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Patil G, Agarwala P, Das P, Pathak S. Rise in the Pathogenic Status of Coagulase-Negative Staphylococci Causing Bloodstream Infection. Cureus 2024; 16:e57250. [PMID: 38686262 PMCID: PMC11056806 DOI: 10.7759/cureus.57250] [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] [Accepted: 03/28/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Coagulase-negative staphylococci (CoNS) are one of the frequently isolated bacteria from blood cultures. Since they are part of the normal skin flora, they were previously considered contaminants. But now, they can be considered as established pathogens causing bloodstream infection (BSI). This study aims to estimate the prevalence of CoNS in BSI cases. METHODS This study was conducted at the Microbiology Department, All India Institute of Medical Sciences (AIIMS), Raipur, India, for eight months (January 2022 to August 2022). Data were collected retrospectively from medical and laboratory records. Paired blood cultures from 5085 clinically suspected sepsis cases were subjected to aerobic culture for five days in the BacT ALERT 3D system. Pathogenicity was established after recovery of CoNS from paired blood cultures of symptomatic patients. RESULTS CoNS were isolated from 2.35% of patients, the most common species being Staphylococcus haemolyticus (51.67%). About 90% of isolates were methicillin-resistant. All the isolates were susceptible to linezolid, teicoplanin, and vancomycin, except one isolate of S. haemolyticus which was intermediate to vancomycin. Minimum inhibitory concentration (MIC) 50 and MIC 90 for vancomycin were 1 ug/ml and 2 ug/ml, respectively. Conclusion: Paired blood cultures are necessary to determine the pathogenicity of CoNS in BSI cases. A high prevalence of methicillin resistance, accompanied by high resistance rates to other non-beta lactam antibiotics, warrants the strict implementation of antimicrobial stewardship practices.
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Affiliation(s)
- Girish Patil
- Microbiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Pragya Agarwala
- Microbiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Padma Das
- Microbiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Swati Pathak
- Microbiology, All India Institute of Medical Sciences, Raipur, Raipur, IND
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Akinduti PA, Obafemi YD, Ugboko H, El-Ashker M, Akinnola O, Agunsoye CJ, Oladotun A, Phiri BSJ, Oranusi SU. Emerging vancomycin-non susceptible coagulase negative Staphylococci associated with skin and soft tissue infections. Ann Clin Microbiol Antimicrob 2022; 21:31. [PMID: 35778767 PMCID: PMC9250237 DOI: 10.1186/s12941-022-00516-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 05/13/2022] [Indexed: 11/15/2022] Open
Abstract
Backgrounds Observable emergence of Vancomycin-Non susceptible Coagulase-negative Staphylococci (VNS-CoNS) associated with skin and soft tissue infections spreading among the urban and rural populace is gradually intensifying severe complications. The isolated VNS-CoNS were evaluated with Matrix-assisted Laser Desorption/ionization Time of Flight Mass Spectrometry (MALDI ToF MS) for species characterization and pan-antimicrobial resistance pattern. Methods Out of 256 clinical samples collected including pus, abscess, ear swabs, eye swabs, and aspirates, 91 CoNS isolates were biotyped and further characterized with MALDI-TOF MS. Staphylococci marker genes, Vancomycin susceptibility, and biofilm assays were performed. Results Of 91 CoNS isolates, S.cohnii (2.3%), S.condimentii (3.4%), S. saprophyticus (6.7%), and S.scuri (21.1%) were characterized with MALDI-TOF with significant detection rate (99.4%; CI 95, 0.775–0.997, positive predictive values, 90.2%) compared to lower biotyping detection rate (p = 0.001). Hemolytic VNS-CoNS lacked nuc, pvl and spa genes from wound, ear, and aspirates of more 0.83 MARI clustered into a separate phylo-diverse group and were widely distributed in urban and peri-urban locations. MALDI TOF–MS yielded a high discriminatory potential of AUC-ROC score of 0.963 with true-positivity prediction. VNS-CoNS of MIC ≥ 16 µg/mL were observed among all the ages with significant resistance at 25th and 75th quartiles. More than 10.5% of CoNS expressed multi-antibiotic resistance with more than 8 µg/mL vancomycin cut-off values (p < 0.05). Conclusion Antibiotic resistant CoNS should be considered significant pathogens rather than contaminant. Biofilm producing VNS-S. sciuri and S. condimentii are potential strains with high pathological tropism for skin, soft tissues and wound infections, and these strains require urgent surveillance in peri-urban and rural communities. Supplementary Information The online version contains supplementary material available at 10.1186/s12941-022-00516-4.
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Affiliation(s)
- Paul A Akinduti
- Microbiology Unit, Department of Biological Sciences, Covenant University, Km 10, Idi-Iroko Road, Ota, Nigeria.
| | - Yemisi Dorcas Obafemi
- Microbiology Unit, Department of Biological Sciences, Covenant University, Km 10, Idi-Iroko Road, Ota, Nigeria
| | - Harriet Ugboko
- Microbiology Unit, Department of Biological Sciences, Covenant University, Km 10, Idi-Iroko Road, Ota, Nigeria
| | - Maged El-Ashker
- Department of Internal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Olayemi Akinnola
- Microbiology Unit, Department of Biological Sciences, Covenant University, Km 10, Idi-Iroko Road, Ota, Nigeria
| | | | - Abiola Oladotun
- Department of Microbiology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Bruno S J Phiri
- Central Veterinary Research Institute (CVRI), Lusaka, Zambia
| | - Solomon U Oranusi
- Microbiology Unit, Department of Biological Sciences, Covenant University, Km 10, Idi-Iroko Road, Ota, Nigeria
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Nasaj M, Saeidi Z, Asghari B, Roshanaei G, Arabestani MR. Identification of hemolysin encoding genes and their association with antimicrobial resistance pattern among clinical isolates of coagulase-negative Staphylococci. BMC Res Notes 2020; 13:68. [PMID: 32041651 PMCID: PMC7011549 DOI: 10.1186/s13104-020-4938-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/03/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Coagulase-negative staphylococci (CoNS) are as considered opportunistic pathogens which capable of producing several toxins, enzymes and resistance genes. The current study aimed to determine the occurrence of different hemolysins genes and patterns of antibiotic resistance among CoNS species. RESULTS The highest frequency of antibiotic resistance was observed against cefoxitin in 49 isolates (53.8%), and the lowest resistance was against novobiocin in 5 isolates (5.5%). None of the isolates was resistant to vancomycin. The prevalence of hla, hla_yidD, hld, and hlb genes was: 87.9%, 62.6%, 56%, and 47.3%, respectively. The hla/yidD and hld genes were detected in 69.4% of S. epidermidis and the hla gene in 94.6% of S. haemolyticus isolates; the hlb gene was detected in 53.1% of the S. epidermidis isolates. The mecA gene was identified in 50 (55%) of the CoNS isolates. In conclusion, the results of statistical analysis showed that the hld gene had a significant association with resistance to levofloxacin and erythromycin antibiotics, the hlb with clindamycin resistance and the hla/yidD with rifampicin and novobiocin resistance. The results of this study showed that there is a significant relationship between hemolysin encoding genes and antibiotic resistance patterns; therefore, detection of virulence factors associated with antibiotic resistance has become a significant issue of concern.
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Affiliation(s)
- Mona Nasaj
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran
| | - Zahra Saeidi
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran
| | - Babak Asghari
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran
| | - Ghodratollah Roshanaei
- Department of Biostatistics, School of Health, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran
| | - Mohammad Reza Arabestani
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran. .,Nutrition Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran.
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4
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Ahmed DM, Messih MAWA, Ibrahim NH, Meabed MH, Abdel-Salam SM. Frequency of icaA and icaD determinants and biofilm formation among coagulase-negative staphylococci associated with nasal carriage in neonatal intensive care units. Germs 2019; 9:61-70. [PMID: 31341833 DOI: 10.18683/germs.2019.1159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/24/2019] [Accepted: 05/31/2019] [Indexed: 11/08/2022]
Abstract
Introduction Nasal colonization with coagulase-negative staphylococci (CoNS) may be a preliminary risk factor for systemic infection. The aim of this study was to assess the frequency of ica A and D genes and biofilm formation among hospital-acquired nasal colonizing CoNS strains isolated from neonates in the neonatal intensive care units (NICUs). Antibiotic sensitivity patterns and some relevant risk factors were estimated. Methods This study assessed nasal colonization with CoNS among neonates at days one and three of admission to NICUs of Beni-Suef University Hospital and Beni-Suef General Hospital from November 2015 to May 2016. The isolates were screened and identified; susceptibility testing was performed. Biofilm formation was examined using the Congo red agar method. Isolates identified as CoNS were tested by polymerase chain reaction (PCR) for the presence of mecA and icaA and icaD genes. Results A total of 340 nasal swabs were collected from 170 neonates. The incidence of nasal colonization with CoNS was 50%. The species most frequently isolated were S. haemolyticus and S. epidermidis. Multidrug resistance (MDR) was detected in 86% of isolates. It was found that there was a strong association between the presence of mecA gene and phenotypic resistance to methicillin and also the presence of the icaA gene and biofilm formation. Conclusions Neonates admitted to NICUs can become reservoirs for CoNS strains, leading to potential dissemination of MDR strains into the community.
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Affiliation(s)
- Doaa Mabrouk Ahmed
- MD, Lecturer, Medical Microbiology and Immunology Department, Faculty of Medicine, Beni-Suef University, Mohamed Hassan Street, Beni-Suef, 6251 Egypt
| | - Mona Abdel Wahab Abel Messih
- MD, Professor, Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, 31 Khatem El Morsalin Street, Giza, Cairo, Egypt
| | - Nermin Hassan Ibrahim
- MD, Assistant Professor, Medical Microbiology and Immunology Department, Faculty of Medicine, Beni-Suef University, Mohamed Hassan Street, Beni-Suef, 6251 Egypt
| | - Mohamed Hussein Meabed
- MD, Professor, Pediatric Medicine, Faculty of Medicine, Beni-Suef University, 138 El Raoda st. Beni-Suef, Beni-Suef, Egypt
| | - Soha Mahmoud Abdel-Salam
- MSc, Assistant Lecturer, Medical Microbiology and Immunology Department, Faculty of Medicine, Beni-Suef University, Mohamed Hassan Street, Beni-Suef, 6251 Egypt
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Al Rahmany D, Albeloushi A, Alreesi I, Alzaabi A, Alreesi M, Pontiggia L, Ghazi IM. Exploring bacterial resistance in Northern Oman, a foundation for implementing evidence-based antimicrobial stewardship program. Int J Infect Dis 2019; 83:77-82. [PMID: 30959249 DOI: 10.1016/j.ijid.2019.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Increasing rate of resistant infections is a challenge to healthcare negatively impacting therapeutic and financial outcomes. Targeted antimicrobial stewardship interventions are needed to counteract this global crisis. On large scale, we sought to identify the prevalence of resistant pathogens and their susceptibility pattern in Northern Oman. MATERIAL AND METHOD Retrospective analysis of all isolates processed by Suhar Hospital microbiology laboratory between Jan1st, 2016 and Dec31st, 2017. Organism identification, susceptibility and phenotyping were performed following CLSI standards and duplicate isolates were excluded. Pertinent microbiological data were collected and analyzed. RESULTS Of 15,733 samples included, Gram-negative bacteria predominate by 67.76%, Gram-positive (29%) and Candida species (2.63%). Frequently isolated Gram-negative bacteria were Escherichia coli (32.39%), Pseudomonas aeruginosa (22.16%), Klebsiellapneumoniae (19.97%) and Acinetobacter baumannii (5.22%), there was virtually no resistance to colistin and tigecycline, while a growing resistance toward ciprofloxacin and meropenem was observed. Resistant E. coli and K. pneumoniae were isolated from bloodstream infection (12%). While Gram-positives were MSSA (27.23%), Streptococcus agalactiae (25.36%), MRSA (16.10%) and CoNS (12.1 %), they were almost universally susceptible to daptomycin and linezolid with low resistance (8˜20%) to clindamycin. Approximately, 50% of Staphylococci (MRSA and CoNS) required vancomycin treatment. CONCLUSION Study findings should guide targeted stewardship interventions to optimize antibiotic prescriptions. Empirical treatment options should be revised, drug-bug match therapy instituted promptly and newer agents considered. Prescribing restriction of formulary antimicrobials that still retain their activity towards bugs - like colistin, linezolid and tigecycline- is a mandatory action. Review empiric use of ciprofloxacin and meropenem to counteract growing resistance.
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Affiliation(s)
| | | | - Iman Alreesi
- Microbiological Laboratory, Sohar Hospital, Oman
| | | | | | - Laura Pontiggia
- Misher College of Arts and Sciences at University of the Sciences, Philadelphia, PA, USA
| | - Islam M Ghazi
- Philadelphia College of Pharmacy at University of the Sciences, Philadelphia, PA, USA.
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Singh S, Dhawan B, Kapil A, Kabra SK, Suri A, Sreenivas V, Das BK. Coagulase-negative staphylococci causing blood stream infection at an Indian tertiary care hospital: Prevalence, antimicrobial resistance and molecular characterisation. Indian J Med Microbiol 2017; 34:500-505. [PMID: 27934830 DOI: 10.4103/0255-0857.195374] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Recent years have seen a rise of coagulase-negative staphylococci (CoNS) from common contaminants to agents of nosocomial blood stream infections (BSI's). Molecular typing and establishing a correlation with antibiotic resistance is essential particularly in countries like India where genotyping studies for drug-resistant CoNS are sparse. METHODS A prospective study was done over 18 months, wherein 42,693 blood samples were received, and 59 patients with BSI due to CoNS were evaluated. The isolates recovered were identified by a biochemical test panel and matrix-assisted laser desorption ionization - time of flight mass spectrometry followed by antimicrobial susceptibility testing by Kirby-Baur disc diffusion method and E-test strips. Staphylococcal chromosomal cassette mec (SCCmec) element was characterised by multiplex polymerase chain reaction for all methicillin-resistant (MR) isolates. RESULTS The majority of CoNS isolated were constituted by Staphylococcus haemolyticus (47.5%) followed by Staphylococcus epidermidis (33.9%), Staphylococcus hominis (11.86%), Staphylococcus cohnii (5.08%) and Staphylococcus warneri (1.69%). Among all isolates 57.6% were MR with statistically significant higher resistance versus methicillin sensitive-CoNS. This difference was significant for erythromycin (76% vs. 44%, P = 0.011), rifampicin (50% vs. 12%,P= 0.002) and amikacin (26.5% vs. 4%, P = 0.023), ciprofloxacin (64.7% vs. 20%, P = 0.001) and cotrimoxazole (55.9% vs. 20%, P = 0.006). SCCmec type I was predominant (61.8%, P = 0.028) and exhibited multidrug resistance (76.2%). Coexistence of SCCmec type I and III was seen in 8.82% MR isolates. CONCLUSION CoNS exhibit high antimicrobial resistance thereby limiting treatment options. The presence of new variants of SCCmec type in hospital-acquired CoNS may predict the antibiotic resistance pattern. This is the first evaluation of the molecular epidemiology of CoNS causing BSI from India and can serve as a guide in the formulation of hospital infection control and treatment guidelines.
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Affiliation(s)
- S Singh
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - B Dhawan
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - A Kapil
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - S K Kabra
- Department of Pediatrics, All Institute of Medical Sciences, New Delhi, India
| | - A Suri
- Department of Neurosurgery, All Institute of Medical Sciences, New Delhi, India
| | - V Sreenivas
- Department of Biostatistics, All Institute of Medical Sciences, New Delhi, India
| | - B K Das
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
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7
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Cavanagh JP, Wolden R, Heise P, Esaiassen E, Klingenberg C, Aarag Fredheim EG. Antimicrobial susceptibility and body site distribution of community isolates of coagulase-negative staphylococci. APMIS 2016; 124:973-978. [PMID: 27599662 DOI: 10.1111/apm.12591] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 07/08/2016] [Indexed: 11/29/2022]
Abstract
The primary aim of this study was to determine antimicrobial resistance in coagulase-negative staphylococci (CoNS) from healthy adults in the community. Healthy adults (n = 114) were swabbed on six body sites; both armpits, both knee pits and both sides of the groin. Species determination was performed using Matrix Assisted Laser Desorption Ionization - Time of Flight (MALDI-TOF) and susceptibility testing for 11 relevant antimicrobials was performed by the disc diffusion method and minimal inhibitory concentration gradient test. In total, 693 CoNS isolates were identified. Susceptibility testing was done on 386 isolates; one CoNS from each species found on each participant from the different body sites. The prevalence of antimicrobial resistance in the CoNS isolates were; erythromycin (24.6%), fusidic acid (19.9%), tetracycline (11.4%), clindamycin (7.8%), gentamicin (6.2%) and cefoxitin (4.1%). Multidrug resistance was observed in 5.2% of the isolates. Staphylococcus epidermidis and S. hominis were the first and second most prevalent species on all three body sites. We conclude that CoNS isolates from healthy adults in the community have a much lower prevalence of antimicrobial resistance than reported in nosocomial CoNS isolates. Still, we believe that levels of resistance in community CoNS should be monitored as the consumption of antimicrobials in primary care in Norway is increasing.
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Affiliation(s)
- Jorunn Pauline Cavanagh
- Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway. .,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Runa Wolden
- Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Philipp Heise
- Institute of Microbiology and Molecular Biology, University of Giessen, Giessen, Germany
| | - Eirin Esaiassen
- Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Claus Klingenberg
- Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Dal-Bó K, Silva RMD, Sakae TM. Nosocomial infections in a neonatal intensive care unit in South Brazil. Rev Bras Ter Intensiva 2015; 24:381-5. [PMID: 23917937 PMCID: PMC4031819 DOI: 10.1590/s0103-507x2012000400015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 10/11/2012] [Indexed: 11/04/2022] Open
Abstract
Objective The aim of this study was to describe the incidence and epidemiology of nosocomial
infection in newborns who were admitted to a neonatal intensive care unit in a
hospital in south Santa Catarina, Brazil. Methods A prospective cohort study was conducted for 1 year among 239 neonates who
remained as in-patients 48 hours after admission. The criteria that were used to
diagnose infection were in accordance with the Centers for Disease Control and
Prevention and the National Health Surveillance Agency. Results The incidence of nosocomial infection was 45.8%. The primary reasons for admission
were primary bloodstream infection (80.7%) and pneumonia (6.7%).
Coagulase-negative Staphylococcus was the most commonly
identified agent in the blood cultures and in the hospital unit. Prematurity was
the most prevalent reason for admission. The general mortality rate was 12.1%, and
mortality from nosocomial infection was 33.8%. Conclusions The incidence of nosocomial infection in the hospital unit was higher than rates
that have been reported in other national studies. The major types of nosocomial
infection were primary bloodstream infection and pneumonia.
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9
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Aghazadeh M, Ghotaslou R, Ahangarzadeh Rezaee M, Moshafi MH, Hojabri Z, Saffari F. Determination of antimicrobial resistance profile and inducible clindamycin resistance of coagulase negative staphylococci in pediatric patients: the first report from Iran. World J Pediatr 2015; 11:250-4. [PMID: 25410671 DOI: 10.1007/s12519-014-0524-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 05/05/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Currently, coagulase negative staphylococci (CoNS) have got much attention as a serious health problem especially in neonates and children. High incidence of antibiotic resistance, in particular methicillin resistance, has complicated the treatment of these organisms. The aim of this study is to determine the susceptibility to different antimicrobial agents and the prevalence of macrolideslincosamides-streptogramins B (MLSB) resistance in CoNS isolates obtained from pediatric patients. METHODS Totally 157 CoNS isolates from various clinical samples were examined for antibiotic resistance using disk diffusion and E-test methods. Double-disk test was applied to detect constitutive and inducible MLSB resistance (cMLSB and iMLSB) phenotypes. RESULTS Resistance to methicillin was seen in 98 (62.4%) isolates. All isolates were susceptible to vancomycin and linezolid. The prevalence of resistance to antibiotics tested was as follows: fusidic acid (n=58, 36.9%), gentamicin (n=73, 46.5%), ciprofloxacin (n=81, 51.6%), clindamycin (n=112, 71.3%), erythromycin (n=129, 82.2%) and trimethoprim/sulfamethoxazole (n=133, 84.7%). iMLSB phenotype was seen in 14 (8.9%) isolates, and 18 (11.5%) and 98 (62.4%) isolates showed MS and cMLSB phenotypes, respectively. We observed that high overall antibiotic resistance rates were associated significantly with methicillin resistance. Conversely, iMLSB phenotype was correlated neither with methicillin resistance nor with invasiveness. CONCLUSION Given the similarity observed between the prevalence of iMLSB and MS phenotypes, the performance of disk diffusion induction test is strongly recommended in our region.
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Affiliation(s)
- Mohammad Aghazadeh
- Tabriz Research Center of Infectious and Tropical Diseases, Tabriz University of Medical Sciences, Tabriz, Iran
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10
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Silva PV, Cruz RS, Keim LS, Paula GRD, Carvalho BTF, Coelho LR, Carvalho MCDS, Rosa JMCD, Figueiredo AMS, Teixeira LA. The antimicrobial susceptibility, biofilm formation and genotypic profiles of Staphylococcus haemolyticus from bloodstream infections. Mem Inst Oswaldo Cruz 2014; 108:812-3. [PMID: 24037208 PMCID: PMC3970699 DOI: 10.1590/0074-0276108062013022] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 06/25/2013] [Indexed: 11/25/2022] Open
Abstract
We analysed the antimicrobial susceptibility, biofilm formation and genotypic
profiles of 27 isolates of Staphylococcus haemolyticus obtained
from the blood of 19 patients admitted to a hospital in Rio de Janeiro, Brazil.
Our analysis revealed a clinical significance of 36.8% and a multi-resistance
rate of 92.6% among these isolates. All but one isolate carried the
mecA gene. The staphylococcal cassette chromosome
mec type I was the most prevalent mec
element detected (67%). Nevertheless, the isolates showed clonal diversity based
on pulsed-field gel electrophoresis analysis. The ability to form biofilms was
detected in 66% of the isolates studied. Surprisingly, no icaAD
genes were found among the biofilm-producing isolates.
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11
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Ghotaslou R, Aghazadeh M, Ahangarzadeh Rezaee M, Moshafi MH, Forootanfar H, Hojabri Z, Saffari F. The prevalence of aminoglycoside-modifying enzymes among coagulase negative staphylococci in Iranian pediatric patients. J Infect Chemother 2014; 20:569-73. [PMID: 25023717 DOI: 10.1016/j.jiac.2014.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/03/2014] [Accepted: 05/22/2014] [Indexed: 11/30/2022]
Abstract
In spite of widespread emergence of aminoglycoside resistance, these drugs are still used in the treatment of staphylococcal infections. This study aimed to investigate the distribution of aminoglycoside resistance and genes encoding aminoglycoside - modifying enzymes (AMEs) as well as Staphylococcal Cassette Chromosome mec (SCCmec) type in coagulase negative staphylococci (CoNS) in pediatric patients. Totally, 93 CoNS isolates were examined for susceptibility to aminoglycosides using disk diffusion and/or E-test methods. AMEs genes and SCCmec types were detected using multiplex PCR. Strain typing was performed using repetitive extragenic palindromic (REP) - PCR assay. The non-susceptibility rates to kanamycin, tobramycin, gentamicin, amikacin and netilmicin were 73%, 59%, 49.5%, 16% and 7.5%, respectively. aac(6')-Ie-aph(2″)-Ia, ant(4')-Ia and aph(3')-IIIa were encountered in 56 (60.2%), 38 (40.8%) and 18 (19.3%) isolates, respectively. In aac(6')-Ie-aph(2″)-Ia- positive isolates, the non- susceptibility rates to kanamycin, gentamicin, tobramycin, amikacin and netilmicin were 83%, 74%, 73%, 49% and 43%, respectively. SCCmec types included type IV (n = 31), I (n = 17), II (n = 5), III (n = 4), and V (n = 2). Three isolates had two types; I + III (n = 2) and III + IV (n = 1) whereas 11 isolates were non-typeable. AMEs genes carriers were distributed frequently into type IV. We found diverse fingerprint patterns among our isolates. In conclusion, there was a strong correlation between alarming rate of aminoglycoside resistance and methicillin resistance. Discordances between phenotypic and genotypic detection of aminoglycoside resistance were discernible. AMEs genes might be related to SCCmec types.
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Affiliation(s)
- Reza Ghotaslou
- Tabriz Research Center of Infectious and Tropical Diseases, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Aghazadeh
- Tabriz Research Center of Infectious and Tropical Diseases, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Hassan Moshafi
- Department of Pharmaceutical Science, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Forootanfar
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Zoya Hojabri
- Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fereshteh Saffari
- Tabriz Research Center of Infectious and Tropical Diseases, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Oliveira HLDCDD, Fleming MECK, Silva PV, Paula GRD, Futuro DO, Velarde GC, Esper LMR, Teixeira LA. Influence of papain in biofilm formed by methicillin-resistant Staphylococcus epidermidis and methicillin-resistant Staphylococcus haemolyticus isolates. BRAZ J PHARM SCI 2014. [DOI: 10.1590/s1984-82502014000200005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Methicillin-resistant Staphylococcus epidermidis (MRSE) and methicillin-resistant Staphylococcus haemolyticus (MRSHa) are important coagulase-negative staphylococci. They are often isolated from bacteremia in humans mainly due to their ability to form biofilm on the surfaces of medical devices. Papain is a complex mixture of proteolytic enzymes and peroxidases extracted from the latex of Carica papaya and it is recognized by accelerating the healing process of wounds. This study aimed to evaluate the ability of the MRSE and MRSHa isolates to produce biofilms. Besides this, the ability of papain to inhibit the formation of biofilms or to disrupt the ones already formed by those bacteria was analyzed. Thirty MRSHa and 30 MRSE were isolated from bacteremia and used in this study. It was observed that papain has ability to reduce biofilms formed by MRSE (p < 0.06) and by MRSHa (p = 0.0005). In addition, papain was able to disrupt mature biofilms made by MRSE (p = 0.014). No antibacterial activity of papain was observed for any isolates of MRSE and MRSHa tested. Papain has been demonstrated as a potential product for reducing biofilm.
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Martins MA, Santos SDLVD, Leão LSNDO, Araújo NP, Bachion MM. Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. Rev Soc Bras Med Trop 2012; 45:717-22. [DOI: 10.1590/s0037-86822012000600012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 10/30/2012] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION: In venous ulcers, the presence of Staphylococcus aureus and coagulase-negative staphylococcus resistance phenotypes can aggravate and limit the choices for treatment. METHODS: Staphylococcus isolated from 69 patients (98 ulcers) between October of 2009 and October of 2010 were tested. The macrolide, lincosamide, streptogramin B (MLS B) group resistance phenotype detection was performed using the D-test. Isolates resistant to cefoxitin and/or oxacillin (disk-diffusion) were subjected to the confirmatory test to detect minimum inhibitory concentration (MIC), using oxacillin strips (E-test®). RESULTS: The prevalence of S. aureus was 83%, and 15% of coagulase-negative staphylococcus (CoNS). In addition were detected 28% of methicillin-resistant Staphylococcus aureus (MRSA) and 47% of methicillin-resistant coagulase-negative staphylococcus (MRCoNS). Among the S. aureus, 69.6% were resistant to erythromycin, 69.6% to clindamycin, 69.6% to gentamicin, and 100% to ciprofloxacin. Considering the MRSA, 74% were highly resistant to oxacillin, MIC ≥ 256µg/mL, and the MLS Bc constitutive resistance predominated in 65.2%. Among the 20 isolates sensitive to clindamycin, 12 presented an inducible MLS B phenotype. Of the MRCoNS, 71.4%were resistant to erythromycin, ciprofloxacin and gentamicin. Considering the isolates positive for β-lactamases, the MIC breakpoint was between 0.5 and 2µg/mL. CONCLUSIONS: The results point to a high occurrence of multi-drug resistant bacteria in venous ulcers in primary healthcare patients, thus evidencing the need for preventive measures to avoid outbreaks caused by multi-drug resistant pathogens, and the importance of healthcare professionals being able to identifying colonized versus infected venous ulcers as an essential criteria to implementing systemic antibacterial therapy.
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