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      Prevalence of methicillin resistance and macrolide–lincosamide–streptogramin B resistance in Staphylococcus haemolyticus among clinical strains at a tertiary-care hospital in Thailand

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          Abstract

          Staphylococcus spp. is a major cause of nosocomial infection and sepsis. However, increasing drug resistance is becoming a challenge to microbiologists. The purpose of this study was to identify and determine antimicrobial resistance phenotypes and drug resistance genes of clinical coagulase-negative staphylococci (CoNS) isolates at Mae Sot Hospital in Tak province, Thailand. A total of 229 CoNS isolates were collected from clinical specimens during two periods in 2014 and in 2015. Staphylococcus haemolyticus was the most prevalent species (37.55%), followed by S. epidermidis (21.83%), S. saprophyticus (11.79%) and S. hominis (11.35%) respectively. The remaining 17.48% of the organisms comprised S. capitis, S. arlettae, S. cohnii, S. equorum, S. xylosus, S. warneri, S. sciuri, S. pettenkoferi, S. kloosii and S. lugdunensis. Methicillin-resistant CoNS (MRCoNS), containing the mecA gene, were detected in 145 of 229 isolates, mostly found in S. haemolyticus and S. epidermidis. In addition, the differentiation of their macrolide–lincosamide–streptogramin B (MLS B) resistance phenotypes was determined by the D-test and corresponding resistance genes. Among 125 erythromycin-resistant CoNS, the prevalence of constitutive type of MLS B, inducible clindamycin resistance and macrolide–streptogramin B resistance phenotypes were 72, 13.60 and 14.40% respectively. These phenotypes were expressed in 80% of MRCoNS strains. In addition, the ermC gene (79.20%) was found to be more prevalent than the ermA gene (22.40%), especially among MRCoNS. These results indicate that CoNS may play an important role in spreading of drug resistance genes. More attention to these organisms in surveillance and monitoring programs is needed.

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          Pathogenesis of infections due to coagulase-negative staphylococci.

          Christof von Eiff, Georg Peters, Christine Heilmann (2002)
          As a group, the coagulase-negative staphylococci (CoNS) are among the most frequently isolated bacteria in the clinical microbiology laboratory and are becoming increasingly important, especially as causes of hospital-acquired infections. These bacteria are normal inhabitants of human skin and mucous membranes and, therefore, one of the major challenges of daily diagnostic work is to distinguish clinically significant CoNS from contaminant strains. This overview addresses current knowledge of the pathogenesis of infections due to CoNS and particularly focuses on virulence factors of the species Staphylococcus epidermidis. S epidermidis has been identified as a major cause of nosocomial infections, especially in patients with predisposing factors such as indwelling or implanted foreign polymer bodies. Most important in the pathogenesis of foreign-body-associated infections is the ability of these bacteria to colonise the polymer surface by the formation of a thick, multilayered biofilm. Biofilm formation takes place in two phases. The first phase involves the attachment of the bacteria to polymer surfaces that may be either unmodified or coated with host extracellular matrix proteins. In the second phase, the bacteria proliferate and accumulate into multilayered cell clusters that are embedded in an extracellular material. The bacterial factors involved in both phases of biofilm formation are discussed in this review. In addition, the most important aspects of the pathogenic potential of S saprophyticus, S lugdunensis, and S schleiferi are described, although, compared with S epidermidis, much less is known in these species concerning their virulence factors.
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            Multiplex PCR assay for simultaneous detection of nine clinically relevant antibiotic resistance genes in Staphylococcus aureus.

            Christiane Kettlitz, Wolfgang Witte, Guido Werner … (2003)
            In this study we describe a multiplex PCR assay for the detection of nine clinically relevant antibiotic resistance genes of Staphylococcus aureus. Conditions were optimized to amplify fragments of mecA (encoding methicillin resistance), aacA-aphD (aminoglycoside resistance), tetK, tetM (tetracycline resistance), erm(A), erm(C) (macrolide-lincosamide-streptogramin B resistance), vat(A), vat(B), and vat(C) (streptogramin A resistance) simultaneously in one PCR amplification. An additional primer pair for the amplification of a fragment of the staphylococcal 16S rDNA was included as a positive control. The multiplex PCR assay was evaluated on 30 different S. aureus isolates, and the PCR results correlated with the phenotypic antibiotic resistance data obtained by the broth microdilution assay. The multiplex PCR assay offers a rapid, simple, and accurate identification of antibiotic resistance profiles and could be used in clinical diagnosis as well as for the surveillance of the spread of antibiotic resistance determinants in epidemiological studies.
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              Whole-genome sequencing of staphylococcus haemolyticus uncovers the extreme plasticity of its genome and the evolution of human-colonizing staphylococcal species.

              Fumihiko Takeuchi, Shinya Watanabe, Tadashi Baba … (2005)
              Staphylococcus haemolyticus is an opportunistic bacterial pathogen that colonizes human skin and is remarkable for its highly antibiotic-resistant phenotype. We determined the complete genome sequence of S.haemolyticus to better understand its pathogenicity and evolutionary relatedness to the other staphylococcal species. A large proportion of the open reading frames in the genomes of S.haemolyticus, Staphylococcus aureus, and Staphylococcus epidermidis were conserved in their sequence and order on the chromosome. We identified a region of the bacterial chromosome just downstream of the origin of replication that showed little homology among the species but was conserved among strains within a species. This novel region, designated the "oriC environ," likely contributes to the evolution and differentiation of the staphylococcal species, since it was enriched for species-specific nonessential genes that contribute to the biological features of each staphylococcal species. A comparative analysis of the genomes of S.haemolyticus, S.aureus, and S.epidermidis elucidated differences in their biological and genetic characteristics and pathogenic potentials. We identified as many as 82 insertion sequences in the S.haemolyticus chromosome that probably mediated frequent genomic rearrangements, resulting in phenotypic diversification of the strain. Such rearrangements could have brought genomic plasticity to this species and contributed to its acquisition of antibiotic resistance.
              Article 0 comments Cited 94 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                S. Teeraputon
                Journal
                Journal ID (nlm-ta): New Microbes New Infect
                Journal ID (iso-abbrev): New Microbes New Infect
                Title: New Microbes and New Infections
                Publisher: Elsevier
                ISSN (Electronic): 2052-2975
                Publication date PMC-release: 24 May 2017
                Publication date Collection: September 2017
                Publication date (Electronic): 24 May 2017
                Volume: 19
                Pages: 28-33
                Affiliations
                [1) ]Department of Medical Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
                [2) ]Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
                [3) ]Medical Technology Group, Maesot Hospital, Tak, Thailand
                Author notes
                [∗ ] Corresponding author: S. Teeraputon, Department of Medical Technology, Allied Health Sciences Faculty, Naresuan University, Phitsanulok, ThailandDepartment of Medical TechnologyAllied Health Sciences FacultyNaresuan UniversityPhitsanulokThailand sirilakt@ 123456nu.ac.th
                Article
                Publisher ID: S2052-2975(17)30043-4
                DOI: 10.1016/j.nmni.2017.05.007
                PMC ID: 5484985
                PubMed ID: 28702199
                SO-VID: 16c8c970-0c97-4217-a130-4c1e80cf9fc7
                Copyright © © 2017 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 30 December 2016
                Date revision received : 9 May 2017
                Date accepted : 15 May 2017
                Categories
                Subject: Original Article

                Keywords: coagulase-negative staphylococci (cons),macrolide–lincosamide–streptogramin b (mlsb) resistance,methicillin-resistant coagulase-negative staphylococci (mrcons),staphylococcus haemolyticus
                Data availability:
                Keywords: coagulase-negative staphylococci (cons), macrolide–lincosamide–streptogramin b (mlsb) resistance, methicillin-resistant coagulase-negative staphylococci (mrcons), staphylococcus haemolyticus

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