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Fujikura Y, Ohno T, Seki M, Mitsutake K. Is administration of anti-MRSA drugs recommended for patients with pneumonia when MRSA is isolated from respiratory specimens? A systematic review and meta-analysis. J Infect Chemother 2024; 30:88-91. [PMID: 37678748 DOI: 10.1016/j.jiac.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/29/2023] [Accepted: 09/03/2023] [Indexed: 09/09/2023]
Abstract
It is unclear whether anti-methicillin-resistant Staphylococcus aureus (MRSA) drugs should be uniformly administered to patients with pneumonia when MRSA is isolated from respiratory specimens. A systematic review was conducted to evaluate the efficacy of the uniform administration of anti-MRSA drugs. Two researchers independently searched the literature as of December 2022, extracted relevant papers, and performed a meta-analysis. The outcomes were mortality and adverse events. No applicable randomized controlled trials were found during the study period, but four observational studies were extracted. The relative risk of mortality in the anti-MRSA group was 1.67 [95% confidence interval 0.65-4.30], which did not differ significantly from the non-administered group. Further investigation into the background of patients demonstrated that anti-MRSA drugs were administered to groups in which only MRSA was cultured. However, the pneumonia severity index did not differ from that in the non-treated group. No studies of adverse events were found. Our review did not find a beneficial contribution to mortality from uniform anti-MRSA medication to patients with pneumonia when MRSA was isolated from respiratory specimens. Factors determining risk-based individualized treatment should be validated as the future question.
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Affiliation(s)
- Yuji Fujikura
- Department of Medical Risk Management and Infection Control, National Defense Medical College Hospital, Japan; Division of Infectious Disease and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Japan.
| | - Tomohiro Ohno
- Division of Infectious Disease and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Masafumi Seki
- Department of Infectious Diseases and Infection Control, International Medical Center, Saitama Medical University School of Medicine, Japan
| | - Kotaro Mitsutake
- Department of Infectious Diseases and Infection Control, International Medical Center, Saitama Medical University School of Medicine, Japan
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2
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Selim A, Kelis K, AlKahtani MDF, Albohairy FM, Attia KA. Prevalence, antimicrobial susceptibilities and risk factors of Methicillin resistant Staphylococcus aureus (MRSA) in dairy bovines. BMC Vet Res 2022; 18:293. [PMID: 35906609 PMCID: PMC9336071 DOI: 10.1186/s12917-022-03389-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Staphylococcus aureus is a common mastitis pathogen in dairy cows, and methicillin-resistant S. aureus (MRSA) has been found in dairy farms all over the world. The study carried out on bovines from three governorates in Egypt, with the goal of determining the prevalence of MRSA in positive milk samples of subclinical mastitis, performing an antibiotic susceptibility test against MRSA isolates and determining the risk factors associated with MRSA. A total of 350 quarter milk samples (n = 200 mixed breed cow; n = 150 water buffalo) were collected and examined for subclinical mastitis using the California mastitis test (CMT) before being exposed to standard microbiological procedures for S. aureus isolation. The disc diffusion method was used to phenotypically analyse the positive S. aureus isolates for MRSA, which was verified by a PCR assay targeting the mecA gene. According to the findings of the study, 41.4% (145/350) milk samples were positive based on CMT, while 35.7% (125/350) of positive samples identified as MRSA based on PCR assay. However, the obtained results revealed non-significant disparity between cattle and buffalo and all predicted risk factors were strongly associated with prevalence of subclinical mastitis. The in-vitro antibiotic susceptibility test revealed that cefoxitin was completely resistant, whereas linezolid, ciprofloxacin, and trimethoprim + sulphamethoxazole were sensitive against the MRSA isolates. The relevance of S. aureus to public health, as well as the development of resistance to antibiotics like methicillin, needs ongoing testing of antimicrobial medications against MRSA isolates.
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Affiliation(s)
- Abdelfattah Selim
- Department of Animal Medicine (Infectious Diseases), Faculty of Veterinary Medicine, Benha University, Toukh, 13736, Egypt.
| | - Khalid Kelis
- Internal Medicine/Adult Endocrinology/Bariatric Medicine, Adiriyah Hospital, MoH, Riyadh, Saudi Arabia
| | - Muneera D F AlKahtani
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
| | - Fatima M Albohairy
- Extramural Research Department, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
| | - Kotb A Attia
- Center of Excellence in Biotechnology Research, King Saud University, P.O. Box 2455, Riyadh, 11451, Saudi Arabia
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Bhatt M, Gupta N, Soneja M, DAS US, Thirumurthy V, Biswas A. Infective Endocarditis Following Chicken Pox: A Rare Association. Kurume Med J 2021; 66:127-133. [PMID: 34135199 DOI: 10.2739/kurumemedj.ms662004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 38-year old immunocompetent male presented to us with chicken pox complicated by development of Guillain-Barre syndrome (GBS) and left-sided native valve endocarditis due to methicillin resistant Staphylococcus aureus (MRSA). This was further complicated by embolization to various vital organs including the brain. The patient was treated with vancomycin for four weeks but did not respond to the treatment. We present this case to highlight the rare complications associated with chicken pox and the challenges faced in management of such a case.
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Affiliation(s)
- Manasvini Bhatt
- Department of Medicine, All India Institute of Medical Sciences
| | - Nitin Gupta
- Department of Medicine, All India Institute of Medical Sciences
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences
| | - Ujjwalkumar S DAS
- Department of Ocular Pharmacology and Pharmacy, All India Institute of Medical Sciences
| | | | - Ashutosh Biswas
- Department of Medicine, All India Institute of Medical Sciences
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Dharmaratne P, Yu L, Wong RCH, Chan BCL, Lau KM, Wang B, Lau CBS, Fung KP, Ng DKP, Ip M. A Novel Dicationic Boron Dipyrromethene-based Photosensitizer for Antimicrobial Photodynamic Therapy against Methicillin-Resistant Staphylococcus aureus. Curr Med Chem 2021; 28:4283-4294. [PMID: 33292110 PMCID: PMC8287893 DOI: 10.2174/0929867328666201208095105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 12/23/2022]
Abstract
Background
We report herein the synthesis of a novel dicationic boron dipyrromethene derivative (compound 3) which is symmetrically substituted with two trimethylammonium styryl groups. Methods
The antibacterial photodynamic activity of compound 3 was determined against sixteen methicillin-resistant Staphylococcus aureus (MRSA) strains, including four ATCC type strains (ATCC 43300, ATCC BAA-42, ATCC BAA-43, and ATCC BAA-44), two mutant strains [AAC(6’)-APH(2”) and RN4220/pUL5054], and ten non-duplicate clinical strains of hospital- and community-associated MRSA. Upon light irradiation, the minimum bactericidal concentrations of compound 3 were in the range of 1.56-50 µM against all the sixteen MRSA strains. Interestingly, compound 3 was not only more active than an analogue in which the ammonium groups are not directly connected to the n-conjugated system (compound 4), but also showed significantly higher (p < 0.05) antibacterial potency than the clinically approved photosensitizer methylene blue. The skin irritation of compound 3 during topical application was tested on human 3-D skin constructs and proven to be non-irritant in vivo at concentrations below 1.250 mM. In the murine MRSA infected wound study, the colony forming unit reduction of compound 3 + PDT group showed significantly (p < 0.05) higher value (>2.5 log10) compared to other test groups except for the positive control. Conclusion
In conclusion, the present study provides a scientific basis for future development of compound 3 as a potent photosensitizer for photodynamic therapy for MRSA wound infection.
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Affiliation(s)
- Priyanga Dharmaratne
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Ligang Yu
- Department of Chemistry, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Roy Chi-Hang Wong
- Department of Chemistry, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Ben Chun-Lap Chan
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Kit-Man Lau
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Baiyan Wang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Clara Bik San Lau
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Kwok-Pui Fung
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Dennis Kee-Pui Ng
- Department of Chemistry, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
| | - Margaret Ip
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
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Vahdani Y, Faraji N, Haghighat S, Yazdi MH, Mahdavi M. Molecular cloning and immunogenicity evaluation of IsdE protein of methicillin resistant Staphylococcus aureus as vaccine candidates. Microb Pathog 2021; 157:104953. [PMID: 34044042 DOI: 10.1016/j.micpath.2021.104953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Methicillin resistant Staphylococcus aureus is one of the most common causes of nosocomial infections. Current therapeutic approaches are not always effective in treatment of nosocomial infections, thus, there is a global demand for the development of novel therapeutic strategies. Staphylococcus aureus possesses various systems to uptake iron. One of the most important of them is iron regulated surface determinant (Isd) which can be an excellent candidate for immunization. Here, following the preparation of recombinant IsdE protein, 20 μg of r-IsdE prepared in various formulations were subcutaneously injected in different groups of mice. Two booster vaccinations were administered in two-week intervals, then, blood samples were collected two weeks after each injection. ELISA was used for the evaluation of total IgG and its isotypes (IgG1 and IgG2a) as well as quantity of IFN-γ, IL-4, IL-17, IL-2 and TNF-α cytokines on the serum samples. Meanwhile, the immunized mice were intraperitoneally inoculated with 5 × 108 CFU of bacteria then, their mortality rate and bacterial load were assessed. Our results showed that immunization with the r-IsdE in various formulations raised total IgG and isotypes (IgG1 and IgG2a) compared with the control groups. Moreover, r-IsdE formulation with MF59 and Freund adjuvants raised production of IFN-γ, IL-4, IL-17, IL-2 and TNF-α cytokines and provided an acceptable protection against Staphylococcus aureus infections. Results of present study suggest that r-IsdE which can easily be expressed by Escherichia coli BL21 system shows a great potential to develop a protective immunity against infections caused by Methicillin resistant Staphylococcus aureus.
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Affiliation(s)
- Yasaman Vahdani
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Negin Faraji
- Department of Biotechnology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Setareh Haghighat
- Department of Microbiology, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mohammad Hossein Yazdi
- Biotechnology Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Immunotherapy Group, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran; Recombinant Vaccine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mehdi Mahdavi
- Immunotherapy Group, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran; Recombinant Vaccine Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Sivaraman GK, Sivam V, Ganesh B, Elangovan R, Vijayan A, Mothadaka MP. Whole genome sequence analysis of multi drug resistant community associated methicillin resistant Staphylococcus aureus from food fish: detection of clonal lineage ST 28 and its antimicrobial resistance and virulence genes. PeerJ 2021; 9:e11224. [PMID: 34113482 PMCID: PMC8158172 DOI: 10.7717/peerj.11224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/15/2021] [Indexed: 11/20/2022] Open
Abstract
Methicillin-resistant staphylococcus aureus (MRSA) sequence type 28 (ST 28) and spa type t021 is a CC30, prototype of ST-30, Community Associated-MRSA (CA-MRSA) (lukS-lukF +). It is a multi-drug resistant strain harbouring staphylococcal endotoxins, haemolysins, ureolysin, serine protease, and antimicrobial resistance genes. In this study, we report the draft genome sequence of this MRSA isolated from the most commonly used food fish, ribbon fish (Trichiurus lepturus). The total number of assembled paired-end high-quality reads was 7,731,542 with a total length of 2.8Mb of 2797 predicted genes. The unique ST28/ t021 CA- MRSA in fish is the first report from India, and in addition to antibiotic resistance is known to co-harbour virulence genes, haemolysins, aureolysins and endotoxins. Comprehensive comparative genomic analysis of CA-MRSA strain7 can help further understand their diversity, genetic structure, diversity and a high degree of virulence to aid in fisheries management.
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Affiliation(s)
- Gopalan Krishnan Sivaraman
- Microbiology, Fermentation & Biotechnology, ICAR- Central Institute of Fisheries Technology, Cochin, Kerala, India
| | - Visnuvinayagam Sivam
- Microbiology, Fermentation & Biotechnology, ICAR- Central Institute of Fisheries Technology, Cochin, Kerala, India
| | - Balasubramanian Ganesh
- Division of Laoratory, ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Ardhra Vijayan
- Microbiology, Fermentation & Biotechnology, ICAR- Central Institute of Fisheries Technology, Cochin, Kerala, India
| | - Mukteswar Prasad Mothadaka
- Microbiology, Fermentation & Biotechnology, ICAR- Central Institute of Fisheries Technology, Cochin, Kerala, India
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7
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Madhavan A, Sachu A, Balakrishnan A, Vasudevan A, Balakrishnan S, Vasudevapanicker J. Comparison of PCR and phenotypic methods for the detection of methicillin resistant Staphylococcus aureus. Iran J Microbiol 2021; 13:31-36. [PMID: 33889360 PMCID: PMC8043827 DOI: 10.18502/ijm.v13i1.5489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background and Objectives: Resistance to methicillin in methicillin resistant strains of Staphylococcus aureus (MRSA) is due to the presence of mec-A gene, which encodes a low affinity penicillin binding protein (PBP)-2a or PBP2. Accurate and rapid identification of MRSA in clinical specimens is essential for timely decision on effective treatment. The aim of the study was to compare three different methods for detection of MRSA namely cefoxitin disc diffusion, CHROM agar MRSA and VITEK-2 susceptibility with PCR which is the gold standard reference method and to find the antibiotic susceptibility pattern of these isolates by VITEK-2. Materials and Methods: A Total of 100 non-duplicate S. aureus isolates were collected from different clinical samples among both outpatient and inpatients. Detection of MRSA among these isolates was done by cefoxitin disc diffusion, VITEK-2, CHROM agar MRSA and PCR. Results: The sensitivity and specificity of cefoxitin disc diffusion and Vitek was found to be 97.2% and 100%, while that of CHROM agar was found to be 100% and 78.6%. The overall prevalence of MRSA in our study by PCR was 72%. Conclusion: Based on the findings in our study, isolates which show cefoxitin zone diameter < 22 mm can be reported as MRSA. However, those isolates which have a zone diameter between 22–24 mm, should ideally be confirmed by PCR.
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Affiliation(s)
- Anitha Madhavan
- Department of Microbiology, Government TD Medical College, Alappuzha, Kerala, India
| | - Arun Sachu
- Department of Microbiology, Believers Church Medical College, Thiruvalla, Kerala, India
| | | | - Anu Vasudevan
- Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Sobha Balakrishnan
- Department of Microbiology, Government TD Medical College, Alappuzha, Kerala, India
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8
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Bhowmik D, Chetri S, Das BJ, Dhar Chanda D, Bhattacharjee A. Distribution of virulence genes and SCCmec types among methicillin-resistant Staphylococcus aureus of clinical and environmental origin: a study from community of Assam, India. BMC Res Notes 2021; 14:58. [PMID: 33568186 PMCID: PMC7876809 DOI: 10.1186/s13104-021-05473-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/01/2021] [Indexed: 12/22/2022] Open
Abstract
Objective This study was designed to discover the dissemination of virulence genes in Methicillin-resistant Staphylococcus aureus from clinical, community and environmental settings. Results This study includes 1165 isolates collected from hospital, community and environmental settings. Among them sixty three were confirmed as MRSA with varied SCCmec types viz; type I, type II, type III, type IV, type V, type VI, type VII, type VIII and type XII. The virulence gene such as sea (n = 54), seb (n = 21), eta (n = 27), etb (n = 2), cna (n = 24), ica (n = 2) and tst (n = 30) was also revealed from this study. The study underscores coexistence of resistance cassette and virulence genes among clinical and environment isolates which is first of its kind from this part of the world.
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Affiliation(s)
| | - Shiela Chetri
- Department of Microbiology, Assam University, Silchar, Assam, India
| | | | - Debadatta Dhar Chanda
- Department of Microbiology, Silchar Medical College and Hospital, Silchar, Assam, India
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9
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Zeng S, Chen D, Liu G, Wu YX, Gao ZQ, Su Y, Yuan JN, Liu L, Shan JC, Pang QF, Zhu T. Salvinorin A protects against methicillin resistant staphylococcus aureus-induced acute lung injury via Nrf2 pathway. Int Immunopharmacol 2020; 90:107221. [PMID: 33293260 DOI: 10.1016/j.intimp.2020.107221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 02/05/2023]
Abstract
Salvinorin A (SA), a neoclerodane diterpene, is isolated from the dried leaves ofSalvia divinorum. SA has traditionally been used treatments for chronic pain diseases. Recent research has demonstrated that SA possesses the anti-inflammatory property. The present study aim to explore the effects and potentialmechanisms ofSA in protection against Methicillin Resistant Staphylococcus aureus (MRSA)-induced acute lung injury (ALI). Here, we firstly found that verylowdosesof SA (50 μg/kg) could markedly decrease the infiltration of pulmonary neutrophils, mRNA expression of pro-inflammatory cytokines (TNF-α, IL-1β and IL-6) and then attenuated ALI cause by MRSA infection in mice. In vitro findings revealed that SA attenuated lipoteichoicacid-induced apoptosis, inflammation and oxidative stress in RAW264.7 cells. Mechanism research revealed that SA increased both mRNA levels and protein levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and up-regulated mRNA expression of its downstream genes (HO-1, Gclm, Trx-1, SOD1 and SOD2). Additionally, Nrf2 knockout mice abolished the inhibitory effect of SA on neutrophil accumulation and oxidative stress in MRSA-induced ALI. In conclusion, SA attenuates MRSA-induced ALI via Nrf2 signaling pathways.
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Affiliation(s)
- Si Zeng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Anesthesiology, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Dan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Gang Liu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Ya-Xian Wu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Zhi-Qi Gao
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Ying Su
- Library, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Jia-Ning Yuan
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China
| | - Liu Liu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Anesthesiology, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Jia-Chen Shan
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qing-Feng Pang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China.
| | - Tao Zhu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China.
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Mazi W, Alshammari F, Yu J, Alam MJ, Saeed M, Alshaghdali K, Saeed A. A descriptive analysis of PVL-positive multidrug-resistant Staphylococcus aureus in hospital-associated infections in Saudi Arabia. Bioinformation 2020; 16:586-593. [PMID: 33214746 PMCID: PMC7649023 DOI: 10.6026/97320630016586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/21/2020] [Indexed: 11/24/2022] Open
Abstract
Methicillin resistant Staphylococcus aureus infections impose a huge risk to public health in healthcare and community settings worldwide. Therefore, it is of interest to document
data on the anti-biogramas and genotypes of isolates from Saudi Arabia. We assessed the antimicrobial susceptibility, determined spa (protein A gene) and analyzed multilocus MLST
genotypes, and detected PVL gene in these isolates. We collected 28 clinical MRSA isolates, cultured and determined the minimum inhibitory concentrations of 17 antimicrobial agents
using Vitek2 system (BioMerieux, USA) from 3 hospitals in Saudi Arabia during the year 2012. Polymorphic region of the spa and seven housekeeping genes were amplified and sequenced.
BioNumerics v.5.1 (Applied Maths) was used for spa typing and MLST. Samples were screened for the presence of PVL and mecA genes using polymerase chain reaction (PCR). Analysis shows
that all isolates were susceptible to chloramphenicol, rifampicin, nitrofurantoin, teicoplanin, daptomycin and vancomycin. The T4573/ST22 strains are found to be prevalent in the
Saudi Arabia (N=6, 21%). We further noted that three isolates (t363/ST240 strain) were resistant to eight antimicrobial agents. Most of t4573/ST22 strains were PVL positive, resistant
to ciprofloxacin and linked to HA-MRSA infections. We document data for the presence of emerging multi drug resistant S. aureus strains carrying the PVL gene circulating within
hospitals. This highlights the urgent need for continuous active surveillance and implementation of prevention measures.
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Affiliation(s)
- Waleed Mazi
- Infection Prevention and Control Department, King Abdul Aziz Specialist Hospital-Taif, Saudi Arabia.,Karolinska Institute, Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden
| | - Fawaz Alshammari
- Department of Clinical Laboratory Sciences College of Applied Medical Sciences, University of Hail-Hail-Kingdom of Saudi Arabia
| | - Jun Yu
- Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, United Kingdom
| | - Md Jahoor Alam
- Department of Biology, College of Science, University of Hail, Hail-Kingdom of Saudi Arabia
| | - Mohd Saeed
- Department of Biology, College of Science, University of Hail, Hail-Kingdom of Saudi Arabia
| | - Khalid Alshaghdali
- Department of Clinical Laboratory Sciences College of Applied Medical Sciences, University of Hail-Hail-Kingdom of Saudi Arabia
| | - Amir Saeed
- Department of Clinical Laboratory Sciences College of Applied Medical Sciences, University of Hail-Hail-Kingdom of Saudi Arabia
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Sultana KN, Kuldeep J, Siddiqi MI, Srivastava SK. Crystallographic and molecular dynamics simulation analysis of NAD synthetase from methicillin resistant Staphylococcus aureus (MRSA). Int J Biol Macromol 2020; 165:2349-2362. [PMID: 33098904 DOI: 10.1016/j.ijbiomac.2020.10.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 10/23/2022]
Abstract
NAD synthetase (NadE) catalyzes the last step in NAD biosynthesis, transforming deamido-NAD+ into NAD+ by a two-step reaction with co-substrates ATP and amide donor ammonia. In this study, we report the crystal structure of Staphylococcus aureus NAD synthetase enzyme (saNadE) at 2.3 Å resolution. We used this structure to perform molecular dynamics simulations of apo-enzyme, enzyme-substrate (NadE with ATP and NaAD) and enzyme-intermediate complexes (NadE with NaAD-AMP) to investigate key binding interactions and explore the conformational transitions and flexibility of the binding pocket. Our results show large shift of N-terminal region in substrate bound form which is important for ATP binding. Substrates drive the correlated movement of loop regions surrounding it as well as some regions distal to the active site and stabilize them at complex state. Principal component analysis of atomic projections distinguish feasible trajectories to delineate distinct motions in enzyme-substrate to enzyme-intermediate states. Our results suggest mixed binding involving dominant induced fit and conformational selection. MD simulation extracted ensembles of NadE could potentially be utilized for in silico screening and structure based design of more effective Methicillin Resistant Staphylococcus aureus (MRSA) inhibitors.
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Affiliation(s)
- Kazi Nasrin Sultana
- Department of Biosciences, Manipal University Jaipur, Dehmi Kalan, Off Jaipur-Ajmer Expressway, Jaipur, Rajasthan 303007, India
| | - Jitendra Kuldeep
- Molecular and Structural Biology Division, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Extension, Lucknow, Uttar Pradesh 226031, India
| | - Mohammad Imran Siddiqi
- Molecular and Structural Biology Division, CSIR-Central Drug Research Institute, Sector 10, Jankipuram Extension, Lucknow, Uttar Pradesh 226031, India
| | - Sandeep Kumar Srivastava
- Department of Biosciences, Manipal University Jaipur, Dehmi Kalan, Off Jaipur-Ajmer Expressway, Jaipur, Rajasthan 303007, India.
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Balachander B, Rajesh D, Pinhero CL, Paul S, Stevens S, Rao S. Response Measures to Infection Outbreaks During the Second Year of Sustenance Phase of Infection Control Quality Improvement. Indian J Pediatr 2020; 87:333-338. [PMID: 32036600 PMCID: PMC7223971 DOI: 10.1007/s12098-020-03201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 01/14/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To analyze the infection outbreaks, control measures and outcomes of the outbreak in the NICU of a tertiary care centre in the year 2018. METHODS This study was conducted in a 30 bedded tertiary care NICU from January 2018 through December 2018. The study design was an Outbreak investigation, based on a program of prospective surveillance for nosocomial infection. All neonates admitted to the NICU formed part of the the study. An Infection Control Quality Improvement (QI) team was available to analyze the infection and initiate response action to outbreaks. RESULTS Three outbreaks were reported in the year 2018. The first was in May 2018 and comprised of colonization with rectal Multi-drug resistant gram negative bacilli (MDR GNB). The outbreak was controlled by using Aseptic non-touch technique (ANTT) for fortification of milk and using distilled water for cleaning of diaper area. The second outbreak in August 2018 was Methicillin resistant Staphylococcus aureus (MRSA) whose source was a maternal Lower segment cesarean section (LSCS) wound. The third outbreak in October 2018 was MDR Acinetobacter. The source was from an outborn having the same organism. All infants were in close proximity to the index case. This outbreak was controlled with cohorting, hand hygiene and strengthening of bundle care. CONCLUSIONS Surveillance aids in early detection and successful control of outbreaks. A systematic search for the source and meticulous containment of spread can successfully control an outbreak.
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Affiliation(s)
- Bharathi Balachander
- Department of Neonatology, St. John's Medical College Hospital, Bangalore, Karnataka, India
| | - Deepa Rajesh
- Department of Neonatology, St. John's Medical College Hospital, Bangalore, Karnataka, India
| | - Cycil Lillian Pinhero
- Department of Neonatology, St. John's Medical College Hospital, Bangalore, Karnataka, India
| | - Sunu Paul
- Department of Neonatology, St. John's Medical College Hospital, Bangalore, Karnataka, India
| | - Sophia Stevens
- Department of Neonatology, St. John's Medical College Hospital, Bangalore, Karnataka, India
| | - Suman Rao
- Department of Neonatology, St. John's Medical College Hospital, Bangalore, Karnataka, India.
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Zheng Y, Qin C, Zhang X, Zhu Y, Li A, Wang M, Tang Y, Kreiswirth BN, Chen L, Zhang H, Du H. The tst gene associated Staphylococcus aureus pathogenicity island facilitates its pathogenesis by promoting the secretion of inflammatory cytokines and inducing immune suppression. Microb Pathog 2019; 138:103797. [PMID: 31614194 DOI: 10.1016/j.micpath.2019.103797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/09/2019] [Accepted: 10/11/2019] [Indexed: 11/25/2022]
Abstract
Staphylococcus aureus (S. aureus) is an important pathogen causing various limited or systemic infections. Methicillin resistant S. aureus (MRSA) in particular presents a major clinical and public health problem. Toxic shock syndrome toxin-1 (TSST-1) encoded by the gene tst is an important virulence factor of tst positive S. aureus, leading to multi-organ malfunction. However, the mechanism of TSST-1 in pathogenesis is only partly clear. In this study, we investigated the prevalence of the tst gene in clinical isolates of S. aureus. Then, animal experiments were performed to further evaluate the influence of the presence of the tst gene associated Staphylococcus aureus Pathogenicity Island (SaPI) on body weight, serum cytokine concentrations and the bacterial load in different organs. In addition, macrophages were used to analyze the secretion of cytokines in vitro and bacterial survival in the cytoplasm. Finally, pathological analysis was carried out to evaluate organ tissue impairment. The results demonstrated that the prevalence of tst gene was approximately 17.8% of the bacterial strains examined. BALB/c mice infected with tst gene associated SaPI positive isolates exhibited a severe loss of body weight and a high bacterial load in the liver, heart, kidney and spleen. Pathological analysis demonstrated that tissue impairment was more severe after infection with tst gene associated SaPI positive isolates. Moreover, the secretion of IL-6, IL-2 and IL17A by macrophages infected with tst gene associated SaPI positive isolates clearly increased. Notably, IL-6 secretion in BALB/c mice infected with tst gene associated SaPI positive isolates was higher than that in BALB/c mice infected with negative ones. Together, these results indicated that the tst gene associated SaPI may play a critical role in the pathological process of infection via a direct and persistent toxic function, and by promoting the secretion of inflammatory cytokines that indirectly induce immune suppression.
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Affiliation(s)
- Yi Zheng
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, PR China
| | - Chenhao Qin
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, PR China
| | - Xianfeng Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, PR China
| | - Yifan Zhu
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, 637007, PR China
| | - Aiqing Li
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, PR China
| | - Min Wang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, PR China
| | - Yiwei Tang
- Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Barry N Kreiswirth
- Public Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, NJ, 07103, USA
| | - Liang Chen
- Public Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, NJ, 07103, USA
| | - Haifang Zhang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, PR China
| | - Hong Du
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, PR China.
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Altaf M, Ijaz M, Ghaffar A, Rehman A, Avais M. Antibiotic susceptibility profile and synergistic effect of non-steroidal anti-inflammatory drugs on antibacterial activity of resistant antibiotics (Oxytetracycline and Gentamicin) against methicillin resistant Staphylococcus aureus (MRSA). Microb Pathog 2019; 137:103755. [PMID: 31542423 DOI: 10.1016/j.micpath.2019.103755] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 01/01/2023]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) may exhibit antibacterial activity and have synergistic effects with antibiotics. One way to re-sensitize MRSA to resistant antibiotics is by combining with approved non-antibiotics. The study was intended to explore susceptibility of MRSA to various antibiotics and non-antibiotics (NSAIDs) by micro dilution broth method. MRSA isolates were confirmed by PCR (mecA gene) and in-vitro antibiotic susceptibility was determined by disc diffusion tests. Combinations of NSAIDs with resistant antibiotics were also evaluated in in-vivo trial in mice. In-vitro antibiotic susceptibility profile presented 100% resistance to Cefoxitin, 37.5% to Gentamicin and Amikacin, 25% to Oxytetracycline, 12.5% to Tylosin, Fusidic acid and Vancomycin, while Ciprofloxacin, Levofloxacin, Moxifloxacin, Trimethoprim + Sulfamethoxazole and Linezolid were found sensitive. Synergistic effect was observed when resistant antibiotics (Oxytetracycline/Gentamicin) were combined with sensitive antibiotics (Ciprofloxacin/Linezolid). Combination of Non-antibiotics (NSAIDs) with resistant antibiotics revealed that Meloxicam showed partial synergism with both Oxytetracycline and Gentamicin, while Flunixin Meglumine presented synergistic effect with Oxytetracycline and partial synergism with Gentamicin. Diclofenac Sodium revealed additive effect with Oxytetracycline while in case of Gentamicin indifferent effect was observed. In-vivo results showed that combinations of Oxytetracycline with Meloxicam/Flunixin Meglumine and Gentamicin with Meloxicam/Flunixin Meglumine were effective. The study concluded that the resistance against milk borne zoonotic MRSA infections can be successfully addressed by combining resistant antibiotics with NSAIDs. Flunixin Meglumine can be used in combination with oxytetracycline against MRSA infection.
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Affiliation(s)
- Muhammad Altaf
- Department of Clinical Medicine and Surgery, University of Veterinary and Animal Sciences, Lahore, 54600, Pakistan
| | - Muhammad Ijaz
- Department of Clinical Medicine and Surgery, University of Veterinary and Animal Sciences, Lahore, 54600, Pakistan.
| | - Awais Ghaffar
- Department of Clinical Medicine and Surgery, University of Veterinary and Animal Sciences, Lahore, 54600, Pakistan
| | - Abdul Rehman
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, 54600, Pakistan
| | - Muhammad Avais
- Department of Clinical Medicine and Surgery, University of Veterinary and Animal Sciences, Lahore, 54600, Pakistan
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15
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Lotha R, Shamprasad BR, Sundaramoorthy NS, Nagarajan S, Sivasubramanian A. Biogenic phytochemicals (cassinopin and isoquercetin) capped copper nanoparticles (ISQ/CAS@CuNPs) inhibits MRSA biofilms. Microb Pathog 2019; 132:178-187. [PMID: 31063809 DOI: 10.1016/j.micpath.2019.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 11/24/2022]
Abstract
Purified glycosides, Isoquercetin and Cassinopin from Crotalaria candicans were selected for the synthesis of biogenic copper nanoparticles (CuNPs).The designed biogenic CuNPs was characterized and when evaluated against panel of gram negative and positive bacteria, the biogenic CuNPs were found to be more effective against methicillin resistant Staphylococcus aureus (MRSA). Antibacterial, anti-biofilm effects and time kill studies confirmed the ability of biogenic CuNPs to curtail MRSA. Scanning electron microscopy, Crystal violet staining and fluorescent live-dead imaging showed that treatment with sub lethal levels of glycoside capped CuNPs resulted in greater than 50% decline in biofilm formation by MRSA, which implies that anti-biofilm effect of biogenic CuNPs is not dependent on antibacterial effect. Alizarin red assay implied that prolonged treatment of biogenic CuNPs in presence of MRSA, releases Cu(II) ions and hence antibiofilm effect is primarily mediated by NP and is not due to released Cu(II) ion. The NPs caused altered membrane permeability and reduced surface hydrophobicity, thus accounting for its antibiofilm effect.
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Affiliation(s)
- Robert Lotha
- Aravind Sivasubramanian, Department of Chemistry, School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamil Nadu, India
| | - Bhanuvalli R Shamprasad
- Aravind Sivasubramanian, Department of Chemistry, School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamil Nadu, India
| | - Niranjana Sri Sundaramoorthy
- Saisubramanian Nagarajan, Center for Research on Infectious Diseases, School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamil Nadu, India
| | - Saisubramanian Nagarajan
- Saisubramanian Nagarajan, Center for Research on Infectious Diseases, School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamil Nadu, India.
| | - Aravind Sivasubramanian
- Aravind Sivasubramanian, Department of Chemistry, School of Chemical and Biotechnology, SASTRA Deemed to Be University, Thanjavur, Tamil Nadu, India.
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16
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Gatadi S, Gour J, Shukla M, Kaul G, Dasgupta A, Madhavi YV, Chopra S, Nanduri S. Synthesis and evaluation of new quinazolin-4(3H)-one derivatives as potent antibacterial agents against multidrug resistant Staphylococcus aureus and Mycobacterium tuberculosis. Eur J Med Chem 2019; 175:287-308. [PMID: 31096152 DOI: 10.1016/j.ejmech.2019.04.067] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/25/2019] [Accepted: 04/25/2019] [Indexed: 01/05/2023]
Abstract
Staphylococcus aureus and Mycobacterium tuberculosis are major causative agents responsible for serious nosocomial and community-acquired infections impacting healthcare systems globally. Over several decades, these pathogens have developed resistance to multiple antibiotics significantly affecting morbidity and mortality. Thus, these recalcitrant pathogens are amongst the most formidable microbial pathogens for which international healthcare agencies have mandated active identification and development of new antibacterial agents for chemotherapeutic intervention. In our present work, a series of new quinazolin-4(3H)-one derivatives were designed, synthesized and evaluated for their antibacterial activity against ESKAP pathogens and pathogenic mycobacteria. The experiments revealed that 4'c, 4'e, 4'f and 4'h displayed selective and potent inhibitory activity against Staphylococcus aureus with MIC values ranging from 0.03-0.25 μg/mL. Furthermore, compounds 4'c and 4'e were found to be benign to Vero cells (CC50 = >5 μg/mL) and displayed promising selectivity index (SI) > 167 and > 83.4 respectively. Additionally, 4'c and 4'e demonstrated equipotent MIC against multiple drug-resistant strains of S. aureus including VRSA, concentration dependent bactericidal activity against S. aureus and synergized with FDA approved drugs. Moreover, compound 4'c exhibited more potent activity in reducing the biofilm and exhibited a PAE of ∼2 h at 10X MIC which is comparable to levofloxacin and vancomycin. In vivo efficacy of 4'c in murine neutropenic thigh infection model revealed that 4'c caused a similar reduction in cfu as vancomycin. Gratifyingly, compounds 4d, 4e, 9a, 9b, 14a, 4'e and 4'f also exhibited anti-mycobacterial activity with MIC values in the range of 2-16 μg/mL. In addition, the compounds were found to be less toxic to Vero cells (CC50 = 12.5->100 μg/mL), thus displaying a favourable selectivity index. The interesting results obtained here suggest the potential utilization of these new quinazolin-4(3H)-one derivatives as promising antibacterial agents for treating MDR-Staphylococcal and mycobacterial infections.
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Affiliation(s)
- Srikanth Gatadi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, India
| | - Jitendra Gour
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, India
| | - Manjulika Shukla
- Division of Microbiology, CSIR-Central Drug Research Institute, Sitapur Road, Sector 10, Janakipuram Extension, Lucknow, 226031, Uttar Pradesh, India
| | - Grace Kaul
- Division of Microbiology, CSIR-Central Drug Research Institute, Sitapur Road, Sector 10, Janakipuram Extension, Lucknow, 226031, Uttar Pradesh, India
| | - Arunava Dasgupta
- Division of Microbiology, CSIR-Central Drug Research Institute, Sitapur Road, Sector 10, Janakipuram Extension, Lucknow, 226031, Uttar Pradesh, India
| | - Y V Madhavi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, India
| | - Sidharth Chopra
- Division of Microbiology, CSIR-Central Drug Research Institute, Sitapur Road, Sector 10, Janakipuram Extension, Lucknow, 226031, Uttar Pradesh, India.
| | - Srinivas Nanduri
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, India.
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17
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Giordani B, Costantini PE, Fedi S, Cappelletti M, Abruzzo A, Parolin C, Foschi C, Frisco G, Calonghi N, Cerchiara T, Bigucci F, Luppi B, Vitali B. Liposomes containing biosurfactants isolated from Lactobacillus gasseri exert antibiofilm activity against methicillin resistant Staphylococcus aureus strains. Eur J Pharm Biopharm 2019; 139:246-252. [PMID: 30991089 DOI: 10.1016/j.ejpb.2019.04.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/08/2019] [Accepted: 04/12/2019] [Indexed: 11/25/2022]
Abstract
Staphylococcus aureus is the major causative agent of skin and soft tissue infections, whose prevention and treatment have become more difficult due to the emergence of antibiotic-resistant strains. In this regard, the development of an effective treatment represents a challenge that can be overcome by delivering new antibiofilm agents with appropriate nanocarriers. In this study, a biosurfactant (BS) isolated from Lactobacillus gasseri BC9 and subsequently loaded in liposomes (LP), was evaluated for its ability to prevent the development and to eradicate the biofilm of different methicillin resistant S. aureus (MRSA) strains. BS from L. gasseri BC9 was not cytotoxic and was able to prevent formation and to eradicate the biofilm of different MRSA strains. BS loaded liposomes (BS-LP) presented a mean diameter (lower than 200 nm) suitable for topical administration and a low polydispersity index (lower than 0.2) that were maintained over time for up 28 days. Notably, BS-LP showed higher ability than free BS to inhibit S. aureus biofilm formation and eradication. BS-LP were loaded in lyophilized matrices able to quickly dissolve (dissolution time lower than 5 s) upon contact with exudate, thus allowing vesicle reconstitution. In conclusion, in this work, we demonstrated the antibiofilm activity of Lactobacillus-derived BS and BS-LP against clinically relevant MRSA strains. Furthermore, the affordable production of lyophilized matrices containing BS-LP for local prevention of cutaneous infections was established.
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Affiliation(s)
- Barbara Giordani
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | | | - Stefano Fedi
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Martina Cappelletti
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Angela Abruzzo
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Carola Parolin
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Claudio Foschi
- Microbiology, DIMES, University of Bologna, Bologna, Italy.
| | - Giulia Frisco
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Natalia Calonghi
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Teresa Cerchiara
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Federica Bigucci
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Barbara Luppi
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
| | - Beatrice Vitali
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy.
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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: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Immergluck LC, Leong T, Malhotra K, Parker TC, Ali F, Jerris RC, Rust GS. Geographic surveillance of community associated MRSA infections in children using electronic health record data. BMC Infect Dis 2019; 19:170. [PMID: 30777016 PMCID: PMC6378744 DOI: 10.1186/s12879-019-3682-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community- associated methicillin resistant Staphylococcus aureus (CA-MRSA) cause serious infections and rates continue to rise worldwide. Use of geocoded electronic health record (EHR) data to prevent spread of disease is limited in health service research. We demonstrate how geocoded EHR and spatial analyses can be used to identify risks for CA-MRSA in children, which are tied to place-based determinants and would not be uncovered using traditional EHR data analyses. METHODS An epidemiology study was conducted on children from January 1, 2002 through December 31, 2010 who were treated for Staphylococcus aureus infections. A generalized estimated equations (GEE) model was developed and crude and adjusted odds ratios were based on S. aureus risks. We measured the risk of S. aureus as standardized incidence ratios (SIR) calculated within aggregated US 2010 Census tracts called spatially adaptive filters, and then created maps that differentiate the geographic patterns of antibiotic resistant and non-resistant forms of S. aureus. RESULTS CA-MRSA rates increased at higher rates compared to non-resistant forms, p = 0.01. Children with no or public health insurance had higher odds of CA-MRSA infection. Black children were almost 1.5 times as likely as white children to have CA-MRSA infections (aOR 95% CI 1.44,1.75, p < 0.0001); this finding persisted at the block group level (p < 0.001) along with household crowding (p < 0.001). The youngest category of age (< 4 years) also had increased risk for CA-MRSA (aOR 1.65, 95%CI 1.48, 1.83, p < 0.0001). CA-MRSA encompasses larger areas with higher SIRs compared to non-resistant forms and were found in block groups with higher proportion of blacks (r = 0.517, p < 0.001), younger age (r = 0.137, p < 0.001), and crowding (r = 0.320, p < 0.001). CONCLUSIONS In the Atlanta MSA, the risk for CA-MRSA is associated with neighborhood-level measures of racial composition, household crowding, and age of children. Neighborhoods which have higher proportion of blacks, household crowding, and children < 4 years of age are at greatest risk. Understanding spatial relationship at a community level and how it relates to risks for antibiotic resistant infections is important to combat the growing numbers and spread of such infections like CA-MRSA.
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Affiliation(s)
- Lilly Cheng Immergluck
- Department of Microbiology/Biochemistry/Immunology, Department of Pediatrics and Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA, 30310, USA. .,Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Traci Leong
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA
| | - Khusdeep Malhotra
- National Center for Primary Care, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA, 30310, USA
| | - Trisha Chan Parker
- Department of Microbiology/Biochemistry/Immunology, Department of Pediatrics and Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA, 30310, USA
| | - Fatima Ali
- Department of Microbiology/Biochemistry/Immunology, Department of Pediatrics and Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA, 30310, USA
| | - Robert C Jerris
- Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA.,Department of Pathology, Emory University, 1364 Clifton Road Northeast, Atlanta, GA, 30322, USA
| | - George S Rust
- Florida State University College of Medicine, 1115 W. Call St, Tallahassee, FL, 32306, USA
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20
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Cameron JK, Hall L, Tong SYC, Paterson DL, Halton K. Incidence of community onset MRSA in Australia: least reported where it is Most prevalent. Antimicrob Resist Infect Control 2019; 8:33. [PMID: 30805180 PMCID: PMC6373119 DOI: 10.1186/s13756-019-0485-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background This is the first review of literature and synthesis of data on community onset methicillin resistant Staphylococcus aureus (CO-MRSA) infections in Australia. Incidence of CO-MRSA varies considerably in Australia, depending on geographic and demographic factors. Methods Data for the rates of MRSA infections were collected from articles identified using PubMed, Scopus, the grey literature and data from State and Federal Government Surveillance Systems. We synthesized data and developed a framework for how data was selected, collated, linked, organized and interpreted. Results The results of our literature search demonstrates considerable gaps in the reporting of CO-MRSA in Australia. Consequently, total incidences were under reported; however the available data suggests the incidence varied between 44 (Tasmania) and 388 (southern Northern Territory) cases per 100,000 person years. Hospitalised cases of CO-MRSA varied between 3.8 (regional Victoria) and 329 (southern Northern Territory). Taking the median percentage of infections by site for all regions available, skin and soft tissue infections (SSTIs) consisted of 56% of hospitalized CO-MRSA, compared with bacteremias, which represented 14%. No region had a complete data set of CO-MRSA infections treated in out-patient settings and so incidences were underestimates. Nevertheless, estimates of the incidence of CO-MRSA treated outside hospitals varied between 11.3 (Melbourne) and 285 (Northern Territory) per 100,000 person-years. These infections were chiefly SSTIs, although urinary tract infections were also noted. Incidences of CO-MRSA blood-stream infections and outpatient skin and soft tissue infections have been increasing with time, except in Tasmania. CO-MRSA is observed to affect people living in remote areas and areas of socioeconomic disadvantage disproportionately. Conclusions We generated the first estimates of the incidence of CO-MRSA infections in Australia and identified stark regional differences in the nature and frequency of infections. Critically, we demonstrate that there has been a lack of consistency in reporting CO-MRSA and a general dearth of data. The only government in Australia that requires reporting of CO-MRSA is the Tasmanian, where the infection was least prevalent. Some regions of Australia have very high incidences of CO-MRSA. To improve surveillance and inform effective interventions, we recommend a standardized national reporting system in Australia that reports infections at a range of infection sites, has broad geographic coverage and consistent use of terminology. We have identified limitations in the available data that hinder understanding the prevalence of CO-MRSA. Electronic supplementary material The online version of this article (10.1186/s13756-019-0485-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jessica K Cameron
- 1Australian Centre for Health Services Innovation and the Institute for Health and Biomedical Innovation, Queensland University Technology, Brisbane, Australia
| | - Lisa Hall
- 1Australian Centre for Health Services Innovation and the Institute for Health and Biomedical Innovation, Queensland University Technology, Brisbane, Australia.,2School of Public Health, University of Queensland, Brisbane, Australia
| | - Steven Y C Tong
- Victorian Infectious Disease Service, The Royal Melbourne Hospital, and Doherty Department University of Melbourne, Peter Doherty Institute for Infection and Immunity, Victoria, Australia.,4Menzies School of Health Research, Darwin, Australia
| | - David L Paterson
- 5UQ Centre for Clinical Research, University of Queensland, Brisbane, Australia
| | - Kate Halton
- 1Australian Centre for Health Services Innovation and the Institute for Health and Biomedical Innovation, Queensland University Technology, Brisbane, Australia
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Quijada NM, Hernández M, Oniciuc EA, Eiros JM, Fernández-Natal I, Wagner M, Rodríguez-Lázaro D. Oxacillin-susceptible mecA-positive Staphylococcus aureus associated with processed food in Europe. Food Microbiol 2019; 82:107-110. [PMID: 31027762 DOI: 10.1016/j.fm.2019.01.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 11/30/2022]
Abstract
We report for the first time an oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) associated with a processed food product in Europe. One isolate (MRSA-ST5-type V SCCmec) was found in cheese among 600 food samples confiscated from air passengers from international flights in Vienna Airport (Austria). Type V SCCmec strains do not harbor functional mecI-mecR1 genes and in such strains mecA expression is regulated by the bla system (blaI-blaR1-blaZ). It has been recently reported that malfunctions in the bla system lead to the constitutive expression of mecA. The OS-MRSA reported in this study harbored the bla system on a plasmid and one deletion occurred in the blaR1 gene causing a frameshift variant that lead to an incomplete BlaR1 protein. This finding highlights the potential role of food as a neglected route of dissemination of emerging MRSA variants.
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Affiliation(s)
- Narciso M Quijada
- Laboratorio de Biología Molecular y Microbiología, Instituto Tecnológico Agrario de Castilla y León (ITACyL), Valladolid, Spain; Department of Biotechnology and Food Science, Faculty of Sciences, University of Burgos, Burgos, Spain
| | - Marta Hernández
- Laboratorio de Biología Molecular y Microbiología, Instituto Tecnológico Agrario de Castilla y León (ITACyL), Valladolid, Spain; Department of Biotechnology and Food Science, Faculty of Sciences, University of Burgos, Burgos, Spain
| | | | - José María Eiros
- Department of Clinical Microbiology, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Isabel Fernández-Natal
- Complejo Asistencial Universitario de León, León, Spain; Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Martin Wagner
- Institute of Milk Hygiene, Milk Technology and Food Science, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria; Christian Doppler Laboratory for Molecular Food Analytics, University of Veterinary Medicine, Vienna, Austria
| | - David Rodríguez-Lázaro
- Department of Biotechnology and Food Science, Faculty of Sciences, University of Burgos, Burgos, Spain.
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Chemmugil P, Lakshmi PTV, Annamalai A. A Multidisciplinary Study to Evaluate the Anti-quorum Sensing Ability of Phyto-compounds in Ruellia patula Jacq. Avicenna J Med Biotechnol 2019; 11:48-58. [PMID: 30800243 PMCID: PMC6359695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Staphylococcus aureus (S. aureus) causing numerous diseases in humans, have become resistant to antibiotics, hence, urging the need for alternative medicines. METHODS In this study, the Indian medicinal weed, Ruellia patula (R. patula) extracted and fractioned through column chromatography was subjected to antibacterial and anti-quorum sensing activity against S. aureus and Methicillin Resistant Staphylococcus aureus (MRSA). RESULTS The obtained results confirmed fraction F44 to have significant effect as antimicrobial and anti-biofilm agent against both the micro-organism. Therefore, few of such highly active fractions were chemical finger printed using GC-MS and the compounds identified were further docked with DNA binding (LytTR) domain of agrA, which revealed that compounds identified from fraction were interactive to the protein. CONCLUSION R. patula is promising antimicrobial and anti-biofilm agent against S. aureus and MRSA.
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Affiliation(s)
- P Chemmugil
- Centre for Bioinformatics, Pondicherry University, Pondicherry, India
| | - PTV Lakshmi
- Centre for Bioinformatics, Pondicherry University, Pondicherry, India,Corresponding author: Lakshmi PTV, Ph.D., Centre for Bioinformatics, Pondicherry University, Pondicherry, India, Tel: +91 9486383094, E-mail:;
| | - A Annamalai
- PG and Research Department of Botany, Arignar Anna Government College, Thiruvalluvar University, Villupuram, Tamilnadu, India
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Nilchan N, Phetsang W, Nowwarat T, Chaturongakul S, Jiarpinitnun C. Halogenated trimethoprim derivatives as multidrug-resistant Staphylococcus aureus therapeutics. Bioorg Med Chem 2018; 26:5343-5348. [PMID: 29784273 DOI: 10.1016/j.bmc.2018.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/10/2018] [Accepted: 05/13/2018] [Indexed: 11/28/2022]
Abstract
Incorporation of halogen atoms to drug molecule has been shown to improve its properties such as enhanced in membrane permeability and increased hydrophobic interactions to its target. To investigate the effect of halogen substitutions on the antibacterial activity of trimethoprim (TMP), we synthesized a series of halogen substituted TMP and tested for their antibacterial activities against global predominant methicillin resistant Staphylococcus aureus (MRSA) strains. Structure-activity relationship analysis suggested a trend in potency that correlated with the ability of the halogen atom to facilitate in hydrophobic interaction to saDHFR. The most potent derivative, iodinated trimethoprim (TMP-I), inhibited pathogenic bacterial growth with MIC as low as 1.25 μg/mL while the clinically used TMP derivative, diaveridine, showed resistance. Similar to TMP, synergistic studies indicated that TMP-I functioned synergistically with sulfamethoxazole. The simplicity in the synthesis from an inexpensive starting material, vanillin, highlighted the potential of TMP-I as antibacterial agent for MRSA infections.
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Affiliation(s)
- Napon Nilchan
- Department of Chemistry and Center for Innovation in Chemistry (PERCH-CIC), Faculty of Science, Mahidol University, Rama VI Road, Bangkok 10400, Thailand
| | - Wanida Phetsang
- Department of Chemistry and Center for Innovation in Chemistry (PERCH-CIC), Faculty of Science, Mahidol University, Rama VI Road, Bangkok 10400, Thailand
| | - Taechin Nowwarat
- Department of Chemistry and Center for Innovation in Chemistry (PERCH-CIC), Faculty of Science, Mahidol University, Rama VI Road, Bangkok 10400, Thailand
| | - Soraya Chaturongakul
- Department of Microbiology, Faculty of Science, Mahidol University, Rama VI Road, Bangkok 10400, Thailand; Center for Emerging Bacterial Infections, Faculty of Science, Mahidol University, Rama VI Road, Bangkok 10400, Thailand
| | - Chutima Jiarpinitnun
- Department of Chemistry and Center for Innovation in Chemistry (PERCH-CIC), Faculty of Science, Mahidol University, Rama VI Road, Bangkok 10400, Thailand.
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Upreti N, Rayamajhee B, Sherchan SP, Choudhari MK, Banjara MR. Prevalence of methicillin resistant Staphylococcus aureus, multidrug resistant and extended spectrum β-lactamase producing gram negative bacilli causing wound infections at a tertiary care hospital of Nepal. Antimicrob Resist Infect Control 2018; 7:121. [PMID: 30338059 PMCID: PMC6174564 DOI: 10.1186/s13756-018-0408-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/17/2018] [Indexed: 12/21/2022] Open
Abstract
Background Treatment and prevention of wound infection continues to be a challenging issue in clinical settings of Nepal especially in the context of globally growing problem of antimicrobial resistance. Study on opportunistic pathogens and sensitivity to commonly prescribed local antimicrobial agents are cardinal to reduce the disease burden of wound infections. The aim of this study was to determine the prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum β-lactamase (ESBL) producing bacteria from wound infections of patients at a tertiary care hospital in Nepal. Methods Pus specimens were processed using standard microbiological procedures. Antimicrobial susceptibility test was performed following the modified Kirby Bauer disc diffusion technique. Clinical information of patients was obtained from preformed questionnaire and hospital record. Results One hundred eighty two pus specimens from wounds of different body parts: leg, hand, backside, abdominal part, foot, breast and chest, head and neck region were collected and analyzed; 113 bacterial isolates were isolated showing the overall bacterial growth rate of 62%, where the highest rate was among patients of ≤10 years age group (82.1%). A higher rate (68.5%) of bacterial isolates were from inpatients (p < 0.05). Among 116 bacterial isolates, Staphylococcus aureus was the most predominant bacteria (56.9%) followed by Escherichia coli (8.6%), coagulase negative staphylococci (7.8%), Acinetobacter spp. (5.2%), Klebsiella pneumoniae (5.2%), Pseudomonas aeruginosa (4.3%), Enterococcus spp. (4.3%), Citrobacter freundii (2.6%), Proteus vulgaris (1.6%) and P. mirabilis (0.9%). Both Gram positive (73.3%) and negative (78.8%) isolates showed high frequency of sensitive to gentamycin. Conclusion Among S. aureus isolates, 60.6% were MRSA strains, whereas 40% of K. pneumoniae and 33.3% of C. freundii were ESBL producing bacteria followed by E. coli (25%). It is thus paramount to address the burden of silently and speedily increasing infections caused by drug resistant strains of MRSA and ESBL in Nepal.
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Affiliation(s)
- Narbada Upreti
- 1Central Department of Microbiology, Tribhuvan University, Kirtipur, Nepal
| | - Binod Rayamajhee
- 2National College (Tribhuvan University), Khusibu, Kathmandu, Nepal.,Department of Infectious Diseases and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Samendra P Sherchan
- 4Department of Global Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA
| | | | - Megha Raj Banjara
- 1Central Department of Microbiology, Tribhuvan University, Kirtipur, Nepal
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Rishi P, Vij S, Maurya IK, Kaur UJ, Bharati S, Tewari R. Peptides as adjuvants for ampicillin and oxacillin against methicillin-resistant Staphylococcus aureus (MRSA). Microb Pathog 2018; 124:11-20. [PMID: 30118800 DOI: 10.1016/j.micpath.2018.08.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/12/2018] [Accepted: 08/13/2018] [Indexed: 01/15/2023]
Abstract
Fast emerging antibiotic resistance in pathogens requires special attention for strengthening the reservoir of antimicrobial compounds. In view of this, several peptides with known antimicrobial activities have been reported to enhance the efficacy of antibiotics against multidrug resistant (MDR) pathogens. In the present study, potential of peptides having distinct mechanism of action, if any, was evaluated to improve the efficacy of conventional antibiotics against methicillin-resistant S. aureus (MRSA). After primary screening of six peptides, two peptides namely T3 and T4 showing very high minimum inhibitory concentrations (MICs) were selected to assess their role in altering the MICs of antibiotics to which the pathogen was resistant. In the presence of the peptides, the MICs of the antibiotics were found to be reduced as per the fractional inhibitory concentration indices (FICI) and time kill assay. These observations prompted us to look for their mechanism of action. The effect of peptides on the morphology of pathogen by field emission scanning electron microscopy (FE-SEM) revealed no damage to the cells at the sub-inhibitory concentrations of the peptide which correlated well with the higher MIC of the peptide, indicating no direct impact on the pathogen. However, dielectric spectroscopy, confocal microscopy and flow cytometry confirmed the interaction and localization of peptides with the bacterial membrane. The peptides were also found to inhibit efflux of ethidium bromide which is the substrate for many proteins involved in efflux system. Therefore, it is speculated that the peptides after interacting with the membrane of the pathogen might have resulted in the inhibition of the efflux of antibiotics thereby reducing their effective concentrations. The study thus suggests that peptides with no antimicrobial activity of their own, can also enhance the efficacy of the antibiotics by interacting with the pathogen thereby, acting as adjuvants for the antibiotics.
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Affiliation(s)
- Praveen Rishi
- Department of Microbiology, Basic Medical Sciences Block-I, Panjab University, Chandigarh, India.
| | - Shania Vij
- Department of Microbiology, Basic Medical Sciences Block-I, Panjab University, Chandigarh, India
| | | | - Ujjwal Jit Kaur
- Department of Microbiology, Basic Medical Sciences Block-I, Panjab University, Chandigarh, India
| | - Sanjay Bharati
- Department of Nuclear Medicine, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| | - Rupinder Tewari
- Department of Microbial Biotechnology, Panjab University, Chandigarh, India
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Tadesse S, Alemayehu H, Tenna A, Tadesse G, Tessema TS, Shibeshi W, Eguale T. Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with infection at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. BMC Pharmacol Toxicol 2018; 19:24. [PMID: 29784040 PMCID: PMC5963020 DOI: 10.1186/s40360-018-0210-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 04/26/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Staphylococcus aureus is one of the major pathogens of public health importance responsible for various forms of infection. Development of resistance to commonly used antimicrobials limited treatment options against infections due to this pathogen. Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with surgical site infection and ear infection and corresponding nasal swab was investigated in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. METHODS Wound and corresponding nasal swabs from patients with surgical site infection from general surgery ward (n = 14), orthopedic ward (n = 21) and those with otitis media (n = 59) from Ear Nose and Throat (ENT) ward were cultured for S. aureus isolation according to standard procedures from December 2013 to June 2014. Isolates were investigated for susceptibility to panel of 17 antimicrobials using Kirby Bauer disc diffusion assay. Susceptibility to methicillin was phenotypically determined based on sensitivity of isolates to cefoxitin and oxacillin. RESULTS A total of 79 S. aureus isolates were recovered from 54(57.4%) of patients. The isolates were resistant to ampicillin (100%), oxacillin and cefoxitin (68.4%, each), clindamycin (63.3%), cephalothin (59.5%), tetracycline (57%), sulfamethoxazole + trimethoprim and bacitracin (53.2%, each), and erythromycin (51.9%). Resistance to two or more antimicrobials was recorded in 74 (95%) of the isolates, while resistance to 3 or more antimicrobials was detected in 65(82.3%) of the isolates. Fifty-four (68.4%) of the isolates were methicillin resistant S. aureus (MRSA). Rate of occurrence of MRSA was more common among isolates from surgical wards (p < 0.001) compared to those from ENT ward. High level of multi-drug resistance (MDR) was detected more commonly among isolates from orthopedic ward than those from general surgical ward and patients with ear infection (p < 0.001). One of the isolate cultured from wound swab of a patient with surgical site infection from orthopedic ward was resistant to all of the 17 antimicrobials tested. CONCLUSION S. aureus isolates from patients in TASH exhibited resistance to majority of antimicrobials commonly employed for the treatment of staphylococcal infections which calls for urgent need of prudent use of antimicrobials and the need for implementation of effective infection control practices to hamper spread of MDR S. aureus.
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Affiliation(s)
- Sileshi Tadesse
- Yekatit 12 Hospital Medical College, P.O. Box157, Addis Ababa, Ethiopia
| | - Haile Alemayehu
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Admasu Tenna
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O.Box 9086, Addis Ababa, Ethiopia
| | - Getachew Tadesse
- Department of Biomedical Sciences, College of Veterinary medicine and Agriculture, Addis Ababa University, P.O. Box 34, Debrezeit, Ethiopia
| | - Tefaye Sisay Tessema
- Institute of Biotechnology, College of natural and Computational sciences, Addis Ababa University, P.O. Box, 1176, Addis Ababa, Ethiopia
| | - Workineh Shibeshi
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia
| | - Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
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Kahsay AG, Hagos DG, Abay GK, Mezgebo TA. Prevalence and antimicrobial susceptibility patterns of methicillin-resistant Staphylococcus aureus among janitors of Mekelle University, North Ethiopia. BMC Res Notes 2018; 11:294. [PMID: 29751844 PMCID: PMC5948666 DOI: 10.1186/s13104-018-3399-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 05/03/2018] [Indexed: 11/30/2022] Open
Abstract
Objective The objective of this study was to determine the prevalence of methicillin-resistant Staphylococcus aureus and antimicrobial susceptibility patterns among janitors working at Mekelle University, Tigray, Northern Ethiopia. Result The overall prevalence of S. aureus and MRSA in the present study were 17.97% (69/384) and 6.25% (24/384) respectively. Although not statistically significant, the prevalence of MRSA among janitors working in the medical area (9.7%, 10/103) was two times higher than the non-medical area (4.9%, 14/281). Janitors who had more service year and who were unable to read and write were found with high isolates of MRSA. Nasal carriage of MRSA among janitors who work in the hospital and who were hospitalized in the last 3 months and those who had exposure to wastes and body fluids were 13 (37.1%) and 10 (38.5%) respectively. Majority of the isolates of S. aureus were sensitive to ciprofloxacin (67; 97%), doxycycline (56; 81%), erythromycin (54; 78%), chloramphenicol (50; 72.5%) and cefoxitin (45; 65.2%). Sixty-seven of the 69 (97%) were resistant to penicillin. Of the 69 isolates of S. aureus, 22 (31.9%) showed multidrug resistant. Fourteen were resistant to three antimicrobials, 2 were resistant to four antimicrobials, and 7 were resistant to five antimicrobials.
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Affiliation(s)
- Atsebaha Gebrekidan Kahsay
- Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | - Dawit Gebreegziabher Hagos
- Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Getahun Kahsay Abay
- Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Tadele Araya Mezgebo
- Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Gitau W, Masika M, Musyoki M, Museve B, Mutwiri T. Antimicrobial susceptibility pattern of Staphylococcus aureus isolates from clinical specimens at Kenyatta National Hospital. BMC Res Notes 2018; 11:226. [PMID: 29615129 PMCID: PMC5883409 DOI: 10.1186/s13104-018-3337-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/28/2018] [Indexed: 11/17/2022] Open
Abstract
Objective To determine antibiotic susceptibility pattern of S. aureus isolates from clinical specimens collected from patients at Kenyatta National Hospital from March 2014–February 2016, and to determine the prevalence and quarterly trends of MRSA throughout the study period. Results A total of 944 S. aureus isolates were analyzed. High sensitivity of S. aureus was observed for quinupristin/dalfopristin (100%), tigecycline (98.2), imipenem (98%), nitrofurantoin (97.6%), linezolid (97.3%), teicoplanin (97.1%) and vancomycin (95.1%). High resistance was recorded against penicillin G (91.9%), trimethoprim/sulfamethoxazole (56.9%) and tetracycline (33.2%). MRSA prevalence among the patients at KNH was 27.8%. Highest proportion (80%) of MRSA was in burns unit. Both MRSA and MSSA were highly susceptible to quinupristin/dalfopristin, tigecycline, linezolid, nitrofurantoin, ampicillin/sulbactam and vancomycin and showed high resistance to commonly used antibiotics such as gentamycin, erythromycin, levofloxacin and tetracycline. A majority of isolates were from pus specimen (68%).
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Affiliation(s)
- Wilfred Gitau
- Department of Medical Microbiology, University of Nairobi, P.O Box 19676-00202, Nairobi, Kenya.
| | - Moses Masika
- Department of Medical Microbiology, University of Nairobi, P.O Box 19676-00202, Nairobi, Kenya
| | - Moses Musyoki
- Department of Medical Microbiology, University of Nairobi, P.O Box 19676-00202, Nairobi, Kenya
| | - Beatrice Museve
- Department of Laboratory Medicine, Microbiology, Kenyatta National Hospital, P.O Box 20723-00202, Nairobi, Kenya
| | - Titus Mutwiri
- Department of Medical Laboratory, Kenya Methodist University, P.O Box 45240-00100, Nairobi, Kenya
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Kuruno N, Kasahara K, Mikasa K. Hand hygiene compliance in a universal gloving setting. Am J Infect Control 2017; 45:830-4. [PMID: 28768591 DOI: 10.1016/j.ajic.2017.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/15/2017] [Accepted: 02/16/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND The use of gloves for every patient contact (ie, universal gloving) has been suggested as an infection prevention adjunct and alternative to contact precautions. However, gloves may carry organisms unless they are changed properly. In addition, hand hygiene is required before donning and after removing gloves, and there are scarce data regarding glove changing and hand hygiene in a universal gloving setting. METHODS This nonrandomized observational before-after study evaluated the effect of education and feedback regarding hand hygiene. Compliance with hand hygiene and glove use was directly observed in a universal gloving setting at a 10-bed intensive care unit in a Japanese tertiary care university teaching hospital. RESULTS A total of 6,050 hand hygiene opportunities were identified. Overall, hand hygiene compliance steadily increased from study period 1 (16.1%) to period 5 (56.8%), although there were indication-specific differences in the baseline compliance, the degree of improvement, and the reasons for noncompliance. There were decreases in the compliance with universal gloving and the incidence of methicillin-resistant Staphylococcus aureus. CONCLUSION It is difficult to properly perform glove use and hand hygiene in a universal gloving setting, given its complexity. Direct observation with specific feedback and education may be effective in improving compliance.
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Suda K, Yanai T, Toma M, Aiyoshi T, Sasaki T, Muraji T. Aggressive gastrointestinal food allergy in neonates and its possible relationship to necrotizing enterocolitis. Int J Surg Case Rep 2017; 36:175-178. [PMID: 28601030 PMCID: PMC5466549 DOI: 10.1016/j.ijscr.2017.05.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/28/2017] [Accepted: 05/29/2017] [Indexed: 11/26/2022] Open
Abstract
Food allergy in neonates with secondary necrotizing enterocolitis is extremely rare. No typical risk factor for necrotizing enterocolitis due to food allergy was found. Methicillin-resistant Staphylococcus aureus in the stool may be a risk factor.
Introduction The incidence of gastrointestinal food allergy (FA) in neonates is increasing. Despite this, cases of patients with gastrointestinal FA who develop necrotizing enterocolitis (NEC) requiring laparotomy are extremely rare. Presentation of case We describe two cases that presented with bloody stool with a probable diagnosis of FA as eosinophils were positive in the stool at onset. Both cases failed conservative treatment. Jejunostomy and ileostomy were performed in both cases due to secondary NEC with underlying acute FA. Post-surgery, raised peripheral blood eosinophil count, presence of cow’s milk-specific IgE antibody and positive allergen-specific lymphocyte stimulation test were found. Stoma closure were performed 3 and 1 months later in both cases. Postoperative recovery was uneventful. Discussion A few reports have not identified risk factors for NEC secondary to FA. Thrombocytopenia and rise in C-reactive protein (CRP) levels 2 days after the development of FA may be suggestive of FA with NEC. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in the fecal culture of both patients at the time of the onset of NEC. The toxic antigen produced by MRSA may cause activation of milk-protein-primed T cells and exacerbate FA. Conclusion The decrease of platelet levels and rise in CRP may indicate the development of secondary NEC in patients with FA. Additionally, MRSA detected in the fecal culture also may be a risk factor for NEC through the activation of cellular immunity reaction pathways.
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Affiliation(s)
- Kazuto Suda
- Department of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan.
| | - Toshihiro Yanai
- Department of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan
| | - Miki Toma
- Department of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan
| | - Tsubasa Aiyoshi
- Department of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan
| | - Takato Sasaki
- Department of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan
| | - Toshihiro Muraji
- Department of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan
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Saba CKS, Amenyona JK, Kpordze SW. Prevalence and pattern of antibiotic resistance of Staphylococcus aureus isolated from door handles and other points of contact in public hospitals in Ghana. Antimicrob Resist Infect Control 2017; 6:44. [PMID: 28491294 PMCID: PMC5424397 DOI: 10.1186/s13756-017-0203-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 05/04/2017] [Indexed: 11/11/2022] Open
Abstract
Background Studies have implicated Staphylococcus aureus as the leading cause of septicemia in the Tamale metropolis of Ghana. The aim of this study was to determine the prevalence and antibiotic susceptibility of S. aureus and Methicillin Resistant S. aureus (MRSA) in the environments of three hospitals in Ghana. Methods A total of 120 swab samples were taken from door handles, stair railings and other points of contact at Tamale Teaching Hospital, Tamale Central Hospital and Tamale West Hospital. The swab samples were directly plated on Mannitol Salt and Baird Parker agar plates and incubated at 37 °C (± 2) for 18–24 h. An antibiotic susceptibility test was performed using the Clinical Laboratory Standard Institute’s guidelines. Isolates resistant to both cefoxitin and oxacillin were considered to be MRSA. Results A total of 47 (39%) positive S. aureus samples were isolated from all three hospitals, of which, eight (17%) were putative MRSA isolates. One MRSA isolate was resistant to all the antibiotics used (cefoxitin, oxacillin, ciprofloxacin, erythromycin, tetracycline, ampicillin, streptomycin and sulfamethoxazole-trimethoprim). Five of the MRSA isolates were multi-drug resistant, whilst the other three were resistant to only two antibiotics. All the multi-drug resistant MRSA isolates were resistant to at least four antibiotics. The percentage of isolates resistant to oxacillin, ampicillin, ciprofloxacin, tetracycline, streptomycin, erythromycin, and sulfamethoxazole/trimethoprim were 17, 13, 9, 28, 89, 13 and 11% respectively. Conclusion The high multi-drug resistance of MRSA in hospital environments in Ghana reinforces the need for the effective and routine cleaning of door handles in hospitals. Further investigation is required to understand whether S. aureus from door handles could be the possible causes of nosocomial diseases in the hospitals. Electronic supplementary material The online version of this article (doi:10.1186/s13756-017-0203-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Courage Kosi Setsoafia Saba
- Department of Biotechnology, Faculty of Agriculture, University for Development Studies, P. O Box TL 1882, Tamale, Ghana
| | - Jean Kwadwo Amenyona
- Department of Ecotourism and Environmental Management, Faculty of Renewable Natural Resources, University for Development Studies, P. O Box TL 1882, Tamale, Ghana
| | - Stephen Wilson Kpordze
- Department of Ecotourism and Environmental Management, Faculty of Renewable Natural Resources, University for Development Studies, P. O Box TL 1882, Tamale, Ghana
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Moustafa MF, Taha TH, Helal M, Alrumman SA. Differential-display reverse transcription-PCR (DDRT-PCR): a new technology for molecular detection and studying one of the antagonistic factors of Bacillus endophyticus strain SA against Staphylococcus aureus (MRSA). 3 Biotech 2016; 6:121. [PMID: 28330192 PMCID: PMC4909024 DOI: 10.1007/s13205-016-0439-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 05/25/2016] [Indexed: 10/25/2022] Open
Abstract
Differential Display (DDRT-PCR) is a powerful technique for analyzing differences in gene expression. In-vivo expression technologies and differential display RT-PCR are providing new approaches to further examine a microbe's response to experimental conditions which more closely resemble natural microbial associations and habitats. In this study, Bacillus endophyticus strain SA isolated from the inner tissue of the stem of the cultivated plant (Salvadora persica, Asir, Kingdom of Saudi Arabia) produces an antagonistic factor. This factor has a broad spectrum of activity against Gram-positive and specifically against Staphylococcus aureus (MRSA). The antagonistic factor was isolated from the bacterial culture medium and purified by thin layer chromatography technique, then analyzed by GC-MS analysis. Identification of the producer strain was performed using the partial nucleotide sequence of 16S rRNA gene, which indicated that this strain is identical to B. endophyticus with 99 % similarity. The sequence of this strain was deposited at NCBI GenBank under accession number KF011545. Application of differential display RT-PCR revealed that the isolate was able to up-regulate a gene with serine protease like protein. The protein is well known as antimicrobial agent and was reported to be produced by plants, animals and insects. Serine protease is also known to be produced by bacteria for purposes oth er than bacterial-bacterial antagonistic effect, which has been confirmed by this study.
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Eshetie S, Tarekegn F, Moges F, Amsalu A, Birhan W, Huruy K. Methicillin resistant Staphylococcus aureus in Ethiopia: a meta-analysis. BMC Infect Dis 2016; 16:689. [PMID: 27871245 PMCID: PMC5117566 DOI: 10.1186/s12879-016-2014-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 11/08/2016] [Indexed: 01/09/2023] Open
Abstract
Background The burden of methicillin resistant Staphylococcus aureus is a major public health concern worldwide; however the overall epidemiology of multidrug resistant strains is neither coordinated nor harmonized, particularly in developing countries including Ethiopia. Therefore, the aim of this meta-analysis was to assess the burden of methicillin resistant Staphylococcos aureus and its antibiotic resistance pattern in Ethiopia at large. Methods PubMed, Google Scholar, and lancet databases were searched and a total of 20 studies have been selected for meta-analysis. Six authors have independently extracts data on the prevalence of methicillin resistant Staphylococcus aureus among clinical isolates of Staphylococcus aureus. Statistical analysis was achieved by using Open meta-analyst (version 3.13) and Comprehensive meta-analysis (version 3.3) softwares. The overall prevalence of methicillin resistant Staphylococcus aureus and its antibiotic resistance pattern were pooled by using the forest plot, table and figure with 95% CI. Results The pooled prevalence of methicillin resistant Staphylococcus aureus was 32.5% (95% CI, 24.1 to 40.9%). Moreover, methicillin resistant Staphylococcus aureus strains were found to be highly resistant to penicillin, ampicillin, erythromycin, and amoxicillin, with a pooled resistance ratio of 99.1, 98.1, 97.2 and 97.1%, respectively. On the other hand, comparably low levels of resistance ratio were noted to vancomycin, 5.3%. Conclusion The overall burden of methicillin resistant Staphylococcus aureus is considerably high, besides these strains showed extreme resistance to penicillin, ampicillin, erythromycin and amoxicillin. In principle, appropriate use of antibiotics, applying safety precautions are the key to reduce the spread of multidrug resistant strains, methicillin resistant Staphylococcus aureus in particular.
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Affiliation(s)
- Setegn Eshetie
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia.
| | - Fentahun Tarekegn
- Department of Anesthesia, College of Medicine and Health Sciences, Bahirdar University, Bahirdar, Ethiopia
| | - Feleke Moges
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
| | - Anteneh Amsalu
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
| | - Wubet Birhan
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
| | - Kahsay Huruy
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
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Schelli K, Rutowski J, Roubidoux J, Zhu J. Staphylococcus aureus methicillin resistance detected by HPLC-MS/MS targeted metabolic profiling. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1047:124-130. [PMID: 27316783 DOI: 10.1016/j.jchromb.2016.05.052] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/24/2016] [Accepted: 05/31/2016] [Indexed: 01/01/2023]
Abstract
Recently, novel bioanalytical methods, such as NMR and mass spectrometry based metabolomics approaches, have started to show promise in providing rapid, sensitive and reproducible detection of Staphylococcus aureus antibiotic resistance. Here we performed a proof-of-concept study focused on the application of HPLC-MS/MS based targeted metabolic profiling for detecting and monitoring the bacterial metabolic profile changes in response to sub-lethal levels of methicillin exposure. One hundred seventy-seven targeted metabolites from over 20 metabolic pathways were specifically screened and one hundred and thirty metabolites from in vitro bacterial tests were confidently detected from both methicillin susceptible and methicillin resistant Staphylococcus aureus (MSSA and MRSA, respectively). The metabolic profiles can be used to distinguish the isogenic pairs of MSSA strains from MRSA strains, without or with sub-lethal levels of methicillin exposure. In addition, better separation between MSSA and MRSA strains can be achieved in the latter case using principal component analysis (PCA). Metabolite data from isogenic pairs of MSSA and MRSA strains were further compared without and with sub-lethal levels of methicillin exposure, with metabolic pathway analyses additionally performed. Both analyses suggested that the metabolic activities of MSSA strains were more susceptible to the perturbation of the sub-lethal levels of methicillin exposure compared to the MRSA strains.
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Affiliation(s)
- Katie Schelli
- Department of Chemistry and Biochemistry, Miami University, 651 E High St., Oxford, OH 45056, USA
| | - Joshua Rutowski
- Department of Chemistry and Biochemistry, Miami University, 651 E High St., Oxford, OH 45056, USA
| | - Julia Roubidoux
- Department of Chemistry and Biochemistry, Miami University, 651 E High St., Oxford, OH 45056, USA
| | - Jiangjiang Zhu
- Department of Chemistry and Biochemistry, Miami University, 651 E High St., Oxford, OH 45056, USA.
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Tekeli A, Ocal DN, Ozmen BB, Karahan ZC, Dolapci I. Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Bloodstream Isolates in a Turkish University Hospital Between 2002 and 2012. Microb Drug Resist 2016; 22:564-569. [PMID: 26982281 DOI: 10.1089/mdr.2015.0116] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important pathogens in the hospital environment. Monitoring of this pathogen by molecular characterization and phenotypic methods is important for the development of suitable infection control measures and proper therapy design. In this study, our aim was to investigate the molecular epidemiological characteristics of MRSA bloodstream isolates obtained from patients hospitalized at Ankara University Ibn-i Sina Hospital in a 10-year period (2002-2012) and monitor the possible changes. A total of 134 isolates were characterized according to their antimicrobial susceptibility profiles, biofilm formation capabilities, accessory gene regulator (agr) locus types, presence of genes encoding Panton-Valentine leukocidin (PVL), staphylococcal enterotoxins A-J (SEs A-J), toxic shock syndrome toxin, sasX, and genes associated with biofilm formation (icaD, icaA, IS256) by polymerase chain reaction. The staphylococcal cassette chromosome mec (SCCmec) types of isolates were also defined and their clonal relationships were investigated by pulsed-field gel electrophoresis (PFGE) analysis and multilocus sequence typing was performed for representative isolates obtained by PFGE. RESULTS The majority of the isolates were resistant to rifampin (100%), ciprofloxacin (97%), tetracycline (97.7%), and gentamicin (94.7%); 100% carried type-III SCCmec and 89.5% were agr type-1. All the isolates were negative for PVL, and sasX genes while all of them carried the icaD, icaA, and IS256 genes. The most common SE was enterotoxin A (97%). Four major PFGE patterns with the dominance of one pattern and seven unique patterns were obtained. All the representative PFGE isolates (n = 11) belonged to sequence type 239. CONCLUSION We have documented the characteristics of the dominant MRSA clone in our hospital, which was a PVL (-), sasX (-) ST239 clone carrying sea (+) with type-III SCCmec, and type-1 agr locus.
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Affiliation(s)
- Alper Tekeli
- 1 Department of Medical Microbiology, Ankara University School of Medicine , Ankara, Turkey
| | - Duygu Nilufer Ocal
- 2 Department of Microbiology, Ankara Diskapi Yildirim Beyazit Training and Research Hospital , Ankara, Turkey
| | - Busra Betul Ozmen
- 1 Department of Medical Microbiology, Ankara University School of Medicine , Ankara, Turkey
| | - Zeynep Ceren Karahan
- 1 Department of Medical Microbiology, Ankara University School of Medicine , Ankara, Turkey .,3 Central Bacteriology Laboratory, İbn-i Sina Hospital , Ankara, Turkey
| | - Istar Dolapci
- 1 Department of Medical Microbiology, Ankara University School of Medicine , Ankara, Turkey
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Sarkar A, Raji A, Garaween G, Soge O, Rey-Ladino J, Al-Kattan W, Shibl A, Senok A. Antimicrobial resistance and virulence markers in methicillin sensitive Staphylococcus aureus isolates associated with nasal colonization. Microb Pathog 2016; 93:8-12. [PMID: 26796298 DOI: 10.1016/j.micpath.2016.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 01/11/2016] [Accepted: 01/11/2016] [Indexed: 02/07/2023]
Abstract
Most Staphylococcus aureus infections occur in previously colonized persons who also act as reservoirs for continued dissemination. This study aimed to investigate the carriage of antimicrobial resistance and virulence markers in S. aureus isolates associated with nasal colonization. The study was conducted from December 2013-April 2014. Nasal swabs were collected and questionnaires administered to 97 medical students in Riyadh Saudi Arabia. Bacterial culture, identification and antimicrobial susceptibility testing were performed by conventional methods and chromogenic agar was used for methicillin resistant S. aureus (MRSA) screening. Molecular characterization of isolates was carried out using the StaphyType DNA microarray. Thirty two students (43%) had S. aureus nasal carriage (MSSA = 31; MRSA = 1). Seventeen clonal complexes (CC) were identified namely: CC15-MSSA (n = 5), CC1-MSSA-SCCfus (n = 4), CC8-MSSA (n = 3), CC22-MSSA (n = 3), CC25-MSSA (n = 3), CC101-MSSA (n = 2). Other CC found as single isolates were CC5-MSSA, CC6-MSSA, CC30-MSSA, CC45-MSSA, CC96-MSSA, CC188-MSSA, CC398-MSSA, CC942-MSSA/PVL+, CC1290-MSSA, ST2482-MSSA, CC80-MRSA-IV/PVL+. The CC1-SCCfus isolates harbored the Staphylococcal cassette chromosome (SCC) with ccrA-1; ccrB-1 and ccrB-3 genes plus the putative fusidic acid resistance marker Q6GD50. One MSSA isolate was genotyped as coagulase negative Staphylococcus spp with an irregular composite SCCmec element. Majority of the isolates harbored various virulence genes including the hemolysin, enterotoxin, and exfoliative genes as well as various adhesive protein producing genes. Although there was low carriage of MRSA, the MSSA isolates harbored various resistance and virulence genes including those usually seen in MRSA isolates. The presence of isolates with incomplete SCCmec elements plus putative resistance and virulence genes is of concern.
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Rodríguez-Pineda J, Terrazas-Estrada JJ, Urdez-Hernández E, Hernández-Sánchez EA, Sánchez-Tejeda SL. [Methicillin resistance and vancomycin susceptibility pattern among blood isolates of Staphylococcus aureus]. Rev Med Inst Mex Seguro Soc 2016; 54:48-51. [PMID: 26820198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Staphylococcus aureus is capable of acquiring resistance against all antimicrobial agents. Vancomycin has been the cornerstone therapy for serious methicillin-resistant S. aureus infections. However, vancomycin treatment failures have been reported. METHODS From March to August 2010, S. aureus blood isolates were included to determine methicillin-resistance and the vancomycin susceptibility by using a standard microdilution method. To detect methicillin-resistance, a Mueller-Hinton agar plate added with oxacillin 4 µg/mL and 2 % NaCl, and an agglutination test were used. Growth of S. aureus on the agar plate and/or reactive agglutination defined a methicillin-resistant organism. Vancomycin susceptibility was assessed by determining the minimal inhibitory concentration (MIC) in Muelller-Hinton agar plates prepared with dilutions ranging from 16 to 0.5 µg/mL. RESULTS A total of 25 blood-isolates of S. aureus were included. A 60 % was methicillin-resistant. All isolates were vancomycin-susceptible (MIC ≤ 2 µg/mL) showing the next MICs distribution: 48 % ≤ 0.5 µg/mL; 44 % 1 µg/mL, and 8 % 2 µg/mL. CONCLUSION The high proportion of methicillin-resistance among S. aureus and the presence of vancomycin susceptible phenotypes (MIC of 2 µg/mL) not only claim for an enforcement of standard precautions and antimicrobial control, but also for a regular surveillance of vancomycin susceptibility pattern using a reference method.
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Affiliation(s)
- Jonathan Rodríguez-Pineda
- Servicio de Infectología Adultos, Hospital de Infectología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Distrito Federal, México.
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Abstract
INTRODUCTION Mupirocin is widely used topical antibiotic for the treatment of skin and soft tissue infections caused by Staphylococcus and Streptococcus. In addition nasal formulations are approved for the use in nasal eradication of methicillin-resistant Staphylococcus aureus in patients and health care workers. Wide usage of mupirocin has resulted in resistance leading to treatment failure. AIM To screen for the mupirocin resistance among the Staphylococcus isolates using disc diffusion and minimum inhibitory concentration method. MATERIALS AND METHODS A cross-sectional study was done at Microbiology Department of Sri Ramachandra University with 100 strains of Staphylococcus spp isolated from skin and soft tissue infections. Methicillin susceptibility was done by disc diffusion method using oxacillin (1 μgm) and cefoxitin (30 μgm) discs. Isolates were screened for mupirocin resistance by disc diffusion method using 5 μgm discs. High level and low level resistance determined by MIC using agar dilution method. RESULTS In 100 Staphylococcus spp 56 were Staphylococcus aureus and 44 were CoNS. Among the 56 Staphylococcus aureus 49 (87.5%) were mupirocin susceptible and 7 (12.5%) resistant by 5μg disc diffusion method. However by MIC method 11 (19.6%) were high and low level mupirocin resistant. Out of 44 CoNS 22 (50%) and 18 (41%) were susceptible by disc diffusion and MIC method respectively. Of the 26 resistant CoNS low level and high level mupirocin resistant was observed in 7 (15.9%) and 19 (43.1%) respectively. CONCLUSION Screening for mupirocin resistance by disc diffusion method is important before attempting decolonisation. Mupirocin resistance is more with CoNS. Disc diffusion method may miss low level Mupirocin resistance.
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Affiliation(s)
- Avr Jeya Sanju
- Student, Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University , Porur, Chennai, India
| | - Sridharan Sathyamoorthy Kopula
- Associate Professor, Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University , Porur, Chennai, India
| | - Kennedy Kumar Palraj
- Associate Professor, Department of Microbiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University , Porur, Chennai, India
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Commons RJ, Robinson CH, Gawler D, Davis JS, Price RN. High burden of diabetic foot infections in the top end of Australia: An emerging health crisis (DEFINE study). Diabetes Res Clin Pract 2015; 110:147-57. [PMID: 26453263 PMCID: PMC4684095 DOI: 10.1016/j.diabres.2015.09.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/07/2015] [Accepted: 09/12/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The risk of diabetes mellitus is increasing worldwide, and is particularly high in Indigenous Australians. Complicated foot infection is one of the most common sequelae of diabetes. We describe the incidence and associations of Indigenous and non-Indigenous inpatients with diabetic foot infections at Royal Darwin Hospital. METHODS All adult Royal Darwin Hospital inpatients with diabetic foot infections were enrolled prospectively from September 2012 to November 2013. Incidence, demographics, microbiology, management and clinical outcomes were analysed by Indigenous status, and association with methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa. RESULTS There were 245 separate hospital admissions in 177 patients with an incidence of 79 admissions per 100,000 person years. Patients occupied a mean of 19.4 hospital beds each day. Compared to the non-Indigenous population, Indigenous patients had a greater incidence of admission (Rate Ratio (RR)=5.1, [95%CI=3.8, 7.0]), were younger (mean difference of 11.1 years; p<0.001), and more likely to undergo major and minor amputations (RR=4.1 [95%CI=1.6, 10.7], and 6.2 [95%CI=3.5, 11.1] respectively). Non-multiresistant methicillin resistant S. aureus was present in 44.7% of wounds from Indigenous patients versus 20.6% of non-Indigenous patients (Odds Ratio (OR)=3.1, [95%CI=1.5, 6.4]), whereas P. aeruginosa presence was significantly lower (15.8% versus 46.0%; OR=0.22; [95%CI=0.11, 0.45]). Methicillin resistant S. aureus or P. aeruginosa infections were associated with longer antibiotic courses and durations of stay. CONCLUSIONS This study highlights a rising burden of diabetic foot infections in the Top End of Australia, with a four-fold increase in bed days since 2002 and an overrepresentation in the Indigenous population.
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Affiliation(s)
- Robert J Commons
- Department of Infectious Diseases, Royal Darwin Hospital, PO Box 41326, Casuarina, Northern Territory, Australia.
| | - Claire H Robinson
- High Risk Foot Service, Royal Darwin Hospital, PO Box 41326, Casuarina, Northern Territory, Australia
| | - David Gawler
- Division of Surgery, Royal Darwin Hospital, PO Box 41326, Casuarina, Northern Territory, Australia
| | - Joshua S Davis
- Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, Northern Territory, Australia
| | - Ric N Price
- Department of Infectious Diseases, Royal Darwin Hospital, PO Box 41326, Casuarina, Northern Territory, Australia; Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, Northern Territory, Australia; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, OX3 7LJ, UK
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Mínguez S, Molinos S, Mateo L, Gimenez M, Mateu L, Cabello J, Olivé A. Septic arthritis due to methylcyllin-resistant Staphylococcus aureus in adults. ACTA ACUST UNITED AC 2015; 11:381-6. [PMID: 25746826 DOI: 10.1016/j.reuma.2014.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 11/19/2014] [Accepted: 12/03/2014] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Septic arthritis due to methylcyllin resistant Staphylococcus aureus (MRSA) is a serious infection that has increased in incidence in the past 10years. METHODS We conducted a retrospective study (1984-2011) in which a description of the clinical and epidemiological characteristics of MRSA arthritis in adults was performed and then compared to native joint infections caused by MRSA vs. methylcyllin sensitive Staphylococcus aureus (MSSA). RESULTS Fourteen MRSA infections were included (7 native joint, 5 prosthetic and 2 bursae). No case was polyarticular. There was significant comorbidity, although none was associated to rheumatoid arthritis. Seven patients had bacteremia. Four required surgical treatment. Six died. When comparing the 7 patients with native joint MRSA infection with the 17 cases caused by MSSA, no significant differences in risk factors were seen, except more malignancies in the MRSA group. The infection was polyarticular in 7 cases (41%) of the MSSA group. Bacteremia was more frequent in the MRSA group (71.4 vs 58.8%). Empirical antibiotic was useful in 28.6% of MRSA cases versus 100% of MSSA cases. There was a greater tendency to associated mortality in MRSA arthritis (57.1% vs 17.6%, P=.07). CONCLUSIONS MRSA septic arthritis is a serious condition that occurs in the elderly and patients with high comorbidity. It is usually monoarticular, with positive blood cultures and higher mortality than MSSA arthritis. In patients at risk, vancomycin empiric antibiotic therapy is indicated.
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Affiliation(s)
- Sonia Mínguez
- Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
| | - Sonia Molinos
- Servicio de Microbiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Lourdes Mateo
- Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Montserrat Gimenez
- Servicio de Microbiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Lourdes Mateu
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Joan Cabello
- Servicio de Traumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Alejandro Olivé
- Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
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Hall H, Gadhok R, Alshafi K, Bilton D, Simmonds NJ. Eradication of respiratory tract MRSA at a large adult cystic fibrosis centre. Respir Med 2015; 109:357-63. [PMID: 25683032 DOI: 10.1016/j.rmed.2015.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/23/2014] [Accepted: 01/24/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The prevalence of MRSA in patients with CF is increasing. There is no consensus as to the optimum treatment. METHOD An observational cohort study of all patients with MRSA positive sputum, 2007-2012. All eradication attempts with subsequent culture results were reviewed. Single vs dual antibiotic regimens were compared for both new and chronic infections. RESULTS 37 patients (median FEV1 58.7 (27.6-111.5)% predicted) were identified, of which 67.6% (n = 25) had newly acquired MRSA. Compared with single regimens, a high proportion of dual regimens achieved MRSA eradication (84.6% vs 50%; p = 0.1) for new infections. Rifampicin/Fusidic acid was associated with high success rates (100% vs 60% for other dual regimens (p = 0.13)). Compared with new infections, chronic MRSA was much less likely to be eradicated (18.2%, p = 0.01). CONCLUSION Combined antibiotic therapy, particularly Rifampicin/Fusidic acid, is a well-tolerated and effective means of eradicating MRSA in patients with cystic fibrosis.
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Affiliation(s)
- H Hall
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
| | - R Gadhok
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
| | - K Alshafi
- Dept of Microbiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
| | - D Bilton
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK
| | - N J Simmonds
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK.
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Lawung R, Chuong LV, Cherdtrakulkiat R, Srisarin A, Prachayasittikul V. Revelation of staphylococcal cassette chromosome mec types in methicillin-resistant Staphylococcus aureus isolates from Thailand and Vietnam. J Microbiol Methods 2014; 107:8-12. [PMID: 25205542 DOI: 10.1016/j.mimet.2014.08.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/25/2014] [Accepted: 08/29/2014] [Indexed: 11/22/2022]
Abstract
Methicillin resistant Staphylococcus aureus (MRSA) is highly prevalent, and its typing plays a crucial role in epidemiology and evolution in both health and community settings. Multiplex PCR and staphylococcal cassette chromosome mec (SCCmec) typing based on mec complexes and cassette chromosome recombinase (ccr) allotypes have been developed for MRSA identification. The first of these procedures can identify 4 mec classes (A, B, C1, and E) and 2 ccr allotypes (B2 and B4) in one tube, and the second can identify mecA, mec class C2, and 3 allotypes (A1, A3, and C). Our method offers a novel means to further differentiate between the main SCCmec types I through XI and is both highly sensitive (detectable up to 0.3ηg DNA) and specific (100%). Several SCCmec types (I, III, IV, V and a non-typeable group) were found in 66 MRSA isolates obtained from Ho Chi Minh City, Vietnam and Nakhon Pathom, Thailand. SCCmec type III was highly predominant in both regions. The designed assay is rapid, convenient, flexible, and reliable. Therefore, this assay is suitable for the high-throughput screening of the main SCCmec types of MRSA isolates.
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Fromm S, Beißwanger E, Käsbohrer A, Tenhagen BA. Risk factors for MRSA in fattening pig herds - a meta-analysis using pooled data. Prev Vet Med 2014; 117:180-8. [PMID: 25241618 DOI: 10.1016/j.prevetmed.2014.08.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/16/2014] [Accepted: 08/25/2014] [Indexed: 12/31/2022]
Abstract
The importance of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) as an infectious agent for humans has increased in recent years in Germany. Although it is well known that the prevalence of MRSA in pig farms is high, risk factors for the presence of MRSA in herds of fattening pigs are still poorly understood. The aim of this study was to evaluate available data from previous studies on MRSA in fattening pigs in a meta-analysis to answer the question: What are the factors associated with the occurrence of MRSA in fattening pig herds? The studies on MRSA in pigs that were identified by literature research were heterogeneous with respect to the risk factors investigated and the type of herds focused on. Therefore we decided to carry out a pooling analysis on herd level rather than a typical meta-analysis. Eligible herd data were identified based on the published literature and communication with the authors. The final data set covered 400 fattening pig herds from 10 different studies and 12 risk factors. The prevalence of MRSA in the 400 fattening pig herds was 53.5%. Data were analyzed using generalized estimating equations (GEE). The resulting multivariate model confirmed previously identified risk factors for MRSA in pig herds (herd size and herd type). It also identified further risk factors: group treatment of fattening pigs with antimicrobial drugs (OR=1.79) and housing fattening pig herds on at least partially slatted floors (OR=2.39) compared to plain floor. In contrast, according to the model, fattening pig herds on farms keeping other livestock along with pigs were less likely to harbor MRSA (OR=0.54). The results underline the benefits from a pooling analysis and cooperative re-evaluation of published data.
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Burch DGS. Effects of tetracycline and zinc on selection of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 398 in pigs (Moodley et al., 2011). Vet Microbiol 2014; 173:398-400. [PMID: 25236984 DOI: 10.1016/j.vetmic.2014.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 08/19/2014] [Accepted: 08/21/2014] [Indexed: 11/17/2022]
Affiliation(s)
- David G S Burch
- Octagon Services Ltd, The Round House, The Friary, Old Windsor, Berkshire SL42NR, UK.
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Calbo E, Zaragoza R. [Ceftaroline fosamil in community-acquired and nosocomial pneumonia]. Enferm Infecc Microbiol Clin 2014; 32 Suppl 2:38-43. [PMID: 24702978 DOI: 10.1016/s0213-005x(14)70157-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Community-acquired pneumonia (CAP) is a common infection in developed countries and causes a large number of hospital admissions and deaths. In recent years, the incidence of this disease has increased, caused by progressive population aging. Following the introduction of the conjugate vaccine against Streptococcus pneumoniae, there have been significant epidemiological changes that require close monitoring because of the possible emergence of new patterns of resistance. This article aims to review the role of ceftaroline fosamil, a new parenteral cephalosporin with antibacterial activity against Gram-negative and Gram-positive pathogens, in the treatment of pneumonia. Several in vitro and in vivo studies have shown the efficacy of ceftaroline fosamil against penicillin-resistant S. pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA). Additionally, ceftaroline has shown similar efficacy and safety to ceftriaxone in the treatment of community-acquired pneumonia with severe prognosis (prognostic severity index III and IV) in two phase III clinical trials. Although a non-inferiority design was used for these clinical trials, some data suggest a superior efficacy of ceftaroline, with earlier clinical response and higher cure rate in infections caused by S. pneumoniae, making this drug particularly interesting for critically-ill patients admitted to the intensive care unit. Ceftaroline may also be considered for empirical and directed treatment of MRSA pneumonia.
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Affiliation(s)
- Esther Calbo
- Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital Universitario Mutua de Terrassa, Terrassa, Barcelona, España; Universidad Internacional de Catalunya, Valencia, España.
| | - Rafael Zaragoza
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España; Coordinador del Programa Interdisciplinar de Atención en la Sepsis Grave, Hospital Universitario Dr. Peset, Valencia, España
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Wong SS, Smith PR, Ayaz A, Sepkowitz D. Hyperimmunoglobulin E syndrome with persistent vertebral osteomyelitis due to methicillin-resistant Staphylococcus aureus: Case report and review of the literature. IDCases 2014; 1:12-3. [PMID: 26839768 PMCID: PMC4735458 DOI: 10.1016/j.idcr.2014.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/04/2014] [Indexed: 11/22/2022] Open
Abstract
-Hyperimmunoglobulin E syndrome is a rare condition with about 250 cases reported -This is the second case report of MRSA vertebral osteomyelitis associated with HIES -Her protracted course suggests a blunted inflammatory response due to HIES
We report a case of vertebral osteomyelitis due to methicillin-resistant Staphylococcus aureus (MRSA) with a slowly progressive, relatively asymptomatic course in a young woman with suspected hyperimmunoglobulin E syndrome (Job's syndrome).
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Affiliation(s)
- San S. Wong
- Division of Infectious Diseases, Maimonides Medical Center, Brooklyn, NY, United States
- Corresponding author. Tel.: +1 2062359759.
| | - Peter R. Smith
- Division of Pulmonary Medicine, Long Island College Hospital, Brooklyn, NY, United States
| | - Asim Ayaz
- Division of Pulmonary Medicine, Long Island College Hospital, Brooklyn, NY, United States
| | - Douglas Sepkowitz
- Division of Infectious Diseases, Long Island College Hospital, Brooklyn, NY, United States
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Kali A, Stephen S, Umadevi S, Kumar S, Joseph NM, Srirangaraj S. Changing Trends in Resistance Pattern of Methicillin Resistant Staphylococcus aureus. J Clin Diagn Res 2013; 7:1979-82. [PMID: 24179914 DOI: 10.7860/jcdr/2013/6142.3377] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 06/03/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Methicillin resistance in Staphylococcus aureus is associated with multidrug resistance, an aggressive course, increased mortality and morbidity in both community and health care facilities. Monitoring of newly emerging and prevalent Methicillin Resistant Staphylococcus aureus (MRSA) strains for their resistance patterns to conventional as well as novel drugs, are essential for infection control. AIMS To study the changing trends in resistance patterns of MRSA at our hospital. SETTINGS AND DESIGN This cross sectional study was carried out in a 750 bed tertiary care hospital in south India. MATERIAL AND METHODS One hundred and two clinical isolates of MRSA which were obtained in 2004-2011 were identified by using oxacillin, cefoxitin disc diffusion test and oxacillin screening agar test. Antibiotic susceptibility test was done for commonly used non beta lactam anti-Staphylococcal drugs, as well as for anti-MRSA drugs like vancomycin, linezolid, mupirocin and rifampicin. Minimum inhibitory concentration (MIC) of vancomycin was determined by using Vancomycin HiComb strip (Himedia, Mumbai, India). Statistical Analysis which was done: Chi-square test and proportions were used to compare the two groups. RESULTS MRSA isolates showed high resistance to co-trimoxazole (82.3%), ciprofloxacin (76.4%), gentamicin (64.7%) and tetracycline (49%) as compared to other drugs. High prevalence of ciprofloxacin resistance was detected, particularly among outpatients. Multi resistant MRSA with a ≥ 3 non-beta lactam agent resistance was 79%. All MRSA isolates were sensitive to vancomycin, linezolid, mupirocin and rifampicin. MRSA had displayed increase in resistance to most antibiotics except tetracycline in recent years. CONCLUSIONS Taking into consideration the prevalence of multidrug resistance in MRSA, resistance patterns should be evaluated periodically and antibiotic therapy should be guided by susceptibility testing.
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Affiliation(s)
- Arunava Kali
- Assistant Professor, Microbiology, Mahatma Gandhi Medical College & Research Institute , Pondicherry, India
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P R V, M J. A comparative analysis of community acquired and hospital acquired methicillin resistant Staphylococcus aureus. J Clin Diagn Res 2013; 7:1339-42. [PMID: 23998061 DOI: 10.7860/jcdr/2013/5302.3139] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 04/18/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE Staphylococcus aureus has developed resistance against most of the therapeutic agents. The most notable example of this phenomenon was the emergence of Methicillin resistant Staphylococcus aureus (MRSA). We are reporting the prevalence and the antibiotic susceptibility pattern of the MRSA isolates from a tertiary care hospital. METHODS A total of 450 Staphylococcus aureus isolates from clinical samples were taken up for the study and they were screened for MRSA by using standard microbiological methods. An antibiotic assay was done for the confirmed MRSA isolates. The differentiation of the isolates into community acquired MRSA (CAMRSA) and hospital acquired MRSA (HAMRSA) was done according to the prescribed criteria. The double disc diffusion test was performed for both the groups, to identify the inducible clindamycin resistance. The HAMRSA and the CAMRSA isolates were subjected to a molecular analysis by PCR, to detect the presence of the Mec A gene and the PVL gene respectively. RESULTS Out of the 450 Staphylococcus aureus isolates, 121 were Methicillin Resistant Staphylococcus aureus (MRSA, 27%) and 329 were Methicillin Sensitive Staphylococcus aureus (MSSA, 73%). 91 MRSA isolates were grouped into HAMRSA and 30 were grouped into CAMRSA, with a prevalence of 20% and 7% respectively. All the MRSA strains were resistant to Penicillin (100%), Cefoxitin (100%) and Oxacillin (100%). 53.7% of the HAMRSA isolates showed inducible clindamycin resistance against that of 44.4% among the CAMRSA isolates. All the isolates were susceptible to Vancomycin and Linezolid. 64% of the HAMRSA isolates showed the presence of the Mec A gene and 48% of the CAMRSA isolates showed the presence of the PVL genes. CONCLUSION The prevalence of the HAMRSA was higher than that of the CAMRSA and they showed a higher drug resistance.
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Affiliation(s)
- Vysakh P R
- Tutor, Department of Microbiology, Chettinad Hospital and Research Institute, Chettinad University, India
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Gulmen S, Kurtoglu T, Meteoglu I, Kaya S, Okutan H. Ozone therapy as an adjunct to vancomycin enhances bacterial elimination in methicillin resistant Staphylococcus aureus mediastinitis. J Surg Res 2013; 185:64-9. [PMID: 23809152 DOI: 10.1016/j.jss.2013.05.085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 04/20/2013] [Accepted: 05/23/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND We aimed to investigate the influence of intraperitoneal ozone therapy on bacterial elimination and mediastinal inflammation in experimental Staphylococcus aureus mediastinitis. MATERIALS AND METHODS Forty Wistar-Albino rats were randomized into five groups (eight per group) as follows: uncontaminated group, untreated contaminated group, ozone group, vancomycin group, and vancomycin + ozone group. Uncontaminated group underwent upper median sternotomy. The remaining four groups were inoculated with 0.5 mL 10(8) colony-forming units/mL methicillin-resistant Staphylococcus aureus in the mediastinal and sternal layers. Untreated contaminated group had no treatment. Rats in the vancomycin group received intramuscular vancomycin (40 mg/kg/d), and ozone was administered intraperitoneally (70 μg/mL, 1 mg/kg/d) in the ozone group for the treatment of mediastinitis. Vancomycin + ozone group rats were treated by the combination of both methods. At the end of 10 d, quantitative bacterial cultures and sternal tissue samples were obtained for determination of bacterial counts and histologic degree of inflammation. RESULTS Both the vancomycin and the ozone treatments caused significant reduction of bacterial counts in quantitative bacterial cultures. Combination of vancomycin and ozone treatments resulted in further reduction of bacterial counts in mediastinum and sternum. Histologic examination of tissue samples revealed significant reduction in severity of mediastinitis related inflammation in vancomycin and vancomycin + ozone groups compared with untreated contaminated group. CONCLUSIONS Ozone therapy as an adjunct to vancomycin leads to enhanced bacterial elimination in infected sternal and mediastinal tissues in experimental methicillin-resistant Staphylococcus aureus mediastinitis. The benefit of adjuvant ozone therapy is suggested to be related to its bactericidal effect.
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Affiliation(s)
- Senol Gulmen
- Department of Cardiovascular Surgery, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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Vasudevan A, Mukhopadhyay A, Goh EYY, Li J, Tambyah PA. Risk factors for infection/colonization caused by resistant Gram negative bacilli in critically ill patients (an observational study of 1633 critically ill patients). Prev Med 2013; 57 Suppl:S70-3. [PMID: 23246839 DOI: 10.1016/j.ypmed.2012.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 12/02/2012] [Accepted: 12/03/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The objective of this study is to identify risk factors associated with multi-resistant Gram negative (RGNB) infection and colonization among critically ill patients. METHODS A prospective cohort study of all patients aged 21-90 admitted for more than 24 hours in Medical and Surgical intensive care units (ICU) at a large teaching hospital in Singapore for the period of Aug '07-Dec '09 was conducted. Patient demographics, comorbidities, antibiotics, invasive devices, and culture results were collected. Forward stepwise logistic regression analyses were done to identify risk factors associated with RGNB infection and colonization. RESULTS Of the 1373 patients included in the analysis, 13.5% developed RGNB infection. A logistic regression analysis including variables with a p value of <0.2 in the univariate analysis showed that recent surgery (OR 2.1, 95% CI 1.2-3.6), renal impairment (OR 2.9, 95% CI 1.5-5.4), liver disease (OR: 3.8, 95% CI 1.7-8.8), central line (OR 1.8, 95% CI 1.01-3.4) were independently associated with RGNB infection in the ICU. Surgery (OR 3.9, 95% CI 2.7-5.7), third-line antibiotics (carbapenem, vancomycin, linezolid) (OR 1.8, 95% CI 1.2-2.9) were independently associated with RGNB infection during their hospitalization. CONCLUSION The major risk factors identified for RGNB infection and colonization in the ICU were mainly patient dependent. However, broad spectrum initial antibiotic treatment remains an important independent modifiable risk factor. Interventions aimed at reducing initial broad spectrum antibiotics are clearly needed to help control the spread of these difficult to treat infections.
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