lung that can occur at all ages and with various etiologies. However, there is no fully accepted consensus for the management of PC in a neonatal intensive care unit. Although the management of PC is generally expectant, it is difficult to decide how long conservative management should be maintained, especially under Korea's medical care environment and the parents' worry and anxiety. We report a male neonate, born at $27^{+5}weeks$ gestation, weighing 1,000 g, who had a post infectious PC caused by methicillin-resistant Staphylococcus aureus sepsis. We treated conservatively for about 100 days (roughly 14 weeks), but unfortunately after a few days of chest retraction, acute exacerbation occurred, video assisted thoracoscopic surgery (VATS) was deemed necessary and performed. The purpose of this publication is to describe the clinical course, aggravation and relief after VATS management with a review of the literature.

A comparison of RPLA and PCR for detection of enterotoxins in methicillin-resistant Staphylococcus aureus(MRSA) strains isolated in dogs

  • Park, Son-il;Han, Hong-ryul
    • Korean Journal of Veterinary Research
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    • v.39 no.4
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    • pp.806-810
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    • 1999
  • A multiplex-polymerase chain reaction (PCR) assay was used to detect staphylococcal enterotoxin production by 12 strains of Staphylococcus aureus isolated from clinical specimens. To evaluate the efficacy and/or sensitivity of this method, the results were compared to those obtained with the reversed passive latex agglutination kit (SET-RPLA, Denka Seiken, Japan). Of 10 strains positive by PCR were positive by RPLA but two strains, representing high sensitivity of the former method. Enterotoxin B was the most prevalent by the two methods. The kappa index between the two methods was 0.826, indicating a higher agreement and fully reliable for use. These results would suggest that sensitive, inexpensive, and relatively rapid multiplex-PCR technique may be an effective means for the detection of staphylococcal enterotoxin genes as an alternative to traditional methods such as kits or immunological methods, which depend upon the amount of enterotoxin produced.

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First Report on Multidrug-Resistant Methicillin-Resistant Staphylococcus aureus Isolates in Children Admitted to Tertiary Hospitals in Vietnam

  • Son, Nguyen Thai;Huong, Vu Thi Thu;Lien, Vu Thi Kim;Nga, Do Thi Quynh;Au, Tran Thi Hai;Nga, Tang Thi;Hoa, Le Nguyen Minh;Binh, Tran Quang
    • Journal of Microbiology and Biotechnology
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    • v.29 no.9
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    • pp.1460-1469
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    • 2019
  • The extensive distribution of multidrug-resistant (MDR) methicillin-resistant Staphylococcus aureus (MRSA) poses a threat to healthcare worldwide. This study aimed to investigate the MDR and molecular patterns of MRSA isolates in children admitted to the two biggest tertiary care pediatric hospitals in northern and southern Vietnam. A total of 168 MRSA strains were collected to determine antibiotic susceptibility by minimum inhibitory concentration tests. Antibiotic-resistant genes, pulsed-field gel electrophoresis, staphylococcal cassette chromosome mec (SCCmec) typing, and multilocus sequence typing were used for the molecular characterization of MRSA. Among the total strains, the MDR rate (51.8%) was significantly higher in the northern hospital than in the southern hospital (73% vs. 39%, p < 0.0001). The MDR-MRSA with the highest rates were "ciprofloxacin-erythromycin-gentamicintetracyclines" (35.6%), followed by "erythromycin-tetracycline-chloramphenicol" (24.1%), and "ciprofloxacin-erythromycin-gentamicin" (19.5%), showing an accumulative total of 79.3%. The most susceptible antibiotics were rifampicin (100%) and vancomycin (100%), followed by doxycycline (94.0%), meropenem (78.0%), and cefotaxime (75.0%). The SCCmecII strains showed greater resistance to gentamicin, ciprofloxacin, tetracycline, meropenem and cephalosporins compared with the other strains. The SCCmecII strains exhibited the highest rate in the tested genes (aacA/aphD: 55.2%, ermA/B/C: 89.7%, and tetK/M: 82.8%). ST5-SCCmecII was the predominant clone in the northern hospital, whereas SCCmecIVa was more pronounced in the southern hospital. In conclusion, our results raised concerns about the predominant MDR-MRSA strains in the pediatric hospitals in Vietnam. The north-south difference in the antibiotic resistance patterns and genetic structure of MRSA suggests different MRSA origins and various uses of antimicrobial agents between the two regions.

Staphylococcal Scalded Skin Syndrome in Children : Comparison of the Clinical Features of That Isolated Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (포도상 구균성 열상 피부 증후군의 임상적 고찰 : Methicillin 내성과 감수성 Staphylococcus aureus 예의 비교)

  • Lee, Seong Hun;Choi, Wu Kyung;Jung, Chang Hyn;Chung, Cheol Ju;Lee, Dong Jean
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.183-191
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    • 2004
  • Purpose : The purpose of this study was to compare the clinical features of staphylococcal scalded skin syndrome(SSSS) isolated methicillin-resistant Staphylococcal aureus(MRSA) with those of SSSS isolated methicillin-sensitive Staphylococcal aureus(MSSA) in children. Methods : We retrospectively reviewed the medical records and microbiological results of 36 cases of SSSS who were admitted to the Pediatric Department of Ulsan Dong-Kang General Hospital from Jan. 1999 to Dec. 2003. Results : Among 36 cases, there were 7 generalized types, 1 abortive type in MRSA group and 5 generalized types, 6 abortive types in MSSA group. The peak incidence of age was between 2 and 5 years in both groups. SSSS were diagnosed with increasing frequency. Most of MRSA group were diagnosed in 2003(6/8). The peak seasonal incidence was fall and winter in both groups. Facial lesion was observed in all cases followed by flexural lesion in both groups. Staphylococci were isolated from the skin and throat most frequently in both groups. Upper respiratory illness and conjunctivitis were most common preceding infections in both groups. Among 8 cases of MRSA group, 4 cases were treated completely with ampicillin-sulbactam. There was no significant difference of mean duration of admission between MRSA group and MSSA group. Conclusion : There was no significant difference of clinical features between MRSA group and MSSA group although generalized types of SSSS were more common in MRSA group than in MSSA group.

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Profiles of coagulase-positive and -negative staphylococci in retail pork: prevalence, antimicrobial resistance, enterotoxigenicity, and virulence factors

  • Lee, Gi Yong;Yang, Soo-Jin
    • Animal Bioscience
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    • v.34 no.4
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    • pp.734-742
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    • 2021
  • Objective: The present study aimed to investigate the occurrence and species of coagulase-positive staphylococci (CoPS) and coagulase-negative staphylococci (CoNS) in retail pork meat samples collected during nationwide monitoring. The staphylococcal isolates were characterized for antimicrobial and zinc chloride resistance and enterotoxigenic potential. Methods: A total of 260 pre-packaged pork meat samples were collected from 35 retail markets in 8 provinces in Korea for isolation of staphylococci. Antimicrobial and zinc chloride resistance phenotypes, and genes associated with the resistance phenotypes were determined on the isolates. Furthermore, the presence and distribution of 19 staphylococcal enterotoxin (SE) genes and enterotoxin-like genes among the pork-associated staphylococci were determined by multiplex polymerase chain reaction-based assays using the specific primer sets. Results: A total of 29 staphylococcal strains (29/260, 11.1%) were isolated from samples of retail pork meat, 24 (83%) of which were CoNS. The four CoNS species identified were S. saprophyticus (n = 16, 55%), S. sciuri (n = 3, 10%), S. warneri (n = 3, 10%), and S. epidermidis (n = 2, 7%). Among the 29 isolates, four methicillin-resistant CoNS (MR-CoNS; three S. sciuri and one S. epidermidis) and one methicillin-resistant CoPS (MR-CoPS; one S. aureus) were identified. In addition, a relatively high level of tetracycline (TET) resistance (52%) was confirmed in CoNS, along with a predominant distribution of tet(K). The most prevalent SEs were sep (45%), and sen (28%), which were carried by 81% of S. saprophyticus. Conclusion: These findings suggest that CoNS, especially S. saprophyticus strains, in raw pork meat could be a potential risk factor for staphylococcal food poisoning (SFP), and therefore, requires further investigation to elucidate the role of SEls in SFP and virulence of the pathogen. Our results also suggest that CoNS from raw pork meat may act as a source for transmission of antimicrobial resistance genes such as staphylococcal cassette chromosome mec and tet(K).

An Easy Method of Disk Diffusion Antibiotic Susceptibility Test for Detection of Erythromycin-induced Resistance to Clindamycin in Staphylococci (포도구균의 Erythromycin 유도성 Clindamycin 내성검출을 위한 간편한 디스크 확산법의 유용성)

  • Joo, Sae-Ick;Lee, Hyun;Lim, Kyu-Sang;Kim, Eui-Chong
    • Korean Journal of Clinical Laboratory Science
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    • v.38 no.1
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    • pp.38-44
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    • 2006
  • A simple and easy modification of AST by disk diffusion was tested for the detection of induced clindamycin resistant Staphylococci and their antimicrobial susceptibility at the same time. The incidence of inducible clindamycin resistant staphylococci in blood culture and their MIC characterization at Seoul National University Hospital was analyzed by an AST contained disk approximation test (D-zone test) and Etest, respectively. Of the total 309 staphylococcal isolates, 139 (45%) isolates presented constitutive resistance to ERY and CLI (ERY-R, CLI-R phenotype), and 59 were ERY-I/R and CLI-S phenotypes. Of the 59 isolates, 19 (32%) isolates were inducible resistant to CLI. The incidence was higher in S. aureus (66.7%) than coagulase-negative staphylococci (CNS, 26.0%). Especially, methicillin-resistant staphylococci (MRSA, 100%; MRCNS, 45.5%) presented higher inducibility than methicillin susceptible (MSSA, 50%; MSCNS, 20%). For most of the inducible clindamycin resistant staphylococci (15 of 19 isolates), their ERY MIC were high (>$128_{\mu}g/mL$) and were methicillin resistant. The remaining 4 isolates were methicillin susceptible and their ERY MIC were of intermediate concentrations ($1-4_{\mu}g/mL$). We concluded that suscetibility testing of staphylococci, especially methicillin resistant, should include the D-zone test.

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Transmission Aspect of Methicillin-resistant Staphylococcus aureus in the Neurosurgical Intensive Care Unit by Analysing Genotype (유전자형 분석에 의한 신경외과 중환자실의 메티실린 내성 황색포도알균의 전파양상)

  • Kim, Yun-Kyung;Hong, Hae-Sook
    • Journal of Korean Academy of Nursing
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    • v.37 no.6
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    • pp.976-985
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    • 2007
  • Purpose: The aim of this study was to identify the present situation of hospital infection and route of infection by clarifying the transmission aspect of methicillin-resistant Staphylococcus aureus(MRSA) in a Neurosurgical Intensive Care Unit by analysing genotype. Methods: MRSA was cultured from twenty five patients with a tracheostomy, twenty five health care workers, and environments in the Neurosurgical Intensive Care Unit of one hospital in D city. Data was collected from December 21, 2004 to November 5, 2005. MRSA isolates representing each genotype were analyzed by spaA typing and a multiplex PCR method capable of identifying the structural type of the staphylococcal cassette chromosome mec(SCCmec) carried by the bacteria. Results: As the same genotype and gene sequence were found among health care workers, patients, and environments, it was assumed that there was cross transmission among them. Conclusion: This study suggests that first, as the hospital infection by MRSA between health care workers and patients in the Neurosurgical Intensive Care Unit was due to result of cross transmission and the relevance of transmission between them was verified, it is necessary to take preventive measures and conduct education. Secondly, development of nursing interventions and study of infection are needed. Thirdly, consistent investment in prevention against hospital infections and environmental renovation is needed.

Genetic characterization of methicillin-resistant Staphylococcus aureus from humans and animals within the community (지역사회 내 일반인 및 동물에서 methicillin 내성 Staphylococcus aureus의 유전학적 특성)

  • Cho, Jae-Keun;Kim, Jin-Hyun;Sung, Myung-Suk;Kim, Ki-Seuk
    • Korean Journal of Veterinary Research
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    • v.51 no.4
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    • pp.267-275
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    • 2011
  • Methicillin-resistant Staphylococcus (S.) aureus (MRSA) is one of the most important nosocomial pathogens worldwide and the emergence of this strain has become a major clinical problem. In this study, we investigated the prevalence of MRSA and their genetic characteristics in 69 S. aureus isolated from humans and animals. In human isolates, higher antimicrobial resistance rates were observed against penicillin (80.6%), followed by erythromycin (11.9%) and tetracycline (9.0%). All of them were susceptible to clindamycin, enrofloxacin, novobiocin, pirlimycin, trimethoprim/sulfamethoxazole and vancomycin. The resistance patterns in animal isolates were similar to those of human isolates. Two (2.9%) MRSA strains were isolated from human (n = 1) and animal (n = 1), and these isolates were confirmed as carrying the mecA gene. One isolate originating from human was resistant to 7 drugs and the other isolate derived from animal was resistant to 11 drugs. Staphylococcal cassette chromosome mec (SCCmec) variant IIIB was identified in animal isolate but SCCmec type of an isolate from human was not exactly determined. Two MRSA isolates showed unrelated PFGE pattern between them. Our results indicated although the frequency of MRSA isolates from humans and animals was low, a continuous surveillance and monitoring should be called for to prevent the contamination and spread of MRSA in the community. To our knowledge, this is the first time that SCCmec type variant IIIB was detected from animals in Korea.

Staphylococcal Scalded Skin Syndrome in a Healthy Adult: Easy to Misdiagnose (건강한 성인에서의 오진하기 쉬운 포도구균성 열상 피부증후군의 치험례)

  • Kim, Hong Il;Kwak, Chan Yee;Park, Eon Ju
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.271-276
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    • 2018
  • A 60-year-old male presented with a three-month history of redness and swelling on his left little finger. His medical history was not informative. Wound culture revealed methicillin-resistant Staphylococcus aureus. After vancomycin administration, the skin lesions became worse and whole body bullae and desquamation occurred. This was initially suspected to be a drug eruption; thus, we switched antibiotics from vancomycin to teicoplanin. However, biopsy revealed Staphylococcal scalded skin syndrome (SSSS). After several days, generalized skin symptoms improved. The patient recovered and is in good physical health without recurrence six months later. We describe a localized form of SSSS, which is very rare in healthy adults. Consequently, there is a high risk of misdiagnosis. Thus, we report a rare case of SSSS in a healthy adult and the importance of early histological examination for accurate diagnosis.

Studies on Chronic Mastitis of Dairy Cattle in Kyungnam Province (경남지방(慶南地方)에서 발생(發生)한 젖소의 만성(慢性) 유방염(乳房炎)에 대한 연구(硏究))

  • Kim, Bong-Hwan;Kim, Jin-Koo;Choe, Sang-Yong
    • Korean Journal of Veterinary Research
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    • v.23 no.2
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    • pp.205-209
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    • 1983
  • Some investigations on chronic mastitis in dairy cattle in Kyungnam Province during the year 1982 were conducted with the special reference to the causative agents and their drug resistance. Milk samples from 46 isolated cases of chronic mastitis cattle were investigated bacteriologically and the organisms recovered were examined for their drug susceptibility against the major antibiotics used in this country by the use of disk diffusion susceptibility test. Four major causative agents involved in chronic mastitis were in order of prevalence Staphylococcus aureus (32.6%), Escherichia coli (28.3%), Streptococcus agalactiae (8.7%) and Candida albicans (8.7%). Staph. epidermidis, Streptococcus uberis, Klebsiella pneumoniae and Candida subtropicalis were found to be one of the minor agents. The majority of staphylococcal isolates were highly resistant to the most of antibiotics employed while 8% of them were resistant to gentamicin and 32% to chloramphenicol. The percentages of staphylococcal cultures resistant to penicillin, lincomycin. streptomycin, methicillin, oleandomycin, tetracycline, cephalothin, ampicillin and erythromycin were 100%, 96%, 96%, 92%, 84%, 84%, 80%, 76%, and 64% respectively. Streptococcal isolates were also highly resistant to the majority of the drugs used although 85.7% of them were susceptible to gentamicin. All Escherichia coli isolates were found to be resistant to erythromycin, lincomycin and penicillin while the majority of them were resistant to ampicillin (92.9%), carbenicillin (85.7%), oleandomycin (85.7%), streptomycin(85.7%), kanamycin (78.6%), methicillin (78.6%) and tetracycline (71.4%). The percentages of E. coli cultures resistant to gentamicin, nitrofurantoin, cephalothin and chloramphenicol were 21.4%, 21.4%, 35.7% and 50.0% respectively.

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