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Penicillin-binding protein 2a (PBP2a) is the primary beta-lactam resistance determinant of methicillin-resistant Staphylococcus aureus (MRSA). MecA, the gene coding for PBP2a, was cloned with the membrane-anchoring region at the N-terminus deleted. The truncated protein (PBP2a) was overexpressed in Escherichia coli mostly in the soluble form accounting for(More)
Antimicrobial therapy can increase the colonization density of gastrointestinal vancomycin-resistant enterococci (VRE). Among previously VRE-colonized patients, we evaluated VRE colonization before and after initiation of antimicrobial therapy by means of polymerase chain reaction (PCR) and culture. Perianal swab samples were obtained at admission to the(More)
BACKGROUND The effect of large-scale expanded surveillance for methicillin-resistant Staphylococcus aureus (MRSA) on health care-associated MRSA disease is not known. OBJECTIVE To examine the effect of 2 expanded surveillance interventions on MRSA disease. DESIGN Observational study comparing rates of MRSA clinical disease during and after hospital(More)
BACKGROUND Clostridium difficile-associated diarrhea (CDAD) is the major cause of health care-associated infectious diarrhea. Current laboratory testing lacks a single assay that is sensitive, specific, and rapid. The purpose of this work was to design and validate a sensitive and specific real-time polymerase chain reaction (PCR) diagnostic test for CDAD.(More)
UNLABELLED Surgical site infections (SSIs) with Staphylococcus aureus are a recognized adverse event of hip and knee replacements. We evaluated the impact of a program to detect S. aureus nasal carriers before surgery with preoperative decolonization (using mupirocin twice daily for 5 days prior to surgery) of carriers. Nasal swab samples were obtained from(More)
We evaluated the use of the BD GeneOhm MRSA real-time PCR assay (BD Diagnostics, San Diego, CA) for the detection of nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA). The initial evaluation consisted of 403 paired nasal swabs and was done using the specimen preparation provided with the kit and an in-house lysis method that was(More)
Nasal carriage of Staphylococcus aureus is considered a source of subsequent infection in health care settings. Utilization of real-time polymerase chain reaction (PCR) for detection of S. aureus has the potential to dramatically affect infection control practice by rapidly identifying S. aureus-colonized patients. We developed and validated the use of(More)
The impact of active surveillance of patients at risk for infection with vancomycin-resistant enterococci (VRE) was examined, and VRE bacteremia rates and the degree of VRE clonality in 2 similar neighboring hospitals were compared. Hospital A did not routinely screen patients for VRE rectal colonization; hospital B actively screened high-risk patients.(More)
Invasive and skin community-associated (CA)-methicillin-resistant Staphylococcus aureus isolates from children were matched with invasive CA-methicillin-sensitive S. aureus strains during 2000-2004. Isolates were analyzed for presence of Panton-Valentine leukocidin. A USA400 lineage clone (n = 6) and the predominant USA300 lineage clone emerged.
Direct multiplex PCR assay using vanA and vanB primers, which provides rapid results, was more sensitive than culture on selective media for samples collected by rectal swab (20 of 46 versus 8 of 46; P < 0.001) or perianal swab (17 of 58 versus 12 of 58; P = 0.059) for the detection of gastrointestinal colonization by vancomycin-resistant enterococci.