Prevalence of icaA and icaD genes in Staphylococcus aureus and Staphylococcus epidermidis strains isolated from patients and hospital staff.

Staphylococci are ubiquitous microorganisms that predominate in normal skin and mucosal flora. Staphylococcus aureus and Staphylococcus epidermidis have been identified as a major cause of nosocomial infections, especially in patients with predisposing factors such as indwelling or implanted foreign bodies. The ability of both S. epidermidis and S. aureus to produce biofilm was compared between 116 clinically significant strains (46 from blood cultures of patients with bloodstream infection and 70 isolated from catheters) and 60 strains isolated from nasal swabs of healthy carriers from hospital staff. The presence of the intercellular adhesion genes (icaA and icaD) was determined by the Polymerase Chain Reaction method, and slime production was examined using qualitative Congo red agar technique. Among clinical strains, 35.2% (19/54) of S. aureus and 48.4% (30/62) of S.epidermidis were both positive icaA and icaD and they produced slime. Among carrier strains, 22.2% (8/36) of S. aureus and 33.3% (8/24) of S. epidermidis were positive for slime synthesis and exhibited ica genes. Our results suggest that the virulence factors contributing to the development of infections can be present in patient and hospital staff isolates. Thus, we consider it is important to detect healthy carriers of slime-producing staphylococci and to control the dissemination of these microorganisms especially in a hospital.

IFN-gamma plays a detrimental role in murine defense against nasal colonization of Staphylococcus aureus.

The anterior nares are the major reservoir in humans of Staphylococcus aureus with the risk of developing endogenous infections or transmitting infections to susceptible persons. The mechanisms that mediate attachment of staphylococci to the nasal mucosa are little known. The purpose of the present work was to study some factors that could influence the nasal colonization in an animal model of mice. We investigated the possible role of IFN-gamma. We used S. aureus ATCC 35556 (SA113) slime-producing and ATCC 25923 non-slime-producing strains. Male 6-week-old BALB/c, C57BL/6 (wild-type, WT), and gene-deficient IL-12p40 (IL-12p40-/-) or IL-4 (IL-4-/-) mice on C57BL/6 background were infected with a dose of S. aureus of 10(6) CFU in 10mul of saline. The total number of S. aureus CFU per nose and lung, specific IgA response and IFN-gamma levels were evaluated. Significant higher CFU were recovery from the narines of C57BL/6 compared with BALB/c mice either after ATCC 35556 (p<0.0001) and ATCC 25923 (p<0.02) strain infection. Low IgA response correlated with high bacterial counting in the C57BL/6 nasal region. Moreover, C57BL/6 mice showed major colonization of slime-producing S. aureus ATCC 35556 than non-slime-producing ATCC 25923 S. aureus strain (p<0.02). IL-12p40-/-mice clarified the bacteria from their nose more efficiently that WT mice after slime-producing S. aureus (p<0.0001). Accordingly, significant lower level of IFN-gamma were detected in IL-12p40-/- compared with WT mice after infection with this strain (p<0.03). The results suggested the influence of the slime production in nasal colonization of S. aureus, and indicate at first time that IFN-gamma may play a detrimental role in this mucosal infection. These results could contribute to elucidate mucosal immune mechanisms involved in S. aureus colonization and then control infections in susceptible persons.

Efectos adversos de consecuencia fatal por tratamiento con fármacos antituberculosos / Fatal adverse effects secundary to antituberculous therapy

We report the case of a patient with several adverse effects, of fatal consequence, associated with drugs used in the treatment for Tuberculosis. Patient was hospitalized at the Hospital Nacional Arzobispo Loayza of Lima, Peru, since May until July 2001. We identified the presence of several adverse effects associated with antituberculosis drugs (dermatitis, nausea, vomit, interstitial nephritis, hepatitis for drug and thrombocytopenia, associated with Intracraneal hemorrhage, of fatal consequence). This study reports a case very infrequent in the world (including Peru), in relation with the presence of several adverse effects of antituberculosis drugs, in the same patient, who died because of these effects. We want to inform the potential risks associated with antituberculosis drugs (of great use in Peru for the high prevalence of Tubersulosis), that must have a regimen and adequate control to avoid severe consequences.