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Methicillin-anti staphylococcus aureus(MRSA) is one of the common pathogenic bacteria in hospital infection. Many asymptomatic MRSA carriers have been found in clinical practice, which can not only transmit the strain to others, but also cause secondary infection due to their own reasons. Decolonization measures can reduce the number of MRSA colonizers, thereby reducing the risk of endogenous infection and secondary transmission. Early identification is the first step to prevent transmission and secondary infection, which requires high accuracy and sensitivity of detection methods. Xpert MRSA/SA assay (Cepheid, Sunnyvale, CA, USA) may be a better choice, which can shorten the time of traditional methods, and has high specificity and sensitivity. Unlike other rapid detection methods, the Xpert MRSA/SA assay may be more suitable for MRSA colonisation detection.
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Objective@#To determine the point prevalence of, and risk factors associated with MRSA carriage among resident physicians of surgical departments at the Ospital ng Maynila Medical Center.@*Methods@#Design: Cross-sectional Study. Setting: Tertiary Government Training Hospital. Participants:51 resident physicians from different surgical departments (general surgery, obstetrics and gynecology, ophthalmology, otorhinolaryngology – head and neck surgery and dermatology) underwent nasal and pharyngeal swabs with microbial culture and sensitivity testing to identify MRSA carriers. Fisher Exact Test and logistic regression were utilized to determine associations between MRSA carriage and various risk factors including frequency of hand washing and departmental affiliation.@*Results@#Overall prevalence rate of MRSA carriage was 9.8%. Otorhinolaryngology residents had the highest combined prevalence of MRSA of 42.9%, significantly higher compared to other departments and were used as a reference in logistic regression analyses. Notably, handwashing only once daily was associated with a 20-fold increase in the risk of MRSA carriage (OR 20.5, 95% CI: 1.82 to 230, p = .014). Other departments did not demonstrate statistically significant differences in MRSA carriage rates.@*Conclusions@#Otorhinolaryngology resident physicians had the highest combined prevalence of MRSA and nasal MRSA was found only in otorhinolaryngology residents. The surgical subspecialty and frequency of handwashing of the healthcare worker were identified as important risk factors to develop MRSA carriage. Targeted interventions (including enhanced infection control protocols and regular screening) are needed especially in high-risk departments.
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Methicillin-Resistant Staphylococcus aureus , Surgical Wound InfectionABSTRACT
ObjectiveTo investigate the bactericidal effect of loaded multifunctional povidoneiodine-nanometer selenium （PVP-I@Se） disinfectant on Staphylococcus aureus （SA） and methicillin-resistant Staphylococcus aureus （MRSA）， and to provide an experimental basis for the reduction of surgical site infection （SSI）. MethodsThe control group was the povidone iodine （PVP-I） group with different concentrations of iodine （50， 75， 100， 200 and 400 μg/mL）. The PVP-I@Se group （experimental group） was the PVP-I group further supplemented with 2 μg/mL Selenium nanoparticles （SeNPs）. Then we compared the bactericidal effect of the two groups of disinfectant solutions on SA and MRSA by examining the minimum inhibitory concentration （MIC）， minimum bactericidal concentration （MBC）， the shortest sterilization time at a concentration of 50 μg/mL iodine and the inhibition zone diameters at concentrations of 200 μg/mL and 400 μg/mL iodine. ResultsMIC values of PVP-I against SA and MRSA were both 79.17 μg/mL， and those of PVP-I@Se were 54.17 and 70.83 μg/mL， respectively. MBC values of PVP-I against SA and MRSA were 129.17 and 150.00 μg/mL， respectively， and those of PVP-I@Se were 70.83 and 87.50 μg/mL， respectively. At a concentration of 50 μg/mL iodine， the shortest sterilization time of PVP-I for SA and MRSA was 130 s and 140 s， respectively， and that of PVP-I@Se was 65 s and 75 s， respectively. At a concentration of 200 μg/ml iodine， the inhibition zone diameters of PVP-I for SA and MRSA were 7.67 mm and 8.33 mm， and those of PVP-I@Se were both 9.50 mm. At a concentration of 400 μg/mL iodine， the inhibition zone diameters of PVP-I for SA and MRSA were 9.00 mm and 9.33 mm， and those of PVP-I@Se were 11.67 mm and 12.00 mm， respectively. ConclusionsPVP-I with different concentrations of 50， 75， 100， 200 and 400 μg/mL iodine supplemented with 2 μg/mL SeNPs have better and faster bactericidal effect on SA and MRSA. When combined with SeNPs， PVP-I can enhance the bactericidal activity against SA and MRSA， but with better sensitizing effect on SA than MRSA and higher demand of iodine concentration （400 μg/mL） for sensitizing effect on MRSA. This study provides a theoretical basis for selecting optimal concentration and action time of the disinfectant， thus reducing SSI.
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ABSTRACT This study aimed to identify factors associated with colonization by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in adult patients admitted to a Brazilian hospital. This is a cross-sectional study, in which patients underwent a nasal swab and were asked about hygiene behavior, habits, and clinical history. Among the 702 patients, 180 (25.6%) had S. aureus and 21 (2.9%) MRSA. The factors associated with MRSA colonization were attending a gym (OR 4.71; 95% CI; 1.42 - 15.06), smoking habit in the last year (OR 2.37; 95% CI; 0.88 - 6.38), previous hospitalization (OR 2.18; CI 95%; 0.89 - 5.25), and shared personal hygiene items (OR 1.99; 95% CI; 0.71 - 5.55). At the time of admission, colonization by CA-MRSA isolates was higher than that found in the general population. This can be an important public health problem, already endemic in hospitals, whose factors such as those associated with habits (smoking cigarettes) and behaviors (team sports practice and activities in gyms) have been strongly highlighted. These findings may help developing infection control policies, allowing targeting patients on higher-risk populations for MRSA colonization.
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The number of deaths caused by drug-resistant bacteria is expected to increase in the future, and there is a need to develop new antimicrobial agents. Recently, the antiplatelet drug ticagrelor has been reported to have promising antibacterial properties. The purpose of this review is to analyze articles and case reports that describe the antimicrobial action of ticagrelor. Ticagrelor was found to have antibacterial reactions against Gram-positive bacteria, including drug-resistant and spore-forming bacteria, while no effect was observed against Gram-negative bacteria. In this paper we discuss a new potential antimicrobial agent, ticagrelor.
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Background: Staphylococci are responsible for life-threatening infections in hospitals and community. Their ability to produce multiple virulence factors and antibiotic resistance is an important reason of high mortality in staphylococcal infections. Biofilm production by these organisms makes it difficult to treat. Most of the treating antibiotics are failing and making it a matter of concern. Aims?This study aims to detect the increased antibiotic resistance in biofilm-producing Staphylococcus and to compare the performance of three potential methods of detection. Methods?A total of 81 isolates of staphylococci including coagulase negative staphylococci (CoNs), methicillin resistant S. aureus (MRSA), and methicillin sensitive S. aureus (MSSA) are included in this study. After the identification, an antibiotic sensitivity test was performed. Biofilm detection was done by three different methods: Congo red agar method, tube adherence method, and microtiter plate method. Result?Out of the 81 samples, 37 CoNs, 17 MRSA, and 27 MSSA were identified. Out of them we got 43 (53%) biofilm producers by Congo red agar method, 40 (49%) by tube adherence method, and 52 (64%) producers by tissue culture plate/microtiter plate method. Most of the biofilm producers showed multiple drug resistance. Conclusion?We found out that the microtiter plate method is sensitive and reliable as compared with the other two methods. Antibiotic resistance was found to be very common in biofilm producers. This was due to the resistance developed as a result of the matrix that does not let the antibiotic bind with the organisms. This can make the treatment of Staphylococcus very difficult in the future as the rate of drug resistance is faster as compared with newly emerging antibiotics.
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Background: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. It is responsible for a wide range of infections including superficial skin infections, food poisoning, osteomyelitis and septicemia. Aim of this study was to identify and to determine antibiotic susceptibility pattern of Staphylococcus aureus from various clinical samples. Materials and methods: Different clinical specimens were collected and processed for routine culture and antibiotic sensitivity test by standard microbiology techniques. Results: A total of 129 S. aureus strains were isolated from various clinical specimens out of which 84 (65.12%) were Methicillin Resistance Staphylococcus aureus (MRSA). 66(51.16%) S. aureus were obtained from indoor (IPD) patients. S. aureus was found higher in male than female. S. aureus was found highly resistant to Benzylpenicillin (94.57%) followed by ciprofloxacin (77.51%), Erythromycin (61.24%), and Cotrimoxazole (51.94%), Clindamycin (44.19%), and Gentamicin (17.05%). 1 (0.78%) of the isolates were resistance to Vancomycin and Linezolid. For urine isolates Nitrofurantoin was drug of choice. Conclusion: Methicillin resistant Staphylococcus aureus was found 65.12% of Staphylococcus aureus isolates. It was most common in males and hospitalized patients. Teicoplanin or Tigecyline seems to be drug of choice followed by Vancomycin, Linezolid, Tetracycline and Gentamicin. It would be helpful to formulating and monitoring the antibiotic policy and ensure proper empiric treatment.
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Objective To evaluate the effectiveness of pharyngeal swabs combined with anal swabs as multidrug-resistant organism(MDRO)admission screening for patients in intensive care unit(ICU),and provide reference for healthcare-associated infection(HAI)prevention and control strategies.Methods Patients who underwent MDRO admission screening by pharyngeal swabs combined with anal swabs within 24 hours of admission to an ICU of a hospital in Shanghai from August 1 to December 31,2022 were included as the experimental group,and those who underwent MDRO admission screening only by pharyngeal swabs from August 1 to December 31,2021 were as the control group.Positive rate of screening,occurrence and pathogen of HAI between the two groups,as well as the sensitivity and specificity of combined admission screening for MDRO in the experimental group were compared.Results A total of 917 patients were included in the study,with 442 cases in the experimental group and 475 cases in the control group.The positive rates of admission screening for MDRO in the experimental and control groups were 7.40％and 3.37％,respectively.The incidences of HAI with MDRO in the experimental and control groups were 2.71％and 5.68％,respectively.Incidences of digestive system HAI with MDRO in the experimental and control groups were 0.68％and 2.32％,respectively.Differences were all statistically significant(all P＜0.05).The area under the ROC curve of admission screening by pharyngeal swabs combined with anal swabs for predicting HAI with MDRO in patients were 0.897(P＜0.01,95％CI:0.802-0.993).The sensitivity and specificity of admi-ssion screening for MDRO by pharyngeal swabs combined with anal swabs in the experimental group were 72.73％and 97.65％,respectively.Conclusion The combination of pharyngeal swabs and anal swabs can be used as an ICU admission screening method for MDRO,and has an important clinical application value.
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Aims@#Mobile phones are used extensively by healthcare workers (HCWs) who are unaware of the amount of contamination these phones carry and act as reservoirs for organisms causing hospital-acquired infections. This investigation was aimed to find the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) contamination and antimicrobial resistance patterns of isolates from HCW’s cellphones.@*Methodology and results@#This study was a hospital-based cross-sectional study. A total of 120 samples were isolated from HCWs’ cellphones and subjected to culture and sensitivity as per the standard guidelines. Five (18.1%) out of 120 collected samples were from 11 lab technicians’ phones and were positive for S. aureus and 6.25% were obtained from 48 nurses’ cellphone swabs. @*Conclusion, significance and impact of study@#The findings of this study reveal that HCWs’ cellphones could be apossible source of infection since a high prevalence of MRSA was found on lab technicians and nurse cellphone sample swabs. On the other hand, all S. aureus isolates were resistant to methicillin and ceftazidime. Also, no significant relationship between the prevalence of MRSA was detected.
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@#Introduction: Humans have learned to recognize and process plants into medicinal forms through centuries. Burns can spread to other tissues, especially when infected with bacteria such as Methicillin-Resistant Staphylococcus aureus (MRSA). The study aimed to assess the in vivo antibacterial and wound healing activity of 2% formulation of 2-Medpy-3-CN on infected burn wounded animal model. Methods: In vitro antibacterial activity of the Alsti was done by broth dilution and disc diffusion methods. Alsti 2% ointment was prepared for the infected burn wound treatment. A total of 18 rats are grouped into A, B, C, and D, the first three groups (A-C) were injured thermally, and Group D was used as healthy controls. The three test Groups were exposed to MRSA ATCC 43300 at 105 CFU/mL. Group A was treated with 2% Alsti, Group B with Silver sulfadiazine 1% (SSD), and Group C was untreated. Wounds healing was assessed by the healed area and microscopic identification of hematoxylin and eosin (H&E)-stained skin tissue. Results: Wound healing progresses with application of Alsti 2% ointment as observed through wound diameter and histopathological changes of the skin. Wound diameter decreases with treatments, while the contrary was observed in the non-treated group. Microscopic observation of the stained skin showed that epidermal development, and collagen formation progress with treatment days. Untreated wounds showed marked inflammation, progressive ulceration, and necrosis. Conclusion: Alsti 2% formulation showed antibacterial and wound healing activities, hence, can be used as alternative in burn wound infections.
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@#Introduction: Staphylococcus aureus is part of the normal human flora that can commonly be found on the skin and mucous membranes of the nasal area. However, in immunosuppressed patients such as those with kidney failures, colonization can potentially lead to infection. There is a concern of increasing antibiotic resistance in S. aureus. This study aimed to determine the prevalence of S. aureus nasal colonization and its antimicrobial susceptibility among haemodialysis-dependent populations. Methods: A cross-sectional study at the Nephrology Unit, Hospital Canselori Tuanku Mukhriz (HCTM) was conducted among haemodialysis-dependent patients between February 2017 to February 2018. Nasal swabs were obtained and cultured on mannitol salt agar. S. aureus isolates were identified by gram staining, tube coagulase and Deoxyribonuclease (DNase). Cefoxitin disc (30 µg) were used to identified the presence of MRSA (methicillin-resistance S. aureus). The S. aureus colonies were further tested against six antibiotics using Kirby Bauer disc diffusion. Result: A total of 134 patients were recruited. S. aureus isolates were detected from 27 patients (20.1%). All S. aureus were phenotypically identified as methicillin-sensitive S. aureus (MSSA) based on the cefoxitin disc. Teicoplanin and linezolid were the most effective with 100% susceptibility. S. aureus exhibited a high resistance rate towards erythromycin (29.6%). No MRSA was isolated in this study. Conclusion: This study highlighted the high prevalence of S. aureus nasal colonization in haemodialysis patients. Teicoplanin and linezolid were found to be the most effective antibiotics against isolated S. aureus.
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Origanum vulgare has been of great interest in academia and pharma industry due to its antioxidant, antifungal and antitumor properties. The present study aimed to find the anti-MRSA potential and in vivo toxicity assessments of O. vulgare. O. vulgare extract was used to monitor anti-MRSA activity in mice. Following MRSA established infection in mice (Mus musculus), treatment with O. vulgare was continued for 7 days. Autopsies were performed and re-isolation, gross lesion scoring and bacterial load in various organs were measured. Additionally, blood sample was analysed for hematological assays. Toxicity assessment of O. vulgare potential as medicine was done at 200 mg/kg and 400 mg/kg by evaluating liver and kidney functions. Bacterial load and gross lesion in lungs and heart were significantly low compared to positive control following O. vulgare treatment. Likewise, O. vulgare treated groups had hematological, neutrophil and TLC values similar to control groups. Increased AST, ALP and total bilirubin along with marked hepatocellular degeneration and distortion around the central vein, inflammatory cell infiltration, and cytoplasmic vacuolization of hepatic cells was observed at higher dose. It is concluded that crude extract of O. vulgare may contain beneficial secondary metabolites and in future may be explored for curing infectious diseases.
Origanum vulgare tem despertado grande interesse na academia e na indústria farmacêutica devido às suas propriedades antioxidantes, antifúngicas e antitumorais. O presente estudo teve como objetivo encontrar o potencial anti-MRSA e avaliações de toxicidade in vivo de O. vulgare. O extrato de O. vulgare foi usado para monitorar a atividade anti-MRSA em camundongos. Após infecção estabelecida por MRSA em camundongos (Mus musculus), o tratamento com O. vulgare foi continuado por 7 dias. As autópsias foram realizadas e o reisolamento, pontuação das lesões grosseiras e carga bacteriana em vários órgãos foram medidos. Além disso, a amostra de sangue foi analisada para ensaios hematológicos. A avaliação da toxicidade do potencial de O. vulgare como medicamento foi feita com 200 mg / kg e 400 mg / kg, avaliando as funções hepática e renal. A carga bacteriana e as lesões graves nos pulmões e no coração foram significativamente baixas em comparação com o controle positivo após o tratamento com O. vulgare. Da mesma forma, os grupos tratados com O. vulgare apresentaram valores hematológicos, de neutrófilos e de TLC semelhantes aos grupos de controle. Aumento de AST, ALP e bilirrubina total juntamente com degeneração hepatocelular marcada e distorção ao redor da veia central, infiltração de células inflamatórias e vacuolização citoplasmática de células hepáticas foram observados em doses mais altas. Conclui-se que o extrato bruto de O. vulgare pode conter metabólitos secundários benéficos e, no futuro, pode ser explorado para a cura de doenças infecciosas.
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Animals , Mice , Mice/anatomy & histology , Mice/blood , Origanum/toxicity , Methicillin-Resistant Staphylococcus aureus/drug effectsABSTRACT
ABSTRACT The methicillin-resistant Staphylococcus aureus (MRSA) USA300-Latin American variant (USA300-LV) lineage is well documented in northern Latin American countries. It has replaced established clones in hospital environments. We herein report a systemic infection caused by a USA300-LV isolate in a 15-year-old boy, from a low-income area of Rio de Janeiro, previously colonized by the same strain. During hospital stay, seven pvl-positive MRSA USA300-LV isolates were recovered by nasal swab, blood and abscess secretion. The patient underwent intravenous vancomycin, daptomycin, and oral sulfamethoxazole/trimethoprim, and was discharged after 45 days after full recovery. This is the first documented case of a community-acquired MRSA infection caused by the USA300-LV variant in Brazil in a previously colonized adolescent with no history of recent travel outside of Rio de Janeiro. The need for improved surveillance programs to detect MRSA colonization in order to control the spread of hypervirulent lineages among community and hospital settings is highlighted.
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Abstract Origanum vulgare has been of great interest in academia and pharma industry due to its antioxidant, antifungal and antitumor properties. The present study aimed to find the anti-MRSA potential and in vivo toxicity assessments of O. vulgare. O. vulgare extract was used to monitor anti-MRSA activity in mice. Following MRSA established infection in mice (Mus musculus), treatment with O. vulgare was continued for 7 days. Autopsies were performed and re-isolation, gross lesion scoring and bacterial load in various organs were measured. Additionally, blood sample was analysed for hematological assays. Toxicity assessment of O. vulgare potential as medicine was done at 200 mg/kg and 400 mg/kg by evaluating liver and kidney functions. Bacterial load and gross lesion in lungs and heart were significantly low compared to positive control following O. vulgare treatment. Likewise, O. vulgare treated groups had hematological, neutrophil and TLC values similar to control groups. Increased AST, ALP and total bilirubin alongwith marked hepatocellular degeneration and distortion around the central vein, inflammatory cell infiltration, and cytoplasmic vacuolization of hepatic cells was observed at higher dose. It is concluded that crude extract of O. vulgare may contain beneficial secondary metabolites and in future may be explored for curing infectious diseases.
Resumo Origanum vulgare tem despertado grande interesse na academia e na indústria farmacêutica devido às suas propriedades antioxidantes, antifúngicas e antitumorais. O presente estudo teve como objetivo encontrar o potencial anti-MRSA e avaliações de toxicidade in vivo de O. vulgare. O extrato de O. vulgare foi usado para monitorar a atividade anti-MRSA em camundongos. Após infecção estabelecida por MRSA em camundongos (Mus musculus), o tratamento com O. vulgare foi continuado por 7 dias. As autópsias foram realizadas e o reisolamento, pontuação das lesões grosseiras e carga bacteriana em vários órgãos foram medidos. Além disso, a amostra de sangue foi analisada para ensaios hematológicos. A avaliação da toxicidade do potencial de O. vulgare como medicamento foi feita com 200 mg / kg e 400 mg / kg, avaliando as funções hepática e renal. A carga bacteriana e as lesões graves nos pulmões e no coração foram significativamente baixas em comparação com o controle positivo após o tratamento com O. vulgare. Da mesma forma, os grupos tratados com O. vulgare apresentaram valores hematológicos, de neutrófilos e de TLC semelhantes aos grupos de controle. Aumento de AST, ALP e bilirrubina total juntamente com degeneração hepatocelular marcada e distorção ao redor da veia central, infiltração de células inflamatórias e vacuolização citoplasmática de células hepáticas foram observados em doses mais altas. Conclui-se que o extrato bruto de O. vulgare pode conter metabólitos secundários benéficos e, no futuro, pode ser explorado para a cura de doenças infecciosas.
Subject(s)
Animals , Rabbits , Oils, Volatile , Origanum , Anti-Infective Agents/toxicity , Plant Extracts/toxicity , Liver , AntioxidantsABSTRACT
ABSTRACT Background: Bloodstream infections (BSI) are a global health issue, leading to high mortality and morbidity among hospitalized patients. Methods: A retrospective, observational and descriptive study was conducted by reviewing blood culture records collected from patients with suspected BSI, between January 2017 and December 2019. Results: The most frequent antimicrobial resistant (AMR) pathogens were methicillin-resistantStaphylococcus aureus(MRSA) (40%), methicillin-resistantS. epidermidis (MRSE) (9.5%), and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (35.3%). Conclusions: Our findings underscore the importance of continued vigilance and advocate for the rational use of antimicrobial agents.
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Abstract Origanum vulgare has been of great interest in academia and pharma industry due to its antioxidant, antifungal and antitumor properties. The present study aimed to find the anti-MRSA potential and in vivo toxicity assessments of O. vulgare. O. vulgare extract was used to monitor anti-MRSA activity in mice. Following MRSA established infection in mice (Mus musculus), treatment with O. vulgare was continued for 7 days. Autopsies were performed and re-isolation, gross lesion scoring and bacterial load in various organs were measured. Additionally, blood sample was analysed for hematological assays. Toxicity assessment of O. vulgare potential as medicine was done at 200 mg/kg and 400 mg/kg by evaluating liver and kidney functions. Bacterial load and gross lesion in lungs and heart were significantly low compared to positive control following O. vulgare treatment. Likewise, O. vulgare treated groups had hematological, neutrophil and TLC values similar to control groups. Increased AST, ALP and total bilirubin alongwith marked hepatocellular degeneration and distortion around the central vein, inflammatory cell infiltration, and cytoplasmic vacuolization of hepatic cells was observed at higher dose. It is concluded that crude extract of O. vulgare may contain beneficial secondary metabolites and in future may be explored for curing infectious diseases.
Resumo Origanum vulgare tem despertado grande interesse na academia e na indústria farmacêutica devido às suas propriedades antioxidantes, antifúngicas e antitumorais. O presente estudo teve como objetivo encontrar o potencial anti-MRSA e avaliações de toxicidade in vivo de O. vulgare. O extrato de O. vulgare foi usado para monitorar a atividade anti-MRSA em camundongos. Após infecção estabelecida por MRSA em camundongos (Mus musculus), o tratamento com O. vulgare foi continuado por 7 dias. As autópsias foram realizadas e o reisolamento, pontuação das lesões grosseiras e carga bacteriana em vários órgãos foram medidos. Além disso, a amostra de sangue foi analisada para ensaios hematológicos. A avaliação da toxicidade do potencial de O. vulgare como medicamento foi feita com 200 mg / kg e 400 mg / kg, avaliando as funções hepática e renal. A carga bacteriana e as lesões graves nos pulmões e no coração foram significativamente baixas em comparação com o controle positivo após o tratamento com O. vulgare. Da mesma forma, os grupos tratados com O. vulgare apresentaram valores hematológicos, de neutrófilos e de TLC semelhantes aos grupos de controle. Aumento de AST, ALP e bilirrubina total juntamente com degeneração hepatocelular marcada e distorção ao redor da veia central, infiltração de células inflamatórias e vacuolização citoplasmática de células hepáticas foram observados em doses mais altas. Conclui-se que o extrato bruto de O. vulgare pode conter metabólitos secundários benéficos e, no futuro, pode ser explorado para a cura de doenças infecciosas.
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Abstract The aim of this study was to characterize phenotypically and genotypically 27 mecApositive Staphylococcus aureus strains with oxacillin MICs of ≤2 g/ml by Vitek 2, isolated indifferent regions of Uruguay. Susceptibility to oxacillin and cefoxitin was studied by gradient dif-fusion, disk diffusion to cefoxitin, and Phoenix and MicroScan systems. PBP2a was determined.SCCmec typing was performed and the isolates were compared by PFGE. Twenty-six isolateswere susceptible to oxacillin; one strain was susceptible to cefoxitin by disk diffusion and 3strains by gradient diffusion. Phoenix and MicroScan panels detected methicillin resistance in25 and 27 strains, respectively. Twenty-six strains tested positive for PBP2a. Twenty-six strainscarried SCCmec V and 24 belonged to pulsotype A. One strain carried SCCmec IV and did notbelong to pulsotype A. Cefoxitin disk diffusion test and PBP2a detection correctly identified 26of these 27 strains as MRSA. PFGE results suggest the dissemination of a cluster of MRSA carryingSCCmec V.
Resumen El objetivo de este estudio fue caracterizar fenotípicamente y genotípicamente 27 cepas de Staphylococcus aureus positivas para mecA y con CIM de oxacilina <2 pg/ml según Vitek 2, obtenidas en diferentes regiones del país. La sensibilidad frente a la oxacilina y la cefoxitina se estudió por difusión en gradiente, por disco-difusión (cefoxitina) y por los sistemas Phoenix y MicroScan. Se analizó la portación de PBP2a, se realizó la tipificación de SCCmec y las cepas se compararon mediante PFGE. Resultaron sensibles a oxacilina por difusión en gradiente 26 cepas; una fue sensible a cefoxitina por disco-difusión y 3 lo fueron por difusión en gradiente. Los sistemas Phoenix y MicroScan detectaron resistencia a meticilina en 25 y 27 cepas, respectivamente. Asimismo, 26 cepas portaban PBP2a y 26 cepas mostraron presencia de SCCmec V, 24 correspondieron al pulsotipo A. Una portaba SCCmec IV y no perteneció al pulsotipo A. La prueba de disco-difusión con cefoxitina y la detección de PBP2a identificaron 26 de 27 cepas como MRSA. La PFGE sugiere la diseminación de un grupo MRSA con SCCmec V. © 2022 Asociación Argentina de Microbiología. Publicado por Elsevier Espana, S.L.U. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Introdução: A sedimentação do Programa de Stewardship de Antimicrobianos (ATMs), além de reduzir a indução da resistência bacteriana, assegura maior segurança aos pacientes. Este estudo teve por objetivo descrever o perfil de sensibilidade do Staphylococcus aureus e Staphylococcus coagulase negativo (S. CON) nas unidades de internação adulta do hospital para instrumentalizar as equipes e realizar o gerenciamento de ATMs. Métodos: Este estudo retrospectivo foi realizado através de busca em prontuário eletrônico de culturas laboratoriais com S. aureus e S. CON, independentemente do foco, dos anos de 2017, 2018 e 2019, das unidades de internação adultas não críticas e UTI adulto. Para análise, foi realizado o cálculo de coeficiente de sensibilidade absoluto e de médias. As variáveis qualitativas foram apresentadas em relação ao agente etiológico, antibiótico e local de isolamento, com posterior identificação de variabilidade e possibilidades terapêuticas disponíveis. Resultados: Apesar de ocorrer similaridade na distribuição das cepas de Staphylococcus spp. nos locais analisados do hospital, observou-se divergência entre os perfis de sensibilidade do S. aureus e S. CON. Existe superioridade no perfil de sensibilidade do S. aureus em comparação com o S. CON em relação a todos ATMs. A sensibilidade do S. aureus à oxacilina, ainda, possibilita tratamento com ß-lactâmicos; entretanto, a escolha de outras classes de ATMs torna-se necessária em casos de infecções complexas e graves. Conclusão: A análise periódica do perfil de sensibilidade aos ATMs é uma estratégia a ser alcançada para um eficaz programa de gerenciamento de ATMs, com fundamentação de protocolos e melhor assistência dos pacientes.
Introduction: The sedimentation of the antimicrobial stewardship program (ASP) reduces the induction of bacterial resistance and ensures greater patient safety. This study aimed to describe the sensitivity profile of Staphylococcus aureus and negative-coagulase Staphylococcus (CoNS) in adult inpatient units of the hospital to instrumentalize the teams and perform ASP management. Methods: This retrospective study was conducted by searching electronic medical records for laboratory cultures with S. aureus and CoNS, regardless of the focus, from 2017, 2018, and 2019, from the adult non-critical inpatient units and adult ICU. For the analysis, the study calculated the absolute sensitivity coefficient and means. Qualitative variables were related to the etiologic agent, antibiotic, and isolation site, with subsequent identification of variability and available therapeutic possibilities. Results: Although similarity occurred in the distribution of Staphylococcus spp. strains in the analyzed hospital sites, divergence was observed between the sensitivity profiles of S. aureus and CoNS. There is superiority in the sensitivity profile of S. aureus over CoNS concerning all ASP. The sensitivity of S. aureus to oxacillin still allows treatment with ß-lactams. However, the choice of other classes of ASP becomes necessary in cases of complex and severe infections. Conclusion: Periodic analysis of the ASP sensitivity profile is a strategy to achieve an effective ASP management program to support protocols and better patient care.
Subject(s)
StaphylococcusABSTRACT
Background: Staphylococcus is notorious for its ability to become resistant to antibiotics. MRSA emerged as nosocomial pathogen in the early 1960. Methicillin Resistant Staphylococcus aureus are implicated in serious infections and nosocomial infection outbreaks, thus limiting the treating options to very few agents such as vancomycin and teicoplanin. Vancomycin has been regarded as the first line drug for the treatment for MRSA but its irrational use lead to emergence of vancomycin resistance. The Aim was to determine the prevalence and resistance of MRSA ,VRSA,VISA isolates from various clinical samples in a tertiary care hospital.Material & Methods:This present prospective study was done in the Microbiology department of Government Medical College. The study was conducted for a period of one and half year i.e from January 2019 to June 2020. All the samples (pus, urine, blood, body fluids, sputum etc) were processed as per standard protocols.Results:Out of 26,471 samples, 6578(24.85%) were found to be culture positive. 1583 isolates were identified as Staphylococcus aureus. Among them 1278(80.7%) were MRSA, 21(1.3%) were VISA and 8(0.5%) were VRSA. Maximum number of MRSA isolates were obtained from orthopaedics ward (22.7%) and Intensive Care Unit and most of them were isolated from pus(45%) followed by blood (19.09%)samples. Among them highest resistance were observed against azithromycin (85.6%), followed by ciprofloxacin (63.5%) and least resistance to rifampicin and doxycycline. Majority of the VISA and VRSA strains were isolated from ICU followed by orthopaedics, surgery. Most of them were isolated from pus followed by blood and urine specimen and most were found to be multidrug resistant while they retained their sensitivity to Linezolid and Teicoplanin.Conclusions:As there is high prevalence of MRSA isolates so the treatment options are limited to vancomycin. Overuse of vancomycin can lead to emergence of VRSA strains. So the need for rational use in the infection-control practices to prevent transmission of MRSA as well as VISA strains. Strict implementation of hand hygiene, decolonization of MRSA carriers,and education of healthcare team will be quite helpful.
ABSTRACT
Introducción: Staphylococcus aureus, es la principal causa de bacteriemia infecciosa y endocarditis, así como de infecciones osteoarti-culares, de piel y tejidos blandos, su reservorio principal es la mucosa nasal. Los trabajadores de la salud son una fuente importante de transmisión de S. aureus y S. aureus resistente a la meticilina (SARM). Objetivo: determinar la presencia de Staphylococcus aureus y SARM en la fosa nasal de auxiliares de enfermería en la ciudad de Bogotá. Materiales y métodos: estudio descriptivo de corte transversal, en auxiliares de enfermería de diferentes instituciones hospitalarias y clínicas en la ciudad de Bogotá, Colombia. Se realizó un muestreo aleatorio. El tamaño de la muestra fue de 491 hisopados de la fosa nasal derecha de igual número de auxiliares de enfermería que al momento del estudio se encontraban laborando a nivel clínico. Se tomó un intervalo de confianza del 95% y error máximo admisible del 5%, se consideró el valor de p= 0,5. Se realizó un estudio de frecuencias y determinación de prevalencias mediante un análisis univariado. Resultados: la presente investigación encontró queel 28,5% de los participantes fueron portadores del Staphylococcus aureus y el 6,1% fueron SARM. Conclusiones: la colonización por Staphylococcus aureus y SARM es frecuente en auxiliares de enfermería.
Introduction: Staphylococcus aureus is a human pathogen of clinical severe relevance, it is the leading cause of infectious bacteremia and endocarditis, as well as osteoarticular, skin, and soft tissue infections; its, main reservoir is the nasal mucosa. Healthcare workers are a significant source of transmission of S. aureus and methicillin-resistant S. aureus (MRSA). Objective: To determine the presence of Staphylococcus aureus and MRSA in the nostrils of nursing assistants in Bogotá's city. Materials and methods: a descriptive cross-sec-tional study in nursing assistants from different hospitals and clinical institutions in Bogotá's city, Colombia. Random sampling was carried out. The sample size was 491 swabs from the right nostril from the same number of nursing assistants working at the clinical level at the time of the study. A confidence interval of 95% and maximum permissible error of 5% were taken, the value of p = 0.5 was considered. A study of frequencies and determination of prevalence was carried out through univariate analysis. Results: the present investigation found that 28.5% of the participants were carriers of Staphylococcus aureus, and 6.1% were methicillin-resistant S. aureus(MRSA). Conclusions: colonization by Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) is common in nursing assistants.