Evidence map›Paper›PMID 34215177›Full record

ArticleBMC microbiology2021

Emergence of a mupirocin-resistant, methicillin-susceptible Staphylococcus aureus clone associated with skin and soft tissue infections in Greece.

Nikolaos Giormezis, Anastassios Doudoulakakis, Katerina Tsilipounidaki, Maria Militsopoulou, George Kalogeras, Vasiliki Stamouli, Fevronia Kolonitsiou, Efthimia Petinaki, Evangelia Lebessi, Iris Spiliopoulou

Open access · goldAbstract read
In one paragraph

Article in BMC microbiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Phenotypic and Genotypic Characterization ofPathogens (Basel, Switzerland) · 2025
    Article
  3. Mechanisms of fusidic acid resistance.Biochemical Society transactions · 2025
    Review
  4. Article
  5. Oligopeptide Sortase Inhibitor ModulatesAntibiotics (Basel, Switzerland) · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Nikolaos GiormezisDepartment of Microbiology, School of Medicine, University of Patras, 26504, Patras, Greece.
Anastassios DoudoulakakisDepartment of Microbiology P. & A, Kyriakou Children's Hospital, Athens, Greece.
Katerina TsilipounidakiDepartment of Microbiology, School of Medicine, University of Thessaly, Larissa, Greece.
Maria MilitsopoulouDepartment of Microbiology, University General Hospital of Patras, Patras, Greece.
George KalogerasDepartment of Microbiology P. & A, Kyriakou Children's Hospital, Athens, Greece.
Vasiliki StamouliDepartment of Microbiology, University General Hospital of Patras, Patras, Greece.
Fevronia KolonitsiouDepartment of Microbiology, School of Medicine, University of Patras, 26504, Patras, Greece.
Efthimia PetinakiDepartment of Microbiology, School of Medicine, University of Thessaly, Larissa, Greece.
Evangelia LebessiDepartment of Microbiology P. & A, Kyriakou Children's Hospital, Athens, Greece.
Iris SpiliopoulouDepartment of Microbiology, School of Medicine, University of Patras, 26504, Patras, Greece. spiliopl@upatras.gr.
Panagiotis & Aglaia Kyriakou Children's Hospital · GRUniversity of Patras · GRGeneral University Hospital of Patras · GRUniversity of Thessaly · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStaphylococcus aureus causes various infections, including skin and soft tissue infections (SSTIs). In this study, methicillin-susceptible S. aureus (MSSA) from SSTIs among patients in three tertiary-care hospitals in Greece were studied in terms of antimicrobial resistance, clonal distribution, toxin and adhesin genes carriage.

resultsDuring a five-year period (2014-2018), 6145 S. aureus were recovered from 13,244 patients with SSTIs and tested for antimicrobial susceptibility. MSSA were 4806 (78.21 %) including 1484 isolates with mupirocin minimum inhibitory concentration (MIC) > 64 mg/L (30.88 %). Two hundred and sixty representative mupirocin-resistant MSSA were analyzed for genes encoding Panton-Valentine leukocidin (PVL, lukS/lukF-PV), exfoliative toxins (eta, etb), adhesin FnbA (fnbA) and resistance genes mupA (high-level resistance to mupirocin), fusB (fusidic acid), aminoglycosides' modifying enzymes, ermA, ermC and msrA (macrolides/lincosamides) by PCRs. Strains were classified into clones by PFGE and MLST. All mupirocin-resistant MSSA were penicillin-resistant; 92.7 % expressed resistance to fusidic acid and 88.9 % to tobramycin. All 260 molecularly analyzed isolates were mupA-positive; all fusidic acid-resistant (241/260) carried fusB whereas, the tobramycin-resistant ones (230), ant(4')-Ia. The majority carried eta (93.85 %), etb (98.08 %) and fnbA (88.85 %). PFGE typing revealed a mostly unvarying population; 260 MSSA were grouped into three types. One major eta/etb-positive clone comprising of 258/260 strains (99.2 %), PFGE type 1, was classified as ST121, including nine strains co-carrying PVL. Another PVL-positive strain was identified as ST1, and one toxins-negative as ST21.

conclusionsA mupirocin-resistant MSSA clone, ST121, carrying resistance, exfoliative toxins and adhesin genes, was spread and predominated in SSTIs from patients in Greece during the five-year studied period.

Indexed as

AdultAnti-Bacterial AgentsBacterial ToxinsExotoxinsGenes, BacterialGreeceHumansLeukocidinsMethicillinMultilocus Sequence TypingMupirocinSoft Tissue InfectionsStaphylococcal InfectionsStaphylococcal Skin InfectionsStaphylococcus aureusAnti-Bacterial AgentsBacterial ToxinsExotoxinsLeukocidinsMethicillinMupirocinPanton-Valentine leukocidinExfoliative toxinsGreeceMSSAMupirocin-resistantSSTIsST121

Identifiers

PMID34215177
PMCPMC8254358
OpenAlexW3175406259

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.