C Cuny

Publications of C Cuny

• Detection of low-level oxacillin resistance in mecA-positive Staphylococcus aureus.

  Authors: W Witte, B Pasemann, C Cuny

  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 04/2007; 13(4):408-12.

  Detection of low-level oxacillin-resistant Staphylococcus aureus is a problem that needs special attention, particularly in relation to methicillin-resistant S. aureus (MRSA) strains in the communityDetection of low-level oxacillin-resistant Staphylococcus aureus is a problem that needs special attention, particularly in relation to methicillin-resistant S. aureus (MRSA) strains in the community that belong to clonal lineage ST80. This study compared different phenotypic methods for the detection of 74 low-level oxacillin-resistant S. aureus strains (oxacillin MIC <or=1 mg/L), 46 MRSA strains (oxacillin MIC >or=2 mg/L) and 117 methicillin-susceptible S. aureus strains. Determination of microbroth dilution MICs for oxacillin was wholly unsatisfactory, and gave a limited specificity for cefoxitin. The sensitivity of disk-diffusion performed according to CLSI recommendations was 92% with an oxacillin 1-microg disk, and 96% with a cefoxitin 30-microg disk; use of a 10-microg cefoxitin disk and a semi-confluent inoculum (breakpoint for resistance <18 mm zone diameter) gave a sensitivity of 97%. When disk-diffusion was performed on IsoSensitest agar with a zone diameter breakpoint for resistance of <22 mm (as recommended by the Swedish Reference Group for Antibiotics), the sensitivity was 95%.

• Characterization of methicillin-resistant Staphylococcus aureus from Ulaanbaatar, Mongolia.

  Authors: D Orth, K Grif, L Erdenechimeg, C Battogtokh, T Hosbayar, B Strommenger, C Cuny, G Walder, C Lass-Flörl, M P Dierich, W Witte

  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 03/2006; 25(2):104-7.

  In order to expand current knowledge of the types of methicillin-resistant Staphylococcus aureus (MRSA) strains circulating in central Asia, six MRSA strains collected from hospitals in Ulaanbaatar,In order to expand current knowledge of the types of methicillin-resistant Staphylococcus aureus (MRSA) strains circulating in central Asia, six MRSA strains collected from hospitals in Ulaanbaatar, Mongolia during 2000-2002 were examined. Three strains possessed a staphylococcal cassette chromosome mec (SCCmec) element of type IV c, were sequence type (ST) 154 according to multilocus sequence typing (MLST), and contained lukS-lukF (Panton-Valentine leukocidin). Another three strains contained a SCCmec element of type III and were MLST type ST 239. Using automated ribotyping, the six MRSA strains were divided into four different EcoRI ribotypes, and two groups of isolates were distinguished by means of SmaI-macrorestriction patterns. In comparison to other countries, the incidence of MRSA in Mongolia is low.

• Emergence of MRSA infections in horses in a veterinary hospital: strain characterisation and comparison with MRSA from humans.

  Authors: C Cuny, J Kuemmerle, C Stanek, B Willey, B Strommenger, W Witte

  Euro surveillance : bulletin européen sur les maladies transmissibles = European communicable disease bulletin. 02/2006; 11(1):44-7.

  Methicillin-resistant Staphylococcus aureus has become an emerging public health problem worldwide, no longer only associated with healthcare-associated infections. With the exception of some recentMethicillin-resistant Staphylococcus aureus has become an emerging public health problem worldwide, no longer only associated with healthcare-associated infections. With the exception of some recent reports concerning infections in cats, dogs and horses, infections with MRSA in companion animals have been infrequently reported. Here we submit findings for MRSA infections in horses in a central European university hospital.

• PCR for the identification of methicillin-resistant Staphylococcus aureus (MRSA) strains using a single primer pair specific for SCCmec elements and the neighbouring chromosome-borne orfX.

  Authors: C Cuny, W Witte

  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 11/2005; 11(10):834-7.

  The chromosomal location of the SCCmec elements containing mecA allows the identification of methicillin-resistant Staphylococcus aureus (MRSA) strains by PCR amplification of a sequence covering theThe chromosomal location of the SCCmec elements containing mecA allows the identification of methicillin-resistant Staphylococcus aureus (MRSA) strains by PCR amplification of a sequence covering the right junction of the SCCmec elements and the adjacent chromosomal region encoding the species-specific ORFX. MRSA strains can be identified specifically using one forward primer, with only one or two mismatches, targeting the SCCmec elements of different types, and one reverse primer targeting the orfX region.

• Emergence of methicillin-resistant Staphylococcus aureus with Panton-Valentine leukocidin genes in central Europe.

  Authors: W Witte, C Braulke, C Cuny, B Strommenger, G Werner, D Heuck, U Jappe, C Wendt, H J Linde, D Harmsen

  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 02/2005; 24(1):1-5.

  The aim of the present study was to investigate strains of methicillin-resistant Staphylococcus aureus (MRSA) for the presence of the lukS-lukF determinant of Panton-Valentine leukocidin and toThe aim of the present study was to investigate strains of methicillin-resistant Staphylococcus aureus (MRSA) for the presence of the lukS-lukF determinant of Panton-Valentine leukocidin and to further characterize strains found to contain the genes. During the past 2 years, MRSA containing the lukS-lukF genes for Panton-Valentine leukocidin, particularly those emerging outside of hospitals, have become of interest. MRSA strains sent to the national reference center in Germany were investigated for lukS-lukF by polymerase chain reaction (PCR). If the presence of lukS-lukF was demonstrated, strains were further characterized by molecular typing (determination of SmaI pattern, spa sequence, and multilocus sequence type), PCR demonstration of resistance genes, and characterization of the SCCmec element. Since the end of 2002, MRSA containing Panton-Valentine leukocidin genes have been demonstrated as the causative agent of 28 cases of infection (9 community-acquired cases, 19 sporadic nosocomial cases) in different areas of Germany. Twenty-seven of these 28 isolates exhibited a unique pattern of genomic typing: all exhibited multilocus sequence type 80, spa sequence type 44, and a SmaI macrorestriction pattern that corresponds to a community-acquired strain of MRSA from France and Switzerland. In addition to resistance to oxacillin, the strains exhibited resistance to ciprofloxacin, tetracycline (tetM), and fusidic acid, the last of which is encoded by the far-1 gene. The far-1 gene was shown to be located on the plasmid. One isolate corresponded to community MRSA (cMRSA) of multilocus sequence type 1 from the USA.

• Obvious lack of association between dynamics of epidemic methicillin-resistant Staphylococcus aureus in central Europe and agr specificity groups.

  Authors: B Strommenger, C Cuny, G Werner, W Witte

  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 02/2004; 23(1):15-9.

  During the past 8 years, changes in the prevalence and spread of different epidemic methicillin-resistant Staphylococcus aureus (MRSA) have been observed in central Europe, with the emergence of newDuring the past 8 years, changes in the prevalence and spread of different epidemic methicillin-resistant Staphylococcus aureus (MRSA) have been observed in central Europe, with the emergence of new strains possessing fewer resistance characters. This has also been demonstrated at the level of particular hospitals. Since variation in agr specificity type has been proposed as a possible reason for population dynamics in Staphylococcus aureus, the agr specificity groups of different epidemic MRSA strains were investigated by PCR using agr group-specific primers. Four of the "old" as well as two "new" epidemic strains exhibited agr specificity group I. One group of epidemic MRSA strains, which has been observed since the beginning of the 1990s, exhibited the agr specificity group II. Sequencing the variable part ( agrB-D-C) of the agr locus revealed only six relevant nucleotide changes within this region, with three of them modifying the Shine-Dalgarno sequence region of agrC. On the basis of the results obtained, it is proposed that the dynamics observed in the population of MRSA in Germany is not due to different agr group specificities in "old" and "new" epidemic clones.

• Emergence of a new community acquired MRSA strain in Germany.

  Authors: W Witte, C Cuny, B Strommenger, C Braulke, D Heuck

  Euro surveillance : bulletin européen sur les maladies transmissibles = European communicable disease bulletin. 02/2004; 9(1):16-8.

  Analysis of community-acquired methicillin-resistant Staphylococcus aureus (c-MRSA) from Germany producing the Panton-Valentine leukocidin revealed a unique SmaI-macrorestriction pattern, differentAnalysis of community-acquired methicillin-resistant Staphylococcus aureus (c-MRSA) from Germany producing the Panton-Valentine leukocidin revealed a unique SmaI-macrorestriction pattern, different from epidemic nosocomial strains. This molecular pattern corresponds to those shown in c-MRSA strains from other countries in the European Union. All isolates exhibited resistance to fusidic acid, which is coded by the far-1 gene. From data on geographical dissemination and time of occurrence, this strain appears to have emerged in Germany in the second half of 2002, and so an already wider dissemination is likely. The emergence of MRSA with resistance to fusidic acid is a first sign of the emergence of a PVL-positive MRSA clone.

• Evaluation of a reverse hybridization blot test for detection of oxacillin-resistant Staphylococcus aureus.

  Authors: C Cuny, S Salmenlinna, W Witte

  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 01/2002; 20(12):906-7.

• Changing pattern of antibiotic resistance in methicillin-resistant Staphylococcus aureus from German hospitals.

  Authors: W Witte, C Braulke, C Cuny, D Heuck, M Kresken

  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. 12/2001; 22(11):683-6.

  OBJECTIVE: To investigate the background of changes of resistance phenotypes in methicillin-resistant Staphylococcus aureus (MRSA) from nosocomial infections in German hospitals by molecular typingOBJECTIVE: To investigate the background of changes of resistance phenotypes in methicillin-resistant Staphylococcus aureus (MRSA) from nosocomial infections in German hospitals by molecular typing and identification of particular resistance genes. METHODS: Isolates from the network for monitoring the spread of MRSA in Germany were subjected to quantitative susceptibility testing, to molecular typing, and to polymerase chain reaction identification of resistance genes. PARTICIPANTS: The network consists of 175 German clinical microbiological laboratories collaborating with the German Reference Center for Staphylococci, which performs typing of staphylococcal isolates from nosocomial infections and data analysis. RESULTS: During the past 5 years, MRSA susceptible to other antibiotics such as oxytetracycline, erythromycin, and gentamicin became more frequent. The proportion of epidemic MRSA clones that had been disseminated in the past and that exhibited broad resistance phenotypes decreased, whereas the proportion of recently emerging MRSA carrying only a few other resistance determinants has increased (1994, 11.5%; 1998, 39%). CONCLUSIONS: The changing pattern of resistance phenotypes of MRSA from nosocomial infections in Germany is mainly due to the spread of recently emerging epidemic strains that are less frequently resistant to antibacterials other than oxacillin. The observed changes cannot simply be attributed to overall antibiotic consumption.

• Methicillin-resistant, quinupristin-dalfopristin-resistant Staphylococcus aureus with reduced sensitivity to glycopeptides.

  Authors: G Werner, C Cuny, F J Schmitz, W Witte

  Journal of clinical microbiology. 10/2001; 39(10):3586-90.

  Of 3,052 Staphylococcus aureus strains collected by the European SENTRY surveillance study, 35 were found to be nonsusceptible to quinupristin-dalfopristin (MIC of > or =2 mg/liter). These isolatesOf 3,052 Staphylococcus aureus strains collected by the European SENTRY surveillance study, 35 were found to be nonsusceptible to quinupristin-dalfopristin (MIC of > or =2 mg/liter). These isolates originated from four hospitals in France and one in Spain. In isolates from two Parisian hospitals exhibiting the same SmaI macrorestriction pattern, streptogramin resistance was based on vatA and vgbA. One isolate from a hospital in Lyon and 22 from a hospital in Lille were of the vatB vgaB streptogramin A resistance genotype and possessed ermA and/or ermC. As deduced from the loss of either streptogramin A or streptogramin B resistance determinants in particular isolates, resistance to quinupristin-dalfopristin requires mechanisms conferring resistance to both compounds. The SmaI macrorestriction patterns of strains from hospitals in Lille and Lyon were different; however, similarity analysis suggested a relatedness of 20 methicillin-resistant S. aureus strains from the Lille hospital, a finding confirmed by PCR typing based on three different genomic polymorphisms. These groups of isolates were found to be hetero-glycopeptide-intermediate susceptible S. aureus. Information about the failure of glycopeptide chemotherapy has not been available.

• Subtyping of MRSA isolates belonging to a widely disseminated clonal group by polymorphism of the dru sequences in mec-associated DNA.

  Authors: W Witte, G Werner, C Cuny

  International journal of medical microbiology : IJMM. 05/2001; 291(1):57-62.

  During the past 7 years the "Berlin epidemic MRSA" has spread throughout whole Germany. SmaI macrorestriction patterns of this clonal group are rather stable as are the length polymorphisms at the 3'During the past 7 years the "Berlin epidemic MRSA" has spread throughout whole Germany. SmaI macrorestriction patterns of this clonal group are rather stable as are the length polymorphisms at the 3' end of the coagulase gene and the x-region of spa. However, the dru region (direct repeat units) of mec-associated DNA exhibits a length polymorphism due to deletion of one or more direct repeat units. Five different subclones could be discriminated by dru region length polymorphism. Location of deletions and of a few point mutations allow a delineation of these subclones.

• Characteristics of a new epidemic MRSA in Germany ancestral to United Kingdom EMRSA 15.

  Authors: W Witte, M Enright, F J Schmitz, C Cuny, C Braulke, D Heuck

  International journal of medical microbiology : IJMM. 04/2001; 290(8):677-82.

  In 1996 a new epidemic MRSA emerged in three hospitals North of Berlin. This strain, Barnim epidemic MRSA, was isolated in 15 hospitals in Northern Germany in 1997 and 29 hospitals throughout GermanyIn 1996 a new epidemic MRSA emerged in three hospitals North of Berlin. This strain, Barnim epidemic MRSA, was isolated in 15 hospitals in Northern Germany in 1997 and 29 hospitals throughout Germany in 1998. Isolates of this clone are non-typeable by phages, its resistance phenotype is PEN, OXA, ERY, CLI, CIP (genotype: mecA, ermC, mutations in grlA and gyrA). The Sma I macrorestriction pattern corresponds to particular phage group II strains which is confirmed by the 16S-23S rRNA gene spacer pattern. Isolates of this clone differ by less than three Sma I macrorestriction fragments from isolates of the EMRSA15 clone from the United Kingdom, the most common epidemic MRSA isolates in the United Kingdom in recent years. Both epidemic strains produce enterotoxin C and possess the sec determinant for this toxin, the configuration of the mec regulon is mecI-, mecRB+, mecRC+. Both share the same Alu I pattern of PCR amplimers of the 3' end region of the coagulase gene. EMRSA 15 and Barnim EMRSA share a common multilocus sequence type indicating a recent, shared evolutionary origin.

• In vitro activity of linezolid against staphylococci.

  Authors: C Cuny, W Witte

  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 07/2000; 6(6):331-3.

• Methicillin resistant Staphylococcus aureus in German hospitals develop narrower patterns of antimicrobial resistance.

  Authors: W Witte, C Braulke, D Heuck, C Cuny

  Euro surveillance : bulletin europeen sur les maladies transmissibles = European communicable disease bulletin. 04/2000; 5(3):31-34.

  The prevalence of methicillin resistant Staphylococcus aureus (MRSA) in German hospitals has continued to increase, but the range of anti-microbials to which they are resistant has decreased. TheThe prevalence of methicillin resistant Staphylococcus aureus (MRSA) in German hospitals has continued to increase, but the range of anti-microbials to which they are resistant has decreased. The trend cannot be attributed to changes in antibiotic consump

• Detection of oxacillin resistance in Staphylococcus aureus by screening tests.

  Authors: C Cuny, B Pasemann, W Witte

  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 11/1999; 18(11):834-6.

• Methicillin-resistant Staphylococcus aureus exhibiting genomic fingerprints of phage group I strains in a hospital and in a nurse's family.

  Authors: C Windmeier, C Cuny, C Braulke, D Heuck, W Witte

  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 03/1999; 18(2):156-8.

• A database system for fragment patterns of genomic DNA of Staphylococcus aureus.

  Authors: H Claus, C Cuny, B Pasemann, W Witte

  Zentralblatt für Bakteriologie : international journal of medical microbiology. 01/1998; 287(1-2):105-16.

  The increasing use of molecular fingerprints in the epidemiology of bacterial nosocomial infections urgently demands a computerised analysis and storage of corresponding patterns, especially withThe increasing use of molecular fingerprints in the epidemiology of bacterial nosocomial infections urgently demands a computerised analysis and storage of corresponding patterns, especially with regard to results obtained at different times and in different laboratories. This paper presents a database system in connection with cluster analysis of clonal relations by using genomic DNA fragment patterns of S. aureus (SmaI-digestion, pulsed-field gel electrophoresis) as an example: The database is operated under MS-Access, version 2.0. The cluster analysis is based on an optimising similarity algorithm.

• Widespread dissemination of epidemic MRSA in German hospitals.

  Authors: W Witte, C Cuny, C Braulke, D Heuck, I Klare

  Euro surveillance : bulletin europeen sur les maladies transmissibles = European communicable disease bulletin. 05/1997; 2(4):25-28.

  Strains of Staphylococcus aureusresistant to multiple antibiotics, including those resistant to methicillin (MRSA), present a major problem in the control of hospital acquired infections. SomeStrains of Staphylococcus aureusresistant to multiple antibiotics, including those resistant to methicillin (MRSA), present a major problem in the control of hospital acquired infections. Some strains show a definite capacity for spread once introduced in

• Typing of Staphylococcus aureus by PCR for DNA sequences flanked by transposon Tn916 target region and ribosomal binding site.

  Authors: C Cuny, W Witte

  Journal of clinical microbiology. 07/1996; 34(6):1502-5.

  The continuous intra- and interhospital spread of multiresistant Staphylococcus aureus demands a rapid molecular typing system. This study describes the fingerprinting of S. aureus by PCRThe continuous intra- and interhospital spread of multiresistant Staphylococcus aureus demands a rapid molecular typing system. This study describes the fingerprinting of S. aureus by PCR amplification of DNA sequences flanked by the target site for transposon Tn916 and the ribosomal binding site and neighboring nucleotides (target 916-Shine-Dalgarno PCR [tar 916-shida PCR]). Both starting points for PCR are known to be randomly distributed on the S. aureus chromosome. By use of SmaI-macrorestriction patterns as the reference method it was shown that this PCR genotyping discriminates among strains of the major clonal groups of the species S. aureus (strains with phage patterns 29, +, 94, 96, and 95 as well as group II and group III patterns) and identifies the six epidemic methicillin-resistant S. aureus strains prevalent in German hospitals. All of the investigated strains including methicillin-sensitive. S. aureus were typeable. Tar 916-shida patterns are stable during the dissemination of epidemic methicillin-resistant S. aureus among different hospitals.

• Discrimination of S. aureus strains by PCR for r-RNA gene spacer size polymorphism and comparison to SmaI macrorestriction patterns.

  Authors: C Cuny, H Claus, W Witte

  Zentralblatt für Bakteriologie : international journal of medical microbiology. 05/1996; 283(4):466-76.

  The size polymorphism of the internal spacer between the 16 S and the 23 S r-RNA genes was studied in S. aureus with the aid of PCR. The patterns of corresponding PCR products were compared withThe size polymorphism of the internal spacer between the 16 S and the 23 S r-RNA genes was studied in S. aureus with the aid of PCR. The patterns of corresponding PCR products were compared with SmaI-generated macrorestriction patterns for definite propagating strains of S. aureus typing phages, for strains with phage pattern 29, phage-group II patterns, phage pattern 94, 96, phage pattern 95 and epidemic methicillin-resistant strains (MRSA). The spacer length polymorphism did not prove to be as discriminative as genomic DNA fragment patterns. However, as shown for S. aureus with phage patterns 29; group II; 94, 96; 95 and also for 4 out of 6 epidemic MRSA, unique patterns of r-RNA gene spacers probably indicate a relatedness among strains which is also suggested by SmaI macrorestriction patterns.