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Jung J, Kim YK, Chang E, Bae S, Kim MJ, Chong YP, Kim SH, Choi SH, Lee SO, Kim YS. The origin of sequence type 72 community-associated methicillin-resistant Staphylococcus aureus (MRSA) and fusidic acid (FA) resistant sequence type 5 MRSA: Analysis of FA resistance and spa type in a single center in South Korea. J Infect Chemother 2024; 30:300-305. [PMID: 37890528 DOI: 10.1016/j.jiac.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023]
Abstract
INTRODUCTION We investigated the prevalence of fusidic acid (FA) resistance in MSSA and MRSA stratified by sequence (ST) and spa types, and determined the prevalence of FA resistance mechanisms. METHODS From August 2014 to April 2020, S. aureus blood isolates were collected in Asan Medical Center, Seoul, South Korea. Antimicrobial susceptibility tests were performed using broth microdilution and interpreted according to EUCAST's FA criteria. We performed spa typing for fusA mutation presence and acquired FA resistance determinants (fusB, fusC, and fusD) by PCR. RESULTS Of the 590 MRSA isolates, 372 were FA resistant, and among 425 MSSA isolates, 136 were resistant. Of the 380 ST5-MRSA isolates, 350 were FA resistant, whereas only 1 of 14 ST5-MSSA isolates was FA resistant. Conversely, of the 163 ST72-MRSA isolates, only 8 were resistant, whereas 37 of 42 ST72-MSSA were resistant. The fusA mutation (80%) was the most common determinant. The one FA resistant ST5-MSSA isolate belonged to the t2460 spa type, the most common spa type (24 of 35 isolates) of FA resistant ST5-MRSA. In addition, t324 and t148, which are minor spa types of ST72-MSSA, were susceptible to FA, in contrast to other ST72-MSSA spa types, and the major spa type of ST72-MRSA (110 of 163 isolates). CONCLUSIONS FA resistance was common in ST5-MRSA and ST72-MSSA, and rare in ST5-MSSA and ST72-MRSA. Our findings suggest that minor clones of ST5-MSSA isolates, with the fusA mutation and minor clones of ST72-MSSA susceptible to FA, may have evolved to harbor the mecA gene.
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Affiliation(s)
- Jiwon Jung
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Kyun Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Center for Antimicrobial Resistance and Microbial Genetics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Center for Antimicrobial Resistance and Microbial Genetics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Tran NN, Morrisette T, Jorgensen SCJ, Orench-Benvenutti JM, Kebriaei R. Current therapies and challenges for the treatment of Staphylococcus aureus biofilm-related infections. Pharmacotherapy 2023; 43:816-832. [PMID: 37133439 DOI: 10.1002/phar.2806] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 05/04/2023]
Abstract
Staphylococcus aureus is a major cause of nosocomial and community-acquired infections and contributes to significant increase in morbidity and mortality especially when associated with medical devices and in biofilm form. Biofilm structure provides a pathway for the enrichment of resistant and persistent phenotypes of S. aureus leading to relapse and recurrence of infection. Minimal diffusion of antibiotics inside biofilm structure leads to heterogeneity and distinct physiological activity. Additionally, horizontal gene transfer between cells in proximity adds to the challenges associated with eradication of biofilms. This narrative review focuses on biofilm-associated infections caused by S. aureus, the impact of environmental conditions on biofilm formation, interactions inside biofilm communities, and the clinical challenges that they present. Conclusively, potential solutions, novel treatment strategies, combination therapies, and reported alternatives are discussed.
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Affiliation(s)
- Nikki N Tran
- Department of Pharmacy, The Ohio State University Wexner Medical Center - The James Cancer Hospital and Solove Research Institute, Columbus, Ohio, USA
| | - Taylor Morrisette
- Department of Clinical Pharmacy and Outcomes Sciences, Medical University of South Carolina College of Pharmacy, Charleston, South Carolina, USA
- Department of Pharmacy Services, Medical University of South Carolina Shawn Jenkins Children's Hospital, Charleston, South Carolina, USA
| | - Sarah C J Jorgensen
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - José M Orench-Benvenutti
- P3 Research Laboratory, Division of Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus, Ohio, USA
| | - Razieh Kebriaei
- P3 Research Laboratory, Division of Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus, Ohio, USA
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Qodrati M, SeyedAlinaghi S, Dehghan Manshadi SA, Abdollahi A, Dadras O. Antimicrobial susceptibility testing of Staphylococcus aureus isolates from patients at a tertiary hospital in Tehran, Iran, 2018-2019. Eur J Med Res 2022; 27:152. [PMID: 35978369 PMCID: PMC9382727 DOI: 10.1186/s40001-022-00778-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/01/2022] [Indexed: 01/04/2023] Open
Abstract
Background Staphylococcus aureus, a human skin and mucous membranes colonizer, could opportunistically cause a variety of infectious diseases. Frequently, it is resistant to methicillin (MRSA), and often, co-resistant to many clinically available antibiotics. MRSA is a major burden for healthcare systems and communities all over the world, especially in developing countries. We addressed the issue that more than a decade had passed since the last report about cumulative antibiogram for S. aureus from our center, whereas The Clinical and Laboratory Standards Institute (CLSI) recommends to analyze and report it on an annual basis in order to guide clinicians to select the best initial empiric antimicrobial therapy. Methods In a cross-sectional retrospective design, data of culture-proven S. aureus from clinical specimens of hospitalized patients at Imam Khomeini Hospital Complex, Tehran, Iran, were collected from September 2018 to September 2019. Antimicrobial susceptibility testing (AST) had been performed using either Kirby–Bauer disk diffusion or VITEK 2 automated system which is based on minimum inhibitory concentration (MIC). The Chi-squared test was used considering the critical p-value to be ≤ .05. Results Among 576 unique isolates, the overall prevalence of MRSA was 37.5%. Patients admitted to the infectious diseases ward and ICUs have a greater chance to have such an isolate. Methicillin resistance was predictive of resistance to most antibiotics: erythromycin (90.9%), clindamycin (85.4% including inducible resistance), gentamicin, cipro-/levo-/moxi-floxacin, trimethoprim–sulfamethoxazole (58.3%), tetracycline, and rifampin. Resistance rate of zero was observed for daptomycin, linezolid, tigecycline, and (roughly) vancomycin. The prevalence of multiple-drug resistant (MDR) isolates was 48.5%. Conclusions Although in this study, the prevalence of MRSA was lower than the previous ones from the same hospital, it is still far from the desired rates. Besides, resistance to clindamycin and trimethoprim–sulfamethoxazole were remarkable. So far, vancomycin is the best choice for empiric treatment of MRSA, with linezolid as the second choice. It is advised to avoid prescribing the newer antibacterial agents as long as the older ones are effective to prevent the emergence of MDR species.
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Affiliation(s)
- Mohammad Qodrati
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences; Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419733141, Iran.
| | - Seyed Ali Dehghan Manshadi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences; Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419733141, Iran. .,Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical University, Tehran, Iran.
| | - Alireza Abdollahi
- Division of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences Tehran, Tehran, Iran
| | - Omid Dadras
- Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway
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Bouaouina S, Aouf A, Touati A, Ali H, Elkhadragy M, Yehia H, Farouk A. Effect of Nanoencapsulation on the Antimicrobial and Antibiofilm Activities of Algerian Origanum glandulosum Desf. against Multidrug-Resistant Clinical Isolates. NANOMATERIALS 2022; 12:nano12152630. [PMID: 35957062 PMCID: PMC9370196 DOI: 10.3390/nano12152630] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023]
Abstract
The emergence of multidrug-resistant (MDR) bacteria is a danger to public health and exposes patients to high risk, increasing morbidity and mortality worldwide. For this purpose, three months of evaluation of MDR’s prevalence and antimicrobial susceptibility patterns in the military regional university hospital of Constantine from different services and samples was carried out. Among a total of 196 isolates, 35.2% were MDR. The use of essential oils such as Origanum glandulosum Desf. as an alternative to antibiotics is attractive due to their rich content of bioactive compounds conferring many biological activities. Also, to overcome the drawbacks of using oils as the hydrophobicity and negative interaction with the environmental conditions, in addition to increasing their activity, encapsulation for the oil was performed using high-speed homogenization (HSH) into nanocapsules and high-pressure homogenization (HPH) into nanoemulsion. Nine volatile constituents were determined using gas chromatography-mass spectrometry analysis (GC-MS) in hydrodistilled oil with thymol, carvacrol, p-cymene, and γ-terpinene as dominants. A dramatic decrease in the major volatile components was observed due to the use of HSH and HPH but generated the same oil profile. The mean particle size of the nanoemulsion was 54.24 nm, while that of nanocapsules was 120.60 nm. The antibacterial activity of the oil and its nanoparticles was estimated on MDR isolates using the disk diffusion, aromatogram, and broth microdilution methods. Consistent with the differences in volatile constituents, the oil exhibited a higher antibacterial activity compared to its nanoforms with the diameters of the inhibition zone against E. coli (20 mm), S. aureus (35 mm), and A. baumannii (40 mm). Both formulations have shown relatively significant activity against the biofilm state at sub-inhibitory concentrations, where nanoemulsion was more potent than nanocapsules. The results obtained suggested that nanoformulations of essential oils are strongly recommended for therapeutic application as alternatives to antibiotics.
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Affiliation(s)
- Sarah Bouaouina
- Laboratory of Applied Microbiology, Faculty of Life Sciences and Nature, University of Ferhat Abbas, Setif 19000, Algeria; (S.B.); (A.A.)
| | - Abdelhakim Aouf
- Laboratory of Applied Microbiology, Faculty of Life Sciences and Nature, University of Ferhat Abbas, Setif 19000, Algeria; (S.B.); (A.A.)
| | - Abdelaziz Touati
- Laboratoire d’Ecologie Microbienne, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria;
| | - Hatem Ali
- Food Technology Department, National Research Center, Cairo 12622, Egypt;
| | - Manal Elkhadragy
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
| | - Hany Yehia
- Food Science and Nutrition Department, College of Food and Agriculture Science, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia;
- Food Science and Nutrition Department, Faculty of Home Economics, Helwan University, Helwan P.O. Box 11611, Egypt
| | - Amr Farouk
- Flavour and Aroma Chemistry Department, National Research Centre, Cairo 12622, Egypt
- Correspondence: ; Tel.: +20-1092327777
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Choi JH, Lee H, Choi EH. Antimicrobial Resistance and Molecular Analysis of Staphylococcus aureus in Staphylococcal Scalded Skin Syndrome among Children in Korea. J Korean Med Sci 2021; 36:e22. [PMID: 33463096 PMCID: PMC7813586 DOI: 10.3346/jkms.2021.36.e22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/06/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Staphylococcal scalded skin syndrome (SSSS) is a skin disease characterized by blistering and desquamation caused by exfoliative toxins (ETs) of Staphylococcus aureus (S. aureus). Although many countries show predominance of methicillin-susceptible S. aureus (MSSA), cases of methicillin-resistant S. aureus (MRSA) have been reported. METHODS Twenty-six children aged <15 years diagnosed with SSSS from January 2010 to December 2017 from three hospitals were included. S. aureus isolates from cases were analyzed for multilocus sequence types and ETs. Medical records were reviewed for clinical characteristics, treatment, and antimicrobial susceptibility patterns of S. aureus. RESULTS Among the 26 cases, mean age was 2.3 years. According to skin manifestations patients were classified as generalized (n = 10, 38.5%), intermediate (n = 11, 42.3%), and abortive (n = 5, 19.2%). Among all cases, 96.2% (25/26) were due to MRSA and the macrolide-resistance rate was 92.3% (24/26). ST89 (n = 21, 80.8%) was the most prevalent clone, followed by single clones of ST1, ST5, ST72, ST121, and ST1507. The eta gene was detected in one (3.8%) isolate which was MSSA. The etb gene was detected in 14 (53.8%) isolates, all of which were ST89. Nafcillin or first-generation cephalosporin was most commonly prescribed (n=20, 76.9%). Vancomycin was administered in four patients (15.4%) and clindamycin in nine patients (34.6%). Among MRSA cases, there was no difference in duration of treatment when comparing the use of antimicrobials to which the causative bacteria were susceptible or non-susceptible (9.75 vs. 8.07 days, P > 0.05). CONCLUSION S. aureus isolated from children with SSSS in Korea demonstrated a high prevalence of methicillin-resistant ST89 clones that harbored the etb gene. The predominance of MRSA suggests that antibiotics to which MRSA are susceptible may be considered for empirical antibiotic treatment in children with SSSS in Korea. Further studies on the role and effectiveness of systemic antibiotics in SSSS are warranted.
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Affiliation(s)
- Jae Hong Choi
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
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Stella Shalini A, Amaladasan M, Prasannabalaji N, Revathi J, Muralitharan G. Synthesis, characterization and antimicrobial studies on 13-membered-N6-macrocyclic transition metal complexes containing trimethoprim. ARAB J CHEM 2019. [DOI: 10.1016/j.arabjc.2014.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Ahonen MJR, Dorrier JM, Schoenfisch MH. Antibiofilm Efficacy of Nitric Oxide-Releasing Alginates against Cystic Fibrosis Bacterial Pathogens. ACS Infect Dis 2019; 5:1327-1335. [PMID: 31136714 PMCID: PMC6773255 DOI: 10.1021/acsinfecdis.9b00016] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Colonization of the lungs by biofilm-forming pathogens is a major cause of mortality in cystic fibrosis (CF). In CF patients, these pathogens are difficult to treat due to the additional protection provided by both the biofilm exopolysaccharide matrix and thick, viscous mucus. The antibiofilm efficacy of nitric oxide (NO)-releasing alginates was evaluated against Pseudomonas aeruginosa, Burkholderia cepacia, Staphylococcus aureus, and methicillin-resistant S. aureus biofilms in both aerobic and anaerobic environments. Varying the amine precursor grafted onto alginate oligosaccharides imparted tunable NO storage (∼0.1-0.3 μmol/mg) and release kinetics (∼4-40 min half-lives) in the artificial sputum media used for biofilm testing. The NO-releasing alginates were highly antibacterial against the four CF-relevant pathogens, achieving a 5-log reduction in biofilm viability after 24 h of treatment, with biocidal efficacy dependent on NO-release kinetics. Aerobic biofilms required greater starting NO doses to achieve killing relative to the anaerobic biofilms. Relative to tobramycin (the minimum concentration of antibacterial agent required to achieve a 5-log reduction in viability after 24 h, MBEC24h, of ≥2000 μg/mL) and vancomycin (MBEC24h ≥ 1000 μg/mL), the NO-releasing alginates proved to be more effective (NO dose ≤ 520 μg/mL) regardless of growth conditions.
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Affiliation(s)
- Mona Jasmine R. Ahonen
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, CB 3290, NC 27599, United States
| | - Jamie M. Dorrier
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, CB 3290, NC 27599, United States
| | - Mark H. Schoenfisch
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, CB 3290, NC 27599, United States
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Rakesh KP, Marichannegowda MH, Srivastava S, Chen X, Long S, Karthik CS, Mallu P, Qin HL. Combating a Master Manipulator: Staphylococcus aureus Immunomodulatory Molecules as Targets for Combinatorial Drug Discovery. ACS COMBINATORIAL SCIENCE 2018; 20:681-693. [PMID: 30372025 DOI: 10.1021/acscombsci.8b00088] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Staphylococcus aureus is a bacterial pathogen that can cause significant disease burden and mortality by counteracting host defenses through producing virulence factors to survive the immune responses evoked by infection. This emerging drug-resistant pathogen has led to a decline in the efficacy of traditional antimicrobial therapy. To combat these threats, precision antimicrobial therapeutics have been created to target key virulence determinants of specific pathogens. Here we review the benefits of, progresses in, and roadblocks to the development of precision antimicrobial therapeutics using combinatorial chemistry.
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Affiliation(s)
- Kadalipura P. Rakesh
- Department of Pharmaceutical Engineering, School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 205 Luoshi Road, Wuhan 430070, Hubei, P. R. China
| | | | - Shobhith Srivastava
- Department of Pharmacology and Therapeutics, King George’s Medical University, Chowk, Lucknow 226003, India
| | - Xing Chen
- Department of Pharmaceutical Engineering, School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 205 Luoshi Road, Wuhan 430070, Hubei, P. R. China
| | - Sihui Long
- Key Laboratory for Green Chemical Process of Ministry of Education, Hubei Key Laboratory of Novel Reactor and Green Chemical Technology, School of Chemical Engineering and Pharmacy, Wuhan Institute of Technology, Wuhan 430073, Hubei, China
| | - Chimatahalli S. Karthik
- Department of Chemistry, Sri Jayachamarajendra College of Engineering, Mysuru 570006, Karnataka, India
| | - Putswamappa Mallu
- Department of Chemistry, Sri Jayachamarajendra College of Engineering, Mysuru 570006, Karnataka, India
| | - Hua-Li Qin
- Department of Pharmaceutical Engineering, School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 205 Luoshi Road, Wuhan 430070, Hubei, P. R. China
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Chan MKL, Koo SH, Quek Q, Pang WS, Jiang B, Ng LSY, Tan SH, Tan TY. Development of a real-time assay to determine the frequency of qac genes in methicillin resistant Staphylococcus aureus. J Microbiol Methods 2018; 153:133-138. [PMID: 30267717 DOI: 10.1016/j.mimet.2018.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The emergence of antiseptic resistance and/or antiseptic-resistance genes in methicillin-resistant Staphylococcus aureus (MRSA) may result in failure of decolonization treatments. Plasmid-encoded efflux pump genes qacA/B and qacC (smr) confer tolerance to chlorhexidine and quaternary ammonium compounds. The objective of this study was to develop and validate a multiplex real time-PCR assay for detection of antiseptic-resistance genes, apply the assay on 200 MRSA isolates and explore if carriage of these genes was associated with resistance to topical antibiotics. METHODOLOGY A SYBR-Green based multiplex real time-PCR assay was developed to detect qacA/B, qacC, and mecA (internal control) simultaneously. The multiplex assay was compared against conventional single-plex PCR followed by agarose gel electrophoresis, using DNA from the first 73 MRSA isolates, followed by multiplex testing of the remaining 127 MRSA isolates. All 200 MRSA isolates were tested for susceptibility to mupirocin, retapamulin, neomycin, bacitracin and octenidine. The genetic diversity of the isolates was investigated by spa-typing. RESULTS The concordance between multiplex and conventional PCR, in assignments of qacA/B and qacC status were 99%(72/73) and 100%(73/73) respectively. Among 200 MRSA isolates, 48(24%) and 44(23%) were found to harbour qacA/B and qacC genes, respectively. These isolates remained susceptible to many common decolonization agents, except mupirocin. The predominant spa-types were t020 and t1081 (41 and 32 isolates respectively). CONCLUSION The real-time assay performed acceptably for the detection of qac genes. A high prevalence of antiseptic-resistance genes were detected in the MRSA isolates in our population and appeared to be associated with spa-type t1081.
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Affiliation(s)
- Maurice Kok Leong Chan
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, 529889, Singapore
| | - Seok Hwee Koo
- Clinical trials and Research Unit, Changi General Hospital, 2 Simei Street 3, 529889, Singapore
| | - Qingyao Quek
- School of Life Sciences and Chemical Technology, Ngee Ann Polytechnic, 535 Clementi Road, 599489, Singapore
| | - Wan Sia Pang
- School of Life Sciences and Chemical Technology, Ngee Ann Polytechnic, 535 Clementi Road, 599489, Singapore
| | - Boran Jiang
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, 529889, Singapore
| | - Lily Siew Yong Ng
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, 529889, Singapore
| | - Si Huei Tan
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, 529889, Singapore
| | - Thean Yen Tan
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, 529889, Singapore.
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Naimi HM, Rasekh H, Noori AZ, Bahaduri MA. Determination of antimicrobial susceptibility patterns in Staphylococcus aureus strains recovered from patients at two main health facilities in Kabul, Afghanistan. BMC Infect Dis 2017; 17:737. [PMID: 29187146 PMCID: PMC5707873 DOI: 10.1186/s12879-017-2844-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/21/2017] [Indexed: 11/24/2022] Open
Abstract
Background Staphylococcus aureus (S. aureus) is a major pathogen implicated in skin and soft tissue infections, abscess in deep organs, toxin mediated diseases, respiratory tract infections, urinary tract infections, post-surgical wound infections, meningitis and many other diseases. Irresponsible and over use of antibiotics has led to an increased presence of multidrug resistant organisms and especially methicillin resistant Staphylococcus aureus (MRSA) as a major public health concern in Afghanistan. As a result, there are many infections with many of them undiagnosed or improperly diagnosed. We aimed to establish a baseline of knowledge regarding the prevalence of MRSA in Kabul, Afghanistan, as well as S. aureus antimicrobial susceptibility to current available antimicrobials, while also determining those most effective to treat S. aureus infections. Methods Samples were collected from patients at two main Health facilities in Kabul between September 2016 and February 2017. Antibiotic susceptibility profiles were determined by the disc diffusion method and studied using standard CLSI protocols. Results Out of 105 strains of S. aureus isolated from pus, urine, tracheal secretions, and blood, almost half (46; 43.8%) were methicillin-sensitive Staphylococcus aureus (MSSA) while 59 (56.2%) were Methicillin-resistant Staphylococcus aureus (MRSA). All strains were susceptible to vancomycin. In total, 100 (95.2%) strains were susceptible to rifampicin, 96 (91.4%) susceptible to clindamycin, 94 (89.5%) susceptible to imipenem, 83 (79.0%) susceptible to gentamicin, 81(77.1%) susceptible to doxycycline, 77 (77.1%) susceptible to amoxicillin + clavulanic acid, 78 (74.3%) susceptible to cefazolin, 71 (67.6%) susceptible to tobramycin, 68 (64.8%) susceptible to chloramphenicol, 60 (57.1%) were susceptible to trimethoprim-sulfamethoxazole, 47 (44.8%) susceptible to ciprofloxacin, 38 (36.2%) susceptible to azithromycin and erythromycin, 37 (35.2%) susceptible to ceftriaxone and 11 (10.5%) were susceptible to cefixim. Almost all (104; 99.05%) were resistant to penicillin G and only 1 (0.95%) was intermediate to penicillin G. Interestingly, 74.6% of MRSA strains were azithromycin resistant with 8.5% of them clindamycin resistant. Ninety-six (91.4%) of the isolates were multi-drug resistant. Conclusions There was a high rate of Methicillin resistance (56.2%) among S. aureus strains in the samples collected and most (91.4%) were multidrug resistant. The most effective antibiotics to treat Staph infections were vancomycin, rifampicin, imipenem, clindamycin, amoxicillin-clavulanic acid, cefazolin, gentamicin and doxycycline. The least effective were azithromycin, ceftriaxone, cefixim and penicillin. We recommend that, where possible, in every case of S. aureus infection in Kabul, Afghanistan, Antibiotic susceptibility testing (AST) should be performed and responsible use of antibiotics should be considered.
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Affiliation(s)
- Haji Mohammad Naimi
- Department of Microbiology, Faculty of Pharmacy, Kabul University, Jamal Meena street, Kabul, Afghanistan.
| | - Hamidullah Rasekh
- Department of Microbiology, Faculty of Pharmacy, Kabul University, Jamal Meena street, Kabul, Afghanistan
| | - Ahmad Zia Noori
- Department of Microbiology, Faculty of Pharmacy, Kabul University, Jamal Meena street, Kabul, Afghanistan
| | - Mohammad Aman Bahaduri
- Department of Microbiology, Faculty of Pharmacy, Kabul University, Jamal Meena street, Kabul, Afghanistan
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Alhussaini MS. Methicillin-resistant Staphylococcus aureus Nasal Carriage Among Patients Admitted at Shaqra General Hospital in Saudi Arabia. Pak J Biol Sci 2017; 19:233-238. [PMID: 29023028 DOI: 10.3923/pjbs.2016.233.238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Methicillin-resistant Staphylococcus aureus (MRSA) have been causing increasing problems in hospitals and nursing homes worldwide. Limited number of studies in Saudi Arabia has attempted to investigate infection and risk factors associated with nosocomial acquired MRSA. The present study was undertaken to determine the occurrence, prevalence, antibiotic susceptibility pattern and genetic characteristics of MRSA among admitted cases at Shaqra General Hospital (Saudi Arabia). METHODOLOGY This study was conducted from October, 2014 to March, 2015. Nasal swabs were taken from 220 patients (105 males and 115 females) admitted at Shaqra General Hospital. The isolates were identified as S. aureus based on morphology, Gram stain, catalase test, coagulase test and mannitol salt agar fermentation. Antibiotic susceptibility testing of MRSA was performed with standard disk diffusion method. All methicillin-resistant isolates were examined for the existence of the mecA gene by PCR technique. RESULTS Of the 220 patients, 90 (40.91%) were found to be nasal carriers of S. aureus. Among these 90 S. aureus isolates, 48 (21.82%) were MRSA. A statistically significant difference was only found for antibiotics usage between those with and without MRSA colonization. Antibiotic susceptibility pattern of isolated MRSA showed high susceptibility to vancomycin, linezolid, rifampicin, teicoplanin, complete resistance to penicillin, ampicillin, oxacillin and cefoxitin and intermediate resistance to amikacin, ciprofloxacin, teicoplanin, tetracycline and vancomycin. CONCLUSION A high prevalence of multidrug-resistant MRSA nasal carriage was found. The identification of MRSA carriers is a step towards establishing a control policy for MRSA and helps to identify measures needed to reduce colonization pressure.
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Affiliation(s)
- Mohammed S Alhussaini
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Shaqra University, Saudi Arabia
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Molecular Typing of Staphylococcus aureus Isolated From Clinical Specimens During an Eight-Year Period (2005 - 2012) in Tabriz, Iran. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2016. [DOI: 10.5812/pedinfect.35563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Baek YS, Jeon J, Ahn JW, Song HJ. Antimicrobial resistance of Staphylococcus aureus isolated from skin infections and its implications in various clinical conditions in Korea. Int J Dermatol 2016; 55:e191-7. [PMID: 26892888 DOI: 10.1111/ijd.13046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/11/2015] [Accepted: 03/18/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Periodic investigations into patterns of antimicrobial resistance can help to optimize the efficacy of treatment and limit the development of resistance. OBJECTIVES The aim of this study was to update information on patterns of antimicrobial resistance in Staphylococcus aureus isolated from skin infections in South Korea. METHODS We retrospectively analyzed clinical information and in vitro antimicrobial resistance data for 965 clinical S. aureus isolates obtained from skin infections during 2010-2013 in a university hospital in South Korea. RESULTS The rate of resistance to oxacillin (methicillin-resistant S. aureus [MRSA]) was 47.4%. Similar rates of resistance to erythromycin (45.6%), fusidic acid (44.0%), and clindamycin (42.3%) were noted. The rate of resistance to mupirocin was 8.4%. Overall, 4.9% of isolates were resistant to both fusidic acid and mupirocin. None of the isolates showed resistance to habekacin, synercid, teicoplanin, or vancomycin. Generally, antimicrobial resistance rates did not increase from 2010 to 2013 except with reference to a few agents such as mupirocin and rifampin. Isolates from surgical patients, inpatients, non-dermatology outpatients, and adult patients showed relatively high rates of resistance to multiple antimicrobials. Resistance to mupirocin was not only lower than that to fusidic acid but was consistent across clinical contexts. CONCLUSIONS The prevalence of MRSA in skin infections in South Korea did not increase during 2010-2013. Isolates from dermatology outpatients showed relatively lower rates of resistance to multiple antimicrobials than isolates from non-dermatology outpatients. Among topical antimicrobials, resistance to mupirocin was relatively low regardless of clinical condition.
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Affiliation(s)
- Yoo Sang Baek
- Department of Dermatology, Guro Hospital, Korea University, Seoul, South Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University, Seoul, South Korea
| | - Jae Woo Ahn
- Department of Dermatology, Guro Hospital, Korea University, Seoul, South Korea
| | - Hae Jun Song
- Department of Dermatology, Guro Hospital, Korea University, Seoul, South Korea
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Baek YS, Baek SH, Yoo YJ. Higher nasal carriage rate of methicillin-resistant Staphylococcus aureus among dental students who have clinical experience. J Am Dent Assoc 2016; 147:348-53. [PMID: 26778005 DOI: 10.1016/j.adaj.2015.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 11/29/2015] [Accepted: 12/02/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) has been isolated from dental clinical surfaces, dental patients, and dental health care professionals. The authors conducted a study to determine the prevalence rate of nasal MRSA colonization among dental school students and to identify the characteristics of the isolated strains. METHODS The authors collected nasal samples from 159 dental students. The authors performed mecA gene detection, staphylococcal cassette chromosome mec (SCCmec) typing, and antimicrobial susceptibility tests on each sample. The authors compared the results of 2 groups (students who had clinical experience and students who did not have clinical experience). RESULTS Five (3.1%) dental students had MRSA colonization, as confirmed by the presence of the mecA gene in the nasal cavity. Prior clinical experience was associated significantly with nasal MRSA carriage (P < .05). Four of the strains were SCCmec type IV, and 1 strain was SCCmec type I. All isolates were resistant to amoxicillin and clavulanic acid, imipenem, and oxacillin, but were susceptible to several antimicrobial agents including mupirocin, trimethoprim and sulfamethoxazole, and rifampin. The nasal MRSA colonization was eradicated with the use of mupirocin ointment. CONCLUSIONS Nasal MRSA colonization occurs in some dental students, especially those who have clinical experience. PRACTICAL IMPLICATIONS Education about MRSA colonization and transmission, as well as infection prevention and control measures is necessary for dental students, especially when they participate in clinical practice.
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Tarazi YH, Almajali AM, Kheer Ababneh MM, Ahmed HS, Jaran AS. Molecular study on methicillin-resistant Staphylococcus aureus strains isolated from dogs and associated personnel in Jordan. Asian Pac J Trop Biomed 2015. [DOI: 10.1016/j.apjtb.2015.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Brown PD. Multiple-locus VNTR Analyses of Methicillin-resistant Staphylococcus aureus from Jamaica. Infect Dis (Lond) 2015; 8:31-8. [PMID: 26448687 PMCID: PMC4583095 DOI: 10.4137/idrt.s31084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 08/23/2015] [Accepted: 08/31/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND This study assessed the antimicrobial susceptibilities and the presence of inducible macrolide–lincosamide–streptogramin B (iMLSB) resistance in methicillin-resistant Staphylococcus aureus (MRSA) of Jamaica as well as the relatedness using polymerase chain reaction-based staphylococcal cassette chromosome mec (SCCmec) and multiple-locus variable numbers of tandem repeat analyses (MLVAs). MATERIALS AND METHODS Antimicrobial susceptibility, the presence of MLSB resistance, and SCCmec and MLVA patterns were assessed for 61 nonduplicate isolates of MRSA from hospitalized patients. RESULTS While no isolate was resistant to vancomycin, 53 (86.9%) isolates were resistant to ciprofloxacin, 52 (85.3%) to erythromycin, 49 (80%) to lincomycin, and 45 (74%) to clindamycin. Of the 52 erythromycin-resistant isolates, 48% exhibited constitutive resistance and 8% showed inducible MLSB (iMLSB) resistance. Most (85%) of typable isolates were SCCmec type IV, and among these, 16 MLVA patterns were identified. CONCLUSION Multidrug resistance continues to characterize MRSA. Among the erythromycin-resistant isolates, constitutive resistance and iMLSB resistance are common. These facts will complicate the treatment of MRSA infections and warrant continued surveillance and judicial use of antimicrobial agents.
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Affiliation(s)
- Paul D Brown
- Department of Basic Medical Sciences, The University of the West Indies at Mona, Jamaica
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Schmidt T, Kock MM, Ehlers MM. Diversity and antimicrobial susceptibility profiling of staphylococci isolated from bovine mastitis cases and close human contacts. J Dairy Sci 2015; 98:6256-69. [PMID: 26188567 DOI: 10.3168/jds.2015-9715] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/08/2015] [Indexed: 11/19/2022]
Abstract
The objectives of this study were to examine the diversity of Staphylococcus spp. recovered from bovine intramammary infections and humans working in close contact with the animals and to evaluate the susceptibility of the staphylococcal isolates to different antimicrobials. A total of 3,387 milk samples and 79 human nasal swabs were collected from 13 sampling sites in the KwaZulu-Natal province of South Africa. In total, 146 Staph. aureus isolates and 102 coagulase-negative staphylococci (CNS) were recovered from clinical and subclinical milk samples. Staphylococcusaureus was isolated from 12 (15.2%) of the human nasal swabs and 95 representative CNS were recovered for further characterization. The CNS were identified using multiplex-PCR assays, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and tuf gene sequencing. Seven Staphylococcus spp. were identified among the CNS of bovine origin, with Staph.chromogenes (78.4%) predominating. The predominant CNS species recovered from the human nasal swabs was Staph.epidermidis (80%) followed by Staph.chromogenes (6.3%). The antimicrobial susceptibility of all staphylococcal isolates was evaluated using disk diffusion and was supplemented by screening for specific antimicrobial resistance genes. Ninety-eight (67.1%) Staph.aureus isolates of bovine origin were pansusceptible; 39 (26.7%) isolates were resistant to a single class, and 7 (4.8%) isolates were resistant to 2 classes of antimicrobials. Two Staph. aureus (1.4%) isolates were multidrug-resistant. Resistance to penicillin was common, with 28.8% of the bovine and 75% of the human Staph. aureus isolates exhibiting resistance. A similar observation was made with the CNS, where 37.3% of the bovine and 89.5% of the human isolates were resistant to penicillin. Multidrug-resistance was common among the human CNS, with 39% of the isolates exhibiting resistance to 3 or more classes of antimicrobials. The antimicrobial susceptibility results suggest that resistance among staphylococci causing bovine intramammary infections in South Africa is uncommon and not a significant cause for concern. In contrast, antimicrobial resistance was frequently observed in staphylococcal isolates of human origin, highlighting a possible reservoir of resistance genes. Continued monitoring of staphylococcal isolates is warranted to monitor changes in the susceptibility of isolates to different classes of antimicrobials.
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Affiliation(s)
- T Schmidt
- Department of Medical Microbiology, University of Pretoria, Pretoria 0001, South Africa; Allerton Provincial Veterinary Laboratory, KwaZulu-Natal Department of Agriculture and Rural Development, Cascades 3202, South Africa.
| | - M M Kock
- Department of Medical Microbiology, University of Pretoria, Pretoria 0001, South Africa; Tshwane Academic Division, National Health Laboratory Service, Pretoria 0001, South Africa
| | - M M Ehlers
- Department of Medical Microbiology, University of Pretoria, Pretoria 0001, South Africa; Tshwane Academic Division, National Health Laboratory Service, Pretoria 0001, South Africa
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Artemisia princeps Inhibits Biofilm Formation and Virulence-Factor Expression of Antibiotic-Resistant Bacteria. BIOMED RESEARCH INTERNATIONAL 2015; 2015:239519. [PMID: 26247012 PMCID: PMC4515282 DOI: 10.1155/2015/239519] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 02/13/2015] [Indexed: 11/17/2022]
Abstract
In this study, we used ethanol extract of A. princeps and investigated its antibacterial effects against MRSA. Ethanol extract of A. princeps significantly inhibited MRSA growth and organic acid production during glucose metabolism at concentrations greater than 1 mg/mL (P < 0.05). MRSA biofilm formation was observed using scanning electron microscopy (SEM) and safranin staining. A. princeps extract was found to inhibit MRSA biofilm formation at concentrations higher than 2 mg/mL significantly (P < 0.05). Bactericidal effects of the A. princeps were observed using confocal laser microscopy, which showed that A. princeps was bactericidal in a dose-dependent manner. Using real-time PCR, expression of mecA, an antibiotic-resistance gene of MRSA, was observed, along with that of sea, agrA, and sarA. A. princeps significantly inhibited mecA, sea, agrA, and sarA, mRNA expression at the concentrations greater than 1 mg/mL (P < 0.05). The phytochemical analysis of A. princeps showed a relatively high content of organic acids and glycosides. The results of this study suggest that the ethanol extract of A. princeps may inhibit proliferation, acid production, biofilm formation, and virulence gene expressions of MRSA, which may be related to organic acids and glycosides, the major components in the extract.
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Youn SH, Lee SS, Kim S, Lee JA, Kim BJ, Kim J, Han HK, Kim JS. Drug utilization review of mupirocin ointment in a Korean university-affiliated hospital. Korean J Intern Med 2015; 30:515-20. [PMID: 26161018 PMCID: PMC4497339 DOI: 10.3904/kjim.2015.30.4.515] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/16/2014] [Accepted: 10/10/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Intranasal mupirocin and chlorhexidine bathing are candidate strategies to prevent healthcare-associated infections caused by methicillin-resistant Staphylococcus aureus (MRSA). In Korea, intranasal mupirocin is not available, and mupirocin ointment, an over-the-counter drug, has been used indiscriminately. Furthermore, because it is covered by health insurance, mupirocin is easy to prescribe within hospitals. METHODS We performed a mupirocin drug utilization review (DUR) within Hallym University Sacred Heart Hospital. Annual use of mupirocin was investigated between 2003 and 2013, and monthly consumption of mupirocin was assessed during the final 2-year period. The DUR focused on August 2012, the period of highest use of mupirocin. Also, we investigated trends in mupirocin resistance in MRSA between 2011 and 2013. RESULTS Annual consumption of mupirocin increased from 3,529 tubes in 2003 to 6,475 tubes in 2013. During August 2012, 817 tubes were prescribed to 598 patients; of these, 84.9% were prescribed to outpatients, and 77.6% at the dermatology department. The most common indication was prevention of skin infections (84.9%), and the ointment was combined with systemic antibiotics in 62.9% of cases. The average duration of systemic antibiotic administration was about 7.8 days. The rate of low-level mupirocin resistance in MRSA increased from 8.0% to 22.0%, and that of high-level mupirocin resistance increased from about 4.0% to about 7.5%. CONCLUSIONS Inappropriate use of mupirocin is prevalent. Considering the increase in resistance and the future application of intranasal mupirocin, prophylactic use of mupirocin in dermatology departments should be reconsidered.
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Affiliation(s)
- Sung Hee Youn
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Seung Soon Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sukyeon Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jeong-a Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Bum Joon Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jounghee Kim
- Department of Pharmacy, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hye-kyung Han
- Department of Pharmacy, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jae-Seok Kim
- Department of Laboratory Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
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Park SH, Park C, Yoo JH, Choi SM, Choi JH, Shin HH, Lee DG, Lee S, Kim J, Choi SE, Kwon YM, Shin WS. Emergence of Community-Associated Methicillin-ResistantStaphylococcus aureusStrains as a Cause of Healthcare-Associated Bloodstream Infections in Korea. Infect Control Hosp Epidemiol 2015; 30:146-55. [DOI: 10.1086/593953] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background.The prevalence of community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) strains causing bloodstream infection (BSI) has not been studied in Korea.Objective.We sought to determine the prevalence of CA-MRSA strains among isolates recovered from patients with MRSA BSIs and to explore epidemiological changes in Korea. We also sought to evaluate clinical characteristics relevant to the development of healthcare-associated BSIs.Methods.We prospectively collected consecutive MRSA isolates from patients with BSI at 4 hospitals from July 1 through November 30, 2007, and we also included MRSA isolates recovered from culture of blood samples collected during a previous year (October 1, 2004 through September 30, 2005) at a different hospital. Molecular typing studies were performed, including pulsed-field gel electrophoresis (PFGE), multilocus sequence typing,Staphylococcusprotein A (spa) typing, and staphylococcal cassette chromosomemec(SCCmec) typing. We compared the clinical characteristics and outcomes of patients with healthcare-associated BSI due to CA-MRSA strains with those of patients with healthcare-associated BSI due to healthcare-associated MRSA (HA-MRSA) strains.Results.There were 76 cases of MRSA BSI, of which 4 (5.3%) were community-associated and 72 (94.7%) were healthcare-associated. Among the 72 HA-MRSA BSIs, 18 (25%) were community onset, and 54 (75%) were hospital onset. PFGE type D-ST72–spaB-SCCmectype IVA MRSA, the predominant genotype of CA-MRSA in Korea, accounted for 19 (25%) of all 76 MRSA BSIs, including 17 (23.6%) of 72 HA-MRSA BSIs and 11 (20.8%) of 53 hospital-onset HA-MRSA BSIs. Patients with healthcare-associated BSIs due to CA-MRSA strains carrying SCCmectype IVA tended to have fewer healthcare-associated risk factors, compared with patients with healthcare-associated BSIs due to HA-MRSA strains carrying other SCCmectypes. The presence of a central venous catheter or other invasive device was the only independent factor differentiating patients infected with hospital-associated genotype strains from patients infected with other strains. Clinical outcomes were similar between both groups.Conclusions.CA-MRSA strains are emerging as a major cause of BSI in healthcare settings in Korea. This changing epidemiology of MRSA poses a challenge to public health and infection control in hospital settings.
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Affiliation(s)
- Younghee Jung
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Infectious Diseases, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Infectious Diseases, Seoul National University Bundang Hospital, Seongnam, Korea
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An eco-friendly and water mediated product selective synthesis of 2-aminopyrimidines and their in vitro anti-bacterial evaluation. Bioorg Med Chem Lett 2014; 24:4999-5007. [DOI: 10.1016/j.bmcl.2014.09.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 08/06/2014] [Accepted: 09/09/2014] [Indexed: 11/20/2022]
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Asadollahi P, Delpisheh A, Maleki MH, Azizi Jalilian F, Alikhani MY, Asadollahi K, Soroush S, Hematian A, Emaneini M, Taherikalani M. Enterotoxin and Exfoliative Toxin Genes Among Methicillin-Resistant Staphylococcus aureus Isolates Recovered From Ilam, Iran. ACTA ACUST UNITED AC 2014. [DOI: 10.17795/ajcmi-20208] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | - Farid Azizi Jalilian
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, IR Iran
- Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran
| | | | | | - Setareh Soroush
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, IR Iran
- Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran
| | | | | | - Morovat Taherikalani
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, IR Iran
- Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran
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Tashakori M, Mohseni Moghadam F, Ziasheikholeslami N, Jafarpour P, Behsoun M, Hadavi M, Gomreei M. Staphylococcus aureus nasal carriage and patterns of antibiotic resistance in bacterial isolates from patients and staff in a dialysis center of southeast Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2014; 6:79-83. [PMID: 25705356 PMCID: PMC4281664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Staphylococcus aureus is an important infection in hemodialysis patients. We studied the prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) and its antibiotic resistance pattern in patients receiving hemodialysis as well as in dialysis unit staff. MATERIALS AND METHODS From June to September 2012, we evaluated 74 cases including 61 patients on hemodialysis and 13 dialysis unit staff. Nasal swabs were taken from all cases and were cultured on a blood medium agar. We identified S. aureus based on conventional laboratory methods. For antimicrobial resistance patterns, we used disk diffusion method. Oxacillin MIC, oxacillin and cefoxcitin disk diffusion methods were used for detection of MRSA. Disk approximation test (D-test) was applied for the frequency of erythromycin induced clindamycin resistance. RESULTS S. aureus carrier state was determined in 12 of the 61 patients on hemodialysis (19.67%) and 5 of the 13 dialysis unit staffs (38.46%). In hemodialyzed patients, MRSA and MSSA carrier of S. aureus were 6.56% and 13.11%, respectively. All nasal carriage states in studied staffs were MSSA. All isolated S. aureus were found to be sensitive to vancomycin, teicoplanin, and rifampin. However, reduced sensitivity of MRSA isolates to other antibiotics was noted. Resistance frequencies to tested antibiotic was as follows: cefteriaxone and penicillin (100%), tetracycline and doxycilin (75%), gentamicin, cloxacillin, and cefazolin (50%), ciprofloxacin, trimethoprim-sulfamethoxazol, erythromycin, and clindamycin (25%). The resistance rate of isolated MSSA against tested antibiotics was lower than isolated MRSA. Inducible clindamycin resistance was shown in 25% of identified MRSA strains. CONCLUSION S. aureus nasal carrier state was lower than former reports from other parts of Iran. The antibiotic resistance patterns also differed, perhaps due to different pattern of administering antibiotics at our hospital. Screening of these patients should be noted as a health priority and microbial sensitivity tests should be considered in order to optimize treatment options.
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Affiliation(s)
- Mahnaz Tashakori
- Department of Paramedical Laboratory Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,Corresponding author: Dr. Mahnaz Tashakori, Address:Department of Paramedical Laboratory Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. Tel: +98-391-5228597, Fax: +98-391-8220185,
| | - Fateme Mohseni Moghadam
- Department of Paramedical Laboratory Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Parvin Jafarpour
- Department of Clincal Skills Rafsanjan University of Medical Science, Rafsanjan, Iran
| | - Maryam Behsoun
- Department of Paramedical Laboratory Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Maryam Hadavi
- Department ofAnesthesiology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammadhossein Gomreei
- Department of Paramedical Laboratory Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Hsu LY, Wijaya L, Tan BH. Management of healthcare-associated methicillin-resistantStaphylococcus aureus. Expert Rev Anti Infect Ther 2014; 3:893-905. [PMID: 16307502 DOI: 10.1586/14787210.3.6.893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Healthcare-associated methicillin-resistant Staphylococcus aureus is a major cause of nosocomial infections worldwide, with significant attributable morbidity and mortality in addition to pronounced healthcare costs. Treatment results with vancomycin--the current recommended antibiotic for serious methicillin-resistant S. aureus infections--have not been impressive. The recent availability of effective antimicrobial agents other than glycopeptides, such as linezolid and daptomycin, as well as the anticipated approval of newer agents with diverse mechanisms of action, has somewhat ameliorated the threat posed by this organism. However, these drugs are expensive, and there is still no overall satisfactory strategy for reducing the incidence of healthcare-associated methicillin-resistant S. aureus in endemic regions. Although early results with the Society for Healthcare Epidemiology of America guidelines give cause for cautious optimism, long-term experience is lacking, and it is likely that these guidelines will have to be adapted according to local conditions and resources before implementation. Trends to keep in mind when considering the problem of healthcare-associated methicillin-resistant S. aureus include the advent of community-associated methicillin-resistant S. aureus, and the propensity of S. aureus to evolve and acquire resistance determinants over time. This was last vividly demonstrated by the handful of vancomycin-resistant S. aureus isolated recently, which had acquired the vancomycin resistance gene from vancomycin-resistant enterococci.
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Affiliation(s)
- Li-Yang Hsu
- Department of Internal Medicine, Singapore General Hospital, S169608, Singapore.
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Song KH, Kim ES, Sin HY, Park KH, Jung SI, Yoon N, Kim DM, Lee CS, Jang HC, Park Y, Lee KS, Kwak YG, Lee JH, Park SY, Song M, Park SK, Lee YS, Kim HB. Characteristics of invasive Staphylococcus aureus infections in three regions of Korea, 2009-2011: a multi-center cohort study. BMC Infect Dis 2013; 13:581. [PMID: 24321206 PMCID: PMC4029571 DOI: 10.1186/1471-2334-13-581] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 12/06/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Despite the importance of invasive Staphylococcus aureus (ISA) infection, its overall burden in non-selected populations has only been defined in a small number of studies in Europe and North America. To define the characteristics of ISA infections in Korea, we conducted a multi-center cohort study to estimate population-based incidence rates. METHODS We conducted a multicenter prospective cohort study at nine university-affiliated active-surveillance core centers (ASCs) in three regions of Korea. To cover all available clinical microbiologic laboratories, we classified the laboratories in these regions into three groups according to their clinical environment as: 1) Nine ASCs, 2) Five major commercial laboratories and 3) Forty-four acute-care hospital-affiliated microbiology laboratories. We requested all the laboratories to report prospectively their numbers of cases of S. aureus isolated from normally sterile sites. Detailed clinical information was collected about the cases in the nine ASCs. RESULTS From 1 July 2009 to 30 June 2011, a total of 1,198 cases of ISA infection were identified at the nine ASCs, including 748 (62%) methicillin-resistant S. aureus (MRSA) infections. Most (81%) ISA infections were healthcare-associated (HCA): 653 (55%) hospital-onset and 322 (27%) community-onset. 223 (19%) were community-associated infections. The most common primary diagnosis was catheter-associated infection (225 cases, 19%). Respiratory tract infection (160, 13%), skin & soft tissue (152, 13%) and bone & joint infections (120, 10%) were also common. 30-day and 12-week mortality rates were 25.6% (262/1,024) and 36.5% (314/860), respectively. Complications, including metastatic infection within 12 weeks, occurred in 17.8% of ISA infections. The most common site of metastatic infection was the lung (9.8%, 84/860). Based on the total of 2,806 observed cases of ISA infection, estimated annual rates of ISA and invasive MRSA infections were 43.3 and 27.7 per 100,000 populations, respectively. CONCLUSIONS Our data provide important information about the clinical characteristics of ISA infections. We estimate that over 21,000 ISA infections and 13,000 invasive MRSA infections occurred in Korea in 2010.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Seongnam, Bundang-gu 463-707, Republic of Korea.
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Antibacterial Activity of Rhus javanica against Methicillin-Resistant Staphylococcus aureus. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:549207. [PMID: 24223060 PMCID: PMC3816054 DOI: 10.1155/2013/549207] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 08/28/2013] [Accepted: 08/28/2013] [Indexed: 12/02/2022]
Abstract
In the present study, the leaves of Rhus javanica (R. javanica) were extracted with ethanol, and we investigated the antimicrobial activity of the ethanol extract of R. javanica against methicillin-resistant Staphylococcus aureus (MRSA). Control groups were treated with media containing 0.1% DMSO. The ethanol extract of R. javanica inhibited the growth of MRSA at concentrations ranging from 0.05 to 0.2 mg/mL and inhibited acid production at concentrations higher than 0.1 mg/mL (P < 0.05). MRSA biofilm formation was determined by scanning electron microscopy and safranin staining. The ethanol extract of R. javanica inhibited the formation of MRSA biofilms at concentrations higher than 0.05 mg/mL. In confocal laser scanning microscopy, high concentration (0.4–1.6 mg/mL) of R. javanica extract showed bactericidal effect in a dose-dependent manner. In real-time PCR analysis, R. javanica extract showed the inhibition of the genetic expression of virulence factors such as mecA, sea, agrA, and sarA in MRSA. Preliminary phytochemical analysis revealed the strong presence of phenolics. These results suggest that R. javanica may be a useful medicinal plant for inhibiting MRSA, which may be related to the presence of phenolics in the R. javanica extract.
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Ethanol Extract of Ulmus pumila Root Bark Inhibits Clinically Isolated Antibiotic-Resistant Bacteria. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:269874. [PMID: 24228058 PMCID: PMC3817893 DOI: 10.1155/2013/269874] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 09/03/2013] [Indexed: 12/21/2022]
Abstract
In this study, root bark of Ulmus pumila (U. pumila) was extracted with ethanol, and then the antimicrobial effects were tested on clinically isolated 12 MRSA strains and 1 standard MRSA strain. U. pumila showed antibacterial activities against all MRSA strains. Minimum inhibitory concentration (MIC) of U. pumila root bark against all MRSA strains revealed a range from 125 to 250 μg/mL. These results may provide the scientific basis on which U. pumila root bark has traditionally been used against infectious diseases in Korea. In real-time PCR analysis, the sub-MIC (64–125 μg/mL) concentrations of U. pumila root bark extract showed the inhibition of the genetic expressions of virulence factors such as mecA, sea, agrA, and sarA in standard MRSA. Phytochemical analyses of U. pumila root bark showed relatively strong presence of phenolics, steroids, and terpenoids. These results suggest that the ethanol extract of U. pumila root bark may have antibacterial activity against MRSA, which may be related to the phytochemicals such as phenolics, steroids, and terpenoids. Further studies are needed to determine the active constituents of U. pumila root bark responsible for such biomolecular activities.
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Olowe OA, Kukoyi OO, Taiwo SS, Ojurongbe O, Opaleye OO, Bolaji OS, Adegoke AA, Makanjuola OB, Ogbolu DO, Alli OT. Phenotypic and molecular characteristics of methicillin-resistant Staphylococcus aureus isolates from Ekiti State, Nigeria. Infect Drug Resist 2013; 6:87-92. [PMID: 23990730 PMCID: PMC3753063 DOI: 10.2147/idr.s48809] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction The characteristics and antimicrobial resistance profiles of Staphylococcus aureus differs according to geographical regions and in relation to antibiotic usage. The aim of this study was to determine the biochemical characteristics of the prevalent S. aureus from Ekiti State, Nigeria, and to evaluate three commonly used disk diffusion methods (cefoxitin, oxacillin, and methicillin) for the detection of methicillin resistance in comparison with mecA gene detection by polymerase chain reaction. Materials and methods A total of 208 isolates of S. aureus recovered from clinical specimens were included in this study. Standard microbiological procedures were employed in isolating the strains. Susceptibility of each isolate to methicillin (5 μg), oxacillin (1 μg), and cefoxitin (30 μg) was carried out using the modified Kirby–Bauer/Clinical and Laboratory Standard Institute disk diffusion technique. They were also tested against panels of antibiotics including vancomycin. The conventional polymerase chain reaction method was used to detect the presence of the mecA gene. Results Phenotypic resistance to methicillin, oxacillin, and cefoxitin were 32.7%, 40.3%, and 46.5%, respectively. The mecA gene was detected in 40 isolates, giving a methicillin-resistant S. aureus (MRSA) prevalence of 19.2%. The S. aureus isolates were resistant to penicillin (82.7%) and tetracycline (65.4%), but largely susceptible to erythromycin (78.8% sensitive), pefloxacin (82.7%), and gentamicin (88.5%). When compared to the mecA gene as the gold standard for MRSA detection, methicillin, oxacillin, and cefoxitin gave sensitivity rates of 70%, 80%, and 100%, and specificity rates of 76.2%, 69.1%, and 78.5% respectively. Conclusion When compared with previous studies employing mecA polymerase chain reaction for MRSA detection, the prevalence of 19.2% reported in Ekiti State, Nigeria in this study is an indication of gradual rise in the prevalence of MRSA in Nigeria. A cefoxitin (30 μg) disk diffusion test is recommended above methicillin and oxacillin for the phenotypic detection of MRSA in clinical laboratories.
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Affiliation(s)
- Olugbenga Adekunle Olowe
- Department of Medical Microbiology and Parasitology, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
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Trend of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in an institution with a high rate of MRSA after the reinforcement of antibiotic stewardship and hand hygiene. Am J Infect Control 2013; 41:e39-43. [PMID: 23522710 DOI: 10.1016/j.ajic.2012.12.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 12/17/2012] [Accepted: 12/17/2012] [Indexed: 11/20/2022]
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) infections are a concern across the worldwide. METHODS Antibiotic stewardship and hand hygiene programs were reinforced in a 2,000-bed tertiary hospital in South Korea where the methicillin resistance rate of Staphylococcus aureus is about 65%. The computerized prescription restriction was implemented in August 2008. "Hand hygiene program," consistent with World Health Organization guideline, was reinforced in December 2008. We assessed the effect of the infection control programs on the incidence of MRSA bloodstream infection (BSI) from January 2006 through November 2011. RESULTS Incidence of MRSA BSI was reduced from 0.171 per 1,000 patient-days in 2009 to 0.116 per 1,000 patient-days in 2011 (P = .009). Monthly mean antibiotic consumption decreased from 690.54 ± 28.33 defined daily dose per 1,000 patients-days in 2008 to 652.47 ± 20.77 (P = .015) in 2011. The rates of performance in hand hygiene increased from 43% in 2008 to 83% in 2011 (P = .043). CONCLUSION Although we did not implement all components of "MRSA bundle," efforts to reinforce antibiotic stewardship and hand hygiene program for 3 years had beneficial effects on the decrease in MRSA BSI in this institute with high rate of MRSA.
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Hasani A, Sheikhalizadeh V, Hasani A, Naghili B, Valizadeh V, Nikoonijad AR. Methicillin resistant and susceptible Staphylococcus aureus: Appraising therapeutic approaches in the Northwest of Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2013; 5:56-62. [PMID: 23467268 PMCID: PMC3577566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Staphylococcus aureus is a versatile organism causing mild to life threatening infections. The major threat of this organism is its multidrug resistance. The present study was carried out to investigate in - vitro activity of conventional antibiotics routinely prescribed for methicillin resistant S. aureus (MRSA) and methicillin sensitive S. aureus (MSSA) infections in the Northwest of Iran and other alternating therapeutic agents which are recommended for Gram positive organisms. MATERIALS AND METHODS Clinical isolates of S. aureus were subjected to multiplex PCR for simultaneous speciation and detection of methicillin resistance. Antibacterial susceptibility pattern was determined using disk diffusion. The Minimum Inhibitory Concentrations (MICs) were determined using E-test strips. RESULTS The results revealed presence of nuc gene in all S. aureus isolates detected phenotypically earlier whereas, mecA gene was observed in 54% of strains. On disk diffusion and MIC determination assay, all MRSA and MSSA strains were susceptible to mupirocin (except one MRSA strain), linezolid and teicoplanin. Six vancomycin intermediate S. aureus strains were detected (VISA) with MIC= 4µg/mL, 5 of them being MRSA. In disk diffusion assay, 17.3% and 3.7% of isolates showed resistance to rifampin and fusidic acid, respectively. However, MIC50 and MIC90 tests shows promising in - vitro impact. CONCLUSION In - vitro mupirocin was found as an effective prophylactic ointment for nasal S. aureus eradication. Our data emphasize the performance of surveillance exercises to outline the existing antibiotics prescription policies and to slow down the emergence of multidrug resistant strains.
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Affiliation(s)
- Alka Hasani
- Research Center of Infectious Diseases and Tropical Medicine, Departments of Medical Microbiology,Departments of Medical Microbiology
| | - Vajihe Sheikhalizadeh
- Research Center of Infectious Diseases and Tropical Medicine, Departments of Medical Microbiology,Departments of Medical Microbiology
| | - Akbar Hasani
- Research Center of Infectious Diseases and Tropical Medicine, Departments of Medical Microbiology,Biochemistry and Laboratory Sciences, Corresponding author: Akbar Hasani Ph.D, Address: Department of Medical Biochemistry and Laboratory Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Fax: +98-411-3364667. E-mail:
| | - Behrouz Naghili
- Research Center of Infectious Diseases and Tropical Medicine, Departments of Medical Microbiology,Infectious Diseases, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahide Valizadeh
- Department of Pharmaceutical Biotechnology, Pasteur Institute of Iran
| | - Ali Reza Nikoonijad
- Department of Infectious Diseases, Urumieh University of Medical Sciences, Urumieh, Iran
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Antimicrobial effect of sophoraflavanone G isolated from Sophora flavescens against mutans streptococci. Anaerobe 2013. [DOI: 10.1016/j.anaerobe.2012.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Joo EJ, Peck KR, Ha YE, Kim YS, Song YG, Lee SS, Ryu SY, Moon C, Lee CS, Park KH. Impact of acute kidney injury on mortality and medical costs in patients with meticillin-resistant Staphylococcus aureus bacteraemia: a retrospective, multicentre observational study. J Hosp Infect 2013; 83:300-6. [PMID: 23369468 DOI: 10.1016/j.jhin.2012.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 12/16/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite the frequent occurrence of acute kidney injury (AKI) associated with meticillin-resistant Staphylococcus aureus (MRSA) infection during treatment, the adverse impact of renal injury on clinical and economic outcomes has not been evaluated. AIM To study the clinical and economic burdens of MRSA bacteraemia and the impact of AKI occurring during treatment on outcomes. METHODS Medical records of patients hospitalized for MRSA bacteraemia between March 2010 and February 2011 in eight hospitals in Korea were reviewed retrospectively to evaluate the risk factors for AKI and mortality. Direct medical costs per patient of MRSA bacteraemia during treatment were estimated from the medical resources consumed. FINDINGS In all, 335 patients were identified to have MRSA bacteraemia. AKI occurred in 135 patients (40.3%) during first-line antibiotic therapy. Independent risk factors for AKI were male sex, underlying renal disease, intra-abdominal and central venous catheter infection, and increase in Pitt bacteraemia score. Seventy-seven (23.0%) patients died during the study period. Underlying solid tumour, high Pitt bacteraemia score, and occurrence of AKI were independent risk factors for mortality. The mean total medical cost per MRSA patient was estimated as South Korean Won 5,435,361 (US$4,906), and occurrence of AKI and ICU admission were identified as independent predictors of increased direct medical costs. Compared with patients who retained their baseline renal function, patients with AKI had a 45% increase in medical costs. CONCLUSIONS Patients who developed AKI showed significantly higher mortality rate and greater direct medical costs compared with patients who retained baseline renal function.
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Affiliation(s)
- E-J Joo
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Martins MA, Santos SDLVD, Leão LSNDO, Araújo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop 2012; 45:717-22. [DOI: 10.1590/s0037-86822012000600012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 10/30/2012] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION: In venous ulcers, the presence of Staphylococcus aureus and coagulase-negative staphylococcus resistance phenotypes can aggravate and limit the choices for treatment. METHODS: Staphylococcus isolated from 69 patients (98 ulcers) between October of 2009 and October of 2010 were tested. The macrolide, lincosamide, streptogramin B (MLS B) group resistance phenotype detection was performed using the D-test. Isolates resistant to cefoxitin and/or oxacillin (disk-diffusion) were subjected to the confirmatory test to detect minimum inhibitory concentration (MIC), using oxacillin strips (E-test®). RESULTS: The prevalence of S. aureus was 83%, and 15% of coagulase-negative staphylococcus (CoNS). In addition were detected 28% of methicillin-resistant Staphylococcus aureus (MRSA) and 47% of methicillin-resistant coagulase-negative staphylococcus (MRCoNS). Among the S. aureus, 69.6% were resistant to erythromycin, 69.6% to clindamycin, 69.6% to gentamicin, and 100% to ciprofloxacin. Considering the MRSA, 74% were highly resistant to oxacillin, MIC ≥ 256µg/mL, and the MLS Bc constitutive resistance predominated in 65.2%. Among the 20 isolates sensitive to clindamycin, 12 presented an inducible MLS B phenotype. Of the MRCoNS, 71.4%were resistant to erythromycin, ciprofloxacin and gentamicin. Considering the isolates positive for β-lactamases, the MIC breakpoint was between 0.5 and 2µg/mL. CONCLUSIONS: The results point to a high occurrence of multi-drug resistant bacteria in venous ulcers in primary healthcare patients, thus evidencing the need for preventive measures to avoid outbreaks caused by multi-drug resistant pathogens, and the importance of healthcare professionals being able to identifying colonized versus infected venous ulcers as an essential criteria to implementing systemic antibacterial therapy.
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Wang JL, Tang HJ, Hsieh PH, Chiu FY, Chen YH, Chang MC, Huang CT, Liu CP, Lau YJ, Hwang KP, Ko WC, Wang CT, Liu CY, Liu CL, Hsueh PR. Fusidic acid for the treatment of bone and joint infections caused by meticillin-resistant Staphylococcus aureus. Int J Antimicrob Agents 2012; 40:103-7. [DOI: 10.1016/j.ijantimicag.2012.03.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 03/14/2012] [Indexed: 12/29/2022]
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Kim SE, Lee SJ, Lee SY, Yoon JS. Clinical significance of microbial growth on the surfaces of silicone tubes removed from dacryocystorhinostomy patients. Am J Ophthalmol 2012; 153:253-257.e1. [PMID: 21920491 DOI: 10.1016/j.ajo.2011.06.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 06/16/2011] [Accepted: 06/24/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE To investigate the bacterial infection of silicone tubes removed from patients who underwent dacryocystorhinostomy (DCR) and assess the correlation between the culture results and postoperative clinical features. DESIGN Retrospective observational case series. METHODS Consecutive epiphora patients who underwent external or endoscopic DCR surgery were reviewed. The postoperatively removed silicone tubes were cultured. Preoperative canalicular stenosis and nasal septal hypertrophy, postoperative inflammation, membranous obstruction of nasal mucosa, and the duration of silicone intubation were reviewed. Correlations between the results of bacterial culture and clinical features were verified. RESULTS A total of 39 silicone tubes removed from 33 patients were cultured: 34 (87.2%) external DCR cases and 5 (12.8%) endoscopic DCR. Culture provided positive results in 37 cases (94.9%). A total of 52 isolates were identified: 73.1% gram-positive bacteria, 23.1% gram-negative bacteria, and 3.8% fungi. Of the gram-positive organisms, 73.9% were Staphylococcus aureus. Most of the gram-negative organisms were Pseudomonas aeruginosa, found in 5 eyes. The time of tube placement was significantly longer in cases with P. aeruginosa than in those with other bacteria (P = .001). The rate of pseudomonas infection was significantly higher in cases with revision than in those without revision (P = .001). Final surgical failure was significantly related with canalicular stenosis (P = .017), pus discharge at extubation (P < .001), history of endoscopic revision (P = .001), and pseudomonal infection (P = .010). CONCLUSIONS Various bacterial species were cultured from removed silicone tubes. Although many of them were normal flora, P. aeruginosa infection showed significant relation with membranous obstruction of nasal mucosa, prolonged silicone intubation, and surgical failure.
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Hanessian S, Giguère A, Grzyb J, Maianti JP, Saavedra OM, Aggen JB, Linsell MS, Goldblum AA, Hildebrandt DJ, Kane TR, Dozzo P, Gliedt MJ, Matias RD, Feeney LA, Armstrong ES. Toward Overcoming Staphylococcus aureus Aminoglycoside Resistance Mechanisms with a Functionally Designed Neomycin Analogue. ACS Med Chem Lett 2011; 2:924-8. [PMID: 24900282 DOI: 10.1021/ml200202y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 09/15/2011] [Indexed: 11/28/2022] Open
Abstract
Deoxygenation of the diol groups in rings A and D of neomycin in combination with the introduction of an N1-(l)-HABA group in the 2-deoxystreptamine subunit (ring B) leads to a novel and potent antibiotic (1) with activity against strains of S. aureus carrying known aminoglycoside resistance determinants, as well as against an extended panel of Methicillin-resistant S. aureus isolates (n = 50). Antibiotic 1 displayed >64 fold improvement in MIC50 and MIC90 against this MRSA collection when compared to the clinically relevant aminoglycosides amikacin and gentamicin. The synthesis was achieved in six steps and 15% overall yield.
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Affiliation(s)
- Stephen Hanessian
- Department of Chemistry, Université de Montréal, C.P. 6128, Succ. Centre-Ville, Montréal, Quebec H3C 3J7, Canada
| | - Alexandre Giguère
- Department of Chemistry, Université de Montréal, C.P. 6128, Succ. Centre-Ville, Montréal, Quebec H3C 3J7, Canada
| | - Justyna Grzyb
- Department of Chemistry, Université de Montréal, C.P. 6128, Succ. Centre-Ville, Montréal, Quebec H3C 3J7, Canada
| | - Juan Pablo Maianti
- Department of Chemistry, Université de Montréal, C.P. 6128, Succ. Centre-Ville, Montréal, Quebec H3C 3J7, Canada
| | - Oscar M. Saavedra
- Department of Chemistry, Université de Montréal, C.P. 6128, Succ. Centre-Ville, Montréal, Quebec H3C 3J7, Canada
| | - James B. Aggen
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Martin S. Linsell
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Adam A. Goldblum
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Darin J. Hildebrandt
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Timothy R. Kane
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Paola Dozzo
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Micah J. Gliedt
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Rowena D. Matias
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Lee Ann Feeney
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
| | - Eliana S. Armstrong
- Achaogen Inc., 7000 Shoreline Court, Suite 371, South San Francisco, California 94080, United States
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Song KH, Kang YM, Sin HY, Yoon SW, Seo HK, Kwon S, Shin MJ, Chang CB, Kim TK, Kim HB. Outcome of cefazolin prophylaxis for total knee arthroplasty at an institution with high prevalence of methicillin-resistant Staphylococcus aureus infection. Int J Infect Dis 2011; 15:e867-70. [PMID: 22019197 DOI: 10.1016/j.ijid.2011.09.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 06/14/2011] [Accepted: 09/14/2011] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the outcome of cefazolin prophylaxis for total knee arthroplasty (TKA) in a hospital with a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection. METHODS Since July 1, 2006, we have applied a 'care bundle' to TKA to prevent surgical site infection (SSI) without using vancomycin as antimicrobial prophylaxis, in accordance with the 1999 Hospital Infection Control Practices Advisory Committee guidelines. All patients undergoing TKA from July 1, 2006 to September 30, 2009 were enrolled. We reviewed data on SSI collected prospectively as part of routine infection control surveillance. RESULTS Of 1323 TKAs, an SSI developed in 14 (1.06%) cases, which is comparable to the percentage obtained in other previous reports. When stratified by the National Nosocomial Infection Surveillance risk index, SSI rates were 0.86% (8/926), 1.30% (5/384), and 7.69% (1/13) in risk categories 0, 1, and 2, respectively. Of 14 SSIs, four (29%) were classified as superficial incisional, two (14%) as deep incisional, and eight (57%) as organ-space SSI. CONCLUSIONS Our data suggest that antimicrobial prophylaxis using only cefazolin can maintain low SSI rates if other important infection management measures are employed, even where there is a high prevalence of MRSA infection.
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Affiliation(s)
- Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam 463-707, Korea
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Baugher KM, Hemme TS, Hawkshaw M, Sataloff RT. MRSA otorrhea: A case series and review of the literature. EAR, NOSE & THROAT JOURNAL 2011; 90:60-79. [PMID: 21328227 DOI: 10.1177/014556131109000206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has become an increasingly common cause of difficult-to-treat head and neck infections. We report a retrospective analysis of 3 cases of MRSA otorrhea treated in our clinic between 2007 and 2009. Culture analysis of otorrhea isolates revealed MRSA infections with identical drug sensitivities. Treatment success was achieved using combinations of linezolid with gentamicin ear drops for 3 to 4 weeks or trimethoprim/sulfamethoxazole (TMP/SMX) with gentamicin drops for 6 weeks. This study illustrates the importance of determining individual drug sensitivities for optimal treatment and maintaining current knowledge of the local MRSA strains. Empiric combination therapy of TMP/SMX with gentamicin is an effective first-line treatment for MRSA otorrhea. Regional differences in clindamycin sensitivities warrant clinical discretion. Fluoroquinolones should be avoided because of high rates of resistance unless culture sensitivity determines that they are appropriate. First-line agents for severe infections include combination therapy with vancomycin or linezolid.
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Affiliation(s)
- Katherine M Baugher
- Department of Otolaryngology-Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
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Impact of rpoB mutations on reduced vancomycin susceptibility in Staphylococcus aureus. J Clin Microbiol 2011; 49:2680-4. [PMID: 21525224 DOI: 10.1128/jcm.02144-10] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Of 38 vancomycin-intermediate Staphylococcus aureus (VISA) clinical strains, 27 (71%) possessed a mutation(s) in rpoB encoding the β-subunit of RNA polymerase. Furthermore, 95.6% of the rifampin-resistant mutants obtained from 9 methicillin-resistant S. aureus (MRSA) clinical isolates showed decreased vancomycin susceptibilities. These data indicate the involvement of an rpoB mutation in VISA phenotype expression.
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Molecular characterization of methicillin-resistant Staphylococcus aureus isolates in Korea. J Clin Microbiol 2011; 49:1979-82. [PMID: 21411580 DOI: 10.1128/jcm.00098-11] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We used several molecular typing methods to analyze 196 methicillin-resistant Staphylococcus aureus (MRSA) and 139 methicillin-susceptible S. aureus (MSSA) isolates collected between 1996 and 2005. The sequence type 72 MRSA has increased in frequency in the community in the Republic of Korea and in hospitals in recent years.
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42
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Cha JD, Moon SE, Kim JY, Jung EK, Lee YS. Antibacterial activity of sophoraflavanone G isolated from the roots of Sophora flavescens against methicillin-resistant Staphylococcus aureus. Phytother Res 2011; 23:1326-31. [PMID: 19288534 DOI: 10.1002/ptr.2540] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In this study, sophoraflavanone G obtained from Sophora flavescens was evaluated against 10 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA), either alone or in combination with ampicillin or oxacillin, via checkerboard assay. At the end point of an optically clear well, the minimum inhibitory concentrations (MICs) ranged from 0.5 to 8 microg/ml for sophoraflavanone G, from 64 to 1024 microg/ml for ampicillin, and from 256 to 1024 microg/ml for oxacillin. The combination of sophoraflavanone G and ampicillin or oxacillin yielded a fractional inhibitory concentration index ranging from 0.188 to 0.375, thereby indicating a principally synergistic effect. The synergistic interaction was verified by time-kill studies using sophoraflavanone G and/or antibiotics. Thirty minutes of treatment with sophoraflavanone G with ampicillin or oxacillin resulted in an increase in the rate of killing in units of CFU/ml to a greater degree than was observed with Sophoraflavanone G alone. These findings indicated that the application of the tested sophoraflavanone G alone or in combination with antibiotics might prove useful in the control and treatment of MRSA infections.
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Affiliation(s)
- Jeong-Dan Cha
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
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43
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Determination of antimicrobial susceptibility patterns and inducible clindamycin resistance in Staphylococcus aureus strains recovered from southeastern Turkey. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2011; 44:57-62. [PMID: 21531354 DOI: 10.1016/j.jmii.2011.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 12/01/2009] [Accepted: 01/13/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND In this study, we determined the susceptibility patterns of Staphylococcus aureus strains to various antimicrobials and prevalence of inducible clindamycin resistance (ICR) in these isolates. METHODS Two hundred and one S aureus strains, isolated from various clinical samples, were included in the study. Antibiotic susceptibilities were studied by disc diffusion method on the basis of the guidelines by the Clinical and Laboratory Standards Institute. The disc diffusion induction test (D test) was applied to determine ICR resistance among erythromycin-resistant S aureus isolates. RESULTS Of the 201 S aureus strains, 101 (50.2%) were resistant to methicillin. All strains were susceptible to vancomycin, teicoplanin, quinupristin/dalfopristin, and linezolid. It was found that 54 (53.4%) methicillin-resistant S aureus (MRSA) strains were erythromycin resistant, and 40 (39.6%) of them showed constitutive clindamycin resistance. ICR was detected in seven (6.9%) MRSA strains. It was found that 13 (13.0%) methicillin-susceptible S aureus (MSSA) strains were erythromycin resistant. Constitutive clindamycin resistance was seen in one (1.0%) MSSA strain, and ICR was detected in 10 (10.0%) cases. CONCLUSION There was a high rate of methicillin resistance among S aureus strains in our hospital. However, no statistically significant difference of ICR was observed between MRSA and MSSA strains (p=0.434) or between inpatients and outpatients (p=0.804). It was concluded that ICR should be routinely evaluated in each S aureus case to avoid therapy failure among patients.
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44
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Kim BN. Appropriate Oral Antibiotics for the Treatment of Culture-Negative Orthopedic Infections-Reply. Infect Chemother 2011. [DOI: 10.3947/ic.2011.43.6.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Baek-Nam Kim
- Department of Internal Medicine, Inje University College of Medicine, Busan, Korea
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Song JH. Antimicrobial Resistance in Gram-positive Cocci: Past 50 Years, Present and Future. Infect Chemother 2011. [DOI: 10.3947/ic.2011.43.6.443] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jae-Hoon Song
- Division of Infectious Diseases, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea
- Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Korea
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46
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Kmet V, Piatnicová E. Antibiotic resistance in commensal intestinal microflora. Folia Microbiol (Praha) 2010; 55:332-5. [PMID: 20680565 DOI: 10.1007/s12223-010-0052-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 04/14/2010] [Indexed: 11/29/2022]
Abstract
The susceptibility toward antibiotics was determined by disc and MIC methods in Lactobacillus and, for comparison, in Escherichia coli strains isolated from cloacal swabs of broiler chickens derived from various farms in Slovakia. The occurrence of acquired tetracycline resistance in E. coli and lactobacilli isolated from the same sample was similar. The presence of tet(M), tet(S), tet(L) and ermB genes was demonstrated in lactobacilli while the tet(M) gene was not detected in E. coli.
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Affiliation(s)
- V Kmet
- Institute of Animal Physiology, Slovak Academy of Sciences, Kosice, 040 01, Slovakia.
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Lee JH, Chae JD, Kim DG, Hong SH, Lee WM, Ki M. Comparison of the Efficacies of Silver-Containing Dressing Materials for Treating a Full-Thickness Rodent Wound Infected by Methicillin-resistant Staphylococcus aureus. Ann Lab Med 2010; 30:20-7. [DOI: 10.3343/kjlm.2010.30.1.20] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Jong Hoon Lee
- Department of Plastic and Reconstructive Surgery, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
| | - Jeong Don Chae
- Department of Laboratory Medicine, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
| | - Dong Gu Kim
- Department of Plastic and Reconstructive Surgery, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
| | - Sung Hee Hong
- Department of Plastic and Reconstructive Surgery, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
| | - Won Mi Lee
- Department of Pathology, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
| | - Moran Ki
- Department of Preventive Medicine, Eulji University School of Medicine, Daejeon, Korea
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de León L, López MR, Moujir L. Antibacterial properties of zeylasterone, a triterpenoid isolated from Maytenus blepharodes, against Staphylococcus aureus. Microbiol Res 2010; 165:617-26. [PMID: 20116223 DOI: 10.1016/j.micres.2009.12.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 12/17/2009] [Accepted: 12/21/2009] [Indexed: 10/19/2022]
Abstract
The anti-staphylococcal properties of zeylasterone and demethylzeylasterone, two 6-oxophenolic triterpenoids isolated from Maytenus blepharodes, were investigated. Zeylasterone was more active than demethylzeylasterone on Staphylococcus aureus cells, showing bactericidal activity at 30 μg/ml (6 × MIC) in less than three hours and bacteriostatic at lower concentrations. At the same cell density, a more drastic reduction in CFU count was obtained when the triterpenoid was incorporated into cultures growing actively. Zeylasterone at 3 × MIC added on S. aureus cultures showed an early inhibitory effect on incorporation of radiolabeled thymidine, uridina and N-acetyl-glucosamine, and later on leucine. It also caused cell membrane disruption in S. aureus, as shown by the inhibition of radiolabeled precursor uptake, rapid potassium leakage, inhibition of NADH oxidation, and formation of mesosome-like structures around the septa. The structural features of the molecule, the blockage of solute transport through the membrane and changes in its permeability, suggest that zeylasterone acts mainly on cytoplasmic membrane.
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Affiliation(s)
- L de León
- Departamento de Microbiología y Biología Celular, Facultad de Farmacia, Universidad de La Laguna, 38206 Tenerife, Canary Islands, Spain
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Kobayashi CCBA, Sadoyama G, Vieira JDG. Determinação da resistência antimicrobiana associada em isolados clínicos de Staphylococcus aureus e Pseudomonas aeruginosa em um hospital público de Goiânia, Estado de Goiás. Rev Soc Bras Med Trop 2009; 42:404-10. [DOI: 10.1590/s0037-86822009000400009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Accepted: 08/10/2009] [Indexed: 11/21/2022] Open
Abstract
Este estudo avaliou a resistência antimicrobiana associada de Pseudomonas aeruginosa e Staphylococcus aureus a um agente antimicrobiano com outras drogas. A resistência antimicrobiana associada foi calculada através do risco relativo. Houve uma relação óbvia entre resistência à oxacilina e a outros agentes antimicrobianos entre os isolados de Staphylococcus aureus resistentes à oxacilina (68,5%) superior a 32%, com exceção da linezolida (6,7%). Resistência associada pronunciada entre drogas foi observada para isolados de Pseudomonas aeruginosa, particularmente entre ciprofloxacina e os carbapenens (59,6% a 60,7%), entre aminoglicosídeos e carbapenens (66,3% a 67,7%) e os demais β-lactâmicos (52,3% a 85,8%). O presente trabalho enfatiza a importância da cultura diagnóstica e do teste de suscetibilidade na seleção de um correto agente antimicrobiano com relação ao impacto clínico no aumento da multirresistência e na seleção de resistência antimicrobiana associada.
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Pappas G, Athanasoulia AP, Matthaiou DK, Falagas ME. Trimethoprim-sulfamethoxazole for methicillin-resistant Staphylococcus aureus: a forgotten alternative? J Chemother 2009; 21:115-26. [PMID: 19423463 DOI: 10.1179/joc.2009.21.2.115] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a growing infectious concern, mainly in the context of its rapid adaptation to novel antibiotic options for its treatment and the growing morbidity, mortality, and healthcare costs associated with its emergence. the authors sought to investigate whether an older antibiotic, such as trimethoprim-sulfamethoxazole (SXT), may have a role in treating MRSA-related infections, according to the available literature on the subject. The authors reviewed literature data on: resistance of MRSA to SXT worldwide in recent years, efficacy of SXT for MRSA decolonization or prophylaxis from MRSA infections, and clinical therapeutic efficacy of SXT in treating mild or severe community-acquired or hospital-acquired MRSA infections. Resistance varies worldwide, in general being low in the industrialized world and higher in developing countries. SXT is one of the numerous understudied options for MRSA decolonization and is growingly recognized as potentially effective in preventing MRSA infections in certain settings. Limited data on its therapeutic efficacy are encouraging, at least for mild, community-acquired infections. SXT may represent a cost-effective alternative weapon against MRSA. Its utility against this increasingly threatening pathogen need clarification through further clinical trials.
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Affiliation(s)
- G Pappas
- Institute of Continuing Medical Education of Ioannina, Greece.
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