Coagulase-positive staphylococci

凝固酶阳性葡萄球菌
  • 文章类型: Journal Article
    奶牛乳腺炎(BM)在全球范围内造成了巨大的经济和经济损失,以金黄色葡萄球菌为主要病原菌之一。BM治疗仍然依赖于抗生素,其广泛使用通常会产生耐甲氧西林的金黄色葡萄球菌(MRSA)和耐莫匹罗星的金黄色葡萄球菌(MuRSA)。这项研究比较了从常规和有机奶牛场的BM牛奶中分离出的凝固酶阳性葡萄球菌(CoPS)的耐药性趋势,并检查了MRSA和MuRSA的患病率。共分离出163种推定葡萄球菌,其中来自4个常规农场(CF1,CF2,CF3,CF4)的74个中的11个和来自3个有机农场(OF1,OF2,OF3)的89个中的17个表现出凝固酶活性。多重PCR扩增证实至少一种来自CF1、CF2、CF3、CF4和OF1的凝固酶阳性分离物是金黄色葡萄球菌,由nuc基因的存在表示。来自CF2的三个分离株含有mecA基因,表明MRSA患病率,而MuRSA基因标记,mupa,在任何分离物中都没有检测到。抗菌试验表明,传统的农场分离株对抗生素的耐药性更强,尤其是氨苄西林和四环素.这表明,如果抗生素的使用没有得到适当和严格的监测和监管,奶牛场就有发展多药耐药性的风险。
    Bovine mastitis (BM) has caused huge economic and financial losses in the dairy industry worldwide, with Staphylococcus aureus as one of its major pathogens. BM treatment still relies on antibiotics and its extensive use often generates methicillin-resistant S. aureus (MRSA) and mupirocin-resistant S. aureus (MuRSA). This study compared the antimicrobial resistance trend in coagulase-positive Stapholococci (CoPS) isolated from BM milk in conventional and organic dairy farms and checked prevalence of MRSA and MuRSA. A total of 163 presumptive Staphylococci were isolated, wherein 11 out of 74 from 4 conventional farms (CF1, CF2, CF3, CF4) and 17 out of 89 from 3 organic farms (OF1, OF2, OF3) exhibited coagulase activity. Multiplex-PCR amplification confirmed at least one coagulase-positive isolate from CF1, CF2, CF3, CF4, and OF1 as S. aureus, denoted by the presence of the nuc gene. Three isolates from CF2 contained the mecA gene, indicating MRSA prevalence, while the MuRSA gene marker, mupA, was not detected in any of the isolates. Antimicrobial testing showed that conventional farm isolates were more resistant to antibiotics, especially ampicillin and tetracycline. This suggests a risk of developing multidrug resistance in dairy farms if antibiotic use is not properly and strictly monitored and regulated.
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  • 文章类型: Journal Article
    葡萄球菌是人类许多感染的原因,从皮肤和软组织感染开始,到心内膜炎等侵入性疾病结束,脓毒症和肺炎,导致高死亡率。败血症患者通常表现出活化的凝血途径,抗凝剂水平下降,纤维蛋白溶解减少,活化的内皮表面和活化的血小板。这导致弥散性血管内凝血和微血栓的形成,会导致多器官衰竭.这篇综述描述了导致血管血栓形成的各种葡萄球菌毒力因子。包括感染患者的深静脉血栓形成。本文介绍了细菌在各种宿主防线中释放的不同因子的作用机制。这反过来会导致血管中血凝块的形成。
    Staphylococci are responsible for many infections in humans, starting with skin and soft tissue infections and finishing with invasive diseases such as endocarditis, sepsis and pneumonia, which lead to high mortality. Patients with sepsis often demonstrate activated clotting pathways, decreased levels of anticoagulants, decreased fibrinolysis, activated endothelial surfaces and activated platelets. This results in disseminated intravascular coagulation and formation of a microthrombus, which can lead to a multiorgan failure. This review describes various staphylococcal virulence factors that contribute to vascular thrombosis, including deep vein thrombosis in infected patients. The article presents mechanisms of action of different factors released by bacteria in various host defense lines, which in turn can lead to formation of blood clots in the vessels.
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  • 文章类型: Journal Article
    意大利中部奶酪的微生物安全和卫生概况是根据2013年至2020年的《意大利国家食品安全控制计划》对1373种奶酪进行的分析定义的,并根据委员会法规(EC)No.2073/2005(经修正)。总共97.4%的奶酪样品被评估为符合食品安全标准,80.5%的工艺卫生标准。在2/414个样本中发现了葡萄球菌肠毒素,而沙门氏菌属。在373和437个样本中的15个样本中分别检测到了单核细胞增生李斯特菌。在12/61和17/88奶酪样本中发现大肠杆菌和凝固酶阳性葡萄球菌计数不令人满意,分别。挤奶物种的影响,牛奶热处理,和奶酪硬度类别被考虑。在牛奶热处理与凝固酶阳性葡萄球菌和单核细胞增生李斯特菌的患病率之间以及在大肠杆菌的硬度和不满意水平之间发现了统计学上的显着关联(p<0.05)。这些数据描述了与这些产品相关的包含的公共卫生风险,并证实了,同时,在牛奶和奶酪生产过程中严格遵守良好卫生习惯的重要性。这些结果可以帮助加强风险分析,并为食品安全决策提供见解。
    A profile of the microbial safety and hygiene of cheese in central Italy was defined based on an analysis of 1373 cheeses sampled under the Italian National Control Plan for Food Safety spanning the years 2013 to 2020 and tested according to Commission Regulation (EC) No. 2073/2005 (as amended). A total of 97.4% of cheese samples were assessed as being satisfactory for food safety criteria and 80.5% for process hygiene criteria. Staphylococcal enterotoxin was found in 2/414 samples, while Salmonella spp. and Listeria monocytogenes were detected in 15 samples out of 373 and 437, respectively. Escherichia coli and coagulase-positive staphylococci counts were found unsatisfactory in 12/61 and 17/88 cheese samples, respectively. The impact of milking species, milk thermal treatment, and cheese hardness category was considered. A statistically significant association (p < 0.05) was found between milk thermal treatment and the prevalence of coagulase-positive staphylococci and Listeria monocytogenes and between hardness and unsatisfactory levels of Escherichia coli. The data depict a contained public health risk associated with these products and confirm, at the same time, the importance of strict compliance with good hygiene practices during milk and cheese production. These results can assist in bolstering risk analysis and providing insights for food safety decision making.
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  • 文章类型: Journal Article
    食物中形成的葡萄球菌肠毒素是葡萄球菌食物中毒暴发(SFPO)的病原体。在这项研究中,我们深入描述了在法国发生的两次独立爆发中涉及的两次凝固酶阳性非色素葡萄球菌。虽然使用PCR方法和生长表型比较无法与金黄色葡萄球菌区分,通过全基因组测序将两个分离株鉴定为星状葡萄球菌.对基因组进行了肠毒素基因的分析,其表达在实验室培养基中测定,第一次,通过使用液相色谱-质谱和ELISA方法在人工污染的牛奶样品中。测得的牛奶中SEB毒素的浓度(0.67ng/ml)与SFPO后其他类型肠毒素的浓度相当。从一组公开的基因组中,我们对S.argenteus的肠毒素基因进行了前所未有的系统研究,包括变种和假基因.最普遍的基因是性别,其次是sel26、sel27和sey。egc簇的频率较低,并且大部分时间携带功能失调的seg基因。我们的结果揭示了S.argenteus的肠毒素特性,并强调在监测S.argenteus作为一种新兴的食源性病原体的重要性。
    Staphylococcal enterotoxins preformed in food are the causative agents of staphylococcal food poisoning outbreaks (SFPO). In this study we characterised in depth two coagulase-positive non-pigmented staphylococci involved in two independent outbreaks that occurred in France. While indistinguishable from Staphylococcus aureus using PCR methods and growth phenotype comparisons, both isolates were identified as Staphylococcus argenteus by whole genome sequencing. The genomes were analysed for the presence of enterotoxin genes, whose expression was determined in laboratory medium and, for the first time, in artificially-contaminated milk samples by using liquid chromatography-mass spectrometry and ELISA methods. The concentration measured for the SEB toxin in milk (0.67 ng/ml) was comparable to concentrations reported for other types of enterotoxins behind SFPO. From a collection of publicly available genomes, we performed an unprecedented systematic investigation of the enterotoxin gene set of S. argenteus, including variants and pseudogenes. The most prevalent genes were sex, followed by sel26, sel27 and sey. The egc cluster was less frequent and most of the time carried a dysfunctional seg gene. Our results shed light on the enterotoxigenic properties of S. argenteus, and emphasize the importance in monitoring of S. argenteus as an emerging foodborne pathogen.
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  • 文章类型: Journal Article
    凝固酶阳性葡萄球菌(CPS)是常见的皮肤病原体,通常需要多个疗程的抗生素。这可能有助于选择耐甲氧西林(MR)和/或耐多药(MDR)菌株。为了确定与皮肤病相关的犬和猫MR/MDRCPS的患病率,回顾性检索了2010年4月至2020年4月的医疗记录.选择具有至少一种CPS阳性培养物的宠物。年龄,性别,抗菌敏感性,记录了既往抗菌药物/免疫调节药物治疗史和甲氧西林耐药/多药耐药状况.犬的假中间葡萄球菌(SP)(575/748)和Schleiferi葡萄球菌(SS)(159/748),和金黄色葡萄球菌(12/22)在猫,是最常见的CPS分离。575个分离株中有23个是MR-SP(56.2%),304/575为MDR-SP(52.8%),100/159为MR-SS(62.9%),71/159为MDR-SS(44.6%)。趋势分析表明,假中介链球菌对苯唑西林和氯霉素的耐药性显着增加(r=0.86,0.8;P=0.0007,0.0034)。MDR-SP的主要危险因素包括苯唑西林耐药(OR:3;95%CI:1.4-6.5;P=0.0044)。PBP2a阳性(OR:2.3;95%CI:1-5;P=0.031)和前一年抗生素使用情况(OR:2.8;95%CI:1.3-5.8;P=0.0071)。苯唑西林耐药是MDR-SS的主要危险因素(OR:8.8;95%CI:3.6-21.1;P<0.0001)。这些结果证实了MR/MDRCPS在转诊的皮肤病患者中的广泛存在。明智地使用抗生素,监测MR/MDR感染和考虑替代疗法对于减少耐药菌株的产生至关重要.
    Coagulase-positive staphylococci (CPS) are common cutaneous pathogens often requiring multiple courses of antibiotics, which may facilitate selection for methicillin-resistant (MR) and/or multidrug-resistant (MDR) strains. To determine the prevalence of canine and feline MR/MDR CPS associated with skin diseases, medical records were retrospectively searched from April 2010 to April 2020. Pets with at least one positive culture for CPS were selected. Age, sex, antimicrobial sensitivity, previous history of antimicrobial/immunomodulatory medications and methicillin resistance/multidrug resistance status were recorded. Staphylococcus pseudintermedius (SP) (575/748) and Staphylococcus schleiferi (SS) (159/748) in dogs, and Staphylococcus aureus (12/22) in cats, were the most common CPS isolated. Three hundred and twenty-three out of 575 isolates were MR-SP (56.2 %), 304/575 were MDR-SP (52.8 %), 100/159 were MR-SS (62.9 %) and 71/159 were MDR-SS (44.6 %). A trend analysis showed a significant increase of resistance to oxacillin and chloramphenicol for S. pseudintermedius (r=0.86, 0.8; P=0.0007, 0.0034, respectively). Major risk factors for MDR-SP included oxacillin resistance (OR: 3; 95 % CI: 1.4-6.5; P=0.0044), positivity for PBP2a (OR: 2.3; 95 % CI: 1-5; P=0.031) and use of antibiotics in the previous year (OR: 2.8; 95 % CI: 1.3-5.8; P=0.0071). Oxacillin resistance was identified as a major risk factor for MDR-SS (OR: 8.8; 95 % CI: 3.6-21.1; P<0.0001). These results confirmed the widespread presence of MR/MDR CPS in referred dermatological patients. Judicious antibiotic use, surveillance for MR/MDR infections and consideration of alternative therapies are crucial in mitigating the development of resistant strains.
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  • 文章类型: Journal Article
    凝固酶阳性葡萄球菌(CoPS)是犬皮肤和耳部感染的主要原因。与葡萄球菌相关的毒力因子包括mec和panton-valentine杀白细胞素(pvl)基因的表达。甲氧西林耐药(MR)通常与mecA基因表达有关,尽管最近发现了一个变体,mecC,已被报道。本研究旨在评估mecA的患病率,从脓皮病犬收集的232例临床CoPS分离株中的mecC和pvl基因。多重PCR,对所有分离株进行头孢西丁的Kirby-Bauer纸片扩散敏感性试验。对127个分离株进行了PBP2a凝集试验。标准MRSA分离物用作阳性对照。在149/232个分离株(64.2%)中鉴定出mecA基因:116个假中间芽孢杆菌,30个凝结链球菌和3个金黄色葡萄球菌。pvl基因仅存在于1种假中间芽孢杆菌(0.4%)中,而没有分离物携带mecC基因。34株对头孢西丁耐药(14.6%),均为mecA阳性。这项研究的结果表明,MR患病率为64.2%,证实了对兽药中抗生素耐药性的担忧。总之,这是第一项分析mecC和pvl与mecA相比的患病率的研究,在来自脓皮病犬的大量CoPS临床分离株中。对兽药中mecC和pvl的流行进行多模式监测对于适当的抗菌管理至关重要。
    Coagulase positive Staphylococci (CoPS) are the leading cause of canine cutaneous and otic infections. Virulence factors associated with Staphylococci include the expression of mec and panton-valentine leukocidin (pvl) genes. Methicillin-resistance (MR) is commonly associated with mecA gene expression, although a recently identified variant, mecC, has been reported. This study aims to evaluate the prevalence of mecA, mecC and pvl genes in 232 clinical isolates of CoPS collected from dogs with pyoderma. A multiplex PCR, and Kirby-Bauer disk diffusion susceptibility test for cefoxitin was performed for all isolates. PBP2a agglutination test was performed on 127 isolates. Standard MRSA isolates were used as positive controls. The mecA gene was identified in 149/232 isolates (64.2%): 116 S. pseudintermedius, 30 S. coagulans and three S. aureus. The pvl gene was present in only 1 isolate of S. pseudintermedius (0.4%), whereas no isolates carried the mecC gene. 34 isolates were resistant to cefoxitin (14.6%) and they were all mecA positive. The results of this study show an MR prevalence of 64.2% confirming concerns about antibiotic resistance in veterinary medicine. In conclusion, this is the first study analyzing the prevalence of mecC and pvl in comparison to mecA, in a large cohort of CoPS clinical isolates from dogs with pyoderma. A multimodal surveillance on the prevalence of mecC and pvl in veterinary medicine is essential to appropriate antimicrobial management.
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  • 文章类型: Journal Article
    细菌素是与人类和动物微生物群的调节相关的抗微生物肽,其在生物医学和生物技术应用中获得了兴趣。在这项研究中,在890种不同来源的葡萄球菌(人类,动物,食物,和环境)和物种,都是凝固酶阳性(CoPS,238个3种分离株)和凝固酶阴性葡萄球菌(CoNS,652个分离株26种)。在890例葡萄球菌中,60(6.7%)通过草坪上斑点方法对所测试的25种指示细菌中的至少一种显示出抗微生物活性。在8.8%的CoPS和6.0%的CoNS中检测到BLIS生产者(BLIS)分离株。具有最高百分比的BLIS+分离株的葡萄球菌是S.chromogenes(38.5%),S、伪中介(26.7%),和S.Warneri(23.1%)。在宠物分离株中更频繁地检测到BLIS的产生,野生动物,和食物。此外,13株BLIS+菌株具有广泛的抗菌活性,和7个这些分离株(金黄色葡萄球菌,美国伪中介,S.sciuri,和人型链球菌)对超过70%的测试指示细菌具有抗菌活性。60个BLIS分离株的遗传特征(通过PCR和测序)揭示了(a)11个携带假定的抗生素样基因的CoNS和CoPS分离株的检测;(b)3个假中间杆菌分离株具有BacSp222细菌素的基因;(c)2个S.染色体分离株呈现假定的环状细菌素(uberolysin-like)的基因,是该CoNS物种的第一份报告。在BLIS+分离株中进行抗菌药物敏感性试验,三分之一的CoNS分离株显示对所有试验抗生素的敏感性,也缺乏所研究的毒力基因。这些BLIS+CoNS是进一步表征研究的良好候选者。
    Bacteriocins are antimicrobial peptides with relevance in the modulation of human and animal microbiota that have gained interest in biomedical and biotechnological applications. In this study, the production of bacteriocin-like inhibitory substances (BLIS) was tested among a collection of 890 staphylococci of different origins (humans, animals, food, and the environment) and species, both coagulase-positive (CoPS, 238 isolates of 3 species) and coagulase-negative staphylococci (CoNS, 652 isolates of 26 species). Of the 890 staphylococci, 60 (6.7%) showed antimicrobial activity by the spot-on-lawn method against at least one of the 25 indicator bacteria tested. BLIS-producer (BLIS+) isolates were detected in 8.8% of CoPS and 6.0% of CoNS. The staphylococcal species with the highest percentages of BLIS+ isolates were S. chromogenes (38.5%), S. pseudintermedius (26.7%), and S. warneri (23.1%). The production of BLIS was more frequently detected among isolates of pets, wild animals, and food. Moreover, 13 BLIS+ isolates showed wide antimicrobial activiy spectrum, and 7 of these isolates (of species S. aureus, S. pseudintermedius, S. sciuri, and S. hominis) demonstrated antimicrobial activity against more than 70% of the indicator bacteria tested. The genetic characterization (by PCR and sequencing) of the 60 BLIS+ isolates revealed the detection of (a) 11 CoNS and CoPS isolates carrying putative lantibiotic-like genes; (b) 3 S. pseudintermedius isolates harboring the genes of BacSp222 bacteriocin; and (c) 2 S. chromogenes isolates that presented the gene of a putative cyclic bacteriocin (uberolysin-like), being the first report in this CoNS species. Antimicrobial susceptibility testing was performed in BLIS+ isolates and one-third of the CoNS isolates showed susceptibility to all antibiotics tested, which also lacked the virulence genes studied. These BLIS+ CoNS are good candidates for further characterization studies.
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  • 文章类型: Journal Article
    葡萄球菌食物中毒的爆发是由摄入受葡萄球菌肠毒素(SE)污染的食物引起的。在迄今为止的文献中描述的27个SE中,使用强烈依赖于抗体可用性的基于免疫酶的方法,只能检测到少数。液相色谱,耦合到高分辨率质谱(LC-HRMS),has,因此,作为一种相关的补充方法,但只用于检测数量有限的肠毒素。在这项工作中,LC-HRMS用于检测和定量24个SE。使用来自24个SE的序列优化了93个特定特征肽和LC-HRMS参数的数据库,包括他们的162个变种。建立无标记的定量方案以克服校准标准品的缺乏。LC-HRMS方法在特异性方面表现出很高的性能,灵敏度,应用于49株肠毒素产生菌株时的准确性。测得的SE浓度取决于SE类型和凝固酶阳性葡萄球菌(CPS)菌株。这项研究表明,LC-MS是ELISA方法的相关替代和补充工具。LC-MS的优势显然在于大量SE的多重分析,和大量样品的自动化分析。
    Staphylococcal food poisoning outbreaks are caused by the ingestion of food contaminated with staphylococcal enterotoxins (SEs). Among the 27 SEs described in the literature to date, only a few can be detected using immuno-enzymatic-based methods that are strongly dependent on the availability of antibodies. Liquid chromatography, coupled to high-resolution mass spectrometry (LC-HRMS), has, therefore, been put forward as a relevant complementary method, but only for the detection of a limited number of enterotoxins. In this work, LC-HRMS was developed for the detection and quantification of 24 SEs. A database of 93 specific signature peptides and LC-HRMS parameters was optimized using sequences from 24 SEs, including their 162 variants. A label-free quantification protocol was established to overcome the absence of calibration standards. The LC-HRMS method showed high performance in terms of specificity, sensitivity, and accuracy when applied to 49 enterotoxin-producing strains. SE concentrations measured depended on both SE type and the coagulase-positive staphylococci (CPS) strain. This study indicates that LC-MS is a relevant alternative and complementary tool to ELISA methods. The advantages of LC-MS clearly lie in both the multiplex analysis of a large number of SEs, and the automated analysis of a high number of samples.
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  • 文章类型: Journal Article
    背景:这项研究调查了波兰繁殖的玉米属可食用蜗牛的卵作为食物,旨在确定沙门氏菌和李斯特菌属中微生物的存在,并确定凝固酶阳性葡萄球菌的数量。
    方法:原材料,半成品,并在生产周期中收集最终产品。检测沙门氏菌的存在。和李斯特菌。并根据ISO标准进行致病性葡萄球菌污染水平的测量。商业生化测试用于肠杆菌科和葡萄球菌属细菌的物种鉴定。API试剂盒和PCR方案用于李斯特菌属微生物的物种确认。
    结果:在任何研究材料中均未发现沙门氏菌和凝固酶阳性葡萄球菌。在生产的每个阶段采集的样品中都发现了李斯特菌属的细菌;但是,在最终产品的样品中证实了单核细胞增生李斯特菌。
    结论:不存在沙门氏菌。最终产品样品中的金黄色葡萄球菌表明在食用蜗牛卵的生产过程中保持了所需的卫生标准。然而,普通花园蜗牛的卵中存在单核细胞增生李斯特菌可能对消费者健康构成潜在风险。
    BACKGROUND: This study investigated the eggs of Polish-bred edible snails of the Cornu genus as a food and aimed to determine the presence of microorganisms in them of the Salmonella and Listeria genera and ascertain the number of coagulase-positive staphylococci.
    METHODS: Raw material, semi-finished products, and the final product were collected during the production cycle. Testing for the presence of Salmonella spp. and Listeria spp. and measuring of the pathogenic staphylococci contamination level were carried out in accordance with ISO standards. Commercial biochemical tests were used for species identification of bacteria of the Enterobacteriaceae family and Staphylococcus genus. An API kit and a PCR protocol were utilised for species confirmation of the microorganisms of the Listeria genus.
    RESULTS: Neither Salmonella nor coagulase-positive staphylococci were found in any of the studied material. Bacteria of the Listeria genus were found in samples taken at every stage of production; however L. monocytogenes was confirmed in samples of the final product.
    CONCLUSIONS: The absence of Salmonella spp. and Staphylococcus aureus in samples of the final product indicates that the required hygiene standard was maintained in the production process of edible snail eggs. Nevertheless, the presence of L. monocytogenes in eggs of common garden snails may pose a potential risk to consumer health.
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  • 文章类型: Journal Article
    The main objectives of the present study were to determine the occurrence of coagulase positive staphylococci (CPS) and to assess the presence and antimicrobial susceptibility profile of Staphylococcus aureus isolates in different raw milk origin (cow and sheep) traditional cheeses marketed in Banat region, Romania. Additionally, the presence of mecA gene in S. aureus isolates and the staphylococcal enterotoxins (SEs) in cheese samples were evaluated. A total of 81.6% (138/169) of the screened samples were positive for CPS. Furthermore, 35.5% (49/138) of the investigated CPS positive cheese samples were contaminated with S. aureus, with an isolation frequency of 46.6% (14/30) in caș, 33.3% (32/96) in telemea, 25% (2/8) in burduf, and 25% (1/4) in urdă assortments, respectively. From the total number of S. aureus isolates, 6.1% (3/49) harbored the mecA gene. Detectable levels of SEs were identified in 4.3% (4/94) of cheese samples with a CPS contamination level higher than 105 log CFU g-1. The expressed antimicrobial susceptibility profile of the tested cheese-origin S. aureus isolates, with the automated Vitek 2 equipment, showed resistance towards amikacin (90.1%, 10 out from 11 tested), enrofloxacin (86.2%, 25/29), ceftiofur (72.7%, 8/11), neomycin (63.6%, 7/11), benzylpenicillin (53.1%, 26/49), kanamycin (41.4%, 12/29), rifampicin (39.5%, 15/38), tetracycline (38.8%, 19/49), tilmicosin (36.4%, 4/11), clindamycin (30.6%, 15/49), ciprofloxacin (30%, 6/20), erythromycin (22.4%, 11/49), tylosin (18.2%, 2/11), oxacillin (16.3%, 8/49), linezolid (15%, 3/20), teicoplanin (15%, 3/20), fusidic acid (13.1%), imipenem (10.5%, 4/38), vancomycin (7.9%, 3/38), ampicillin (5.5%, 1/18), mupirocin (5.5%, 1/18), fosfomycin (5%, 1/20), and gentamicin (4.1%, 2/49). Twenty-four (49%) S. aureus isolates exhibited multidrug resistance. The investigation highlighted a common occurrence of multidrug-resistant S. aureus strains in the monitored cheese assortments, which can constitute a potential risk for consumers\' health.
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