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Streptococci, Healthcare-associated infections - Coggle Diagram

- - - - LA-MRSA
        
        First described in 2003 in patients with contact to pig farming in The Netherlands
        
        LA-MRSA mostly of clonal complex (CC) 398
        
        Spread in Europe and worldwide
        
        Livestock as reservoir
        
        Colonization/infection of other hosts/habitats
        - Spill over into hospital settings!
        
        Carriage of numerous novel and uncommon antimicrobial resistance genes
        
        Many on plasmids and other mobile genetic elements
- - - - Resistance to antibiotics
        
        bacteria in biofilms are more resistant to antibiotics than their planktonic counterparts (>500-fold)
        
        varying metabolic activity and gene expression within biofilms
        Role of extracellular matrix
        
        simple diffusion barrier
        
        binding to positively charged antibiotic molecules (e.g. aminoglycosides)
        
        attenuation of host response
        
        retention of host nutrients
      - PIA
        
        Homoglycan made of β-1,6-linked N-acetylglycosamine residues
        -20% of the residues are deacetylated
        
        icaADBC-Operon: encodes for enzymes for PIA-synthesis