Archive for January 23, 2018

Ceftriaxone-Resistant Neisseria gonorrhoeae, Canada, 2017

Emerging Infectious Diseases February 2018 V.24 N.2

Brigitte Lefebvre, Irene Martin, Walter Demczuk, Lucie Deshaies, Stéphanie Michaud, Annie-Claude Labbé, Marie-Claude Beaudoin, and Jean Longtin

Author affiliations: Institut National de Santé Publique du Québec, Québec, Québec, Canada (B. Lefebvre, J. Longtin); Public Health Agency of Canada, Winnipeg, Manitoba, Canada (I. Martin, W. Demczuk); Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Québec (L. Deshaies); Direction de Santé Publique du Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Québec (S. Michaud); Université de Montréal, Québec (A.-C. Labbé); Centre de Recherche en Infectiologie, Université Laval, Québec (M.-C. Beaudoin, J. Longtin)

We identified a ceftriaxone-resistant Neisseria gonorrhoeae isolate in a patient in Canada.

This isolate carried the penA-60 allele, which differs substantially from its closest relative, mosaic penA XXVII (80% nucleotide identity).

Epidemiologic and genomic data suggest spread from Asia. Antimicrobial susceptibility surveillance helps prevent spread of highly resistant N. gonorrhoeae strains.

PDF

https://wwwnc.cdc.gov/eid/article/24/2/pdfs/17-1756.pdf

 

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January 23, 2018 at 8:02 am

Use of Pristinamycin for Macrolide-Resistant Mycoplasma genitalium Infection

Emerging Infectious Diseases February 2018 V.24 N.2

Tim R.H., Jørgen S. Jensen, Christopher K. Fairley, Mieken Grant, Jennifer A. Danielewski, Jenny Su, Gerald L. Murray, Eric P.F. Chow, Karen Worthington, Suzanne M. Garland, Sepehr N. Tabrizi, and Catriona S. Bradshaw

Author affiliations: Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia (T.R.H. Read, C.K. Fairley, M. Grant, E.P.F. Chow, K. Worthington, C.S. Bradshaw); Monash University, Melbourne, Victoria, Australia (T.R.H. Read, C.K. Fairley, G.L. Murray, E.P.F. Chow, C.S. Bradshaw); Statens Serum Institut, Copenhagen, Denmark (J.S. Jensen); Murdoch Children’s Research Institute, Parkville, Victoria, Australia (J.A. Danielewski, J. Su, G.L. Murray, S.M. Garland, S.N. Tabrizi); Royal Women’s Hospital, Parkville (J.A. Danielewski, J. Su, G.L. Murray, S.M. Garland, S.N. Tabrizi); University of Melbourne, Parkville (S.M. Garland, S.N. Tabrizi, C.S. Bradshaw)

High levels of macrolide resistance and increasing fluoroquinolone resistance are found in Mycoplasma genitalium in many countries.

We evaluated pristinamycin for macrolide-resistant M. genitalium in a sexual health center in Australia.

Microbiologic cure was determined by M. genitalium–specific 16S PCR 14–90 days after treatment began. Of 114 persons treated with pristinamycin, infection was cured in 85 (75%).

This percentage did not change when pristinamycin was given at daily doses of 2 g or 4 g or at 3 g combined with 200 mg doxycycline.

In infections with higher pretreatment bacterial load, treatment was twice as likely to fail for each 1 log10 increase in bacterial load. Gastrointestinal side effects occurred in 7% of patients.

Pristinamycin at maximum oral dose, or combined with doxycycline, cured 75% of macrolide-resistant M. genitalium infections.

Pristinamycin is well-tolerated and remains an option where fluoroquinolones have failed or cannot be used.

PDF

https://wwwnc.cdc.gov/eid/article/24/2/pdfs/17-0902.pdf

 

January 23, 2018 at 8:01 am

Spread of Meropenem-Resistant Streptococcus pneumoniae Serotype 15A-ST63 Clone in Japan, 2012–2014

Emerging Infectious Diseases February 2018 V.24 N.2

Satoshi Nakano, Takao Fujisawa, Yutaka Ito, Bin Chang, Yasufumi Matsumura, Masaki Yamamoto, Miki Nagao, Shigeru Suga, Makoto Ohnishi, and Satoshi Ichiyama

Author affiliations: Kyoto University Graduate School of Medicine, Kyoto, Japan (S. Nakano, Y. Matsumura, M. Yamamoto, M. Nagao, S. Ichiyama); National Hospital Organization Mie National Hospital, Tsu, Japan (T. Fujisawa, S. Suga); Nagoya City University Graduate School of Medical Science, Nagoya, Japan (Y. Ito); National Institute of Infectious Diseases, Tokyo, Japan (B. Chang, M. Ohnishi)

After the introduction of pneumococcal conjugate vaccines, the incidence of pneumococcal infections due to meropenem-resistant serotype 15A-ST63 strains increased in Japan.

By using whole-genome sequencing and comparing sequences with those of clones from the United Kingdom, the United States, and Canada, we clarified the traits of the serotype 15A-ST63 clone.

Our analysis revealed that the meropenem-resistant serotype 15A-ST63 strains from Japan originated from meropenem-susceptible strains from Japan.

Recombination site prediction analysis showed that the meropenem-resistant strain-specific recombination regions included the pbp1a and pbp2b regions.

A detailed analysis of the composition of these genes indicated that resistance seems to be caused by pbp1a recombination.

The pbp1a gene in meropenem-resistant isolates was identical to that in multidrug (including meropenem)–resistant serotype 19A-ST320 pneumococci, which have spread in the United States.

The global spread of pneumococci of this lineage is noteworthy because serotype 15A is not included in the currently used 13-valent pneumococcal conjugate vaccine.

PDF

https://wwwnc.cdc.gov/eid/article/24/2/pdfs/17-1268.pdf

January 23, 2018 at 7:59 am

Hypervirulent Klebsiella pneumoniae in Cryptogenic Liver Abscesses, Paris, France

Emerging Infectious Diseases February 2018 V.24 N.2

Benjamin Rossi, Maria Ludovica Gasperini, Véronique Leflon-Guibout, Alice Gioanni, Victoire de Lastours, Geoffrey Rossi, Safi Dokmak, Maxime Ronot, Olivier Roux, Marie-Hélène Nicolas-Chanoine, Bruno Fantin, and Agnès LefortComments to Author

Author affiliations: Hôpital Beaujon, Clichy, France (B. Rossi, M.L. Gasperini, V. Leflon-Guibout, A. Gioanni, V. de Lastours, G. Rossi, S. Dokmak, M. Ronot, O. Roux, M.-H. Nicolas-Chanoine, B. Fantin, A. Lefort); Université Paris Diderot, Paris, France (V. de Lastours, M. Ronot, Marie-Hélène Nicolas-Chanoine, B. Fantin, A. Lefort)

Liver abscesses containing hypervirulent Klebsiella pneumoniae have emerged during the past 2 decades, originally in Southeast Asia and then worldwide. We hypothesized that hypervirulent K. pneumoniae might also be emerging in France.

In a retrospective, monocentric, cohort study, we analyzed characteristics and outcomes for 199 consecutive patients in Paris, France, with liver abscesses during 2010−2015. We focused on 31 patients with abscesses containing K. pneumoniae.

This bacterium was present in most (14/27, 52%) cryptogenic liver abscesses. Cryptogenic K. pneumoniae abscesses were more frequently community-acquired (p<0.00001) and monomicrobial (p = 0.008), less likely to involve cancer patients (p<0.01), and relapsed less often (p<0.01) than did noncryptogenic K. pneumoniae liver abscesses.

K. pneumoniae isolates from cryptogenic abscesses belonged to either the K1 or K2 serotypes and had more virulence factors than noncryptogenic K. pneumoniae isolates.

Hypervirulent K. pneumoniae are emerging as the main pathogen isolated from cryptogenic liver abscesses in the study area.

PDF

https://wwwnc.cdc.gov/eid/article/24/2/pdfs/17-0957.pdf

January 23, 2018 at 7:57 am

Plasmid-Encoded Transferable mecB-Mediated Methicillin Resistance in Staphylococcus aureus

Emerging Infectious Diseases February 2018 V.24 N.2

Becker et al.

During cefoxitin-based nasal screening, phenotypically categorized methicillin-resistant Staphylococcus aureus (MRSA) was isolated and tested negative for the presence of the mecA and mecC genes as well as for the SCCmec-orfX junction region.

The isolate was found to carry a mecB gene previously described for Macrococcus caseolyticus but not for staphylococcal species.

The gene is flanked by β-lactam regulatory genes similar to mecR, mecI, and blaZ and is part of an 84.6-kb multidrug-resistance plasmid that harbors genes encoding additional resistances to aminoglycosides (aacA-aphD, aphA, and aadK) as well as macrolides (ermB) and tetracyclines (tetS).

This further plasmidborne β-lactam resistance mechanism harbors the putative risk of acceleration or reacceleration of MRSA spread, resulting in broad ineffectiveness of β-lactams as a main therapeutic application against staphylococcal infections.

PDF

https://wwwnc.cdc.gov/eid/article/24/2/pdfs/17-1074.pdf

January 23, 2018 at 7:55 am

Clinical and Molecular Epidemiology of Staphylococcal Toxic Shock Syndrome in the United Kingdom

Emerging Infectious Diseases February 2018 V.24 N.2

Sharma et al.

Staphylococcal toxic shock syndrome (TSS) was originally described in menstruating women and linked to TSS toxin 1 (TSST-1)–producing Staphylococcus aureus.

Using UK national surveillance data, we ascertained clinical, molecular and superantigenic characteristics of TSS cases. Average annual TSS incidence was 0.07/100,000 population.

Patients with nonmenstrual TSS were younger than those with menstrual TSS but had the same mortality rate.

Children <16 years of age accounted for 39% of TSS cases, most caused by burns and skin and soft tissue infections.

Nonmenstrual TSS is now more common than menstrual TSS in the UK, although both types are strongly associated with the tst+ clonal complex (CC) 30 methicillin-sensitive S. aureus lineage, which accounted for 49.4% of all TSS and produced more TSST-1 and superantigen bioactivity than did tst+ CC30 methicillin-resistant S. aureus strains.

Better understanding of this MSSA lineage and infections in children could focus interventions to prevent TSS in the future.

PDF

https://wwwnc.cdc.gov/eid/article/24/2/pdfs/17-0606.pdf

January 23, 2018 at 7:53 am


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