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Keiichi Hiramatsu - One of the best experts on this subject based on the ideXlab platform.
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new trends in staphylococcus aureus infections glycopeptide resistance in hospital and Methicillin resistance in the community
Current Opinion in Internal Medicine, 2002Co-Authors: Keiichi Hiramatsu, Keiko Okuma, Munetaka Yamamoto, Satoshi Hori, Maria KapiAbstract:Purpose of review Methicillin-resistant Staphylococcus aureus is prevalent in hospitals throughout the world, and we have got used to its presence in daily clinical practice. However, Methicillin-resistant S. aureus has not remained static over the past four decades, but seems to be evolving in unfamiliar directions. This review focuses on recent findings on two directions of Methicillin-resistant S. aureus evolution: the acquisition of multiple antibiotic resistance in the hospital and the trend towards Methicillin-resistant S. aureus as a community pathogen. Recent findings We looked at reports on glycopeptide resistance in S. aureus and those on community-acquired Methicillin-resistant S. aureus strains, with some references of historical value to explain the entire picture of this ‘new field’ of the Methicillin-resistant S. aureus problem. Summary The references given here (excluding some of low credibility) attest the increasing awareness of the two conspicuous problems concerning Methicillin-resistant S. aureus infection. One is the increasing trend of glycopeptide-resistance, making difficult the successful treatment of multi-drug-resistant Methicillin-resistant S. aureus infection in the hospital. On the other hand, non-multi-drug-resistant Methicillin-resistant S. aureus strains are emerging as novel threats in the community, the genetic analysis of which indicates that they are independent clones from those found in hospitals.
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the emergence and evolution of Methicillin resistant staphylococcus aureus
Trends in Microbiology, 2001Co-Authors: Keiichi Hiramatsu, Makoto KurodaAbstract:Abstract Significant advances have been made in recent years in our understanding of how Methicillin resistance is acquired by Staphylococcus aureus . Integration of a staphylococcal cassette chromosome mec (SCC mec ) element into the chromosome converts drug-sensitive S . aureus into the notorious hospital pathogen methicilin-resistant S . aureus (MRSA), which is resistant to practically all β-lactam antibiotics. SCC mec is a novel class of mobile genetic element that is composed of the mec gene complex encoding Methicillin resistance and the ccr gene complex that encodes recombinases responsible for its mobility. These elements also carry various resistance genes for non-β-lactam antibiotics. After acquiring an SCC mec element, MRSA undergoes several mutational events and evolves into the most difficult-to-treat pathogen in hospitals, against which all extant antibiotics including vancomycin are ineffective. Recent epidemiological data imply that MRSA has embarked on another evolutionary path as a community pathogen, as at least one novel SCC mec element seems to have been successful in converting S . aureus strains from the normal human flora into MRSA.
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genetic organization of the chromosome region surrounding meca in clinical staphylococcal strains role of is431 mediated meci deletion in expression of resistance in meca carrying low level Methicillin resistant staphylococcus haemolyticus
Antimicrobial Agents and Chemotherapy, 2001Co-Authors: Yuki Katayama, Keiichi HiramatsuAbstract:We report on the structural diversity of mecA gene complexes carried by 38 Methicillin-resistant Staphylococcus aureus and 91 Methicillin-resistant coagulase-negative Staphylococcus strains of seven different species with a special reference to its correlation with phenotypic expression of Methicillin resistance. The most prevalent and widely disseminated mec complex had the structure mecI-mecR1-mecA-IS431R (or IS431mec), designated the class A mecA gene complex. In contrast, in S. haemolyticus, mecA was bracketed by two copies of IS431, forming the structure IS431L-mecA-IS431R. Of the 38 S. haemolyticus strains, 5 had low-level Methicillin resistance (MIC, 1 to 4 mg/liter) and characteristic heterogeneous Methicillin resistance as judged by population analysis. In these five strains, IS431L was located to the left of an intact mecI gene, forming the structure IS431L-class A mecA-gene complex. In other S. haemolyticus strains, IS431L was associated with the deletion of mecI and mecR1, forming the structure IS431L-ΔmecR1-mecA-IS431mec, designated the class C mecA gene complex. Mutants with the class C mecA gene complex were obtained in vitro by selecting strain SH621, containing the IS431L-class A mecA gene complex with low concentrations of Methicillin (1 and 3 mg/liter). The mutants had intermediate level of Methicillin resistance (MIC, 16 to 64 mg/liter). The mecA gene transcription was shown to be derepressed in a representative mutant strain, SH621-37. Our study indicated that the mecI-encoded repressor function is responsible for the low-level Methicillin resistance of some S. haemolyticus clinical strains and that the IS431-mediated mecI gene deletion causes the expression of Methicillin resistance through the derepression of mecA gene transcription.
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genetic organization of the chromosome region surrounding meca in clinical staphylococcal strains role of is431 mediated meci deletion in expression of resistance in meca carrying low level Methicillin resistant staphylococcus haemolyticus
Antimicrobial Agents and Chemotherapy, 2001Co-Authors: Yuki Katayama, Teruyo Ito, Keiichi HiramatsuAbstract:We report on the structural diversity of mecA gene complexes carried by 38 Methicillin-resistant Staphylococcus aureus and 91 Methicillin-resistant coagulase-negative Staphylococcus strains of seven different species with a special reference to its correlation with phenotypic expression of Methicillin resistance. The most prevalent and widely disseminated mec complex had the structure mecI-mecR1-mecA-IS431R (or IS431mec), designated the class A mecA gene complex. In contrast, in S. haemolyticus, mecA was bracketed by two copies of IS431, forming the structure IS431L-mecA-IS431R. Of the 38 S. haemolyticus strains, 5 had low-level Methicillin resistance (MIC, 1 to 4 mg/liter) and characteristic heterogeneous Methicillin resistance as judged by population analysis. In these five strains, IS431L was located to the left of an intact mecI gene, forming the structure IS431L-class A mecA-gene complex. In other S. haemolyticus strains, IS431L was associated with the deletion of mecI and mecR1, forming the structure IS431L-DeltamecR1-mecA-IS431mec, designated the class C mecA gene complex. Mutants with the class C mecA gene complex were obtained in vitro by selecting strain SH621, containing the IS431L-class A mecA gene complex with low concentrations of Methicillin (1 and 3 mg/liter). The mutants had intermediate level of Methicillin resistance (MIC, 16 to 64 mg/liter). The mecA gene transcription was shown to be derepressed in a representative mutant strain, SH621-37. Our study indicated that the mecI-encoded repressor function is responsible for the low-level Methicillin resistance of some S. haemolyticus clinical strains and that the IS431-mediated mecI gene deletion causes the expression of Methicillin resistance through the derepression of mecA gene transcription.
Yuki Katayama - One of the best experts on this subject based on the ideXlab platform.
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genetic organization of the chromosome region surrounding meca in clinical staphylococcal strains role of is431 mediated meci deletion in expression of resistance in meca carrying low level Methicillin resistant staphylococcus haemolyticus
Antimicrobial Agents and Chemotherapy, 2001Co-Authors: Yuki Katayama, Keiichi HiramatsuAbstract:We report on the structural diversity of mecA gene complexes carried by 38 Methicillin-resistant Staphylococcus aureus and 91 Methicillin-resistant coagulase-negative Staphylococcus strains of seven different species with a special reference to its correlation with phenotypic expression of Methicillin resistance. The most prevalent and widely disseminated mec complex had the structure mecI-mecR1-mecA-IS431R (or IS431mec), designated the class A mecA gene complex. In contrast, in S. haemolyticus, mecA was bracketed by two copies of IS431, forming the structure IS431L-mecA-IS431R. Of the 38 S. haemolyticus strains, 5 had low-level Methicillin resistance (MIC, 1 to 4 mg/liter) and characteristic heterogeneous Methicillin resistance as judged by population analysis. In these five strains, IS431L was located to the left of an intact mecI gene, forming the structure IS431L-class A mecA-gene complex. In other S. haemolyticus strains, IS431L was associated with the deletion of mecI and mecR1, forming the structure IS431L-ΔmecR1-mecA-IS431mec, designated the class C mecA gene complex. Mutants with the class C mecA gene complex were obtained in vitro by selecting strain SH621, containing the IS431L-class A mecA gene complex with low concentrations of Methicillin (1 and 3 mg/liter). The mutants had intermediate level of Methicillin resistance (MIC, 16 to 64 mg/liter). The mecA gene transcription was shown to be derepressed in a representative mutant strain, SH621-37. Our study indicated that the mecI-encoded repressor function is responsible for the low-level Methicillin resistance of some S. haemolyticus clinical strains and that the IS431-mediated mecI gene deletion causes the expression of Methicillin resistance through the derepression of mecA gene transcription.
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genetic organization of the chromosome region surrounding meca in clinical staphylococcal strains role of is431 mediated meci deletion in expression of resistance in meca carrying low level Methicillin resistant staphylococcus haemolyticus
Antimicrobial Agents and Chemotherapy, 2001Co-Authors: Yuki Katayama, Teruyo Ito, Keiichi HiramatsuAbstract:We report on the structural diversity of mecA gene complexes carried by 38 Methicillin-resistant Staphylococcus aureus and 91 Methicillin-resistant coagulase-negative Staphylococcus strains of seven different species with a special reference to its correlation with phenotypic expression of Methicillin resistance. The most prevalent and widely disseminated mec complex had the structure mecI-mecR1-mecA-IS431R (or IS431mec), designated the class A mecA gene complex. In contrast, in S. haemolyticus, mecA was bracketed by two copies of IS431, forming the structure IS431L-mecA-IS431R. Of the 38 S. haemolyticus strains, 5 had low-level Methicillin resistance (MIC, 1 to 4 mg/liter) and characteristic heterogeneous Methicillin resistance as judged by population analysis. In these five strains, IS431L was located to the left of an intact mecI gene, forming the structure IS431L-class A mecA-gene complex. In other S. haemolyticus strains, IS431L was associated with the deletion of mecI and mecR1, forming the structure IS431L-DeltamecR1-mecA-IS431mec, designated the class C mecA gene complex. Mutants with the class C mecA gene complex were obtained in vitro by selecting strain SH621, containing the IS431L-class A mecA gene complex with low concentrations of Methicillin (1 and 3 mg/liter). The mutants had intermediate level of Methicillin resistance (MIC, 16 to 64 mg/liter). The mecA gene transcription was shown to be derepressed in a representative mutant strain, SH621-37. Our study indicated that the mecI-encoded repressor function is responsible for the low-level Methicillin resistance of some S. haemolyticus clinical strains and that the IS431-mediated mecI gene deletion causes the expression of Methicillin resistance through the derepression of mecA gene transcription.
Sheldon L Kaplan - One of the best experts on this subject based on the ideXlab platform.
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staphylococcus aureus retropharyngeal abscess in children
Pediatric Infectious Disease Journal, 2015Co-Authors: Nicholas K Brown, Edward O Mason, Kristina G Hulten, Sheldon L KaplanAbstract:A retrospective review of 33 patients comparing community-associated Methicillin-resistant Staphylococcus aureus retropharyngeal abscess (RPA) with community-associated Methicillin-susceptible S. aureus RPA from 2002–2013 at Texas Children’s Hospital revealed most cases of S. aureus RPA have been du
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Optimal imaging strategy for community-acquired Staphylococcus aureus musculoskeletal infections in children.
Pediatric Radiology, 2008Co-Authors: Lorna P. Browne, Edward O Mason, Sheldon L Kaplan, Christopher I. Cassady, Rajesh Krishnamurthy, R. Paul GuillermanAbstract:Background Invasive musculoskeletal infections from community-acquired Methicillin-resistant and Methicillin-susceptible Staphylococcus aureus (CA-SA) are increasingly encountered in children. Imaging is frequently requested in these children for diagnosis and planning of therapeutic interventions.
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prospective comparison of risk factors and demographic and clinical characteristics of community acquired Methicillin resistant versus Methicillin susceptible staphylococcus aureus infection in children
Pediatric Infectious Disease Journal, 2002Co-Authors: Carlos A Sattler, Edward O Mason, Sheldon L KaplanAbstract:Context.Community-acquired, Methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in children are increasing in frequency for unknown reasons.Objectives.To compare the presence of risk factors for Methicillin resistance between patients with CA-MRSA and community-acquired Methicillin-susc
Stefan Schwarz - One of the best experts on this subject based on the ideXlab platform.
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novel abc transporter gene vga c located on a multiresistance plasmid from a porcine Methicillin resistant staphylococcus aureus st398 strain
Antimicrobial Agents and Chemotherapy, 2009Co-Authors: Kristina Kadlec, Stefan SchwarzAbstract:A novel ABC transporter gene, vga(C), was identified on the 14,365-bp multiresistance plasmid pKKS825 in a porcine Methicillin (meticillin)-resistant Staphylococcus aureus isolate of sequence type 398. The vga(C) gene encodes a 523-amino-acid protein which confers resistance not only to streptogramin A antibiotics but also to lincosamides and pleuromutilins. Plasmid pKKS825 also carries the resistance genes aadD, tet(L), and dfrK, which may enable the coselection of vga(C) under selective pressure by kanamycin/neomycin, tetracyclines, and trimethoprim.
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identification of a novel trimethoprim resistance gene dfrk in a Methicillin resistant staphylococcus aureus st398 strain and its physical linkage to the tetracycline resistance gene tet l
Antimicrobial Agents and Chemotherapy, 2009Co-Authors: Kristina Kadlec, Stefan SchwarzAbstract:A novel trimethoprim resistance gene, designated dfrK, was detected in close proximity to the tetracycline resistance gene tet(L) on the ca. 40-kb plasmid pKKS2187 in a porcine Methicillin (meticillin)-resistant Staphylococcus aureus isolate of sequence type 398. The dfrK gene encodes a 163-amino-acid dihydrofolate reductase that differs from all so-far-known dihydrofolate reductases.
Philip R Cohen - One of the best experts on this subject based on the ideXlab platform.
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community acquired Methicillin resistant staphylococcus aureus skin infection an emerging clinical problem
Journal of The American Academy of Dermatology, 2004Co-Authors: Philip R Cohen, Razelle KurzrockAbstract:Community-acquired Methicillin-resistant Staphylococcus aureus skin infections at an outpatient university health center were evaluated. In all, 41 cultures were performed in 36 of 853 patients. Of the 19 patients with S aureus infection, Methicillin resistance occurred in 10 (53%) and generally manifested as abscesses or cellulitis. Therefore, Methicillin resistance should be considered, even in the community setting, and appropriate cultures performed.