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Manente R, Santella B, Pagliano P, Santoro E, Casolaro V, Borrelli A, Capunzo M, Galdiero M, Franci G, Boccia G. Prevalence and Antimicrobial Resistance of Causative Agents to Ocular Infections. Antibiotics (Basel) 2022; 11:antibiotics11040463. [PMID: 35453215 PMCID: PMC9032492 DOI: 10.3390/antibiotics11040463] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
Bacterial ocular infections are a worldwide health problem and, if untreated, can damage the structure of the eye and contribute to permanent disability. Knowledge of the prevalence and antimicrobial susceptibility patterns of the main causative agents involved in ocular infections is necessary for defining an optimal antibiotic therapy. The aim of this study was to analyse bacterial species involved in ocular infections and the antimicrobial susceptibility patterns. Conjunctival swab samples were collected from patients with bacterial conjunctivitis at the University Hospital San Giovanni di Dio e Ruggi d’Aragona between January 2015 and December 2019. The identification and antibiotic sensitivity tests were performed using the VITEK 2 system. A total of 281 causative agents of ocular infections were isolated, 81.8% of which were Gram-positive bacteria. Coagulase-negative staphylococci (CoNS) were the most commonly isolated species among Gram-positive bacteria, followed by Staphylococcus aureus. In contrast, Pseudomonas spp. and Escherichia coli were the main species isolated among Gram-negative bacteria (18.2%). Overall, linezolid, teicoplanin, tigecycline and vancomycin were the most effective antimicrobials. Analysis of resistance rates over time highlighted increasing resistance for azithromycin, clarithromycin and erythromycin among CoNS, and clindamycin and erythromycin among Staphylococcus aureus. This study has identified the profiles of the major pathogens involved in ocular infection and their susceptibility patterns, which will help improve the treatments and the choice of antibiotics in ocular infections.
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Affiliation(s)
- Roberta Manente
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (B.S.); (M.G.)
| | - Biagio Santella
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (B.S.); (M.G.)
| | - Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
| | - Emanuela Santoro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
| | - Vincenzo Casolaro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
| | - Anna Borrelli
- Azienda Ospedaliero Universitaria San Giovanni di Dio e Ruggi D’Aragona, 84131 Salerno, Italy;
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica e Microbiologica, Azienda Ospedaliero-Universitaria S. Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
| | - Massimiliano Galdiero
- Section of Microbiology and Virology, University Hospital “Luigi Vanvitelli”, 80138 Naples, Italy; (R.M.); (B.S.); (M.G.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica e Microbiologica, Azienda Ospedaliero-Universitaria S. Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
- Correspondence: (G.F.); (G.B.)
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy; (P.P.); (E.S.); (V.C.); (M.C.)
- Dai Dipartimento Di Igiene Sanitaria e Medicina Valutativa U.O.C. Patologia Clinica e Microbiologica, Azienda Ospedaliero-Universitaria S. Giovanni di Dio e Ruggi D’Aragona Scuola Medica Salernitana, Largo Città di Ippocrate, 84131 Salerno, Italy
- Correspondence: (G.F.); (G.B.)
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Tahoun A, Elnafarawy HK, El-Sharkawy H, Rizk AM, Alorabi M, El-Shehawi AM, Youssef MA, Ibrahim HMM, El-Khodery S. The Prevalence and Molecular Biology of Staphylococcus aureus Isolated from Healthy and Diseased Equine Eyes in Egypt. Antibiotics (Basel) 2022; 11:antibiotics11020221. [PMID: 35203823 PMCID: PMC8868267 DOI: 10.3390/antibiotics11020221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 02/04/2023] Open
Abstract
This work aimed to characterize S. aureus isolates from the eyes of healthy and clinically affected equines in the Kafrelsheikh Governorate, Egypt. A total of 110 animals were examined for the presence of S. aureus, which was isolated from 33 animals with ophthalmic lesions and 77 healthy animals. We also investigated the antimicrobial resistance profile, oxacillin resistance mechanism, and the major virulence factors implicated in many studies of the ocular pathology of pathogenic S. aureus. The association between S. aureus eye infections and potential risk factors was also investigated. The frequency of S. aureus isolates from clinically affected equine eyes was significantly higher than in clinically healthy equids. A significant association was found between the frequency of S. aureus isolation from clinically affected equine eyes and risk factors including age and season but not with sex or breed factors. Antimicrobial resistance to common antibiotics used to treat equine eyes was also tested. Overall, the isolates showed the highest sensitivity to sulfamethoxazole (100%) and the highest resistance to cephalosporin (90.67%) and oxacillin (90.48%). PCR was used to demonstrate that mecA was present in 100% of oxacillin- and β-lactam-resistant S. aureus strains. The virulence factor genes Spa (x region), nuc, and hlg were identified in 62.5%, 100%, and 56%, of isolates, respectively, from clinically affected equines eyes. The severity of the eye lesions increased in the presence of γ-toxin-positive S. aureus. The phylogenetic tree of the Spa (x region) gene indicated a relationship with human reference strains isolated from Egypt as well as isolates from equines in Iran and Japan. This study provides insight into the prevalence, potential risk factors, clinical pictures, zoonotic potential, antimicrobial resistance, and β-lactam resistance mechanism of S. aureus strains that cause eye infection in equines from Egypt.
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Affiliation(s)
- Amin Tahoun
- Department of Animal Medicine, Faculty of Veterinary Medicine, Kafrelshkh University, Kafrelsheikh 33511, Egypt
- Correspondence:
| | - Helmy K. Elnafarawy
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; (H.K.E.); (M.A.Y.); (H.M.M.I.); (S.E.-K.)
| | - Hanem El-Sharkawy
- Department of Poultry and Rabbit Diseases, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh 33511, Egypt;
| | - Amira M. Rizk
- Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Benha University, Benha 13518, Egypt;
| | - Mohammed Alorabi
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (M.A.); (A.M.E.-S.)
| | - Ahmed M. El-Shehawi
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; (M.A.); (A.M.E.-S.)
| | - Mohamed A. Youssef
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; (H.K.E.); (M.A.Y.); (H.M.M.I.); (S.E.-K.)
| | - Hussam M. M. Ibrahim
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; (H.K.E.); (M.A.Y.); (H.M.M.I.); (S.E.-K.)
| | - Sabry El-Khodery
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt; (H.K.E.); (M.A.Y.); (H.M.M.I.); (S.E.-K.)
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Laskey E, Chen Y, Sohn MB, Gruber E, Chojnacki M, Wozniak RAF. Efficacy of a Novel Ophthalmic Antimicrobial Drug Combination Toward a Large Panel of Staphylococcus aureus Clinical Ocular Isolates From Around the World. Cornea 2020; 39:1278-1284. [PMID: 32639313 PMCID: PMC7483989 DOI: 10.1097/ico.0000000000002414] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Staphylococcus aureus is a leading cause of keratitis requiring urgent antimicrobial treatment. However, rising antibiotic resistance has rendered current ophthalmic antibiotics increasingly ineffective. First, a diverse, ocular S. aureus strain set was evaluated for resistance to 6 commonly used ophthalmic antibiotics. Next, a recently discovered antimicrobial drug combination containing polymyxin B/trimethoprim (PT) + rifampin that displayed impressive efficacy toward S. aureus in both in vitro and in vivo studies was evaluated as a potential novel keratitis therapeutic through testing this combination's efficacy against the clinical strain set. METHODS A total of 163 S. aureus isolates were collected either commercially or from the Flaum Eye Institute, University of Rochester. The minimum inhibitory concentrations of moxifloxacin, levofloxacin, vancomycin, erythromycin, tobramycin, rifampin, and PT were determined for the entire strain set to establish the incidence of resistance to current treatment options among a contemporary clinical isolate set and compared with the performance of PT + rifampin. RESULTS Among all 163 isolates tested, high rates of antibiotic resistance were found toward erythromycin (69% resistance), moxifloxacin (33%), levofloxacin (40%), and tobramycin (17%). Conversely, the entire strain set, including multidrug resistant isolates, was sensitive to PT + rifampin, demonstrating the potency of this combination. CONCLUSIONS We established that antibiotic resistance is pervasive among clinical S. aureus isolates, underscoring the concern for the effectiveness of current ophthalmic antibiotics. The drug combination of PT + rifampin, however, eradicated 100% of isolates tested, demonstrating the ability to overcome existing circulating resistance factors, and as such, might represent a promising therapeutic for S. aureus keratitis.
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Affiliation(s)
- Emily Laskey
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Yimin Chen
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Michael B Sohn
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY; and
| | - Emma Gruber
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Michaelle Chojnacki
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Rachel A F Wozniak
- Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, Rochester, NY
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Decreased expression of femXAB genes and fnbp mediated biofilm pathways in OS-MRSA clinical isolates. Sci Rep 2019; 9:16028. [PMID: 31690794 PMCID: PMC6831631 DOI: 10.1038/s41598-019-52557-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 10/01/2019] [Indexed: 02/03/2023] Open
Abstract
Methicillin-Resistant Staphylococcus aureus (MRSA) is a significant threat to human health. Additionally, biofilm forming bacteria becomes more tolerant to antibiotics and act as bacterial reservoir leading to chronic infection. In this study, we characterised the antibiotic susceptibility, biofilm production and sequence types (ST) of 74 randomly selected clinical isolates of S. aureus causing ocular infections. Antibiotic susceptibility revealed 74% of the isolates as resistant against one or two antibiotics, followed by 16% multidrug-resistant isolates (MDR), and 10% sensitive. The isolates were characterized as MRSA (n = 15), Methicillin-sensitive S. aureus (MSSA, n = 48) and oxacillin susceptible mecA positive S. aureus (OS-MRSA, n = 11) based on oxacillin susceptibility, mecA gene PCR and PBP2a agglutination test. All OS-MRSA would have been misclassified as MSSA on the basis of susceptibility test. Therefore, both phenotypic and genotypic tests should be included to prevent strain misrepresentation. In addition, in-depth studies for understanding the emerging OS-MRSA phenotype is required. The role of fem XAB gene family has been earlier reported in OS-MRSA phenotype. Sequence analysis of the fem XAB genes revealed mutations in fem × (K3R, H11N, N18H and I51V) and fem B (L410F) genes. The fem XAB genes were also found down-regulated in OS-MRSA isolates in comparison to MRSA. In OS-MRSA isolates, biofilm formation is regulated by fibronectin binding proteins A & B. Molecular typing of the isolates revealed genetic diversity. All the isolates produced biofilm, however, MRSA isolates with strong biofilm phenotype represent a worrisome situation and may even result in treatment failure.
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Nithya V, Rathinam S, Siva Ganesa Karthikeyan R, Lalitha P. A ten year study of prevalence, antimicrobial susceptibility pattern, and genotypic characterization of Methicillin resistant Staphylococcus aureus causing ocular infections in a tertiary eye care hospital in South India. INFECTION GENETICS AND EVOLUTION 2019; 69:203-210. [PMID: 30708134 DOI: 10.1016/j.meegid.2019.01.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/14/2019] [Accepted: 01/24/2019] [Indexed: 11/28/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of vision threatening ocular infections. This study aimed to determine the prevalence and antimicrobial susceptibility pattern of MRSA and their genotypic characterization in ocular infections. The study period was from January 2007 to December 2017 in Aravind Eye Hospital, Madurai. Retrospective analysis of clinical records found a total of 1306 Staphylococcus aureus in various ocular infections. Among these, 274 (21%) were found to be MRSA with an increased incidence from 9% in 2007 to 38% in 2017 (P = .007). MRSA was isolated commonly from lacrimal sac infection 89 (32%), lid infection 55 (20%), keratitis 45 (16%) and orbital infection 34 (12%). MRSA isolates showed 100% sensitivity to vancomycin, 91% to chloramphenicol and majority of MRSA isolates were resistant to all fluoroquinolones. MSSA strains showed very minimal resistance to chloramphenicol (5%) and also there was no resistance to vancomycin. In case of the MSSA isolates, resistance to fluroquinolones (ciprofloxacin, gatifloxacin, moxifloxacin, ofloxacin and levofloxacin) was found to increase during study period. Methicillin-resistance is conferred by the carriage of Staphylococcal Cassette Chromosome mec (SCCmec) and most of our isolates were belonged to SCCmec type V and IV which is known to be community acquired MRSA. MLST sequencing on seven housekeeping genes revealed, sequence type ST772 was predominant followed by ST22. Agr typing identified most of the isolates (69) were agr type II (77%). By spa typing, there are 16 spa types were identified, among which 60% of the isolates had t657 spa type.
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Affiliation(s)
- Velusamy Nithya
- Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, India
| | | | | | - Prajna Lalitha
- Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, India.
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Gade SK, Shivshetty N, Sharma N, Bhatnagar S, Garg P, Venuganti VVK. Effect of Mucoadhesive Polymeric Formulation on Corneal Permeation of Fluoroquinolones. J Ocul Pharmacol Ther 2018; 34:570-578. [DOI: 10.1089/jop.2018.0059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Sudeep Kumar Gade
- Department of Pharmacy, Birla Institute of Technology and Science (BITS) Pilani, Hyderabad Campus, Hyderabad, India
- Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Nagaveni Shivshetty
- Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Natalia Sharma
- Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
| | - Shubhmita Bhatnagar
- Department of Pharmacy, Birla Institute of Technology and Science (BITS) Pilani, Hyderabad Campus, Hyderabad, India
| | - Prashant Garg
- Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India
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Antibiofilm and membrane-damaging potential of cuprous oxide nanoparticles against Staphylococcus aureus with reduced susceptibility to vancomycin. Antimicrob Agents Chemother 2015; 59:6882-90. [PMID: 26303796 DOI: 10.1128/aac.01440-15] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 08/14/2015] [Indexed: 11/20/2022] Open
Abstract
The antimicrobial effects of copper ions and salts are well known, but the effects of cuprous oxide nanoparticles (Cu2O-NPs) on staphylococcal biofilms have not yet been clearly revealed. The present study evaluated Cu2O-NPs for their antibacterial and antibiofilm activities against heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) and vancomycin-intermediate S. aureus (VISA). Nanoscaled Cu2O, generated by solution phase technology, contained Cu2O octahedral nanoparticles. Field emission electron microscopy demonstrated particles with sizes ranging from 100 to 150 nm. Cu2O-NPs inhibited the growth of S. aureus and showed antibiofilm activity. The MICs and minimum biofilm inhibitory concentrations ranged from 625 μg/ml to 5,000 μg/ml and from 2,500 μg/ml to 10,000 μg/ml, respectively. Exposure of S. aureus to Cu2O-NPs caused leakage of the cellular constituents and increased uptake of ethidium bromide and propidium iodide. Exposure also caused a significant reduction in the overall vancomycin-BODIPY (dipyrromethene boron difluoride [4,4-difluoro-4-bora-3a,4a-diaza-s-indacene] fluorescent dye) binding and a decrease in the viable cell count in the presence of 7.5% sodium chloride. Cu2O-NP toxicity assessment by hemolysis assay showed no cytotoxicity at 625 to 10,000 μg/ml concentrations. The results suggest that Cu2O-NPs exert their action by disruption of the bacterial cell membrane and can be used as effective antistaphylococcal and antibiofilm agents in diverse medical devices.
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Shenoy SB, Thotakura M, Kamath Y, Bekur R. Endogenous Endophthalmitis in Patients with MRSA Septicemia: A Case Series and Review of Literature. Ocul Immunol Inflamm 2015. [DOI: 10.3109/09273948.2015.1020173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Garg P, Mathur U, Sony P, Tandon R, Morris TW, Comstock TL. Clinical and Antibacterial Efficacy and Safety of Besifloxacin Ophthalmic Suspension Compared With Moxifloxacin Ophthalmic Solution. Asia Pac J Ophthalmol (Phila) 2015; 4:140-5. [PMID: 26065499 DOI: 10.1097/apo.0000000000000055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the efficacy of besifloxacin ophthalmic suspension 0.6% compared with moxifloxacin ophthalmic solution 0.5% in the treatment of bacterial conjunctivitis in an Indian population. DESIGN Multicenter, randomized, double-masked, active-controlled, parallel-group, clinical trial, including 6 clinical sites in India. METHODS Patients were randomized to receive 1 drop of besifloxacin or moxifloxacin in the infected eye(s), 3 times daily, for 5 days. Primary efficacy end points included clinical resolution and bacterial eradication at day 5. Secondary efficacy end points included clinical resolution and bacterial eradication at day 8, ocular discharge, bulbar conjunctival injection, investigator's global assessment, and bacterial eradication by species. Efficacy was analyzed using the Cochran-Mantel-Haenszel and Pearson χ2 tests. Safety was assessed by the incidence of ocular and nonocular treatment-emergent adverse events (AEs), changes in visual acuity, and biomicroscopy and ophthalmoscopy findings. Data presented are that for the subset of patients from India. RESULTS Of the 123 patients randomized at clinical sites in India, 96.7% completed the study. Day 5 differences in microbial eradication (100% besifloxacin vs 96.3% moxifloxacin) and in clinical resolution (78.9% besifloxacin vs 71.4% moxifloxacin) were not statistically significant. No statistically significant between-group differences were observed for secondary end points. All ocular AEs in both groups were mild or moderate in severity. There were no drug-related ocular AEs with besifloxacin. CONCLUSIONS Treatment of bacterial conjunctivitis with besifloxacin 0.6% produces similar antibacterial and clinical efficacy as that with moxifloxacin 0.5% in an Indian population, with no clinically meaningful safety concerns.
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Affiliation(s)
- Prashant Garg
- From the *L. V. Prasad Eye Institute, Hyderabad; †Dr Shroff's Charity Eye Centre, Delhi; ‡Shroff Eye Centre, Gurgaon, Haryana; and §Dr R. P. Centre for Ophthalmic Sciences, AIIMS, New Delhi, India; and ¶Medical Affairs, Bausch + Lomb, Rochester, NY and ∥R&D Microbiology and Sterilization Sciences
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Kar S, Panda S, Sharma S, Singh DV, Das S, Sahu SK, Das T. Comparison of Type of Species and Antibacterial Susceptibility Profile of Staphylococci Isolated From Normal Healthy Conjunctiva and Ocular Infections. Asia Pac J Ophthalmol (Phila) 2013; 2:365-71. [PMID: 26107148 DOI: 10.1097/apo.0b013e31829c022a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To compare the prevalence of various staphylococcal species in ocular infections [OIs (n = 105)] and in normal healthy conjunctiva [NC (n = 51)]. Antibacterial susceptibility profile of the isolates and prevalence of mecA gene among the isolates were also compared. DESIGN A prospective, comparative, experimental study. METHODS Antibiotic susceptibility was determined against chloramphenicol, ciprofloxacin, gatifloxacin, moxifloxacin, ofloxacin, cefazolin, vancomycin and cefoxitin by disc diffusion technique as per Clinical and Laboratory Standards Institute guidelines. Methicillin resistance was confirmed by detection of mecA gene by polymerase chain reaction. RESULTS The prevalence of Staphylococcus aureus was significantly higher (P < 0.0001) in OIs compared with NC (48.6%, 9.8%), whereas the prevalence of Staphylococcus epidermidis was higher (P = 0.02) in NC (22.9%, 41.2%). Overall methicillin resistance was higher in S. epidermidis (66.7% each in OIs and NC) compared with S. aureus (OIs: 7.8%; NC: 0%), which was statistically significant (P < 0.0001). Methicillin resistance was also high among other coagulase-negative staphylococci in both groups [OIs: 40% (12/30); NC: 28% (7/25)]. Vancomycin was effective against all the isolates from both groups. Cefazolin was equally effective. CONCLUSIONS This study found S. aureus to be a major pathogen in OIs, although it is not common conjunctival flora. The data caution that prevalence of methicillin resistance in coagulase-negative staphylococci is more than S. aureus in OIs and must be considered in their treatment. Despite methicillin resistance, staphylococci from OIs and NC remain sensitive to vancomycin and cefazolin.
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Affiliation(s)
- Sarita Kar
- From the *L. V. Prasad Eye Institute, Bhubaneswar, India; and †Infectious Disease Biology, Institute of Life Sciences, Bhubaneswar, India
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Miller D, Chang JS, Flynn HW, Alfonso EC. Comparative In Vitro Susceptibility of Besifloxacin and Seven Comparators Against Ciprofloxacin- and Methicillin-Susceptible/Nonsusceptible Staphylococci. J Ocul Pharmacol Ther 2013; 29:339-44. [DOI: 10.1089/jop.2012.0081] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Darlene Miller
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida
| | - Jonathan S. Chang
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida
| | - Harry W. Flynn
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida
| | - Eduardo C. Alfonso
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida
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Safety and immunogenicity of a novel Staphylococcus aureus vaccine: results from the first study of the vaccine dose range in humans. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2010; 17:1868-74. [PMID: 20943877 DOI: 10.1128/cvi.00356-10] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Merck V710 is a novel vaccine containing the conserved Staphylococcus aureus iron surface determinant B shown to be protective in animal models. A phase I, multicenter, double-blind study of the dose range was conducted to assess the immunogenicity and safety of an adjuvanted liquid formulation of V710. A total of 124 adults (18 to 55 years of age) were randomized 1:1:1:1 to receive one 0.5-ml intramuscular injection of V710 (5 μg, 30 μg, or 90 μg) or saline placebo. A positive immune response was defined as at least a 2-fold increase in IsdB-specific IgG levels from baseline levels. Local and systemic adverse events were assessed for 5 and 14 days, respectively, following vaccination. Positive immune responses were detected in 12 (67%) of the 18 subjects in the groups receiving 30 and 90 μg V710 tested at day 10. At day 14, a significantly greater proportion of subjects manifested a positive immune response with higher geometric mean concentrations in the V710 30-μg (86%; geometric mean concentration of 116 μg/ml) and 90-μg (87%; geometric mean concentration of 131 μg/ml) dose groups than in the V710 5-μg (29%; geometric mean concentration of 51 μg/ml) or placebo (4%; geometric mean concentration of 23 μg/ml) groups. Immune responses were durable through day 84. Subjects <40 and ≥40 years of age had comparable immune responses. The most common adverse events were injection-site pain, nausea, fatigue, and headache, usually of mild intensity. No immediate reactions or serious adverse events were reported. In this first study of V710 in humans, a single 30-μg or 90-μg dose was more immunogenic than the 5-μg dose or placebo. Immune responses were evident by 10 to 14 days after vaccination in most responders.
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