1
|
Touaitia R, Mairi A, Ibrahim NA, Basher NS, Idres T, Touati A. Staphylococcus aureus: A Review of the Pathogenesis and Virulence Mechanisms. Antibiotics (Basel) 2025; 14:470. [PMID: 40426537 PMCID: PMC12108373 DOI: 10.3390/antibiotics14050470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2025] [Revised: 04/01/2025] [Accepted: 04/26/2025] [Indexed: 05/29/2025] Open
Abstract
Staphylococcus aureus is a formidable human pathogen responsible for infections ranging from superficial skin lesions to life-threatening systemic diseases. This review synthesizes current knowledge on its pathogenesis, emphasizing colonization dynamics, virulence mechanisms, biofilm formation, and antibiotic resistance. By analyzing studies from PubMed, Scopus, and Web of Science, we highlight the pathogen's adaptability, driven by surface adhesins (e.g., ClfB, SasG), secreted toxins (e.g., PVL, TSST-1), and metabolic flexibility in iron acquisition and amino acid utilization. Nasal, skin, and oropharyngeal colonization are reservoirs for invasive infections, with biofilm persistence and horizontal gene transfer exacerbating antimicrobial resistance, particularly in methicillin-resistant S. aureus (MRSA). The review underscores the clinical challenges of multidrug-resistant strains, including vancomycin resistance and decolonization strategies' failure to target single anatomical sites. Key discussions address host-microbiome interactions, immune evasion tactics, and the limitations of current therapies. Future directions advocate for novel anti-virulence therapies, multi-epitope vaccines, and AI-driven diagnostics to combat evolving resistance. Strengthening global surveillance and interdisciplinary collaboration is critical to mitigating the public health burden of S. aureus.
Collapse
Affiliation(s)
- Rahima Touaitia
- Department of Natural and Life Sciences, Faculty of Exact Sciences and Natural and Life Sciences, University of Tebessa, Tebessa 12002, Algeria;
| | - Assia Mairi
- Laboratoire d’Ecologie Microbienne, Faculté des Sciences de la Nature et de la Vie (FSNV), Université de Bejaia, Bejaia 06000, Algeria; (A.M.); (A.T.)
| | - Nasir Adam Ibrahim
- Department of Biology, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13318, Saudi Arabia;
| | - Nosiba S. Basher
- Department of Biology, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13318, Saudi Arabia;
| | - Takfarinas Idres
- Research Laboratory for Management of Local Animal Resources, Rabie Bouchama National Veterinary School of Algiers, Issad ABBAS Street, BP 161 Oued Semar, Algiers 16059, Algeria;
| | - Abdelaziz Touati
- Laboratoire d’Ecologie Microbienne, Faculté des Sciences de la Nature et de la Vie (FSNV), Université de Bejaia, Bejaia 06000, Algeria; (A.M.); (A.T.)
| |
Collapse
|
2
|
Navidifar T, Zare Banadkouki A, Parvizi E, Mofid M, Golab N, Beig M, Sholeh M. Global prevalence of macrolide-resistant Staphylococcus spp.: a comprehensive systematic review and meta-analysis. Front Microbiol 2025; 16:1524452. [PMID: 40182286 PMCID: PMC11967404 DOI: 10.3389/fmicb.2025.1524452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 01/22/2025] [Indexed: 04/05/2025] Open
Abstract
Background Staphylococcus is a genus of bacteria responsible for various infections ranging from mild skin to severe systemic diseases. Methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative staphylococci (CoNS) are significant challenges owing to their resistance to multiple antibiotics, including macrolides, such as erythromycin, clarithromycin, and azithromycin. Objective This study aimed to systematically review and synthesize data on the prevalence of macrolide resistance in Staphylococcus spp., identify trends and changes in resistance patterns over time, and assess how testing methods and guidelines affect reported resistance rates. Methods The study conducted a systematic search of the Scopus, PubMed, Web of Science, and EMBASE databases. Studies have reported the proportion of macrolide-resistant Staphylococcus spp. Two authors independently extracted and analyzed the data using a random-effects model. Heterogeneity was assessed, and subgroup analyses were performed based on country, continent, species, AST guidelines, methods, and period. Results In total, 223 studies from 76 countries were included. The pooled prevalence of resistance to erythromycin, clarithromycin, and azithromycin were 57.3, 52.6, and 57.9%, respectively. Significant heterogeneity was observed across studies (I2 > 95%, p < 0.001). Oceania (72%) had the highest erythromycin resistance, whereas Europe had the lowest (40.7%). Subgroup analyses revealed variations in resistance based on the species, with higher resistance in MRSA than in MSSA and CoNS than in other species. Over time, a slight decrease in erythromycin resistance has been observed (59.6% from 2015-2019 to 55% from 2020-2023). Conclusion This study emphasizes the high prevalence of macrolide resistance in Staphylococcus spp. and its notable regional variation. These findings highlight the necessity for standardized methodologies and global surveillance to manage macrolide resistance effectively. Controlling antibiotic resistance should prioritize enhancing public health measures and updating treatment guidelines. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=557756, CRD42024557756.
Collapse
Affiliation(s)
- Tahereh Navidifar
- Department of Basic Sciences, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Abbas Zare Banadkouki
- Department of Microbiology, Shahid Beheshti University, Tehran, Iran
- Quality Control Department of Temad Mfg, Co., Tehran, Iran
| | - Elnaz Parvizi
- Department of Microbiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Maryam Mofid
- School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Narges Golab
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Beig
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Sholeh
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| |
Collapse
|
3
|
Graziano G, Notarbartolo V, Priano W, Maida CM, Insinga V, Rinaudo G, Russo A, Palermo R, Vitale F, Giuffrè M. Surveillance of Multidrug-Resistant Pathogens in Neonatal Intensive Care Units of Palermo, Italy, during SARS-CoV-2 Pandemic. Antibiotics (Basel) 2023; 12:1457. [PMID: 37760753 PMCID: PMC10525448 DOI: 10.3390/antibiotics12091457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a topic of concern, especially in high-level care departments like neonatal intensive care units (NICUs). The systematic use of an "active" epidemiological surveillance system allows us to observe and analyze any changes in microbial distribution, limiting the risk of healthcare-associated infection (HAI) development. METHODS We have conducted a longitudinal observational study in the five NICUs of Palermo, comparing the "pre-pandemic period" (March 2014-February 2020) with the "pandemic" one (March 2020-February 2022). The primary aim of the study was to evaluate the cumulative prevalence of carriage from multi-drug resistant (MDR) bacteria in the cumulative NICUs (NICU C). RESULTS During the "pre-pandemic period", 9407 swabs were collected (4707 rectal, 4700 nasal); on the contrary, during the "pandemic period", a total of 2687 swabs were collected (1345 rectal, 1342 nasal). A statistically significant decrease in MDR-Gram-negative bacteria (GNB) carriage prevalence was detected during the pandemic. At the same time, there was a general worsening of the carriage of carbapenemase-forming MDR-GNB (CARBA-R+) and methicillin-resistant Staphylococcus aureus (MRSA) during the pandemic period. A significant reduction in methicillin-susceptible Staphylococcus aureus (MSSA) carriage was detected too. CONCLUSIONS The surveillance of MDRO carriage in NICUs is fundamental for limiting the social and economic burden of HAIs.
Collapse
Affiliation(s)
- Giorgio Graziano
- Clinical Epidemiology Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (G.G.); (C.M.M.); (A.R.); (F.V.)
| | - Veronica Notarbartolo
- Neonatology and Neonatal Intensive Care Unit, Ingrassia Hospital, 90132 Palermo, Italy;
| | - Walter Priano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
| | - Carmelo Massimo Maida
- Clinical Epidemiology Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (G.G.); (C.M.M.); (A.R.); (F.V.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
| | - Vincenzo Insinga
- Neonatology and Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy;
| | - Grazia Rinaudo
- Neonatology and Neonatal Intensive Care Unit, Villa Sofia Cervello Hospitals, 90146 Palermo, Italy;
| | - Arianna Russo
- Clinical Epidemiology Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (G.G.); (C.M.M.); (A.R.); (F.V.)
| | - Roberta Palermo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
| | - Francesco Vitale
- Clinical Epidemiology Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (G.G.); (C.M.M.); (A.R.); (F.V.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (W.P.); (R.P.)
- Neonatology and Neonatal Intensive Care Unit, University Hospital “P. Giaccone”, 90127 Palermo, Italy;
| |
Collapse
|
4
|
Aqel H, Sannan N, Foudah R. From Hospital to Community: Exploring Antibiotic Resistance and Genes Associated with Virulence Factor Diversity of Coagulase-Positive Staphylococci. Antibiotics (Basel) 2023; 12:1147. [PMID: 37508243 PMCID: PMC10376022 DOI: 10.3390/antibiotics12071147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/25/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Coagulase-positive staphylococcus (CoPS), including methicillin-resistant Staphylococcus aureus (MRSA), poses a global threat. The increasing prevalence of MRSA in Saudi Arabia emphasizes the need for effective management. This study explores the prevalence of virulence-associated genes and antibiotic resistance patterns in CoPS. Nasal swabs from 200 individuals were collected, and standard protocols were used for the isolation, identification, and characterization of CoPS and coagulase-negative staphylococci (CoNS). Additionally, antimicrobial susceptibility testing and PCR were conducted. Bacterial growth was observed in 58.5% of participants, with 12% positive for CoPS and 30% positive for CoNS. Hospital personnel carriers showed a significantly higher proportion of CoNS compared with non-hospital personnel carriers. Non-hospital personnel CoPS strains displayed higher sensitivity to oxacillin than hospital personnel strains. Cefoxitin exhibited the highest sensitivity among β-lactam antibiotics. All isolates were sensitive to trimethoprim/sulfamethoxazole, rifampin, and quinupristin. Polymerase chain reaction analysis detected methicillin resistance genes in both non-hospital and hospital personnel MRSA strains. The coa and spa genes were prevalent in MRSA isolates, while the Luk-PV gene was not detected. A high prevalence of CoPS and CoNS was observed in both non-hospital and hospital personnel carriers. Occupational risk factors may contribute to the differences in the strain distribution. Varying antibiotic susceptibility patterns indicate the effectiveness of oxacillin and cefoxitin. Urgent management strategies are needed due to methicillin resistance. Further research is necessary to explore additional virulence-associated genes and develop comprehensive approaches for CoPS infection prevention and treatment in Saudi Arabia.
Collapse
Affiliation(s)
- Hazem Aqel
- Basic Medical Sciences Department, College of Medicine, Al-Balqa' Applied University, Salt 19117, Jordan
- King Abdullah International Medical Research Centre, King Abdulaziz Medical City, Jeddah 22384, Saudi Arabia
| | - Naif Sannan
- King Abdullah International Medical Research Centre, King Abdulaziz Medical City, Jeddah 22384, Saudi Arabia
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21423, Saudi Arabia
| | - Ramy Foudah
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia
| |
Collapse
|
5
|
Wolde W, Mitiku H, Sarkar R, Shume T. Nasal Carriage Rate of Staphylococcus aureus, Its Associated Factors, and Antimicrobial Susceptibility Pattern Among Health Care Workers in Public Hospitals, Harar, Eastern Ethiopia. Infect Drug Resist 2023; 16:3477-3486. [PMID: 37287547 PMCID: PMC10243340 DOI: 10.2147/idr.s396570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
Background Staphylococcus aureus is the bacteria that colonizes the nasal nares of health-care workers and serves as a reservoir for the spread of pathogen for subsequent infections, mainly Methicillin-resistant Staphylococcus aureus. However, there is a limited study conducted regarding this topic in Harar, Eastern Ethiopia. Objective The main objective of this study was to determine the prevalence of nasal carriage of Staphylococcus aureus, associated factors and antimicrobial susceptibility patterns among health-care workers of public hospitals in Harar, Eastern Ethiopia from May 15 to July 30, 2021. Methods A hospital-based cross-sectional study was conducted on 295 health-care workers. A simple random sampling technique was used to select the participant. Nasal swabs were collected and cultured at 35°C for 24hrs. S. aureus was identified using the coagulase test and catalase test. Methicillin resistance S. aureus (MRSA) was screened using a cefoxitin disc on Muller Hinton agar using the Kirby-Bauer disc diffusion method. Data were entered into EPI-Info version-7 and transferred to SPSS-20 for analysis. Factors associated with nasal carriage of Staphylococcus aureus were determined by using chi-square analysis. A p-value of less than 0.05 was considered statistically significant. Results The prevalence of Staphylococcus aureus in this study was 15.6% (95% CI: 11.7%, 20.3%) and methicillin-resistant Staphylococcus aureus was 11.2% (95% CI: 7.8%, 15.4%), respectively. Age (P < 0.001), work experience (p < 0.001), working unit (p < 0.02), antibiotic use within 3 months (p < 0.001), hand washing habit (p < 0.01), hand rub use (p < 0.001), living with smokers (p < 0.001), living with pets (p < 0.001) and having chronic diseases (p < 0.001) were found significantly associated with Staphylococcus aureus nasal carriage. Conclusion The prevalence of Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus are high in our study. The study emphasizes the need for regular surveillance among hospital staff and the environment to prevent MRSA transmission among health-care personnel.
Collapse
Affiliation(s)
- Wondimagegn Wolde
- Department of Medical Microbiology and Immunology, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Habtamu Mitiku
- Department of Tropical and Infectious Disease and Parasitology, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Rajesh Sarkar
- Department of Medical Microbiology and Immunology, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Tadesse Shume
- Department of Medical Microbiology and Immunology, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| |
Collapse
|
6
|
Antibacterial Efficacy and Healing Potential of Honey from Different Zones in Nigeria on Diabetic-Induced Wound Infection in Wistar Rats. Int J Microbiol 2022; 2022:5308435. [PMID: 36312784 PMCID: PMC9616666 DOI: 10.1155/2022/5308435] [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: 06/15/2022] [Revised: 07/21/2022] [Accepted: 10/08/2022] [Indexed: 11/17/2022] Open
Abstract
There is an increase in drug-resistant strains causing infection, thus making available therapeutics less effective. As resistance increases, modern medicine focuses on the antibacterial potential of natural products, which can aid in wound healing. The present study determined Nigeria honey's antibacterial efficacy in treating diabetes-induced wound infections in Wistar albino rats. 54 Wistar rats randomly divided into 9 groups of 6 each were used for the study: group I (negative control, no treatment), group II (positive control, diabetes without treatment), group III (diabetes treated with 1% silver sulfadiazine), and groups IV–IX (diabetes treated with different honey samples). Physiochemical analysis and microbiological and antibacterial activity of the honey samples were determined. The treatments were carried out for 17 days, and wound contraction, malondialdehyde (MDA) levels, and catalase activity were measured. Results obtained showed that the most effective honey was DCH (21.5 ± 2.12), followed by HBP + M (15 ± 2.12) and TRB, JS, and HBP (13 ± 2.8; 13 ± 1.41; 13.5 ± 0.71) for antibacterial activity on Staphylococcus aureus. Microbiologically, no coliform was detected in all the samples, confirming the honey's quality. The amount of lipid peroxidation was raised in the diabetic group with no treatment, 1% silver sulfadiazine group, and JS group, while no significant reduction was observed in other groups. Differences in wound contraction were significantly notable on various days of measurement, day 3 (p < 0.002), day 6 (p < 0.046), and day 9 (p = 0.00). The catalase level in the different treatment groups increased significantly (p < 0.05), implying an antioxidant potential of the different honey samples except for Jos honey. The study concludes that honey infused with moringa was faster and more efficient in healing diabetic wounds than other honey samples and silver sulfadiazine.
Collapse
|
7
|
Prevalence and Clindamycin Resistance Profile of Staphylococcus aureus and Associated Factors among Patients Attending the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia. Interdiscip Perspect Infect Dis 2022; 2022:6503929. [PMID: 35747449 PMCID: PMC9213149 DOI: 10.1155/2022/6503929] [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: 09/18/2021] [Revised: 12/14/2021] [Accepted: 05/18/2022] [Indexed: 11/17/2022] Open
Abstract
Clindamycin can serve as an alternative treatment for staphylococcal infections. Routine susceptibility tests may fail to determine inducible type clindamycin resistance and can be a source of failure in clinical therapeutics. Therefore, this study aimed to determine Staphylococcus aureus (S. aureus) prevalence, inducible clindamycin resistance pattern, and associated factors among patients attending the University of Gondar Comprehensive Specialized Hospital, Gondar, northwest Ethiopia. Methods. A cross-sectional study was conducted from January to April 2018. Clinical samples were inoculated on appropriate culture media. Standard bacteriological tests, including Gram stain, catalase, and coagulase tests, identified the presence of S. aureus. The antimicrobial susceptibility tests and the D-test were performed by using the Kirby-Bauer disk diffusion technique on the Mueller-Hinton agar. The D-test was performed using clindamycin (CLI) 2 ug and erythromycin (ERY) 15 ug disks located approximately 15 mm apart, and the cefoxitin susceptibility test was used to characterize methicillin-resistant S. aureus (MRSA). The association between S. aureus infection and different variables was assessed using bivariate and multivariate analysis. A P value <0.05 was considered statistically significant. Result. Of 388 study participants, the overall prevalence of S. aureus was 17% (66/388). Of these, the inducible type of clindamycin resistance was 25.8% (17/66) and 21.2% (14/66) were MRSA. All isolates were susceptible to chloramphenicol and resistant to tetracycline. A family size of 4-6 (AOR = 2.627, 95% CI (1.030-6.702)) and >7 (AOR = 3.892, 95% CI (1.169-12.959)), inpatient study participants (AOR = 3.198, 95% CI (1.197-8.070)), illness in the previous 4 weeks (AOR = 2.116, 95% CI (1.080-4.145)), and a history of chronic disease (AOR = 0.265, 95% CI (0.094-0.750)) were likely to have S. aureus infection. Conclusion. This study shows a considerable high magnitude of MRSA and inducible clindamycin resistance S. aureus isolates. To rule out clindamycin susceptibility testing, the D-test should be routinely performed.
Collapse
|
8
|
Epidemiology of Methicillin-Resistant Staphylococcus Aureus in Arab Countries of the Middle East and North African (MENA) Region. Mediterr J Hematol Infect Dis 2021; 13:e2021050. [PMID: 34527202 PMCID: PMC8425352 DOI: 10.4084/mjhid.2021.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
Available data suggest a high burden of methicillin-resistant staphylococcus aureus (MRSA) in Arab countries of the Middle East and North Africa (MENA). To review the MRSA rates and molecular epidemiology in this region, we used PubMed search engine to identify relative articles published from January 2005 to December 2019. Great heterogeneity in reported rates was expectedly seen. Nasal MRSA colonization ranged from 2%–16% in Gulf Cooperation Council (GCC), 1–9% in the Levant, and 0.2%–9% in North African Arab states. Infective MRSA rates ranged from 9%–38% in GCC, 28%–67% in the Levant, and 28%–57% in North African states. Studies demonstrated a wide clonal diversity in the MENA. The most common molecular types belonged to 5 clonal complexes (CC) known to spread worldwide: CC5, CC8, CC22, CC30, and CC80. The most prevalent strains had genotypes related to the European community-acquired MRSA (CA-MRSA), Brazilian/Hungarian hospital-acquired MRSA (HA-MRSA), UK-EMRSA-15 HA-MRSA, and USA300 CA-MRSA. Finally, significant antimicrobial resistance was seen in the region with variation in patterns depending on location and clonal type. For a more accurate assessment of MRSA epidemiology and burden, the Arab countries need to implement national surveillance systems.
Collapse
|
9
|
Baroja I, Guerra S, Coral-Almeida M, Ruíz A, Galarza JM, de Waard JH, Bastidas-Caldes C. Methicillin-Resistant Staphylococcus aureus Nasal Colonization Among Health Care Workers of a Tertiary Hospital in Ecuador and Associated Risk Factors. Infect Drug Resist 2021; 14:3433-3440. [PMID: 34471363 PMCID: PMC8403571 DOI: 10.2147/idr.s326148] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/07/2021] [Indexed: 12/19/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to most of the commonly used antibiotics and is therefore a public health issue. Colonization with MRSA is a risk factor for infection or transmission. Purpose To determine the prevalence of colonization with Staphylococcus aureus (SA) and MRSA strains in health care workers (HCWs) at a tertiary hospital in Ecuador and to determine the risk factors associated with carriage. Methods Out of a cohort of 3800 HCWs, 481 individuals from different hospital departments were randomly selected, and a single nasal swab was collected. Detection of SA and MRSA was carried out with the LightCycler® MRSA Advanced Test. A questionnaire was performed that gathered demographic and occupational information of the participants to determine risk factors for MRSA colonization. Statistical analysis was performed with univariate and multivariate analysis and the R-software version 4.0.2. Results Colonization with SA and MRSA occurred in respectively 23.7% (95% CI, 22.7–24.6) and 5% (95% CI, 3.39–7.58) of the individuals. The multivariate analysis showed that being older in age (OD 1.09) and being male (OD 2.78) were risk factors for SA and MRSA colonization (p-value < 0.001). Previous use of antibiotics or the use of nasal ointments diminished the colonization rates of SA (24% versus 3.7% and 10.1% respectively). Conclusion About 20% of the HCWs who were colonized with SA were colonized with MRSA, representing a risk for nosocomial infections and hospital outbreaks. Active monitoring and a decolonization treatment of the HCWs can reduce these risks.
Collapse
Affiliation(s)
- Isabel Baroja
- Facultad de Ingenierías y Ciencias Aplicadas, Biotecnología, Universidad de Las Américas, Quito, Ecuador.,Unidad Técnica de Genética Molecular, Hospital de Especialidades Carlos Andrade Marín, Quito, Ecuador
| | - Sara Guerra
- Facultad de Ingenierías y Ciencias Aplicadas, Biotecnología, Universidad de Las Américas, Quito, Ecuador.,Unidad Técnica de Genética Molecular, Hospital de Especialidades Carlos Andrade Marín, Quito, Ecuador
| | - Marco Coral-Almeida
- Grupo de Bio-Quimioinformatica, Facultad de Ciencias de la Salud, Universidad de Las Américas, Quito, Ecuador
| | - Alejandra Ruíz
- Unidad Técnica de Genética Molecular, Hospital de Especialidades Carlos Andrade Marín, Quito, Ecuador.,IESS Quito Sur General Hospital, Institutional Coordination of Epidemiological Surveillance and Infectology, Molecular Microbiology, Quito, Ecuador.,Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Juan Miguel Galarza
- Unidad Técnica de Genética Molecular, Hospital de Especialidades Carlos Andrade Marín, Quito, Ecuador.,Unidad de Biociencias, Gerencia de Molecular y Oncodiagnóstico, SIMED S.A., Quito, Ecuador
| | - Jacobus H de Waard
- One Health Research Group, Facultad de Ingenierías y Ciencias Aplicadas, Biotecnología, Universidad de Las Américas, Quito, Ecuador
| | - Carlos Bastidas-Caldes
- Facultad de Ingenierías y Ciencias Aplicadas, Biotecnología, Universidad de Las Américas, Quito, Ecuador.,One Health Research Group, Facultad de Ingenierías y Ciencias Aplicadas, Biotecnología, Universidad de Las Américas, Quito, Ecuador.,Programa de Doctorado en Salud Pública y Animal, Universidad de Extremadura, Extremadura, España
| |
Collapse
|
10
|
Najar B, Mecacci G, Nardi V, Cervelli C, Nardoni S, Mancianti F, Ebani VV, Giannecchini S, Pistelli L. Volatiles and Antifungal-Antibacterial-Antiviral Activity of South African Salvia spp. Essential Oils Cultivated in Uniform Conditions. Molecules 2021; 26:2826. [PMID: 34068756 PMCID: PMC8126244 DOI: 10.3390/molecules26092826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 01/06/2023] Open
Abstract
Spontaneous emissions of S. dentata Aiton and S. scabra Thunb., as well as the essential oil (EO) composition of the cited species, together with S. aurea L., were investigated. The chemical profile of the first two species is reported here for the first time. Moreover, in vitro tests were performed to evaluate the antifungal activity of these EOs on Trichophyton mentagrophytes, Microsporum canis, Aspergillus flavus, Aspergillus niger, and Fusarium solani. Secondly, the EO antibacterial activity against Escherichia coli, Staphylococcus aureus, and Staphylococcus pseudointermedius was examined, and their antiviral efficacy against the H1N1 influenza virus was assessed. Leaf volatile organic compounds (VOCs), as well as the EOs obtained from the arial part of Salvia scabra, were characterized by a high percentage of sesquiterpene hydrocarbons (97.8% and 76.6%, respectively), mostly represented by an equal amount of germacrene D (32.8% and 32.7%, respectively). Both leaf and flower spontaneous emissions of S. dentata, as well as the EO composition, showed a prevalence of monoterpenes divided into a more or less equal amount of hydrocarbon and oxygenated compounds. Interestingly, its EO had a non-negligible percentage of oxygenated sesquiterpenes (29.5%). S. aurea EO, on the contrary, was rich in sesquiterpenes, both hydrocarbons and oxygenated compounds (41.5% and 33.5%, respectively). S. dentata EO showed good efficacy (Minimal Inhibitory Concentration (MIC): 0.5%) against M. canis. The tested EOs were not active against E. coli and S. aureus, whereas a low inhibition of S. dentata EO was observed on S. pseudointermedius (MIC = 10%). Once again, S. dentata EO showed a very good H1N1 inhibition; contrariwise, S. aurea EO was completely inactive against this virus. The low quantity of S. scabra EO made it impossible to test its biological activity. S. dentata EO exhibited interesting new perspectives for medicinal and industrial uses.
Collapse
Affiliation(s)
- Basma Najar
- Department of Pharmacy, University of Pisa, Via Bonanno Pisano 33, 56126 Pisa, Italy; (G.M.); (V.N.); (L.P.)
| | - Giulia Mecacci
- Department of Pharmacy, University of Pisa, Via Bonanno Pisano 33, 56126 Pisa, Italy; (G.M.); (V.N.); (L.P.)
| | - Valeria Nardi
- Department of Pharmacy, University of Pisa, Via Bonanno Pisano 33, 56126 Pisa, Italy; (G.M.); (V.N.); (L.P.)
| | - Claudio Cervelli
- Council for Agricultural Research and Economics (CREA), Corso Inglesi 508, 18038 Sanremo, Italy;
| | - Simona Nardoni
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy; (S.N.); (F.M.); (V.V.E.)
| | - Francesca Mancianti
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy; (S.N.); (F.M.); (V.V.E.)
- Interdepartmental Research Center “Nutraceutical and Food for Health”, University of Pisa, Via del Borghetto, 80, 56126 Pisa, Italy
| | - Valentina Virginia Ebani
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy; (S.N.); (F.M.); (V.V.E.)
- Interdepartmental Research Center “Nutraceutical and Food for Health”, University of Pisa, Via del Borghetto, 80, 56126 Pisa, Italy
| | - Simone Giannecchini
- Department of Experimental and Clinical Medicine, University of Florence, Viale Morgagni 48, 50134 Florence, Italy;
| | - Luisa Pistelli
- Department of Pharmacy, University of Pisa, Via Bonanno Pisano 33, 56126 Pisa, Italy; (G.M.); (V.N.); (L.P.)
- Interdepartmental Research Center “Nutraceutical and Food for Health”, University of Pisa, Via del Borghetto, 80, 56126 Pisa, Italy
| |
Collapse
|
11
|
Nasal Carriage and Methicillin Resistance of Staphylococcus aureus among Schoolchildren in Sana'a City, Yemen. Int J Microbiol 2021; 2021:5518317. [PMID: 34035816 PMCID: PMC8121562 DOI: 10.1155/2021/5518317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/11/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background Staphylococcus aureus (S. aureus) is a frequent cause of serious health problems with high morbidity and mortality. The risk of S. aureus infections is increased with the emergence of methicillin-resistant S. aureus (MRSA). This study aims to determine the nasal carriage rate of both S. aureus and MRSA among schoolchildren in Sana'a city. Methods This is a cross-sectional study conducted from January 2018 to May 2020. Five hundred and thirty-six students were enrolled. Their age ranged from 5 to 19 years with the mean age and standard deviation equal to 13.3 ± 3.5 years. Nasal swabs were collected from each student for culturing and methicillin susceptibility testing. Results Students with positive culture were 271 (51%) males and 265 (49%) females. S. aureus was isolated from 129 (24%) students whereas the overall prevalence of MRSA was 8 (1.5%). S. aureus was significantly recovered from students at the age group of 10–14 years (χ2 = 7.02; p=0.03), females than males (OR = 1.96; χ2 = 10.75; p=0.001), and students who were admitted into hospitals (OR = 1.6; χ2 = 4.89; p=0.03). Nevertheless, there were no significant differences between MRSA carriage and students' age (χ2 = 2.3; p=0.32), gender (OR = 1.02; χ2 = 0.001; p=0.63), and hospital admission (OR = 1.4; χ2 = 0.25; p=0.62). Conclusions The prevalence of MRSA is low among schoolchildren in Sana'a city. Age, gender, and previous hospital admission were statistically associated with nasal carriage of S. aureus but not MRSA nasal carriage.
Collapse
|
12
|
Khan RA, Ahmed A, Sapitan A, Maktabi A, Al-Subaie S, Khandekar R. Prevalence and determinants of methicillin-resistant Staphylococcus aureus and methicillin-sensitive Staphylococcus aureus carrier among staff of a tertiary eye hospital in Saudi Arabia. Oman J Ophthalmol 2021; 14:88-93. [PMID: 34345142 PMCID: PMC8300282 DOI: 10.4103/ojo.ojo_98_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The objective of this study was to estimate the prevalence and risk factors of methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) carriers among staff of a tertiary eye hospital in Saudi Arabia. METHODS This retrospective study was conducted in 2019. Nasal and axillary swabs of health-care staff were used to determine carriers of MRSA. Bacteria were identified by culture and sensitivity tests. These isolates were grouped as antibiotic resistant, sensitive, and others not in the S. aureus group. Demographics and other determinants were associated with carrier status. RESULTS We evaluated the carrier status of 430 staff. There were 110 (24.9%; 95% confidence interval [CI]: 21.5, 29.7) S. aureus-positive staff, 21 (11.7%; 95% CI: 11.7, 26.4) of who carried the MRSA strain. Carrier status was significantly higher among physicians (31%) compared to nurses (22.5%) and other staff (5.7%) (P < 0.001). MRSA carrier status was significantly associated with >5 years of employment at the eye hospital (P = 0.02). MRSA was significantly associated with staff who were of Indian nationality (75%) compared to other nationalities (P = 0.04) and those who were at the hospital for <5-year stay compared more than 5 years at the hospital (P = 0.001). All carriers responded to decolonization treatment. CONCLUSIONS The high prevalence of MRSA and relatively easy treat MRSA carriers points at the need for universal screening for MRSA carriers among eye health staff.
Collapse
Affiliation(s)
- Ruhi A Khan
- Department of Employee Health, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Anwar Ahmed
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Anita Sapitan
- Department of Laboratory, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Azza Maktabi
- Department of Laboratory, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Sultan Al-Subaie
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Rajiv Khandekar
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| |
Collapse
|
13
|
Aldawsari A, Tawfik K, Al-Zaagi I. Antimicrobial-Resistant Bacteria and Prescription of Antibiotics at a Tertiary Care Hospital in Riyadh, Saudi Arabia. Cureus 2020; 12:e12098. [PMID: 33489515 PMCID: PMC7805534 DOI: 10.7759/cureus.12098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Purpose The purpose of the study was to assess the bacterial resistance and annual antibiotic consumption at a tertiary care hospital in Riyadh, Saudi Arabia over a two-year period. Methods This retrospective cohort study was conducted at a tertiary care hospital in Riyadh, Saudi Arabia from January 1, 2016, to December 31, 2017. Results The results showed that there was no significant difference between 2016 and 2017 data regarding patient characteristics like bed occupancy rate, the average length of stay, and the number of admissions; the same was true for bacterial characteristics like the number of bacteria, percentage of isolates in the group, and multidrug resistance (MDR) percentage (p: >0.05). Between 2016 and 2017, there was a slight reduction in the sensitivity of Escherichia coli (E. coli) carbapenem-resistant Enterobacteriaceae (CRE) (97%, 86%) and Klebsiella pneumoniae (K. pneumoniae) CRE (80%, 76%) towards colistin. There was also a decrease in the sensitivity of Acinetobacter baumannii (A. baumannii) multidrug-resistant organism (MDRO) from 42% to 29% against tigecycline, but an increase in the sensitivity of K. pneumoniae CRE (33%, 50%) and E. coli CRE (76%, 82%). The percentage of MDR strains in gram-positive bacteria showed that more than half of Staphylococcus aureus (S. aureus) were methicillin-resistant (61%, 59%) in 2016 and 2017 respectively. There was a reduction in the percentage of MDR strains in some gram-negative bacteria like Pseudomonas aeruginosa (P. aeruginosa) MDRO (24%, 19%),E. coli extended-spectrum beta-lactamases (ESBL) (56%, 50%), E. coli CRE (4%, 1%), K. pneumoniae CRE (49%, 33%), A. baumannii CRE (90%, 76%), and Proteus mirabilis (P. mirabilis) ESBL (54%, 50%). Conclusion MDRO bacteria are very common in the hospital where the study was conducted. Immediate action is required to tackle this problem.
Collapse
Affiliation(s)
- Anbar Aldawsari
- Pharmaceutical Services, King Saud Medical City, Riyadh, SAU
| | | | | |
Collapse
|
14
|
Truppa C, Abo-Shehada MN. Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: a systematic review. BMC Infect Dis 2020; 20:936. [PMID: 33297983 PMCID: PMC7724697 DOI: 10.1186/s12879-020-05503-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In spite of the evident general negative effects of armed conflict on countries' health systems and populations' health outcomes, little is known about similar impacts of conflicts on the spread of antimicrobial resistances (AMR). This review was to address this evidence gap and describe: 1. Patterns of AMR in the Middle East (ME) and resistance profiles of pathogens included in the Global AMR Surveillance System (GLASS) supported by the World Health Organization; 2. Differences in proportions of AMR isolates between conflict and non-conflict countries. METHODS A systematic literature review was conducted following PRISMA guidelines and searching five electronic databases. Subject heading and free text were searched for "antimicrobial resistances" and "Middle East", to identify observational studies on AMR published from January 2011 to June 2018. Data were extracted from included articles on a predefined set of variables. Percentages of AMR were analysed as median and interquartile ranges. Risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 132 articles met the inclusion criteria. Included studies showed heterogeneity in study design, laboratory methods and standards for interpretation of results, and an overall high risk of bias. Main findings were the following: 1. High proportions of carbapenem resistance in Acinetobacter spp. (median 74.2%), and both carbapenem resistance (median 8.1 and 15.4% for E. coli and K. pneumoniae respectively) and ESBL-production (median 32.3 and 27.9% for E. coli and K. pneumoniae respectively) amongst Enterobacteriaceae. S. aureus isolates showed a median methicillin resistance percentage of 45.1%, while vancomycin resistance was almost absent. A median of 50% of the strains of S. pneumoniae showed non-susceptibility to penicillin. 2. Similar trends were observed in conflict and non-conflict affected countries. CONCLUSIONS There is a lack of standardization in the methodological approach to AMR research in the Middle East. The proportion of antibiotic resistances among specific GLASS pathogens is high, particularly among Acinetobacter spp.
Collapse
Affiliation(s)
- Claudia Truppa
- International Committee of the Red Cross, Geneva, Switzerland
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Mahmoud N. Abo-Shehada
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
| |
Collapse
|
15
|
Ali MA, Rajab AM, Al-Khani AM, Ayash SQ, Basha AC, Abdelgadir A, Rajab TM, Enabi S, Saquib N. Methicillin-resistant Staphylococcus aureus development in intensive care patients. A case-control study. Saudi Med J 2020; 41:1181-1186. [PMID: 33130837 PMCID: PMC7804236 DOI: 10.15537/smj.2020.11.25465] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives: To determine the factors associated with the development of methicillin-resistant Staphylococcus aureus (MRSA), hospital stay and mortality, and early versus late MRSA infection. Methods: Cases (n=44) were intensive care unit (ICU) patients admitted to King Fahd Specialist Hospital, Al-Qassim, Saudi Arabia between 2015 and 2019 who developed MRSA during their hospital stay. Controls (n=48) were patients from the same place and period who did not develop MRSA. Data were abstracted from hospital records. Results: Admission with sepsis (case: 46% vs. control: 2%, p<0.001) and having at least one comorbid condition (case: 95% vs. control: 46%, p<0.001) were significantly associated with the development of MRSA. Age (mean ± SD: case: 65±18, control: 64±18, p=0.7) and gender (% male, case: 52%, control: 56%, p=0.70) were not associated with the development of MRSA. Approximately 73% of all MRSA cases developed within the first 2 weeks of admission. Among the early cases, 44% died during their ICU stay; the corresponding percentage among the late cases was 42% (p=0.69). There was no difference between early and late MRSA cases in terms of non-sepsis admissions (50% vs. 67%, p=0.32) or comorbid status (at least one: 97% vs. 92%, p=0.17). Conclusion: Sepsis and comorbid conditions were significant risk factors for MRSA development among hospital patients.
Collapse
Affiliation(s)
- Mohamed A Ali
- College of Medicine, Sulaiman Al Rajhi University, Al-Qassim, Kingdom of Saudi Arabia. E-mail.
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Genc O, Arikan I. The relationship between hand hygiene practices and nasal Staphylococcus aureus carriage in healthcare workers. LA MEDICINA DEL LAVORO 2020; 111:54-62. [PMID: 32096773 PMCID: PMC7809962 DOI: 10.23749/mdl.v111i1.8918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/10/2020] [Indexed: 11/17/2022]
Abstract
Background: The nasal carriage rate of Staphylococcus aureus in healthcare workers (HCWs) is higher than the general population. Their hands serve as vectors for transmitting S.aureus colonized in the nose to patients. Objectives: To determine the rate of nasal S.aureus carriage and methicillin resistance in HCWs and to evaluate the relationship between carriage and personal risk factors and hand hygiene behaviors. Methods: The questionnaire included questions about sociodemographic characteristics, occupational and personal risk factors for S.aureus carriage, the “Hand Hygiene Belief Scale (HHBS),” and “Hand Hygiene Practices Inventory (HHPI)”. Nasal culture was taken from all participants. Presence of S.aureus, methicillin and mupirocin resistance were investigated in samples. Results: The study was carried out with 269 HCWs. The prevalence of S.aureus carriage was 20.1% (n:54). Among 54 S.aureus carriers, only one person had MRSA (0.37%). All S.aureus isolates were susceptible to mupirocin. S.aureus carriage was found to be significantly lower in the smoker group (p:0.015) and in the personnel wearing gloves during the procedures of each patient (p:0.002). S.aureus culture positivity was found to decrease significantly with increasing handwashing frequency (p:0.003). The mean HHPI score was higher in women (p:0.001). The mean HHPI score was lower in the group with nasal carriers than in non-carriers (p:0.176). Conclusion: The knowledge of hand hygiene practices, high frequency of handwashing, and wearing different gloves during the procedure of each patient decrease S.aureus nasal carriage in HCWs. In addition mupirocin is still effective in nasal S.aureus carriers.
Collapse
Affiliation(s)
- Ozlem Genc
- Department of Medical Microbiology, Faculty of Medicine, Kutahya Health Science University, Turkey.
| | - Inci Arikan
- Department of Public Health, Faculty of Medicine, Kutahya Health Science University, Turkey.
| |
Collapse
|
17
|
Gaber SN, Bassyouni RH, Masoud M, Ahmed FA. Promising anti-microbial effect of apple vinegar as a natural decolonizing agent in healthcare workers. ALEXANDRIA JOURNAL OF MEDICINE 2020. [DOI: 10.1080/20905068.2020.1769391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Sylvana N. Gaber
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Rasha H. Bassyouni
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Mohamed Masoud
- Department of Public Health, Faculty of Medicine-Fayoum University, Fayoum, Egypt
| | - Fatma A. Ahmed
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| |
Collapse
|
18
|
Chakolwa G, Samutela MT, Kwenda G, Mulundu G, Mwansa J, Hang'ombe BM, Simulundu E, Lukwesa C. Carriage rate and antimicrobial resistance profiles of Staphylococcus aureus among healthcare workers at a large tertiary referral hospital in Lusaka, Zambia. SCIENTIFIC AFRICAN 2019. [DOI: 10.1016/j.sciaf.2019.e00105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
19
|
Dias M, Saleem J. Surface colonization and subsequent development of infections with multi drug resistant organisms in a neonatal intensive care unit. Ann Clin Microbiol Antimicrob 2019; 18:12. [PMID: 30894188 PMCID: PMC6425662 DOI: 10.1186/s12941-019-0312-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study analyzes colonization of the neonates in a NICU and incidence of these colonized infants developing infections due to the colonizers. METHODS Over a 12 month period, samples (surface swabs and rectal swabs) were obtained from all the infants admitted to NICU. The samples were cultured and examined for the presence of colonizers and especially for multi-drug resistant organisms. RESULTS From the total 533 patients, 473 (89%) neonates acquired colonizers and 60 (11%) did not. Of the 473 (89%) colonized infants, 57 (12%) developed infections of whom 33 (58%) were infected from the same organism as the colonizer and 24 (42%) neonates developed an infection that was different from the colonizer. 416 (88%) infants did not develop any infection inspite of being colonized. CONCLUSIONS The total numbers of babies contracting infection were more in the colonized group than the non-colonized. Other factors like gestational age and preterm may have played a role in development of infection in addition to colonization in these babies. Screening for the presence of MDRO colonization may be of limited use in predicting infections in the colonized individual. However, knowledge of their presence results in implementation of strict infection control practices. This along with judicious uses of antimicrobials effectively reduces infections from colonized bacteria and more importantly prevent their spread.
Collapse
Affiliation(s)
- Mary Dias
- Department of Microbiology, St. John's Medical College, Sarjapur Road, Bangalore, Karnataka, 560034, India.
| | - Juveyriya Saleem
- Department of Microbiology, St. John's Medical College, Sarjapur Road, Bangalore, Karnataka, 560034, India
| |
Collapse
|
20
|
Complex Clonal Diversity of Staphylococcus aureus Nasal Colonization among Community Personnel, Healthcare Workers, and Clinical Students in the Eastern Province, Saudi Arabia. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4208762. [PMID: 30662908 PMCID: PMC6312594 DOI: 10.1155/2018/4208762] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 11/26/2018] [Indexed: 01/19/2023]
Abstract
Here, 210 healthy participants including community personnel (70), clinical students (68), and healthcare workers (HCWs) (72) from the eastern region of Saudi Arabia were studied. Sixty-three Staphylococcus aureus isolates were obtained from the nares of 37% of the community personnel and 26% of the clinical students and HCWs. Methicillin-resistant S. aureus (MRSA) was found in 16% (10 isolates) of the 63 isolates; six were from HCWs. Molecular characterization revealed high clonal diversity among the isolates, with 19 different spa types, 12 clonal complexes (CCs), and seven sequence types (STs) detected. The most common strain type was USA900, CC15, and t084, seen in 11 methicillin-susceptible S. aureus (MSSA) isolates. Moreover, three novel spa types in six isolates and one novel ST in two isolates were identified, most from HCWs. Interestingly, 29 isolates were mecA positive by PCR, whereas only 10 isolates were MRSA by disk diffusion (cefoxitin resistant). Of the 19 MSSA mecA-positive isolates, 16 were PBP2a negative, leaving three unique isolates from HCWs that were mecA and PBP2a positive yet cefoxitin susceptible. Our findings highlight the importance of phenotypically and genotypically characterizing S. aureus strains isolated from healthy communities to monitor the risk of possible cross-transmission to hospitalized patients. The identified strains showed a clonal lineage relationship with previously reported S. aureus and MRSA strains acquired from hospital settings.
Collapse
|
21
|
Methicillin-resistant Staphylococcus aureus tracking spread among health-care workers and hospitalized patients in critical wards at a university hospital, Tehran, Iran. New Microbes New Infect 2018; 27:29-35. [PMID: 30534385 PMCID: PMC6278718 DOI: 10.1016/j.nmni.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/04/2018] [Accepted: 11/08/2018] [Indexed: 11/22/2022] Open
Abstract
Health-care workers may serve as a reservoir for dissemination of methicillin-resistant Staphylococcus aureus (MRSA) to patients in hospital settings. The present study aimed to screen MRSA in nasal swabs of health-care workers and clinical specimens from patients and investigate the possible relationship between these isolates at a university hospital in Tehran, Iran. Additionally, we aimed to identify potential risk factors for MRSA colonization in health-care workers. Staphylococcus aureus strains were isolated from health-care workers and inpatients who completed a questionnaire on risk factors. Cefoxitin disc diffusion test was also used for detection of MRSA. Moreover, all of the MRSA isolates were subjected to pulsed-field gel electrophoresis (PFGE). Colonization rate of MRSA among health-care workers was 22.5%. Furthermore, out of 24 S. aureus isolates obtained from patients, nine (37.5%) were MRSA. Regarding risk factors, the prevalence of nasal MRSA carriage among hospital personnel who used masks was significantly lower than in those without masks (p 0.007). Using PFGE, 10 clusters and 14 singletons were identified among the MRSA isolates. In this regard, most of the MRSA isolates recovered from health-care carriers and patients in intensive care wards, especially general intensive care units, were grouped in certain clusters, indicating intra-ward transmission of the mentioned isolates in these restricted areas. We concluded that screening and decolonization of carriers, contact precautions, prudent use of antibiotics and implementation of active surveillance are recommended strategies for the prevention and control of MRSA transmission in hospital settings.
Collapse
|
22
|
Moghnieh RA, Kanafani ZA, Tabaja HZ, Sharara SL, Awad LS, Kanj SS. Epidemiology of common resistant bacterial pathogens in the countries of the Arab League. THE LANCET. INFECTIOUS DISEASES 2018; 18:e379-e394. [PMID: 30292478 DOI: 10.1016/s1473-3099(18)30414-6] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 06/03/2018] [Accepted: 06/18/2018] [Indexed: 12/12/2022]
Abstract
No uniformly organised collection of data regarding antimicrobial resistance has occurred in the countries of the Arab League. 19 countries of the Arab League have published data for antimicrobial susceptibility for the WHO priority organisms, and seven of 14 of these organisms are included in this Review (Escherichia coli, Klebsiella spp, Pseudomonas aeruginosa, Acinetobacter baumannii, Salmonella spp, Staphylococcus aureus, and Streptococcus pneumoniae). Although E coli and Klebsiella spp resistance to third-generation cephalosporins is common in all countries, with prevalence reaching more than 50% in Egypt and Syria, carbapenem resistance is emerging, albeit with a prevalence of less than 10%. Conversely, a large amount of carbapenem resistance has been reported for P aeruginosa and A baumannii across the Arab League, reaching 50% and 88% of isolates in some countries. As for Salmonella spp, the prevalence of fluoroquinolone resistance has exceeded 30% in several areas. With regards to the Gram-positive pathogens, the prevalence of meticillin resistance in S aureus is reported to be between 20% and 30% in most countries, but exceeds 60% in Egypt and Iraq. The prevalence of penicillin non-susceptibility among pneumococci has reached more than 20% in Algeria, Egypt, Morocco, Saudi Arabia, and Tunisia. These findings highlight the need for structured national plans in the region to target infection prevention and antimicrobial stewardship.
Collapse
Affiliation(s)
- Rima A Moghnieh
- Division of Infectious Diseases, Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon
| | - Zeina A Kanafani
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Hussam Z Tabaja
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Sima L Sharara
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Lyn S Awad
- Pharmacy Department, Makassed General Hospital, Beirut, Lebanon
| | - Souha S Kanj
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
| |
Collapse
|
23
|
Wu TH, Lee CY, Yang HJ, Fang YP, Chang YF, Tzeng SL, Lu MC. Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus among nasal carriage strains isolated from emergency department patients and healthcare workers in central Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 52:248-254. [PMID: 30292763 DOI: 10.1016/j.jmii.2018.08.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/22/2018] [Accepted: 08/31/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Screening and identification of methicillin-resistant Staphylococcus aureus (MRSA) carriage are helpful for controlling MRSA dissemination in hospitals. The aim of our study was to determine the prevalence of nasal carriages and diversity of MRSA among patients and healthcare workers (HCWs) at two regional hospitals in Taiwan. METHODS Nasal swabs were obtained prospectively from 204 patients visiting the emergency department (ED) and 326 HCWs in two regional hospitals in Changhua, Taiwan, between February 2015 and June 2015. All the MRSA isolates were further molecularly characterized. RESULTS Of the 204 participating patients, the nasal carriage rates of S. aureus and MRSA were 22.1% and 7.8%, respectively. For HCWs, the S. aureus and MRSA carriage rates were 26.1% and 6.1%, respectively. There was no statistically significant difference in MRSA carriage rate between patients and HCWs (P = 0.447). Patients receiving hemodialysis were significantly associated with MRSA colonization (P = 0.012). The leading three sequence types (ST) were ST59 (16, 44.4%), ST45 (11, 30.6%), and ST239 (3, 8.3%) for all 36 MRSA isolates. ST59/SCCmec IV/t437/PVL-negative and ST45/SCCmec V/t1081/PVL-negative were the predominant clones among HCWs (30%) and participating patients (19%), respectively. CONCLUSION Overall, a substantial proportion of patients visiting the ED and HCWs harbored CA-MRSA, mostly ST59 strains, in their nares. It is noteworthy that MRSA ST45 strains supplanted ST239 as the second leading nasal MRSA colonization strain in our study.
Collapse
Affiliation(s)
- Tsung-Hua Wu
- Department of Pediatrics, Chang Hua Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Chun-Yi Lee
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Hui-Ju Yang
- Department Surgical Intensive Care Unit, Chang Hua Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Yu-Ping Fang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Yu-Fen Chang
- Department Laboratory, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Shu-Ling Tzeng
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Min-Chi Lu
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Microbiology and Immunology, School of Medicine, China Medical University, Taichung, Taiwan.
| |
Collapse
|
24
|
Kong Y, Ye J, Zhou W, Jiang Y, Lin H, Zhang X, Qian J, Zhang Y, Ge H, Li Y. Prevalence of methicillin-resistant Staphylococcus aureus colonisation among healthcare workers at a tertiary care hospital in southeastern China. J Glob Antimicrob Resist 2018; 15:256-261. [PMID: 30144635 DOI: 10.1016/j.jgar.2018.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/06/2018] [Accepted: 08/15/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the carriage rates of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) among healthcare workers (HCWs) at a tertiary-care hospital in southeastern China and to analyse the epidemiological relatedness of the S. aureus isolates. METHODS A total of 242 pharynx swabs were collected in March-April 2016 from 242 HCWs working in seven different wards and departments. Isolates were identified as S. aureus based on morphology, coagulase test and Vitek test. Antimicrobial susceptibility testing was performed by using the Kirby-Bauer disk diffusion method. The epidemiological relatedness of the S. aureus isolates was determined by pulsed-field gel electrophoresis (PFGE). RESULTS From the 242 HCWs, 70 (28.9%) S. aureus strains, including 10 (4.1%) MRSA strains, were identified during screening, with the highest MRSA rate detected in nurses (8/107; 7.5%). Carriage rates of S. aureus and MRSA among surgical HCWs were 30.0% (63/210) and 4.3% (9/210), respectively. Methicillin-susceptible S. aureus (MSSA) isolates were grouped by PFGE analysis into five similar groups (A-E), with most isolates belonging to groups D and E, accounting for 63.0% of isolates. Furthermore, two MRSA isolates from gastrointestinal surgery had identical PFGE patterns. CONCLUSIONS The prevalence of S. aureus colonisation among HCWs was high in this hospital, although the MRSA carriage rate in surgical wards was low. The identical PFGE pattern detected in two MRSA isolates from the same surgical department supports that effective control for possible cross-infection should be implemented.
Collapse
Affiliation(s)
- Yi Kong
- Department of Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Jiaxin Ye
- Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Wanqing Zhou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China.
| | - Yihong Jiang
- Department of Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Hongyi Lin
- Department of Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Xianpin Zhang
- Department of Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Jing Qian
- Department of Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Yaying Zhang
- Department of Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Hai Ge
- Department of Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Yang Li
- Department of Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| |
Collapse
|
25
|
El-Deeb W, Fayez M, Elmoslemany A, Kandeel M, Zidan K. Methicillin resistant Staphylococcus aureus among goat farms in Eastern province, Saudi Arabia: Prevalence and risk factors. Prev Vet Med 2018; 156:84-90. [PMID: 29891150 DOI: 10.1016/j.prevetmed.2018.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/10/2018] [Accepted: 05/03/2018] [Indexed: 10/17/2022]
Abstract
A cross sectional study was conducted on 1010 goats from 25 flocks located in the eastern province, Saudi Arabia, to study the prevalence of methicillin resistant Staphylococcus aureus (MRSA) among goat farms. A total of 235 milk samples and 775 nasal swabs were collected for bacteriological investigation. Based on resistance to cefoxitin, 20 isolates were permissively identified as MRSA. PCR with specific primers was used to confirm MRSA. The prevalence of MRSA was 2%; with maximum prevalence in mastitic milk (9.2%) and swabs from animals showed respiratory signs (2.6%), while the lowest prevalence was identified in apparently normal milk (0.6). The standard disk diffusion test was used for in vitro evaluation of isolates resistance profile to 13 antimicrobial agents. Multidrug resistance (MDR) was detected in all MRSA and in 23.5% of methicillin sensitive Staphylococcus aureus (MSSA). Univariable association between the prevalence of MDR/MRSA strains and management practices indicated a higher prevalence with larger size flocks, where raising animals for both meat and milk production, and where antibiotics were used during the last 30 days, the latter was particularly pertinent to penicillin-streptomycin. Multivariable models indicated that larger flocks (200-400, and >400) were, respectively, 4 and 3.5 fold more likely to have MDR S. aureus compared to smaller flocks (<200).
Collapse
Affiliation(s)
- Wael El-Deeb
- Department of Clinical Studies, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia; Department of Veterinary Medicine, Infectious Diseases and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt.
| | - Mahmoud Fayez
- Ministry of Agriculture, Al-Ahsa Central Lab, Saudi Arabia; Veterinary Serum and Vaccine Research Institute, Cairo, Egypt
| | - Ahmed Elmoslemany
- Hygiene and Preventive Medicine Department, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr el-Sheikh, 35516, Egypt
| | - Mahmoud Kandeel
- Department of Physiology, Biochemistry and Pharmacology, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia; Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelshikh University, Kafrelshikh, Egypt
| | - Kamal Zidan
- Veterinary Serum and Vaccine Research Institute, Cairo, Egypt
| |
Collapse
|
26
|
Alawi MM, Darwesh BM. A stepwise introduction of a successful antimicrobial stewardship program. Experience from a tertiary care university hospital in Western, Saudi Arabia. Saudi Med J 2017; 37:1350-1358. [PMID: 27874151 PMCID: PMC5303774 DOI: 10.15537/smj.2016.12.15739] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center. Methods Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs). Indicators were prospectively monitored and included hospital mortality as the safety indicator; incidence of multi-drug resistance (MDR) infections as the effectiveness indicator, RA cost savings as the cost-effectiveness indicator and RA consumption indicated the process implementation. Results Between 2012 and 2014, dispensations of RAs decreased by 67% and prescriptions by 75%; no increase in mortality rate was observed. Microbiologically, there was a decreasing trend of incidence across all monitored infections, but this was only significant for Acinetobacter baumannii (p=0.007). Cost analysis showed a decrease in expenditure for RAs, with an average monthly saving of up to 326,020USD. Conclusions Stepwise implementation of ASPs is a safe and cost-effective strategy for improving antibiotic prescribing practice and to reduce multi-drug resistance.
Collapse
Affiliation(s)
- Maha M Alawi
- Infection Control & Environmental Health Unit, Department of Medical Microbiology & Parasitology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. E-mail.
| | | |
Collapse
|
27
|
Hussein NR, Assafi MS, Ijaz T. Methicillin-resistant Staphylococcus aureus nasal colonisation amongst healthcare workers in Kurdistan Region, Iraq. J Glob Antimicrob Resist 2017; 9:78-81. [PMID: 28419870 DOI: 10.1016/j.jgar.2017.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 01/07/2017] [Accepted: 01/26/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine the prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare workers (HCWs) compared with non-HCWs at Duhok city, Kurdistan Region, northern Iraq. METHODS A total of 182 HCWs with different occupations and working in different hospital units as well as 198 non-HCWs were recruited. Nasal swab samples were collected and were inoculated on mannitol salt agar and incubated at 35°C for 48h. Isolates identified as S. aureus underwent antimicrobial sensitivity testing to oxacillin. MRSA isolates were selected and investigated for presence of the mecA gene. RESULTS Among the HCWs, 41/182 (22.5%) were carriers of S. aureus compared with 37/198 (18.7%) non-HCWs (P=0.4). Amongst the S. aureus carriers, 25/41 strains (61.0%) isolated from HCWs were MRSA compared with 8/37 strains (21.6%) isolated from non-HCWs (P=0.039). The mean age of MRSA carriers was 35.6±6.7years compared with 30±5.8years for MRSA non-carriers (P=0.0177). The mean working years of MRSA carriers was significantly higher than that of MRSA non-carriers (7.8±5.5years vs. 3.9±5.3years; P=0.04). CONCLUSIONS The prevalence of MRSA was very high amongst HCWs. Regular screening of carriers is required for prevention of nosocomial infections.
Collapse
Affiliation(s)
- Nawfal R Hussein
- Department of Internal Medicine, School of Medicine, Faculty of Medical Sciences, Duhok, Kurdistan Region, Iraq
| | - Mahde S Assafi
- Department of Biology, Faculty of Sciences, University of Zakho, Zakho, Iraq.
| | - Tayyaba Ijaz
- Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| |
Collapse
|
28
|
El-Kersh TA, Marie MA, Al-Sheikh YA, Al-Agamy MH, Al Bloushy AA. Prevalence and risk factors of early fecal carriage of Enterococcus faecalis and Staphylococcus spp and their antimicrobial resistant patterns among healthy neonates born in a hospital setting in central Saudi Arabia. Saudi Med J 2017; 37:280-7. [PMID: 26905350 PMCID: PMC4800892 DOI: 10.15537/smj.2016.3.13871] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objectives: To investigate the prevalence, antibiotic resistant profiles, and risk factors of early fecal carriage of Enterococcus faecalis (E. faecalis) and staphylococci among 150 healthy Saudi neonates born in a hospital setting in central Saudi Arabia. Methods: This prospective study was conducted in Al-Bukayriyah General Hospital, Qassim, Saudi Arabia, between June 2012 and January 2013. The E. faecalis and Staphylococcus spp. isolates were identified manually, and Vitek2 system was used for identity confirmation at the species level and minimum inhibitory concentration-susceptibility testing. Results: Enterococcus faecalis (n=73) and Staphylococcus spp. (n=18) were recovered. Unlike staphylococci, E. faecalis colonization did not significantly vary from day one up to 7 days of life, regardless of the type of feeding, but it was relatively higher among vaginally versus cesarean delivery. Both Staphylococcus epidermidis (S. epidermidis) and Staphylococcus aureus carriage increase as the body weight increases, and this difference was significant (p=0.025) for S. epidermidis. High-level resistance in Gentamycin among E. faecalis isolates was 25% and 11% to Streptomycin. Thirty percent of S. epidermidis were resistant to oxacillin and exhibited multidrug-resistant (MDR) patterns of 5 resistant markers, which were also observed among 2/5 (40%) of Methicillin-resistant Staphylococcus aureus isolates. Conclusion: Enterococcus faecalis did not significantly vary in relation to type of delivery, age up to 7 days, and type of feeding. The neonatal fecal carriage of MDR isolates should be considered as a crucial reservoir to the further spread of antimicrobial resistance genes among hospitals, cross infections, and the community.
Collapse
Affiliation(s)
- Talat A El-Kersh
- Department of Clinical Laboratory Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
| | | | | | | | | |
Collapse
|
29
|
A Frequency and Molecular Typing Study of Methicillin-Resistant Staphylococcus aureus Isolates in Teaching Hospitals in Shahrekord, SouthWestern Iran. Jundishapur J Microbiol 2016. [DOI: 10.5812/jjm.39654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
30
|
Abstract
Antimicrobial resistance (AMR) is increasingly being highlighted as an urgent public and animal health issue worldwide. This issue is well demonstrated in bacteria that are resistant to last-line antibiotics, suggesting a future with untreatable infections. International agencies have suggested combating strategies against AMR. Saudi Arabia has several challenges that can stimulate the emergence and spread of multidrug-resistant bacteria. Tackling these challenges need efforts from multiple sectors to successfully control the spread and emergence of AMR in the country. Actions should include active surveillance to monitor the emergence and spread of AMR. Infection prevention and control precautions should also be optimized to limit further spread. Raising awareness is essential to limit inappropriate antibiotics use, and the antibiotic stewardship programs in hospital settings, outpatients, and community pharmacies, should regulate the ongoing use of antimicrobials.
Collapse
Affiliation(s)
- Hosam M Zowawi
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia. E-mail.
| |
Collapse
|
31
|
The strategic plan for combating antimicrobial resistance in Gulf Cooperation Council States. J Infect Public Health 2016; 9:375-85. [DOI: 10.1016/j.jiph.2016.03.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
32
|
Natoli L, Guy RJ, Shephard M, Causer L, Badman SG, Hengel B, Tangey A, Ward J, Coburn T, Anderson D, Kaldor J, Maher L, TTANGO Investigators. "I Do Feel Like a Scientist at Times": A Qualitative Study of the Acceptability of Molecular Point-Of-Care Testing for Chlamydia and Gonorrhoea to Primary Care Professionals in a Remote High STI Burden Setting. PLoS One 2015; 10:e0145993. [PMID: 26713441 PMCID: PMC4703135 DOI: 10.1371/journal.pone.0145993] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 12/11/2015] [Indexed: 11/19/2022] Open
Abstract
Background Point-of-care tests for chlamydia (CT) and gonorrhoea (NG) could increase the uptake and timeliness of testing and treatment, contribute to improved disease control and reduce reproductive morbidity. The GeneXpert (Xpert CT/NG assay), suited to use at the point-of-care, is being used in the TTANGO randomised controlled trial (RCT) in 12 remote Australian health services with a high burden of sexually transmissible infections (STIs). This represents the first ever routine use of a molecular point-of-care diagnostic for STIs in primary care. The purpose of this study was to explore the acceptability of the GeneXpert to primary care staff in remote Australia. Methods In-depth qualitative interviews were conducted with 16 staff (registered or enrolled nurses and Aboriginal Health Workers/Practitioners) trained and experienced with GeneXpert testing. Interviews were digitally-recorded and transcribed verbatim prior to content analysis. Results Most participants displayed positive attitudes, indicating the test was both easy to use and useful in their clinical context. Participants indicated that point-of-care testing had improved management of STIs, resulting in more timely and targeted treatment, earlier commencement of partner notification, and reduced follow up efforts associated with client recall. Staff expressed confidence in point-of-care test results and treating patients on this basis, and reported greater job satisfaction. While point-of-care testing did not negatively impact on client flow, several found the manual documentation processes time consuming, suggesting that improved electronic connectivity and test result transfer between the GeneXpert and patient management systems could overcome this. Managing positive test results in a shorter time frame was challenging for some but most found it satisfying to complete episodes of care more quickly. Conclusions In the context of a RCT, health professionals working in remote primary care in Australia found the GeneXpert highly acceptable. These findings have implications for use in other primary care settings around the world.
Collapse
Affiliation(s)
- Lisa Natoli
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
- The Burnet Institute, Melbourne, VIC, Australia
- * E-mail:
| | - Rebecca J. Guy
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | - Mark Shephard
- Flinders University International Centre for Point of-Care Testing, Flinders University, Adelaide, SA, Australia
| | - Louise Causer
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | | | - Belinda Hengel
- Apunipima Cape York Health Council, Cairns, QLD, Australia
| | - Annie Tangey
- Ngaanyatjarra Health Service, Alice Springs, NT, Australia
| | - James Ward
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Tony Coburn
- Queensland Aboriginal and Islander Health Council, Brisbane, QLD, Australia
| | | | - John Kaldor
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | - Lisa Maher
- The Kirby Institute, UNSW Australia, Sydney, NSW, Australia
| | | |
Collapse
|