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    ABSTRACT: Introduction: The infections by S. aureus threaten to turn into a serious problem of public health. The capacity of the bacteria as colonizing and infected agent in humans is due to the wide spectrum of factors that it possesses, so much of colonization as of virulence. Between them, the phenol-soluble modulins (PSMs) have reached a height because it has been identified that they have lytic activity against leukocytes and erythrocytes, inflammatory properties and capacity of causing antimicrobial interference against commensal species and participants in the biofilm formation. Objective: to describe the advances around the importance of the PSMs in the pathogenesis of the infections by S. aureus. Methods: a bibliographic search was carried out in PubMed, including clinical trials, molecular epidemiology studies and review articles related with the PSMs of S. aureus. The keywords used were: bacterial toxins, phenol-soluble modulin, Staphylococcus aureus, Methicillin-Resistant Staphylococcus aureus, Colombia, Cartagena. Results: a total of 53 articles were included in this review. The PSMs were described in S. aureus by the first time in 2007, since then, their classification in the bacteria has been carried out and there has been identified the participation of these molecules in different biological processes of the bacteria as the quorum sensing, and its proinflammatory potential. Between the most significant aspects of these molecules is the possible clinical utility due to the interference inter-specie that has been observed. Conclusion: there exists increasing information that supports the role of the PSMs in the pathogenesis of the S. aureus. Nevertheless, the pathogenic power of the bacteria could be attribute to the sum of several factor dependent of the microorganism and of the human host.
    Revista Ciencias Biomédicas 2215-7840. 07/2014; 5(1):107-115.
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    ABSTRACT: We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern.
    New England Journal of Medicine 04/2014; 370(16):1524-31. · 51.66 Impact Factor
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    ABSTRACT: Romania is one of the countries with the highest prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the world. To obtain data on affiliation of MRSA to strains and clonal complexes and on the population of methicillin susceptible S. aureus (MSSA), clinical isolates from bloodstream infections, skin and soft tissue infections as well as from screening swabs were collected at hospitals in Ia?i, a city in the North-Eastern part of Romania. Isolates were characterised by microarray hybridisation. Nearly half of all isolates (47%), and about one third (34%) of bloodstream isolates were MRSA. The prevalence of the Panton-Valentine leukocidin (PVL) was also high (31% among MRSA, 14% among MSSA). The most common MRSA strain was a PVL-negative CC1-MRSA-IV that might have emerged locally, as a related MSSA was also common. PVL-positive CC8-MRSA-IV (''USA300'') and PVL-negative ST239-like MRSA-III were also frequently found while other MRSA strains were only sporadically detected. Among MSSA, PVL-positive CC121 as well as PVL-negative CC1, CC22 and CC45 predominated. Although this study provides only a snapshot of S. aureus/MRSA epidemiology in Romania, it confirms the high burden of MRSA and PVL on Romanian healthcare settings. Copyright: ß 2014 Monecke et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: Most of the isolates were collected during project number PNII – IDEI code ID_1586/2008 supported by CNCSIS –UEFISCSU. There was no external funding for this project. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: E. Mü ller, S. Monecke and R. Ehricht are employees of Alere Technologies, the company that manufactures the microarrays also used in this study. This has no influence on study design, data collection and analysis, and this does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials. The other authors declare that no competing interests exist.

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