Impact and control of methicillin-resistant Staphylococcus aureus (MRSA) in long-term care facilities

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are a growing concern in long-term care facilities (LTCF). Epidemiologic studies performed in our area have shown high rates of MRSA colonization in elderly residents, and very high rates in some centres. However, the clinical impact of nasal MRSA colonization is often slight. Prevention of MRSA transmission in LTCF includes the application of simple preventive measures with proven effectiveness, such as hand washing, adequately covering of infected wounds, and proper use of antibiotics, without limiting the activities of colonized residents or carrying out active surveillance.     

Novel inhibitors of the methicillin-resistant Staphylococcus aureus (MRSA)-pyruvate kinase

Novel bisindolyl-cycloalkane indoles resulted from the reaction of aliphatic dialdehydes and indole. As bisindolyl-natural alkaloid compounds have recently been reported as inhibitors of the methicillin-resistant Staphylococcus aureus (MRSA)-pyruvate kinase (PK), we tested our novel compounds as MRSA PK inhibitors and now report first inhibiting activities. We discuss structure–activity relationships of structurally varied compounds. Activity influencing substituents have been characterized and relations to antibacterial activities of the most active compounds have been proved.     

Antibacterial activity of aminoderivatized chitosans against methicillin-resistant Staphylococcus aureus (MRSA)

This work describes the anti-MRSA activity of aminoderivatized chitosans. Two kinds of aminoethyl-chitosans (AEC), AEC90 and AEC50, having degrees of deacetylation of 90% and 50%, respectively, exhibited the strongest anti-MRSA activities by presenting MICs of 16–64 μg/mL against two standard strains and twelve clinical isolates. The bactericidal activity, thermal and pH stability, and cell membrane integrity effects of AEC90 and AEC50 are also discussed.     

Antibacterial potential of Malaysian ethnomedicinal plants against methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA)

This study aimed to evaluate the antibacterial activities of 61 plant extracts from 49 Malaysian ethnomedicinal plants and to investigate the interaction of the active plant extracts in combination with synthetic antibiotics against the MSSA and MRSA strains. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the plant extracts were determined using a microdilution method against MSSA and MRSA strains. The interaction between active plant extracts and the antibiotics was assessed using the checkerboard method. The total fractional inhibitory concentration (∑FIC) indices from the combination were calculated to determine the nature of the interaction. Out of the 61 plant extracts tested against the MSSA strain, 7 plant extracts (̴ 11%) showed MIC values of less than 200 μg/mL, 17 extracts (̴ 28%) showed MIC between 200 and 800 µg/mL and seed extracts of Areca catechu showed MBC values of 400 μg/mL. The seed extract of A. catechu showed MIC and MBC of 400 μg/mL against the MRSA strains while leaf extract of Cocos nucifera showed MIC of 400 μg/mL against MRSA NCTC 12493. When the active plant extracts (MIC ≤ 200 µg/mL for MSSA, and ≤ 400 µg/mL for MRSA) were tested in combination with vancomycin and ciprofloxacin, they showed no interaction against both MSSA and MRSA with ∑FIC between 1.06 and 2.03. These findings provide a preliminary overview of the anti-MSSA and anti-MRSA properties of Malaysian ethnobotanical plants to combat Staphylococcal infections. Further research is needed to establish an antibacterial profile of the tested plant extracts.     

百里香酚联合苯唑西林对耐甲氧西林金黄色葡萄球菌(MRSA)生物被膜的影响

【背景】耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)能以生物被膜的状态存在,从而产生多重耐药性和持续性感染。【目的】通过研究百里香酚和苯唑西林单用和联用对耐甲氧西林金黄色葡萄球菌生物被膜的形成抑制和清除作用,探究联合用药对MRSA生物被膜的影响,为临床联合应用抗MRSA药物提供理论依据。【方法】采用微量肉汤稀释法测定苯唑西林对MRSA标准菌株USA300的最低抑菌浓度;采用结晶紫染色法和菌落计数法评估百里香酚和苯唑西林单用和联用对USA300生物被膜形成抑制和清除作用。【结果】百里香酚和苯唑西林在亚抑菌浓度下对USA300生物被膜的形成具有一定的抑制作用。在较高浓度下,百里香酚对其24 h和72 h形成的生物被膜有良好的清除作用,而苯唑西林无清除作用。两药联用对生物被膜的抑制和清除作用进一步增强,在较低浓度下有较好的抑制和清除效果。【结论】百里香酚和苯唑西林联合用药与单独用药相比,对USA300的生物被膜的抑制和清除作用增强,两药联合有协同抗菌作用。     

High-throughput identification of antibacterials against methicillin-resistant Staphylococcus aureus (MRSA) and the transglycosylase

To identify new transglycosylase inhibitors with potent anti-methicillin-resistant Staphylococcus aureus (MRSA) activities, a high-throughput screening against Staphylococcus aureus was conducted to look for antibacterial cores in our 2M compound library that consists of natural products, proprietary collection, and synthetic molecules. About 3600 hits were identified from the primary screening and the subsequent confirmation resulted in a total of 252 compounds in 84 clusters which showed anti-MRSA activities with MIC values as low as 0.1 μg/ml. Subsequent screening targeting bacterial transglycosylase identified a salicylanilide-based core that inhibited the lipid II polymerization and the moenomycin-binding activities of transglycosylase. Among the collected analogues, potent inhibitors with the IC(50) values below 10 μM against transglycosylase were identified. The non-carbonhydrate scaffold reported in this study suggests a new direction for development of bacterial transglycosylase inhibitors.     

A computational model of antibiotic-resistance mechanisms in methicillin-resistant Staphylococcus aureus (MRSA)

An agent-based model of bacteria-antibiotic interactions has been developed that incorporates the antibiotic-resistance mechanisms of Methicillin-Resistant Staphylococcus aureus (MRSA). The model, called the Micro-Gen Bacterial Simulator, uses information about the cell biology of bacteria to produce global information about population growth in different environmental conditions. It facilitates a detailed systems-level investigation of the dynamics involved in bacteria-antibiotic interactions and a means to relate this information to traditional high-level properties such as the Minimum Inhibitory Concentration (MIC) of an antibiotic. The two main resistance strategies against β-lactam antibiotics employed by MRSA were incorporated into the model: β-lactamase enzymes, which hydrolytically cleave antibiotic molecules, and penicillin-binding proteins (PBP2a) with reduced binding affinities for antibiotics. Initial tests with three common antibiotics (penicillin, ampicillin and cephalothin) indicate that the model can be used to generate quantitatively accurate predictions of MICs for antibiotics against different strains of MRSA from basic cellular and biochemical information. Furthermore, by varying key parameters in the model, the relative impact of different kinetic parameters associated with the two resistance mechanisms to β-lactam antibiotics on cell survival in the presence of antibiotics was investigated.     

Two-dimensional analysis of exoproteins of methicillin-resistant Staphylococcus aureus (MRSA) for possible epidemiological applications

We applied two-dimensional gel electrophoresis (2-DE) to the total exoproteins secreted from pathogenic MRSA strains and identified major protein spots by N-terminal amino acid sequence analysis. In approximately 300 to 500 spots visualized on each gel, various exoproteins and cell-associated proteins were identified and their sites on the gels confirmed for construction of a reference map. Major exotoxins such as enterotoxins SEA, SEB, and SEC,, toxic shock syndrome toxin-1 (TSST-1), and hemolysins were distributed in the region of pI 6.8 to 8.1 and MW 21 to 35 kDa. Although the differences between calculated and observed values of pI and MW were relatively small in each exoprotein, those of several proteins including alpha-hemolysin and SEB were considerably deviated from the positions of the expected values. Some exoproteins were detected as multiple spots. These included beta-hemolysin, enterotoxins SEA, SEB, and SEC3, glutamic acid-specific endopeptidase, glycerophosphoryl diester phosphodiesterase and triacylglycerol lipase. The multiple spots of these exoproteins may be generated by the action of own proteases. Certain similarities of 2-DE patterns among strains belonging to the same coagulase types were observed. On the basis of 2-DE image analysis, coagulase type II strains secreted somewhat larger amounts of SEB and SEC3 as well as TSST-1 than the strains belonging to other coagulase types. Taken together, 2-DE analysis of exoproteins is applicable to epidemiological studies for MRSA, as compared with pulsed field gel electrophoresis of restricted chromosomal DNA.     

鹰嘴豆芽素A对耐甲氧西林金黄色葡萄球菌外排系统的抑制作用

【目的】MRSA外排系统是其对多种药物耐药性的主要原因,为此研究鹰嘴豆芽素A对MRSA外排系统的抑制作用。【方法】以MRSA41577为供试菌株,通过二倍稀释法、双平板法和荧光分光光度法测定鹰嘴豆芽素A对MRSA41577的抑制作用及其对外排系统的影响;通过RT-PCR检测加药前后MRSA41577外排蛋白norA的表达量;SDS-PAGE检测加药前后与MRSA41577外排相关蛋白的变化,并用液相色谱质谱仪进行鉴定确认。【结果】鹰嘴豆芽素A本身无抑菌活性,但鹰嘴豆芽素A和环丙沙星联合作用后,MRSA41577对环丙沙星的敏感性显著提高,其中40μg/mL的鹰嘴豆芽素A能使环丙沙星对MRSA41577的MIC从64μg/mL降低到8μg/mL,且作用强度与药物浓度呈正相关。经鹰嘴豆芽素A处理MRSA41577后,菌体内环丙沙星的蓄积量随着药物处理时间的增加而增加,在处理15min时与对照组相比,菌体内环丙沙星蓄积量增加了83%(P﹤0.01),与阳性对照利血平的作用效果相当。鹰嘴豆芽素A能降低MRSA41577的norA表达量,与对照组相比,鹰嘴豆芽素A和环丙沙星作用MRSA41577 16h后,norA的相对表达量降低了65%,其抑制效果优于阳性对照利血平的48%。SDS-PAGE电泳结果显示,鹰嘴豆芽素A作用MRSA4157716h后,与对照组相比菌体的蛋白谱带发生了明显的变化,其中与外排系统相关的蛋白除norA蛋白明显减少外,ABC转运体ATP结合蛋白也明显减少。【结论】鹰嘴豆芽素A是MRSA41577的外排泵抑制剂,其作用机制是通过降低MRSA41577菌体内norA基因的表达量,进而减少norA蛋白的表达量,来抑制MRSA41577对环丙沙星等药物的排出而恢复其对药物的敏感性。     

Synergistic effects between aminoethyl-chitosans and β-lactams against methicillin-resistant Staphylococcus aureus (MRSA)

Two kinds of aminoethyl-chitosans (AEC), AEC90 and AEC50, which had degrees of deacetylation of 90% and 50%, respectively, were prepared and their synergistic effects in combination with β-lactams including ampicillin, penicillin, and oxacillin against two standard methicillin-resistant Staphylococcus aureus (MRSA) strains and twelve clinical isolated MRSA strains were investigated. When AECs and β-lactams were combined, synergistic effects were observed with fractional inhibitory concentration (FIC) indices of 0.252–0.508, and the MICs of β-lactams in the presence of AECs were dramatically reduced.     

Changes of methicillin-resistant Staphylococcus aureus (MRSA) phagotypes in Gdansk in 1990-1998

The aim of the study was the assessment of changes in the occurrence of various MRSA phagotypes in hospitals in the Gdańsk area in 1990-1998. The study was carried out on 175 MRSA strains: 45 strains isolated in 1990-1995 and 130 in 1997-1998. The studied staphylococci were obtained from various clinical materials from patients in 18 hospitals. Phagotyping was done with a set of 10 experimental phages from MRSA strains obtained from the Central Public Health Laboratory in London. Drug-resistance was determined by the disc-diffusion method and in case of strains with medium susceptibility to fusidic acid the minimal inhibitory concentration (MIC) was determined by serial dilutions on solid medium. The study showed among MRSA strains isolated in 1997-1998 a new, previously not known strains with phage pattern MR25/M5 predominated (57.7%). Its presence was found in various hospitals in that area. MRSA belonging to MR25/M5 phagotype were mostly resistant to doxycycline, gentamycin, erythromycin, clindamycin, ciprofloxacin, rifampicin and were resistant or only had medium susceptibility to fusidic acid. The MIC values for strains with medium susceptibility to fusidic acid (4-8 micrograms/ml) showed an evident decrease of the susceptibility to this antibiotic, formerly common in MRSA. At the same time, in 1997-1998 a considerable decrease was observed of the number of MRSA strains belonging to MR8/MR12/MR25/30/33/38/M5/622 phagotype (from 31.1% to 0.8%), and disappearance of strains with phagotypes MR25/56B/M3 and MR8/MR25/622, which in 1990-1995 accounted for 15.6% of the studied staphylococci.     

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in Poland: further evidence for the changing epidemiology of MRSA

This study reports the isolation of CA-MRSA strain which was found to colonize the nasal mucosa of a patient undergoing haemodialysis treatment. The MRSA was subjected to molecular analysis by Pulsed Field Gel Electrophoresis (PFGE), multiplex PCR assay for staphylococcal cassette chromosome mec (SCCmec) typing, and PCR detection of the pvl gene encoding for Panton-Valentine leukocidin. The analyzed MRSA harbored the SCCmec type IV and the pvl gene-two unique genetic markers of CA-MRSA. The PFGE pattern of the strain corresponded to the common European CA-MRSA (MLST Type ST80). Moreover, the strain was only resistant to beta-lactam agents and tetracycline. This study adds further evidence for the changing epidemiology of MRSA and indicates the ability of CA-MRSA to affect persons with established risk factors in addition to previously healthy individuals.     

Affinity apheresis for treatment of bacteremia caused by Staphylococcus aureus and/or methicillin-resistant S. aureus (MRSA)

Staphylococcus aureus (SA) bacteremia is associated with high mortality, and often results in metastatic infections. The methicillin-resistant SA (MRSA) is an urgent health care issue, as nosocomial infections with these bacteria represent limited treatment alternatives. Samples of whole blood containing challenge inoculums of SA and MRSA strains were passed through columns packed with surface-heparinized polyethylene beads. The bound bacteria were eluted and quantitatively determined by culturing and by real-time PCR. Significant amounts of both SA and MRSA adhered to the heparinized beads (more than 65% of inoculated bacteria). After rinsing with buffer at high ionic strength, viable bacteria or bacterial DNA were eluted from the columns, indicating that the binding was specific. The conclusions that can be made from these experiments are that, as earlier reported in the literature, the high affinity of SA to heparin is retained in whole blood, and MRSA in whole blood binds to heparin with similar or higher affinity than SA. It should be possible to lower the amount of SA and/or MRSA from the blood of infected patients to levels that could be taken care of by the immune system. In previous studies, we have shown that passing blood from septic patients over beads coated with end-point-attached, biologically active heparin is a useful technique for regulating the levels of heparin-binding cytokine. These findings in combination with the present findings indicate the possibility of creating an apheresis technology for treatment of sepsis caused by SA and/or MRSA.     

Inhibition of methicillin-resistant Staphylococcus aureus (MRSA) biofilm by cationic poly (D,L-lactide-co-glycolide) nanoparticles

Abstract

The emergent need for new treatment methods for multi-drug resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) has focused attention on novel potential tools like nanoparticles (NPs). In the present study, a drug-free cationic nanoparticles (CNPs) system was developed and its anti-MRSA effects were firstly investigated. The results showed that CNPs (261.7?nm, 26.1?mv) showed time- and concentration-dependent activity against MRSA growth, killing ～ 90% of planktonic bacterial cells in 3?h at 400?μg ml^?1, and completely inhibiting biofilm formation at 1000?μg ml^?1. Moreover, CNPs at 400?μg ml^?1 reduced the minimum inhibitory concentration (MIC) of vancomycin on inhibition of planktonic MRSA growth (～ 25%) and biofilm formation (～ 50%). The CNPs–bacteria interaction force was up to 22 nN. Overall, these data suggest that CNPs have a good potential in clinical applications for the prevention and treatment of MRSA infection.     

Identification of the third type of PVL phage in ST59 methicillin-resistant Staphylococcus aureus (MRSA) strains

The genes lukS-PV and lukF-PV for Panton-Valentine leukocidin (PVL) that confers high virulence to Staphylococcus aureus are located on the prophages (PVL phages) which have been classified into group 1 and 2 sfi21-like Siphoviridae. We report novel PVL phages lysogenized in ST59 methicillin-resistant Staphylococcus aureus (MRSA) strains isolated in Japan (JCSC7247) and Taiwan (JCSC5967). The genomes of φ7247PVL and φ5967PVL showed more than 99% identity, and the regions containing the five genes located at both ends of the prophages, int (integrase), hol (holin), ami (amidase), lukS-PV, and lukF-PV, are highly homologous to extant PVL phages. The genes for the structural module are less homologous to these phages, but are highly homologous to non-PVL phages belonging to group 3 Sfi21-like Siphoviridae, for example φN315. Subsequent PCR identification and nucleotide sequencing of an additional 11 Taiwanese ST59 MRSA isolates suggested they all carry the same phage as φ5967PVL, which differed from φ7247PVL by a single base. This study adds evidence to the notion that novel PVL phages would be generated through illegitimate recombination events by acquiring the region at which hol, ami, luk, and int genes would line up upon lytic growth, and suggests that the PVL-positive MRSA clones that have emerged worldwide may carry distinct phages.     

Antibody used to identify penicillin-binding protein 2' in methicillin-resistant strains of Staphylococcus aureus (MRSA)

We found that tau, one of the major microtubule-associated proteins, is a good substrate for protein kinase C. The phosphorylation occurred mainly on serine residues and the sites phosphorylated by protein kinase C were largely different from those phosphorylated by cAMP-dependent protein kinase as analyzed by phosphopeptide mapping. The protein kinase C-mediated phosphorylation of tau reduced its abilities to promote tubulin polymerization and to cross-link actin filaments. The reduction in its abilities was in proportion to the number of phosphates incorporated into tau.