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Microbiology Australia Microbiology Australia
Issue 3

Vertical Transmission, September 2008

It is a real thrill to be writing this, my first Vertical Transmission as President. On behalf of the Society, I would like to thank Keryn Christiansen for her great leadership over the last 2 years during a time of substantial organisational change within the Society. On a personal note, she has been a fantastic mentor and I look to the next 2 years with more confidence than perhaps would otherwise have been the case.

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Staphylococcus aureus

Staphylococcus aureus is one of the major bacterial pathogens of man, causing a variety of diseases from mild skin and soft-tissue infections to severe invasive infections with high mortality. In the healthcare setting it is the most frequent cause of surgical site, lower respiratory tract and cardiovascular infections and the second most common cause of blood stream infections and pneumonia. The ability of S. aureus to develop resistance to all classes of antimicrobials, in particular the ß-lactams, has become a major global problem. In the pr...

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Complete genome sequencing of Staphylococcus aureus: insights into virulence and antimicrobial resistance

Staphylococcus aureus remains one of the most important opportunistic bacterial pathogens of humans. It is characterised by the presence of many virulence factors, as well as an ability to rapidly develop or acquire antimicrobial resistance.

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Evolution of multiple drug resistance in staphylococci

Since the dawn of the era of antibiotic therapy, beginning with the introduction of the first penicillins (ß-lactams) in the 1940s, strains of Staphylococcus aureus exhibiting resistance to antibiotics have become more and more prevalent in both clinical and community settings. Foremost among these strains are the so-called methicillin-resistant S. aureus (MRSA), which have gained worldwide notoriety as hospital ‘superbugs’. The name MRSA belies the true nature of these organisms, as they are not only resistant to penicillin and the ß-lactamase...

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Epidemiology of MRSA in Australia

Methicillin-resistant Staphylococcus aureus (MRSA) has presented challenges to laboratories and clinicians since it first appeared in Australia in the mid-1960s. However, in spite of its long presence and familiarity, a clear understanding of its epidemiology has only been possible with the recent advent of sequence-based typing methods (see the article by O’Brien and Giffard, page 131).

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Two approaches to Staphylococcus aureus typing

Typing of Staphylococcus aureus is carried out to detect outbreaks, monitor transmission and infer virulence and resistance properties. There are now many different extant typing methods. This article summarises the broad classes of typing approaches and describes two methods. One is based on micro-array technology while the other is based upon the interrogation of polymorphic sites using real-time PCR.

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Detecting hVISA

Rates of reduced vancomycin susceptibility (RVS) among isolates of methicillin-susceptible Staphylococcus aureus (MSSA), especially methicillin-resistant S. aureus (MRSA), have increased. Although vancomycin remains the therapeutic mainstay for MRSA, clinical response to vancomycin has been compromised by RVS among our hospital clones. Laboratories need simple procedures to detect these organisms. Whilst routine disc or MIC susceptibility testing is not reliable, some useful screening procedures are available.

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AGAR community and hospital Staphylococcus aureus surveillance

Point-prevalence antimicrobial surveillance programmes conducted by the Australian Group on Antimicrobial Resistance (AGAR) from 1986-1999 included consecutive clinical isolates of Staphylococcus aureus regardless of acquisition. Following a reported increase in community-acquired infections caused by methicillin-resistant S. aureus (MRSA) in the literature, AGAR performed the first survey of infections from outpatients, emergency department and general practitioner patients in 2000. Further community surveys were conducted in 2002, 2004 and 20...

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Keeping epidemic MRSA out of Western Australian hospitals

Since 1982 methicillin-resistant Staphylococcus aureus (MRSA) isolated in WA has been notifiable by State legislation. During this time the WA Department of Health (DoH), which administers and sets policy for the government-funded healthcare facilities and licences all private healthcare facilities operating within the State, has promoted a comprehensive MRSA management policy. This policy, which involves all WA healthcare facilities, medical microbiology laboratories and the DoH, is similar to the ‘search and destroy policy’ used in northern E...

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Community MRSA and Panton-Valentine leukocidin (PVL): the perfect storm, or a storm in a tea-cup?

Staphylococcus aureus is well known for its propensity to encode and express a formidable range of virulence determinants that can cause considerable morbidity and mortality in its host. Amongst these determinants is Panton-Valentine leukocidin (PVL), a cytolytic exotoxin first described in the late 19th century. This toxin is found in many S. aureus clones; however, of particular concern is the fact that community-acquired methicillin-resistant S. aureus (CA-MRSA) clones that contain the PVL determinant have been associated with severe necroti...

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Endemic MRSA management: is screening useful?

Endemic hospital methicillin-resistant Staphylococcus aureus (MRSA) remains a cause of significant morbidity and mortality. However, there is no universal consensus on optimal control measures. MRSA screening has been reported as a successful intervention but generally in association with a raft of other measures. Improved hand hygiene, antibiotic stewardship and the availability of isolation facilities are considered to be basic components in MRSA control. Targeted screening of high risk patients is likely to be useful for MRSA control but onl...

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Staphylococcus aureus bacteraemia: The Australia New Zealand Cooperative on Outcomes in Staphylococcal Sepsis (ANZCOSS)

Staphylococcus aureus is such a common organism, both as a coloniser and cause of infection in humans, that it is easy to take it for granted. Microbiologists, infectious diseases specialists and infection control practitioners deal with the organism on a regular basis, from screening for methicillin-resistant strains (MRSA) in asymptomatic carriers to treating patients with life-threatening sepsis syndrome in intensive care units.

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Improved methods in the identification and screening for antimicrobial resistance: chromogenic screening for Staphylococcus aureus and methicillin resistance

New enzyme specific synthetic chromogenic substrates offer an advance in the laboratory screening and detection of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA), with increased efficiency, reduced labour costs and decreased turn around times, especially when incorporated into existing laboratory workflows, to support current methods of microbial identification and the detection of resistance.

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Detection of MRSA nasal colonisation using the BD GeneOhm MRSA Assay

The BD GeneOhm MRSA Assay is a qualitative in vitro test for the rapid direct detection of methicillin-resistant S. aureus (MRSA) nasal colonisation. The test performed on the Smart Cycler utilises polymerase chain reaction (PCR) for the amplification of MRSA DNA and fluorogenic target-specific hybridisation probes for the detection of the amplified DNA. The procedure takes about 60-75 minutes, depending on the number of specimens processed, allowing same-day reporting within a few hours of specimen collection.

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Staphylococcus aureus and food borne disease

Staphylococcal food poisoning, which usually presents clinically at 2-6 hours post exposure, is attributed to the ingestion of food containing pre-formed staphylococcal enterotoxins (SEs) which are quite resistant to acid and proteolysis. Most cases of staphylococcal intoxication resolve within 24-48 hours, although they may be serious.

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ASM Affairs, September 2008

ASM 2008, 6-10 July, Melbourne Conference report; 2007 Frank Fenner Award; Rita Colwell / Nancy Millis Postgraduate Travel Award; 2008 David White Excellence in Teaching Award; 2008 Oxoid ASM Culture Media Award; 2008 Roche ASM Molecular Diagnostic Award; ASM 2008 6-10 July, Melbourne EDSIG workshops

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