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C Braulke

Bio: C Braulke is an academic researcher from Robert Koch Institute. The author has contributed to research in topics: Methicillin-resistant Staphylococcus aureus & Staphylococcus aureus. The author has an hindex of 12, co-authored 23 publications receiving 903 citations.

Papers
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Journal ArticleDOI
TL;DR: The value of spa typing in combination with BURP (based upon repeat pattern) grouping analysis as a frontline tool in the epidemiological typing of S. aureus is determined, based on a random collection of clinical isolates sent to the German Reference Centre for Staphylococci within a 6-month period.
Abstract: We determined the value of spa typing in combination with BURP (based upon repeat pattern) grouping analysis as a frontline tool in the epidemiological typing of Staphylococcus aureus, based on a random collection of 1,459 clinical isolates sent to the German Reference Centre for Staphylococci within a 6-month period. The application was found to be helpful for the classification of isolates into the particular clonal lineages currently prevalent in Germany. Due to its major advantages because of the ease of interpretation and the exchangeability of the results, the use of spa typing greatly simplifies communication between laboratories on both the national and the international levels. Thus, it is an excellent tool for national and international surveillance of S. aureus as well as for analysis of the short-term local epidemiology. However, to overcome the limitations of the BURP grouping method in terms of typing accuracy and discriminatory power, the results of the default BURP grouping method must be interpreted with caution. Additional markers, like staphylococcal chromosomal cassette mec, lineage-specific genes, or alternative DNA polymorphisms, are indispensable. They should be selected by dependence on the clonal lineage indicated by spa typing and subsequent BURP analysis as well as on the basis of the particular question to be addressed.

253 citations

Journal ArticleDOI
TL;DR: Investigation of strains of methicillin-resistant Staphylococcus aureus for the presence of the lukS–lukF determinant of Panton–Valentine leukocidin and to further characterize strains found to contain the genes revealed a unique pattern of genomic typing.
Abstract: The aim of the present study was to investigate strains of methicillin-resistant Staphylococcus aureus (MRSA) for the presence of the lukS–lukF determinant of Panton–Valentine leukocidin and to further characterize strains found to contain the genes. During the past 2 years, MRSA containing the lukS–lukF genes for Panton–Valentine leukocidin, particularly those emerging outside of hospitals, have become of interest. MRSA strains sent to the national reference center in Germany were investigated for lukS–lukF by polymerase chain reaction (PCR). If the presence of lukS–lukF was demonstrated, strains were further characterized by molecular typing (determination of SmaI pattern, spa sequence, and multilocus sequence type), PCR demonstration of resistance genes, and characterization of the SCCmec element. Since the end of 2002, MRSA containing Panton–Valentine leukocidin genes have been demonstrated as the causative agent of 28 cases of infection (9 community-acquired cases, 19 sporadic nosocomial cases) in different areas of Germany. Twenty-seven of these 28 isolates exhibited a unique pattern of genomic typing: all exhibited multilocus sequence type 80, spa sequence type 44, and a SmaI macrorestriction pattern that corresponds to a community-acquired strain of MRSA from France and Switzerland. In addition to resistance to oxacillin, the strains exhibited resistance to ciprofloxacin, tetracycline (tetM), and fusidic acid, the last of which is encoded by the far-1 gene. The far-1 gene was shown to be located on the plasmid. One isolate corresponded to community MRSA (cMRSA) of multilocus sequence type 1 from the USA.

137 citations

Journal ArticleDOI
TL;DR: The prevalence of MRSA has increased in central Europe (and Germany) during the last 5 years, to 8.7%, and the mecA gene has been acquired by strains previously sensitive to methicillin.

133 citations

Journal ArticleDOI
Wolfgang Witte1, C Cuny1, Birgit Strommenger1, C Braulke1, D Heuck1 
TL;DR: Analysis of community-acquired methicillin-resistant Staphylococcus aureus (c-MRSA) from Germany producing the Panton-Valentine leukocidin revealed a unique SmaI-macrorestriction pattern, different from epidemic nosocomial strains.
Abstract: Analysis of community-acquired methicillin-resistant Staphylococcus aureus (c-MRSA) from Germany producing the Panton-Valentine leukocidin revealed a unique SmaI-macrorestriction pattern, different from epidemic nosocomial strains. This molecular pattern corresponds to those shown in c-MRSA strains from other countries in the European Union. All isolates exhibited resistance to fusidic acid, which is coded by the far-1 gene. From data on geographical dissemination and time of occurrence, this strain appears to have emerged in Germany in the second half of 2002, and so an already wider dissemination is likely. The emergence of MRSA with resistance to fusidic acid is a first sign of the emergence of a PVL-positive MRSA clone.

64 citations

Journal ArticleDOI
TL;DR: This PCR-based assay was able to correctly identify the majority of the isolates as caMRSA of sequence type 80 (ST80), clonal complex 1 (USA400), and ST8 (USA300) and provides a reliable tool for monitoring the emergence and spread of different ca MRSA clones.
Abstract: The continuous spread of community-acquired methicillin-resistant Staphylococcus aureus (caMRSA) and the introduction of these highly virulent isolates into hospitals represent increasing threats. The timely recognition of caMRSA strains is crucial for infection control purposes. Thus, we developed a PCR-based assay for the easy and rapid determination of those caMRSA clones that currently are the most prevalent in Germany and Central Europe. This assay was able to correctly identify the majority of the isolates as caMRSA of sequence type 80 (ST80), clonal complex 1 (USA400), and ST8 (USA300). In combination with spa typing-BURP (based upon repeat pattern) analysis and resistance typing, it provides a means for the extensive characterization of suspicious isolates. Thus, this assay represents a reliable tool for monitoring the emergence and spread of different caMRSA clones. The resulting information, in combination with careful interpretation of the epidemiological records, might help to prevent the further spread of those highly virulent caMRSA clones.

60 citations


Cited by
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Journal ArticleDOI
TL;DR: This review details the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection and addresses the therapy of these infections and strategies for their prevention.
Abstract: Summary: Staphylococcus aureus is an important cause of skin and soft-tissue infections (SSTIs), endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, foreign-body infections, and sepsis. Methicillin-resistant S. aureus (MRSA) isolates were once confined largely to hospitals, other health care environments, and patients frequenting these facilities. Since the mid-1990s, however, there has been an explosion in the number of MRSA infections reported in populations lacking risk factors for exposure to the health care system. This increase in the incidence of MRSA infection has been associated with the recognition of new MRSA clones known as community-associated MRSA (CA-MRSA). CA-MRSA strains differ from the older, health care-associated MRSA strains; they infect a different group of patients, they cause different clinical syndromes, they differ in antimicrobial susceptibility patterns, they spread rapidly among healthy people in the community, and they frequently cause infections in health care environments as well. This review details what is known about the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection. It also addresses the therapy of these infections and strategies for their prevention.

1,807 citations

Journal ArticleDOI
TL;DR: In this paper, the authors used sequence typing of the spa gene repeat region to study the epidemiology of MRSA at a German university hospital during two periods of 10 and 4 months, respectively.
Abstract: The spa gene of Staphylococcus aureus encodes protein A and is used for typing of methicillin-resistant Staphylococcus aureus (MRSA) We used sequence typing of the spa gene repeat region to study the epidemiology of MRSA at a German university hospital One hundred seven and 84 strains were studied during two periods of 10 and 4 months, respectively Repeats and spa types were determined by Ridom StaphType, a novel software tool allowing rapid repeat determination, data management and retrieval, and Internet-based assignment of new spa types following automatic quality control of DNA sequence chromatograms Isolates representative of the most abundant spa types were subjected to multilocus sequence typing and pulsed-field gel electrophoresis One of two predominant spa types was replaced by a clonally related variant in the second study period Ten unique spa types, which were equally distributed in both study periods, were recovered The data show a rapid dynamics of clone circulation in a university hospital setting spa typing was valuable for tracking of epidemic isolates The data show that disproval of epidemiologically suggested transmissions of MRSA is one of the main objectives of spa typing in departments with a high incidence of MRSA

1,544 citations

Journal ArticleDOI
TL;DR: Active surveillance cultures are essential to identify the reservoir for spread of MRSA and VRE infections and make control possible using the CDC's long-recommended contact precautions, demonstrating consistency of evidence, high strength of association, reversibility, dose gradient, and specificity for control with this approach.
Abstract: patients with MRSA or VRE usually acquire it via spread. The CDC has long-recommended contact precautions for patients colonized or infected with such pathogens. Most facilities have required this as policy, but have not actively identified colonized patients with sur veillance cultures, leaving most colonized patients undetected and unisolated. Many studies have shown control of endemic and/or epidemic MRSA and VRE infections using surveillance cultures and contact precautions, demonstrating consistency of evidence, high strength of association, reversibility, a dose gradient, and specificity for control with this approach. Adjunctive control measures are also discussed. CONCLUSION: Active surveillance cultures are essential to identify the reservoir for spread of MRSA and VRE infections and make control possible using the CDC’s long-recommended contact precautions (Infect Control Hosp Epidemiol 2003;24:362-386).

1,432 citations

Journal ArticleDOI
TL;DR: In this article, the authors describe how Staphylococcus aureus can acquire resistance against all classes of antibiotics by mutation of an existing bacterial gene or horizontal transfer of a resistance gene from another bacterium.

1,099 citations

Journal ArticleDOI
TL;DR: In areas in which community-associated MRSA infection is endemic, empirical treatment of suspected necrotizing fasciitis should include antibiotics predictably active against this pathogen.
Abstract: background Necrotizing fasciitis is a life-threatening infection requiring urgent surgical and medical therapy. Staphylococcus aureus has been a very uncommon cause of necrotizing fasciitis, but we have recently noted an alarming number of these infections caused by communityassociated methicillin-resistant S. aureus (MRSA). methods

1,023 citations