Evidence map›Paper›PMID 39939973›Full record

ArticleBMC infectious diseases2025

Genomic characterization of healthcare-associated ST5 MRSA causing severe pseudomembranous enteritis in intensive care unit.

Lu Sun, Feiteng Zhu, Yiyi Chen, Yue Shi, Haiping Wang, Yunsong Yu, Zhihua Lu, Yan Chen

Abstract readCase Reports
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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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

8 authors.

Lu Sun *Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Feiteng Zhu *Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Yiyi ChenDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Yue ShiKey Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, Zhejiang, China.
Haiping WangDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Yunsong YuDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Zhihua LuDepartment of Intensive Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. hzhza86403393@zju.edu.cn.
Yan ChenDepartment of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. chenyan@zju.edu.cn.

Funding

National Natural Science Foundation of China 81971977National Natural Science Foundation of China 82102434
6 · The paper itself

Abstract

backgroundMethicillin resistant Staphylococcus aureus (MRSA) is one of the main causes of hospital-acquired infections, but the diagnosis of MRSA pseudomembranous enteritis has faded in recent years. Here, we reported a pseudomembranous enteritis case in a young male patient caused by ST5 MRSA.

methodsClinical data of the patient were collected from medical records. Mass spectrometry identification, antimicrobial susceptibility testing, whole genome sequencing, as well as resistance and virulence genes detection of MRSA strain were performed.

resultsA 27-year-old young man with acute pancreatitis and septic shock in the intensive care unit passed large volume of intestine-like "stool" with more than 200 centimetres in length. A large number of Gram-positive cocci was persistently found in the stool samples. Histopathological examination of the intestine-like stool revealed that this stool was actually pseudomembrane, consisting of fibrinous exudate, inflammatory cells and clusters of gram-positive cocci adjacent to the luminal border. The patient was suspected for diagnosis of pseudomembranous enteritis. Stool and gastric juice cultures were positive for MRSA. These strains belonged to ST5-SCCmec II-t311, and harbored abundant virulence genes, especially enterotoxin genes. They contained not only sea, sec3, sel, but an enterotoxin gene cluster (egc, seg, sei, sem, sen, seo, yent1 and yent2), which may serve as an enterotoxin gene nursery. Besides, the strains were related to the isolates of the same hospital between 2013 and 2015, and there may be nosocomial transmission.

conclusionsThe severe clinical symptoms in this patient and the described virulence genes all suggested that these ST5 strains belonged to a kind of hypervirulent MRSA lineage. At the same time, the analysis of cgMLST indicated that there might be nosocomial transmission, which required the society to pay more attention to this highly virulent nosocomial clone.

Indexed as

Cross InfectionEnterocolitis, PseudomembranousMethicillin-Resistant Staphylococcus aureusStaphylococcal InfectionsAdultAnti-Bacterial AgentsFecesGenome, BacterialGenomicsHumansIntensive Care UnitsMaleMicrobial Sensitivity TestsVirulence FactorsWhole Genome SequencingAnti-Bacterial AgentsVirulence FactorsHealthcare-associated MRSAHypervirulentIntensive care unitPseudomembranous enteritis

Identifiers

PMID39939973
PMCPMC11823201

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