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Meticillin-resistant Staphylococcus pseudintermedius
Synonym(s): MRSP (previously MRSI); MR-S.pseudintermedius (previously MR-S.intermedius), methicillin-resistant S. pseudintermedius
Introduction
Classification
Taxonomy
- Genus: Staphylococcus
- Family: Micrococcaceae
- Species: pseudintermedius
- Antimicrobial-resistance: carries additional genetic marker mecA for meticillin-resistance and broad β-lactam resistance.
Etymology
- Gk: staphyle- bunch of grapes; coccus- grain or berry; Gk: pseud- like/similar to; Latin: intermedius:-in-between. S. intermedius Staphylococcus intermedius was first described in 1976 as the main skin pathogen in dogs with characteristics ‘in between’ S. aureus Staphylococcus aureus and S. epidermidis Staphylococcus epidermidis; S. pseudintermedius was formerly named S. intermedius. It was first described as a separate species in 2005 when results from molecular analyses became available.
- Meticillin (INN; international non-proprietory name) or Methicillin (USAN; United States adopted names): semisynthetic penicillin introduced for clinical use in 1959 but no longer manufactured today. Marker for broad beta-lactam antibiotic resistance.
Distribution
- Worldwide.
- Primarily dogs but also an important multidrug-resistant pathogen in cats.
- MRSP prevalence varies between countries (and likely regions) but increasing worldwide since 2005. At present (2017), MRSP rates, as reported by veterinary diagnostic laboratories from clinical S. pseudintermedius isolates (almost all from dogs), are around 5% in the UK, 20-30% in continental Europe and up to 50% in the US and areas in Asia.
- MRSP infections in humans are rare (individual cases reported).
Significance
- For the patient:
- Multidrug-resistance of MRSP complicates treatment of infections.
- Superficial infections can have a good prognosis as topical antibacterial therapy should be effective provided compliant owners and pets.
- Deep infections may be difficult to treat.
- MRSP typically more drug resistant than MRSA Methicillin-resistant Staphylococcus aureus.
- Some strains resistant to all clinically relevant and licensed drugs.
- For the veterinary practice:
- MRSP should be considered a nosocomial pathogen.
- Spreads easily between dogs (and cats), survives many months on dry surfaces, spread by direct and indirect contact.
- Extensive environmental and personal hygiene measures needed to prevent/stop outbreaks.
- For owners:
- Zoonotic infections are reported although rare.
- Immuno-compromised people likely with increased risk.
- Good hygiene measures will limit the risk of transmission.
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Clinical Effects
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Diagnosis
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Morris D O, Loeffler A, Davis M F et al (2017) Recommendations for approaches to meticillin-resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures.: Clinical Consensus Guidelines of the World Association for Veterinary Dermatology. Vet Dermatol 28 (3), 304-e69 PubMed.
- Borio S, Colombo S, La Rosa G et al (2015) Effectiveness of a combined (4% chlorhexidine digluconate shampoo and solution) protocol in MRS and non-MRS canine superficial pyoderma: a randomized, blinded, antibiotic-controlled study. Vet Dermatol 26 (5), 339-344, e72 PubMed.
- Grönthal T, Moodley A, Nykäsenoja S et al (2014) Large outbreak caused by methicillin resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital--from outbreak control to outbreak prevention. PLoS One 9 (10), e110084 PubMed.
- Moodley A, Damborg P, Nielsen S S (2014) Antimicrobial resistance in methicillin susceptible and methicillin resistant Staphylococcus pseudintermedius of canine origin: literature review from 1980 to 2013. Vet Microbiol 171 (3-4), 337-341 PubMed.
- Beco L, Guaguère E, Lorente Méndez C et al (2013) Suggested guidelines for using systemic antimicrobials in bacterial skin infections: part 2-- antimicrobial choice, treatment regimens and compliance. Vet Rec 172 (6), 156-160 PubMed.
- Singh A, Walker M, Rousseau J et al (2013) Methicillin-resistant staphylococcal contamination of clothing worn by personnel in a veterinary teaching hospital. Vet Surg 42 (6), 643-648 PubMed.
- Bond R, Loeffler A (2012) What's happened to Staphylococcus intermedius? Taxonomic revision and emergence of multi-drug resistance. J Small Anim Pract 53 (3), 147-154 PubMed.
- Feng Y, Tian W, Lin D et al (2012) Prevalence and characterization of methicillin-resistant Staphylococcus pseudintermedius in pets from South China. Vet Microbiol 160 (3-4), 517-524 PubMed.
- Frank LA, Loeffler A (2012) Meticillin-resistant Staphylococcus pseudintermedius: clinical challenge and treatment options. Vet Dermatol 23 (4), 283-291, e56 PubMed.
- Walther B, Hermes J, Cuny C et al (2012) Sharing more than friendship--nasal colonization with coagulase-positive staphylococci (CPS) and co-habitation aspects of dogs and their owners. PLoS One 7 (4), e35197 PubMed.
- Weese J S, Faires M C, Frank L A et al (2012) Factors associated with methicillin-resistant versus methicillin-susceptible Staphylococcus pseudintermedius infection in dogs. J Am Vet Med Assoc 240 (12), 1450-1455 PubMed.
- Windahl U, Reimegård E, Holst B S et al (2012) Carriage of methicillin-resistant Staphylococcus pseudintermedius in dogs--a longitudinal study. BMC Vet Res 8, 34 PubMed.
- Paul N C, Moodley A, Ghibaudo G et al (2011) Carriage of methicillin-resistant Staphylococcus pseudintermedius in small animal veterinarians: indirect evidence of zoonotic transmission. Zoonoses Public Health 58 (8), 533-539 PubMed.
- Soedarmanto I, Kanbar T, Ülbegi-Mohyla H et al (2011) Genetic relatedness of methicillin-resistant Staphylococcus pseudintermedius (MRSP) isolated from a dog and the dog owner. Res Vet Sci 91 (3), e25-27 PubMed.
- van Duijkeren E, Catry B, Greko C et al (2011) Review on methicillin-resistant Staphylococcus pseudintermedius. J Antimicrob Chemother 66 (12), 2705-2714 PubMed.
- Loeffler A, Linek M, Moodley A et al (2007) First report of multi-resistant, mecA-positive Staphylococcus intermedius in Europe: 12 cases from a veterinary dermatology referral clinic in Germany. Vet Dermatol 18 (6), 412-421 PubMed.