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Clinical, Epidemiological, and Laboratory Aspects of Methicillin-Resistant Staphylococcus aureus (MRSA) Infections

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Methicillin-Resistant Staphylococcus aureus (MRSA) Protocols

Part of the book series: Methods in Molecular Biology ((MIMB,volume 391))

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen responsible for both hospital- and community-onset disease. Resistance to methicillin in S. aureus is mediated by PBP2a, a penicillin-binding protein with low affinity to β-lactams, encoded by the mecA gene. Accurate susceptibility testing of S. aureus isolates and screening of patients for colonization with MRSA are important tools to limit the spread of this organism. This review focuses on the clinical significance of MRSA infections and new approaches for the laboratory diagnosis and epidemiological typing of MRSA strains.

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References

  1. Panlilio, A. L., Culver, D. H., Gaynes, R. P., Banerjee, S., Henderson, S., Tolson, J. S., and Martone, W. J. (1992) Methicillin-resistant Staphylococcus aureus in U.S. hospitals, 1975–1991. Infect. Control Hosp. Epidemiol. 13, 582–586.

    Article  CAS  PubMed  Google Scholar 

  2. Stefani, S. and Varaldo, P. E. (2003) Epidemiology of methicillin-resistant staphylococci in Europe. Clin. Microbiol. Infect. 9, 1179–1186.

    Article  CAS  PubMed  Google Scholar 

  3. Kuehnert, M. J., Hill, H. A., Kupronis, B. A., Tokars, J. I., Solomon, S. L., and Jernigan, D. B. (2005) Methicillin-resistant-Staphylococcus aureus hospitalizations, United States. Emerg. Infect. Dis. 11, 868–872.

    PubMed  Google Scholar 

  4. Cuevas, O., Cercenado, E., Vindel, A., Guinea, J., Sanchez-Conde, M., Sanchez-Somolinos, M., and Bouza, E. (2004) Evolution of the antimicrobial resistance of Staphylococus spp. in Spain: five nationwide prevalence studies. Antimicrob. Agents Chemother. 48, 4240–4245.

    Article  CAS  PubMed  Google Scholar 

  5. Simor, A. E., Ofner-Agostini, M., Bryce, E., et al. (2001) The evolution of methicillin-resistant Staphylococcus aureus in Canadian hospitals: 5 years of national surveillance. CMAJ 165, 21–26.

    CAS  PubMed  Google Scholar 

  6. Cosgrove, S. E., Qi, Y., Kaye, K. S., Harbarth, S., Karchmer, A. W., and Carmeli, Y. (2005) The impact of methicillin resistance in Staphylococcus aureus bacteremia on patient outcomes: mortality, length of stay, and hospital charges. Infect. Control Hosp. Epidemiol. 26, 166–174.

    Article  PubMed  Google Scholar 

  7. Abramson, M. A. and Sexton, D. J. (1999) Nosocomial methicillin-resistant and methicillin-susceptible Staphylococus aureus primary bacteremia: at what costs? Infect. Control Hosp. Epidemiol. 20, 408–411.

    Article  CAS  PubMed  Google Scholar 

  8. NNIS system. (2004) National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1992 through June 2004, issued October 2004. Am. J. Infect. Control 32, 470–485.

    Article  Google Scholar 

  9. Wisplinghoff, H., Bischoff, T., Tallent, S. M., Seifert, H., Wenzel, R. P., and Edmond, M. B. (2004) Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin. Infect. Dis. 39, 309–317.

    Article  PubMed  Google Scholar 

  10. Jones, M. E., Draghi, D. C., Thornsberry, C., Karlowsky, J. A., Sahm, D. F., and Wenzel R. P. (2004) Emerging resistance among bacterial pathogens in the intensive care unit—a European and North American Surveillance study (2000–2002). Ann. Clin. Microbiol. Antimicrob. 29, 3–14.

    Article  Google Scholar 

  11. Palavecino, E. (2004) Community-acquired methicillin-resistant Staphylococcus aureus infections. Clin. Lab. Med. 24, 403–418.

    Article  PubMed  Google Scholar 

  12. Herold, B. C., Immergluck, L. C., Maranan, M. C., et al. (1998) Communityacquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 279, 593–598.

    Article  CAS  PubMed  Google Scholar 

  13. Francis, J. S., Doherty, M. C., Lopatin, U., et al. (2005) Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. Clin. Infect. Dis. 40, 100–107.

    Article  PubMed  Google Scholar 

  14. Miller, L. G., Perdreau-Remington, F., Rieg, G., et al. (2005) Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles. N. Engl. J. Med. 352, 1445–1453.

    Article  CAS  PubMed  Google Scholar 

  15. Naimi, T. S., LeDell, K. H., Como-Sabetti, K., et al. (2003) Comparison of community-and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA 290, 2976–2984.

    Article  CAS  PubMed  Google Scholar 

  16. Fey, P. D., Said-Salim, B., Rupp, M. E., et al. (2003) Comparative molecular analysis of community-or hospital-acquired methicillin-resistant Staphylococcus aureus. Antimicrob. Agents Chemother. 47, 196–203.

    Article  CAS  PubMed  Google Scholar 

  17. Mulvey, M. R., MacDougall, L., Cholin, B., Horsman, G., Fidyk, M., Woods, S., and Saskatchewan CA-MRSA Study Group. (2005) Community-associated methicillinresistant Staphylococcus aureus, Canada. Emerg. Infect. Dis. 11, 844–850.

    CAS  PubMed  Google Scholar 

  18. Vandenesch, F., Naimi, T., Enright, M. C., et al. (2003) Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence. Emerg. Infect. Dis. 9, 978–984.

    PubMed  Google Scholar 

  19. Okuma, K., Iwakawa, K., Turnidge, J. D., et al. (2002) Dissemination of new methicillin-resistant Staphylococcus aureus clones in the community. J. Clin. Microbiol. 40, 4289–4294.

    Article  CAS  PubMed  Google Scholar 

  20. McCormick, J. K., Yarwood, J. M., and Schlievert, P. M. (2001) Toxic shock syndrome and bacterial superantigens: an update. Annu. Rev. Microbiol. 55, 77–104.

    Article  CAS  PubMed  Google Scholar 

  21. Lina, G., Piemont, Y., Godail-Gamot, F., et al. (1999) Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin. Infect. Dis. 29, 1128–1132.

    Article  CAS  PubMed  Google Scholar 

  22. Said-Salim, B., Mathena, B., Braughton, K., et al. (2005) Differential distribution and expression of Panton-Valentine leucocidin among community-acquired methicillin-resistant Staphylococcus aureus strains. J. Clin. Microbiol. 43, 3373–3379.

    Article  CAS  PubMed  Google Scholar 

  23. Barber, M. (1961) Methicillin-resistant staphylococci. J. Clin. Pathol. 14, 385–393.

    Article  CAS  PubMed  Google Scholar 

  24. McDougal, L. K. and Thornsberry, C. (1986) The role of beta-lactamase in staphylococcal resistance to penicillinase-resistant penicillins and cephalosporins. J. Clin. Microbiol. 23, 832–839.

    CAS  PubMed  Google Scholar 

  25. Tomasz, A., Drugeon, H. B., de Lencastre, H. M., Jabes, D., McDougal, L., and Bille, J. (1989) New mechanism for methicillin resistance in Staphylococcus aureus: clinical isolates that lack the PBP 2a gene and contain normal penicillin-binding proteins with modified penicillin-binding capacity. Antimicrob. Agents Chemother. 33, 1869–1874.

    CAS  PubMed  Google Scholar 

  26. Ubukata, K., Yamashita, N., and Konno, M. (1985) Occurrence of a beta-lactam-inducible penicillin-binding protein in methicillin-resistant staphylococci. Antimicrob. Agents Chemother. 27, 851–857.

    CAS  PubMed  Google Scholar 

  27. Chambers, H. F. (1997) Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications. Clin. Microbiol. Rev. 10, 781–791.

    CAS  PubMed  Google Scholar 

  28. Fasola, E. L. and Peterson, L. R. (1992) Laboratory detection and evaluation of antibiotic-resistant Staphylococcus aureus nosocomial infections. In: Weinstein RS, Gram AR (eds). Advances in Pathology, Volume V. Chicago, IL. Mosby-Year Book, Inc. 285–306.

    Google Scholar 

  29. Hiramatsu, K., Cui, L., Kuroda, M., and Ito, T. (2001) The emergence and evolution of methicillin-resistant Staphylococcus aureus. Trends Microbiol. 9, 486–493.

    Article  CAS  PubMed  Google Scholar 

  30. Song, M. D., Wachi, M., Doi, M., Ischino, F., and Matsuhashi, M. (1987) Evolution of an inducible penicillin-target protein in methicillin-resistant Staphylococcus aureus by gene fusion. FEBS Lett. 221, 167–171.

    Article  CAS  PubMed  Google Scholar 

  31. Katayama, Y., Ito, T., and Hiramatsu, K. (2000) A new class of genetic element, staphylococcus cassette chromosome mec, encodes methicillin resistance in Staphylococcus aureus. Antimicrob. Agents Chemother. 44, 1549–1555.

    Article  CAS  PubMed  Google Scholar 

  32. Ito, T., Katayama, Y., Asada, K., Mori, N., Tsutsumimoto, K., Tiensasitorn, C., and Hiramatsu, K. (2001) Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureus. Antimicrob. Agents Chemother. 45, 1323–1336.

    Article  CAS  PubMed  Google Scholar 

  33. Ito, T., Ma, X. X., Takeuchi, F., Okuma, K., Yuzawa, H., and Hiramatsu, K. (2004) Novel type V staphylococcal cassette chromosome mec driven by a novel cassette chromosome recombinase, ccrC. Antimicrob. Agents Chemother. 48, 2637–2651.

    Article  CAS  PubMed  Google Scholar 

  34. Hiramatsu, K., Hanaki, H., Ino, T., Yabuka, K., Oguri, T., and Tenover, F. C. (1997) Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility. J. Antimicrob. Chemother. 40, 135, 136.

    Article  CAS  PubMed  Google Scholar 

  35. Centers for Disease Control and Prevention. (2004) Vancomycin-resistant Staphylococcus aureus: New York 2004. MMWR Morb. Mortal. Wkly. Rep. 53, 322, 323.

    Google Scholar 

  36. Tenover, F. C. and McDonald, L. C. (2005) Vancomycin-resistant staphylococci and enterococci: epidemiology and control. Curr. Opin. Infect. Dis. 18, 300–305.

    Article  CAS  PubMed  Google Scholar 

  37. Appelbaum, P. C. and Bozdogan, B. (2004) Vancomycin resistance in Staphylococcus aureus. Clin. Lab. Med. 24, 381–402.

    Article  PubMed  Google Scholar 

  38. Severin, A., Wu, S. W., Tabei, K., and Tomasz, A. (2004) Penicillin-binding protein 2 is essential for expression of high-level vancomycin resistance and cell wall synthesis in vancomycin-resistant Staphylococcus aureus carrying the enterococcal vanA gene complex. Antimicrob. Agents Chemother. 48, 4566–4573.

    Article  CAS  PubMed  Google Scholar 

  39. Coldren, F. M., Palavecino, E., and Carroll, D. L. (2005) Atomic force microscopy as a potential diagnostic technique in staphylococcal infections. Microsc. Microanal. 11(Suppl. 2), 980, 981.

    Google Scholar 

  40. Touhami, A., Jericho, M. H., and Beveridge, T. J. (2004) Atomic force microscopy of cell growth and division in Staphylococcus aureus. J. Bacteriol. 186, 3286–3295.

    Article  CAS  PubMed  Google Scholar 

  41. Tollersrud, T., Berge, T., Andersen, S. R., and Lund, A. (2001) Imaging the surface of Staphylococcus aureus by atomic force microscopy. APMIS 109, 541–545.

    Article  CAS  PubMed  Google Scholar 

  42. Boyle-Vavra, S., Hahm, J., Sibener, S. J., and Daum, R. S. (2000) Structural and topological differences between a glycopeptide-intermediate clinical strain and glycopeptide-susceptible strains of Staphylococcus aureus revealed by atomic force microscopy. Antimicrob. Agents Chemother. 44, 3456–3460.

    Article  CAS  PubMed  Google Scholar 

  43. Crisostomo, M. I., Westh, H., Tomasz, A., Chung, M., Oliveira, D. C., and de Lencastre, H. (2001) The evolution of methicillin resistance in Staphylococcus aureus: similarity of genetic backgrounds in historically early methicillin-susceptible and-resistant isolates and contemporary epidemic clones. Proc. Natl. Acad. Sci. USA 98, 9865–9870.

    Article  CAS  PubMed  Google Scholar 

  44. Enright, M. C., Robinson, D. A., Randle, G., Feil, E. J., Grundmann, H., and Spratt, B. G. (2002) The evolutionary history of methicillin-resistant Staphylococcus aureus (MRSA). Proc. Natl. Acad. Sci. USA 99, 7687–7692.

    Article  CAS  PubMed  Google Scholar 

  45. Robinson, D. A. and Enright, M. C. (2003) Evolutionary models of the emergence of methicillin-resistant Staphylococcus aureus. Antimicrob. Agents Chemother. 47, 3926–3934.

    Article  CAS  PubMed  Google Scholar 

  46. Feil, E. J., Cooper, J. E., Grundmann, H., et al. (2003) How clonal is Staphylococcus aureus? J. Bacteriol. 11, 3307–3316.

    Article  Google Scholar 

  47. Oliveira, D. C., Tomasz, A., and de Lencastre, H. (2002) Secrets of success of a human pathogen: molecular evolution of pandemic clones of methicillin-resistant Staphylococcus aureus. Lancet Infect. Dis. 2, 180–189.

    Article  CAS  PubMed  Google Scholar 

  48. Oliveira, D. C., Tomasz, A., and de Lencastre, H. (2001) The evolution of pandemic clones of methicillin-resistant Staphylococcus aureus: identification of two ancestral genetic backgrounds and the associated mec elements. Microb. Drug Resist. 7, 349–361.

    Article  CAS  PubMed  Google Scholar 

  49. Chambers, H. F. and Hackbarth, C. J. (1987) Effect of NaCl and nafcillin on penicillin-binding protein 2a and heterogeneous expression of methicillin resistance in Staphylococcus aureus. Antimicrob. Agents Chemother. 31, 1982–1988.

    CAS  PubMed  Google Scholar 

  50. Clinical and Laboratory Standards Institute/NCCLS. (2005) Performance Standards for Antimicrobial Susceptibility Testing; Fifteenth Informational Supplement. CLSI/NCCLS document M100-S15. CLSI, Wayne, PA.

    Google Scholar 

  51. Swenson, J. M., Tenover, F. C., and Cefoxitin Disk Study Group. (2005) Results of disk diffusion testing with cefoxitin correlate with presence of mecA in Staphylococcus spp. J. Clin. Microbiol. 43, 3818–3823.

    Article  CAS  PubMed  Google Scholar 

  52. Yamazumi, T., Furuta, I., Diekema, D. J., Pfaller, M. A., and Jones, R. N. (2001) Comparison of the Vitek gram-positive susceptibility 106 card, the MRSA-Screen latex agglutination test, and mecA analysis for detecting oxacillin resistance in a geographically diverse collection of clinical isolates of coagulase-negative staphylococci. J. Clin. Microbiol. 39, 3633–3636.

    Article  CAS  PubMed  Google Scholar 

  53. Swenson, J. M., Williams, P. P., Killgore, G., O’Hara, C. M., and Tenover, F. C. (2001) Performance of eight methods, including two new rapid methods, for detection of oxacillin resistance in a challenge set of Staphylococcus aureus organisms. J. Clin. Microbiol. 39, 3785–3788.

    Article  CAS  PubMed  Google Scholar 

  54. Charles, P. G., Ward, P. B., Johnson, P. D., Howden, B. P., and Grayson, M. L. (2004) Clinical features associated with bacteremia due to heterogeneous vancomycinintermediate Staphylococcus aureus. Clin. Infect. Dis. 38, 448–451.

    Article  PubMed  Google Scholar 

  55. Howden, B. P., Ward, P. B., Charles, P. G., et al. (2004) Treatment outcomes for serious infections caused by methicillin-resistant Staphylococcus aureus with reduced vancomycin susceptibility. Clin. Infect. Dis. 38, 521–528.

    Article  CAS  PubMed  Google Scholar 

  56. Paule, S. M., Pasquariello, A. C., Hacek, D. M., Fisher, A. G., Thomson, R. B. Jr., Kaul, K. L., and Peterson, L. R. (2004) Direct detection of Staphylococcus aureus from adult and neonate nasal swab specimens using real-time polymerase chain reaction. J. Mol. Diagn. 6, 191–196.

    Article  CAS  PubMed  Google Scholar 

  57. Warren, D. K., Liao, R. S., Merz, L. R., Eveland, M., and Dunne, W. M. Jr. (2004) Detection of methicillin-resistant Staphylococcus aureus directly from nasal swab specimens by a real-time PCR assay. J. Clin. Microbiol. 42, 5578–5581.

    Article  CAS  PubMed  Google Scholar 

  58. Peterson, L. R., Petzel, R. A., Clabots, C. R., Fasching, C. E., and Gerding, D. N. (1993) Medical technologists using molecular epidemiology as part of the infection control team. Diagn. Microbiol. Infect. Dis. 16, 303–311.

    Article  CAS  PubMed  Google Scholar 

  59. Tenover, F., Arbeit, R., Goering, R. V., Mickelsen, P. A., Murray, B. E., Persing, D. H., and Swaminathan, B. (1995) Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J. Clin. Microbiol. 33, 2233–2239.

    CAS  PubMed  Google Scholar 

  60. McDougal, L. K., Steward, C. D., Killgore, G. E., Chairtram, S. K., McAllister, S. K., and Tenover, F. C. (2003) Pulsed-field gel electrophoresis typing of oxacillin-resistant Staphylococcus aureus isolates from the United States: establishing a national database. J. Clin. Microbiol. 41, 5113–5120.

    Article  CAS  PubMed  Google Scholar 

  61. Enright, M. C., Day, N. P., Davies, C. E., Peacock, S. J., and Spratt, B. G. (2000) Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J. Clin. Microbiol. 38, 1008–1015.

    CAS  PubMed  Google Scholar 

  62. van Belkum, A., Kluytmans, J., van Leeuwen, W., et al. (1995) Multicenter evaluation of arbitrarily primed PCR for typing of Staphylococcus aureus strains. J. Clin. Microbiol. 33, 1537–1547.

    PubMed  Google Scholar 

  63. Shopsin, B., Gomez, M., Montgomery, S. O., et al. (1999) Evaluation of protein A gene polymorphic region DNA sequencing for typing of Staphylococcus aureus strains. J. Clin. Microbiol. 37, 3556–3563.

    CAS  PubMed  Google Scholar 

  64. Dunman, P. M., Mounts, W., McAleese, F., et al. (2004) Uses of Staphylococcus aureus GeneChips in genotyping and genetic composition analysis. J. Clin. Microbiol. 42, 4275–4283.

    Article  CAS  PubMed  Google Scholar 

  65. Siberry, G. K., Tekle, T., Carroll, K., and Dick, J. (2003) Failure of clindamycin treatment of methicillin-resistant Staphylococcus aureus expressing inducible clindamycin resistance in vitro. Clin. Infect. Dis. 37, 1257–1260.

    Article  PubMed  Google Scholar 

  66. Appelbaum, P. C. and Jacobs, M. R. (2005) Recently approved and investigational antibiotics for treatment of severe infections caused by Gram-positive bacteria. Curr. Opin. Microbiol. 8, 510–517.

    Article  CAS  PubMed  Google Scholar 

  67. Wilson, P., Andrew, J. A., Charlesworth, R., Walesby, R., Singer, M., Farrell, D. J., and Robbins, M. (2003) Linezolid resistance in clinical isolates of Staphylococcus aureus. J. Antimicrob. Chemother. 51, 186–188.

    Article  CAS  PubMed  Google Scholar 

  68. Tsiodras, S., Gold, H. S., Sakoulas, G., et al. (2001) Linezolid resistance in a clinical isolate of Staphylococcus aureus. Lancet 358, 207, 208.

    Article  CAS  PubMed  Google Scholar 

  69. Hirano, L. and Bayer, A. S. (1991) Beta-lactam-beta-lactamase-inhibitor combinations are active in experimental endocarditis caused by b-lactamase-producing oxacillin-resistant staphylococci. Antimicrob. Agents Chemother. 35, 685–690.

    CAS  PubMed  Google Scholar 

  70. Cantoni, L., Wenger, A., Glauser, M., and Billie, J. (1989) Comparative efficacy of amoxicillin-clavulanate, cloxacillin, and vancomycin against methicillin-sensitive and methicillin-resistant Staphylococcus aureus in rats. J. Infect. Dis. 159, 989–993.

    CAS  PubMed  Google Scholar 

  71. Fasola, E. L., Fasching, C. E., and Peterson, L. R. (1995) Molecular correlation between in vitro and in vivo activity of beta-lactam and beta-lactamase inhibitor combinations against methicillin-resistant Staphylococcus aureus. J. Lab. Clin. Med. 125, 200–211.

    CAS  PubMed  Google Scholar 

  72. Miller, K., Storey, C., Stubbings, W. J., Hoyle, A. M., Hobbs, J. K., and Chopra, I. (2005) Antistaphylococcal activity of a novel cephalosporin CB-181963 (CAB-175). J. Antimicrob. Chemother. 55, 579–582.

    Article  CAS  PubMed  Google Scholar 

  73. Entenza, J. M., Hohl, P., Heinze-Krauss, I., Glauser, M. P., and Moreillon, P. (2002) BAL9141, a novel extended-spectrum cephalosporin active against methicillin-resistant Staphylococcus aureus in treatment of experimental endocarditis. Antimicrob. Agents Chemother. 46, 171–177.

    Article  CAS  PubMed  Google Scholar 

  74. Fung-Tomc, J. C., Clark, J., Minassian, B., et al. (2002) In vitro and in vivo activities of a novel cephalosporin, BMS-247243, against methicillin-resistant and-susceptible staphylococci. Antimicrob. Agents Chemother. 46, 971–976.

    Article  CAS  PubMed  Google Scholar 

  75. Chambers, H. F. (2003) Solving staphylococcal resistance to beta-lactams. Trends Microbiol. 11, 145–148.

    Article  CAS  PubMed  Google Scholar 

  76. Katayama, Y., Zhang, H. Z., and Chambers, H. F. (2004) PBP 2a mutations producing very-high-level resistance to beta-lactams. Antimicrob. Agents Chemother. 48, 453–459.

    Article  CAS  PubMed  Google Scholar 

  77. Chambers, H. F. (2005) Evaluation of ceftobiprole in a rabbit model of aortic valve endocarditis due to methicillin-resistant and vancomycin-intermediate Staphylococcus aureus. Antimicrob. Agents Chemother. 49, 884–888.

    Article  CAS  PubMed  Google Scholar 

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Palavecino, E. (2007). Clinical, Epidemiological, and Laboratory Aspects of Methicillin-Resistant Staphylococcus aureus (MRSA) Infections. In: Ji, Y. (eds) Methicillin-Resistant Staphylococcus aureus (MRSA) Protocols. Methods in Molecular Biology, vol 391. Humana Press. https://doi.org/10.1007/978-1-59745-468-1_1

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