RESUMEN
To investigate the strain composition and drug resistance characteristics of G+(Gram positive cocci) cocci causing bloodstream infections in the People's Hospital of Inner Mongolia Autonomous Region in recent years and provide a basis for the empirical and rational use of drugs for the prevention and treatment of bloodstream infections caused by G+cocci. The strain composition and drug-resistant characteristics of G+cocci isolated from positive blood culture specimens sent to various departments of the Inner Mongolia Autonomous Region People's Hospital from January 2015 to December 2022 were retrospectively analyzed, and the higher detection rates of Staphylococcus hominis and Staphylococcus epidermidis, Enterococcus faecium and Enterococcus faecalis, and methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) were examined. MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) were comparatively analyzed for resistance. The resistance data were analyzed by Whonet 5.6 statistical software, the significance of difference was analyzed by SPSS 22.0 software, and the resistance rate was compared by χ2 test. The results showed that 1 209 strains of G+cocci, in terms of the composition ratio, from high to low, were mainly human staphylococci (32.5%,393/1 209), Staphylococcus epidermidis (27.8%, 336/1 209), Staphylococcus aureus (14.9%,180/1 209) and Enterococcus faecalis (10.6%, 128/1 209). Among them, the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) (42.8%, 77/180) was lower than that of methicillin-resistant coagulase-negative staphylococcus (MRCNS) (71.5%, 608/850); and among enterococci, the detection rate of Enterococcus faecalis (71.5%, 128/179) was much higher than that of Enterococcus faecalis (28.5%, 51/179). For drug resistance, the resistance rate to five commonly used antimicrobial drugs, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin and tetracycline, was higher in Staphylococcus hominis than in Staphylococcus epidermidis (χ2=7.152-64.080, P<0.05); however, for the aminoglycoside antimicrobial drug gentamicin, the rate of resistance in Staphylococcus humanus was lower than in Staphylococcus epidermidis, and the difference was statistically significant (χ2=11.895, P<0.05); no strains resistant to linezolid and vancomycin were found in both. Comparison of the resistance rates to seven antimicrobial drugs, gentamicin, rifampicin, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin and tetracycline, was significantly higher in MRSA than in MSSA (χ2=6.169-56.941, P<0.05); however, the resistance rate to cotrimoxazole, MRSA (15.6%, 12/77) was significantly lower than that of MSSA (35.3%, 36/102), and the difference was statistically significant (χ2=5.155, P<0.05); MRSA and MSSA resistant to linezolid and vancomycin were not found. The resistance rate of Enterococcus faecalis to penicillin G and ampicillin was much higher than that of Enterococcus faecalis, and the difference was statistically significant (χ2=22.965, P<0.05), and vancomycin-resistant enterococci (VRE) were not found. In conclusion, for staphylococci, except for individual antibiotics, S.hominis and MRSA were more resistant to most antimicrobial drugs than S. epidermidis and MSSA, showing a multidrug-resistant pattern. For enterococci, except for penicillin G and ampicillin resistance rate, Enterococcus faecalis is much higher than Enterococcus faecalis, the rest of the antimicrobial drugs did not see a significant difference, in addition to vancomycin-resistant enterococci were not detected. Clinicians should pay great attention to the monitoring data of multidrug-resistant G+cocci isolated from blood cultures to provide a basis for empirical and rational use of drugs in the clinic, to effectively prevent and reduce the incidence of bloodstream infections caused by G+cocci.
Asunto(s)
Antibacterianos , Pruebas de Sensibilidad Microbiana , Humanos , Antibacterianos/farmacología , China , Cocos Grampositivos/efectos de los fármacos , Cocos Grampositivos/aislamiento & purificación , Estudios Retrospectivos , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Enterococcus faecalis/efectos de los fármacos , Enterococcus faecalis/aislamiento & purificación , Farmacorresistencia Bacteriana , Hospitales , Staphylococcus aureus/efectos de los fármacos , Staphylococcus epidermidis/efectos de los fármacos , Staphylococcus epidermidis/aislamiento & purificación , Bacteriemia/microbiología , Bacteriemia/epidemiologíaRESUMEN
Gram-positive catalase-negative cocci (GPCNCs) are significant components of the genital microbiota in sheep and goats. However, characterizing them can be difficult due to overlapping culture features and the limited information on their susceptibility to antibiotics. In this study, 97 foreskin and 13 vaginal swabs were investigated using a culturomic approach. Of 110 animals, 76 (69.09 %) hosted GPCNCs, including strains from Streptococcaceae (37, 33.64 %), Aerococcaceae (30, 27.27 %), Enterococcaceae (6, 5.45 %) and other minor species. With increasing antimicrobial resistance rates in livestock, surveillance programs are globally required, so we conducted a pilot study on GPCNCs isolated from the genital mucosa surfaces of sheep and goats using the minimal inhibitory concentration assay (MIC). Due to gaps in interpretative standard breakpoints, normalized resistance interpretation was used for setting epidemiological susceptibility cut-off values (COWTs). Of 57 suitable strains, the majority (80.71 %) showed high COWTs with decrease susceptibility to at least one antimicrobial class, with 22.81 % displaying multiresistant profiles. Of interest, combined resistances to beta-lactams, macrolides, lincosamides, and tetracyclines were detected in strains of Streptococcus plurianimalium. Further combinations, including resistance to beta-lactams, pleuromutilins, aminoglycosides, and lincosamides, were also recorded in both Streptococcus uberis and Enterococcus spp. strains. Being beta-lactams, macrolides, and tetracyclines the most used antibiotics in livestock worldwide, our results highlight the need for their prudent use. Collectively, our findings highlight that small ruminant genital microbiota can serve as reservoirs for opportunistic severe pathogens, often zoonotic, carrying multidrug resistances, thus standing for high risks for both animals and humans.
Asunto(s)
Antibacterianos , Cabras , Pruebas de Sensibilidad Microbiana , Vagina , Animales , Cabras/microbiología , Ovinos , Femenino , Antibacterianos/farmacología , Masculino , Vagina/microbiología , Microbiota/efectos de los fármacos , Proyectos Piloto , Farmacorresistencia Bacteriana , Cocos Grampositivos/efectos de los fármacos , Cocos Grampositivos/aislamiento & purificación , Catalasa , Prepucio/microbiologíaRESUMEN
OBJECTIVES: This study aims to evaluate two commercial broth microdilution (BMD) systems, E1-185-100 (Merlin) and FDANDPF (ThermoFisher), for dalbavancin susceptibility testing in comparison with reference BMD assay. METHODS: Study collection was composed of 200 non-replicate multidrug-resistant Gram-positive cocci of clinical origin, including 180 methicillin-resistant Staphylococcus aureus, 10 vancomycin-resistant enterococci, seven linezolid-resistant Staphylococcus epidermidis, and three methicillin-resistant coagulase-negative staphylococci. S. aureus ATCC 29213 and Enterococcus faecalis ATCC 29212 reference strains were also included as controls. Testing was performed according to the ISO 20776-1 standard, starting from the same bacterial inoculum, and results were compared according to the ISO 20776-2 standard. RESULTS: Reference BMD showed that 92.6% (187/202) of the strains were susceptible to dalbavancin, whereas few staphylococci and all VanA-producing enterococci showed a resistant phenotype. In comparison with the reference method, Category Agreement and Essential Agreement were 98% (198/202; 95% CI, 95.4-99.3%) and 98% (198/202; 95% CI, 95.4-99.3%) for both Merlin and ThermoFisher panels. A few false susceptibilities were observed, for both commercial systems, with dalbavancin-resistant staphylococci. BIAS values of 11% and 3% were calculated for the Merlin and ThermoFisher systems, respectively. DISCUSSION: This study, reporting the first evaluation of the two commercially available BMD assays for dalbavancin susceptibility testing, revealed an overall good correlation with reference BMD, although with some underestimation tendency of MIC values by both commercial systems. Further studies involving a higher number of resistant isolates will be necessary to better evaluate this issue.
Asunto(s)
Antibacterianos , Staphylococcus aureus Resistente a Meticilina , Pruebas de Sensibilidad Microbiana , Teicoplanina , Teicoplanina/farmacología , Teicoplanina/análogos & derivados , Antibacterianos/farmacología , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Humanos , Cocos Grampositivos/efectos de los fármacosRESUMEN
Bacterial bloodstream infections are of great concern globally. Of late, the emergence of drug resistant bacteria worsen the related morbidity and mortality. This study was aimed to determine the bacterial profile, antimicrobial susceptibility patterns, and associated factors among the blood stream infection (BSI) suspected patients attending the Arba Minch General Hospital (AMGH), southern Ethiopia, from 01 June through 31st August, 2020. A cross-sectional study was conducted among 225 BSI suspected patients. Systematic random sampling method was used to select patients. Blood culture was done to isolate bacterial pathogens. Antimicrobial susceptibility test was performed by employing the Kirby-Bauer disc diffusion method. Descriptive statistics and multivariable logistic regression analysis were done by Statistical Package for Social Service (SPSS) version 22. The rate of prevalence of bacteriologically confirmed cases was 22/225 (9.8%). Majority of BSI were caused by Gram-positive cocci, 13/22 (59.1%), particularly the isolates of S. aureus, 7/22 (31.8%) followed by Enterococci species, 4/22 (18.2%) and coagulase-negative Staphylococci (CoNS), 2/22 (9.1%). Among the Gram-negative bacteria 9/22 (41.1%), Klebsiella species 4/22 (18.2%) was the prominent one followed by Escherichia coli 2/22 (9.1%), Pseudomonas aeruginosa 2/22 (9.1%), and Enterobacter species 1/22 (4.5%). All the isolates of Gram-negative bacteria were susceptible to meropenem whereas 69.2% of the isolates of Gram-positive counterparts were susceptible to erythromycin. Slightly above two third (68.2%) of the total isolates were multidrug resistant. Insertion of a peripheral intravenous line was significantly associated with BSI [p = 0.03; Adjusted Odds Ratio = 4.82; (Confidence Interval: 1.08-21.46)]. Overall results revealed that eventhough the prevalence of BSI in Arba Minch is comparatively lower (9.8%), multidrug resistance is alarmingly on the rise, which is to be addressed through effective surveillance and control strategies.
Asunto(s)
Sepsis/tratamiento farmacológico , Sepsis/etiología , Sepsis/microbiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Bacteriemia/microbiología , Bacterias/clasificación , Infecciones Bacterianas/tratamiento farmacológico , Enfermedades Transmisibles/tratamiento farmacológico , Estudios Transversales , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Etiopía/epidemiología , Femenino , Bacterias Gramnegativas/efectos de los fármacos , Cocos Grampositivos/efectos de los fármacos , Hospitales Generales , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana EdadRESUMEN
BACKGROUND/PURPOSE: Ceftaroline, with a unique activity against methicillin-resistant Staphylococcus aureus (MRSA), was not launched in Taiwan before 2019. The in vitro susceptibility data of ceftaroline against important Taiwanese pathogens are lacking. METHODS: The in vitro susceptibility of ceftaroline against important pathogens collected from 2012 through 2018 were extracted from the Antimicrobial Testing Leadership and Surveillance program. Broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) to ceftaroline against all isolates. RESULTS: During the study period, the in vitro data regarding isolates of S. aureus (n = 2049), Staphylococcus epidermidis (n = 185), Streptococcus pneumoniae (n = 334), Streptococcus pyogenes (n = 170), Haemophilus influenzae (n = 75), Haemophilus parainfluenzae (n = 10) and Klebsiella pneumoniae (n = 680) regardless of hospital sites of collection were analyzed. Among the S. aureus isolates studied, 19.4% showed MICs of 1 mg/L to ceftaroline, and 4.4% showed in vitro susceptible-dose dependent to ceftaroline (all MICs, 2 mg/L). Most of other Gram-positive cocci, all H. influenzae and H. parainfluenzae isolates were susceptible to ceftaroline. By contrast, about one-third (35.9%) of K. pneumoniae isolates, irrespective of infection sources, exhibited non-susceptibility to ceftaroline (MIC range, 0.015-256 mg/L; MIC50 and MIC90 values, 0.12 and 256 mg/L, respectively). CONCLUSIONS: From the pharmacodynamic perspectives, the ceftaroline dosage of 600 mg as a 2-h intravenous infusion every 8 h is effective against all S. aureus and other Gram-positive isolates regardless of acquisition sites in Taiwan. Before ceftaroline is prescribed in treatment of the patient with Gram-negative infection, a cautious evaluation about patient's healthcare-associated factor is warranted.
Asunto(s)
Antibacterianos/farmacología , Cefalosporinas/farmacología , Cocos Grampositivos/efectos de los fármacos , Haemophilus/efectos de los fármacos , Klebsiella pneumoniae/efectos de los fármacos , Infecciones por Bacterias Grampositivas/microbiología , Cocos Grampositivos/clasificación , Cocos Grampositivos/patogenicidad , Haemophilus/clasificación , Haemophilus/patogenicidad , Humanos , Klebsiella pneumoniae/patogenicidad , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/patogenicidad , Pruebas de Sensibilidad Microbiana , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/microbiología , Infecciones de los Tejidos Blandos/tratamiento farmacológico , Infecciones de los Tejidos Blandos/microbiología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/patogenicidad , Taiwán , CeftarolinaRESUMEN
Urinary tract infections (UTIs) are the third most common types of infection in human medicine worldwide. There is increasing appreciation for the pathogenic role of Gram-positive cocci (GPC) in UTIs, as they have a plethora of virulence factors, maintaining their pathogenicity and high affinity for the epithelial cells of the urinary tract. The study was carried out using microbiological data collected corresponding to the period between 2008 and 2017. Antimicrobial susceptibility testing was performed using the disk diffusion method and E-tests. The age range of patients affected from the outpatient and inpatient groups differed significantly (43 [range 0.7-99] vs. 68 [range 0.4-99] years; p = 0.008). 3962 GPCs were obtained from inpatient and 4358 from outpatient samples, corresponding to 20.5 ± 2.8% (range 17.5-26.8%) and 20.6 ± 2.6% (range 17.8-26.0%) of all positive urine samples (p > 0.05); in both groups, Enterococcus spp. were the most prevalent (outpatients: 79.6%; inpatients: 88.5%). High-level aminoglycoside resistance in enterococci was noted in 31.0-46.6% of cases. A pronounced increase in the number of MRSA was seen in the second half of the study period (0.6-1.9% vs. 9.8-11.6%; p = 0.038). The ratio of VRE isolates was 0.16%, no VISA/VRSA isolates were detected.
Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Bacterias Grampositivas/microbiología , Cocos Grampositivos , Infecciones Urinarias/microbiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Farmacorresistencia Bacteriana , Enterococcus/efectos de los fármacos , Femenino , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/epidemiología , Cocos Grampositivos/efectos de los fármacos , Humanos , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Prevalencia , Factores Sexuales , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Adulto JovenRESUMEN
Gram-positive anaerobic cocci (GPAC), a large group of anaerobic bacteria, are the members of the normal microbiota that colonizes the skin and mucosal surfaces of the human body. However, in case of a wound or when the host becomes immunocompromised, GPAC can cause invasive and most frequently mixed infections. GPAC are the second most frequently isolated bacteria in anaerobic infections. Although the studies are limited, GPAC have been reported to develop resistance to antimicrobial drugs. The resistance of the pathogens to the antimicrobials and improper therapy can cause poor clinical outcomes. Therefore, monitoring of the resistance trends of regional clinically important anaerobic bacteria periodically is recommended. In our study, we aimed to determine the antimicrobial susceptibility profiles of clinically important GPAC. A total of 100 non-duplicated pathogenic GPAC isolates were collected from Marmara University Hospital between 2013 and 2015. The isolates were identified by using conventional methods, "matrix-assisted laser desorption ionization-time of flight mass spectrometry system (MALDI-TOF MS)" (VITEK MS; v3.0, bioMerieux, France) and 16S rRNA gene sequencing. Antimicrobial susceptibility test was carried out by the agar dilution method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The following antimicrobials were tested: penicillin, amoxicillin/ clavulanic acid (AMC), cefoxitin, meropenem, clindamycin, erythromycin, tetracycline, tigecycline, chloramphenicol, moxifloxacin and metronidazole. The minimum inhibitory concentration (MIC) results were interpreted according to the breakpoints described by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoints recommended by CLSI for cefoxitin, tetracycline and moxifloxacin, and breakpoint recommended by Food and Drug Administration (FDA) for tigecycline were used since there were no EUCAST breakpoints for these antimicrobials. MIC50 and MIC90 values were determined for erythromycin since the breakpoint was not described by EUCAST, CLSI or FDA guidelines. The identification results showed that the strains (n= 100) consisted of five different GPAC genus; Parvomonas (40%), Finegoldia (34%), Peptoniphilus (14%), Peptostreptococcus (10%) and Anaerococcus (1%). All of the organisms were susceptible to meropenem, tigecycline and metronidazole. The isolates were highly susceptible to penicillin, AMC, cefoxitin, and chloramphenicol, since the resistance rates against these antimicrobials were 5% or less. The resistance rates against clindamycin, tetracycline and moxifloxacin were 14%, 31% and 24%, respectively. In total, 11% of the isolates were multidrug resistant. Metronidazole and tigecycline displayed high in vitro activity against GPAC and both are appropriate antimicrobials for the selection of empiric therapy. The effectiveness of meropenem was also found high, but it was observed that this antimicrobial would be more appropriate to use in the treatment of severe mixed infections accompanied by other microorganisms with the resistance potential. Detection of penicillin and AMC resistant isolates, which are frequently used in the treatment of GPAC infection, requires periodic monitoring of the antimicrobial susceptibility patterns of GPAC. The high rates of resistance against clindamycin, tetracycline and moksifloxacin indicated that these antimicrobials should not be used for empirical treatment of infections without prior antimicrobial susceptibility testing. This study is one of the largest susceptibility studies specifically carried out on GPAC to date in Turkey. We believe that our results will provide good surveillance data both for our hospital and our country.
Asunto(s)
Antibacterianos , Farmacorresistencia Bacteriana , Cocos Grampositivos , Anaerobiosis , Antibacterianos/farmacología , Cocos Grampositivos/efectos de los fármacos , Cocos Grampositivos/genética , Humanos , Pruebas de Sensibilidad Microbiana , ARN Ribosómico 16S/genética , TurquíaRESUMEN
Pterostilbene (PTE), a dimethylated analogue of resveratrol, mostly contained in Vitis vinifera leaves or in other plant sources is well-known for its antioxidant activity. Due to its bioavailability, low hydrophilicity and thus ability to penetrate hydrophobic biological membranes it was found to be an antimicrobial agent. These properties of PTE offer the possibility of its use in the treatment of microbial infections. The emergence of antibiotic resistance of microorganisms is often caused by their ability to form biofilm; new substances with antibiofilm activity are therefore sought. The representatives of opportunistic pathogenic gram-positive and gram-negative bacteria as well as fungi were used for the determination of minimum inhibitory concentrations (MIC50 and MIC80), minimum biofilm inhibitory concentrations (MBIC50 and MBIC80) and minimum biofilm eradication concentrations (MBEC50 and MBEC80) of PTE and commonly used antibiotics erythromycin, polymyxin B or antimycotic amphotericin B. Total biofilm biomass was investigated by crystal violet staining, and the results were confirmed using microscopic techniques. The most significant antibiofilm action was proved for gram-positive cocci, e.g., MBEC50 of PTE for all strains of Staphylococcus epidermidis tested was 25 mg/L. By contrast, the antibiotic ERM did not exhibit antibiofilm activity in most cases. The permeabilization of cell membranes of gram-positive cocci biofilm by MBIC50 and MBEC50 of PTE was confirmed by LIVE/DEAD staining using spinning disc confocal microscopy. PTE significantly influenced the ability of gram-positive cocci to form biofilm and it effectively eradicated pre-formed biofilm in vitro; its potential for the treatment of biofilm-associated infections of Staphylococcus spp. or Enterococcus faecalis is thus apparent.
Asunto(s)
Antibacterianos/farmacología , Antioxidantes/farmacología , Biopelículas/efectos de los fármacos , Cocos Grampositivos/efectos de los fármacos , Estilbenos/farmacología , Biopelículas/crecimiento & desarrollo , Enterococcus faecalis/efectos de los fármacos , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Extractos Vegetales/farmacología , Hojas de la Planta/química , Pseudomonas aeruginosa/efectos de los fármacos , Staphylococcus epidermidis/efectos de los fármacos , Vitis/químicaRESUMEN
Abstract Background: The increasingly frequent use of dermoscopy makes us think about the possibility of transfer of microorganisms, through the dermatoscope, between doctor and patients. Objectives: To identify the most frequent gram-positive cocci in dermatoscopes and smartphone adapters, as well as the resistance profile, and to evaluate the factors associated with a higher risk of bacterial contamination of the dermatoscopes. Methods: A cross-sectional study was carried out with 118 dermatologists from Porto Alegre/Brazil between September 2017 and July 2018. Gram-positive cocci were identified by MALDI-TOF MS and habits of use of the dermatoscope were evaluated through an anonymous questionnaire. Results: Of the dermatoscopes analysed, 46.6% had growth of gram-positive cocci on the lens and 37.3% on the on/off button. The microorganisms most frequently found were S. epidermidis, S. hominis and S. warneri. Attending a hospital, using the dermatoscope at the hospital, with inpatients and in the intensive care unit were significantly associated with colonisation by gram-positive cocci. The highest resistance rates were observed for penicillin, erythromycin and sulfamethoxazole-trimethoprim. Study limitations: The non-search of gram-negative bacilli, fungi and viruses. Moreover, the small number of adapters did not make it possible to better define if the frequency differences were statistically significant. Conclusion: Coagulase-negative staphylococci were frequently identified. S. aureus was detected only on the lens.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Infecciones por Bacterias Grampositivas/epidemiología , Cocos Grampositivos/aislamiento & purificación , Dermoscopía/instrumentación , Teléfono Inteligente , Dermatólogos/estadística & datos numéricos , Brasil/epidemiología , Pruebas de Sensibilidad Microbiana , Estudios Transversales , Encuestas y Cuestionarios , Factores de Riesgo , Infecciones por Bacterias Grampositivas/microbiología , Cocos Grampositivos/crecimiento & desarrollo , Cocos Grampositivos/efectos de los fármacos , Distribución por Sexo , Distribución por Edad , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Farmacorresistencia Bacteriana , Persona de Mediana Edad , Antibacterianos/farmacologíaRESUMEN
BACKGROUND: The increasingly frequent use of dermoscopy makes us think about the possibility of transfer of microorganisms, through the dermatoscope, between doctor and patients. OBJECTIVES: To identify the most frequent gram-positive cocci in dermatoscopes and smartphone adapters, as well as the resistance profile, and to evaluate the factors associated with a higher risk of bacterial contamination of the dermatoscopes. METHODS: A cross-sectional study was carried out with 118 dermatologists from Porto Alegre/Brazil between September 2017 and July 2018. Gram-positive cocci were identified by MALDI-TOF MS and habits of use of the dermatoscope were evaluated through an anonymous questionnaire. RESULTS: Of the dermatoscopes analysed, 46.6% had growth of gram-positive cocci on the lens and 37.3% on the on/off button. The microorganisms most frequently found were S. epidermidis, S. hominis and S. warneri. Attending a hospital, using the dermatoscope at the hospital, with inpatients and in the intensive care unit were significantly associated with colonisation by gram-positive cocci. The highest resistance rates were observed for penicillin, erythromycin and sulfamethoxazole-trimethoprim. STUDY LIMITATIONS: The non-search of gram-negative bacilli, fungi and viruses. Moreover, the small number of adapters did not make it possible to better define if the frequency differences were statistically significant. CONCLUSION: Coagulase-negative staphylococci were frequently identified. S. aureus was detected only on the lens.
Asunto(s)
Dermatólogos/estadística & datos numéricos , Dermoscopía/instrumentación , Infecciones por Bacterias Grampositivas/epidemiología , Cocos Grampositivos/aislamiento & purificación , Teléfono Inteligente , Adulto , Distribución por Edad , Antibacterianos/farmacología , Brasil/epidemiología , Estudios Transversales , Farmacorresistencia Bacteriana , Femenino , Infecciones por Bacterias Grampositivas/microbiología , Cocos Grampositivos/efectos de los fármacos , Cocos Grampositivos/crecimiento & desarrollo , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Factores de Riesgo , Distribución por Sexo , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Encuestas y CuestionariosRESUMEN
The article presents the results of a multicenter study of the etiology, antibiotic sensitivity and pharmacoepidemiology of infective endocarditis in the Russian Federation. The purpose of this study is to analyze the current practice of management of patients with infective endocarditis in conditions of low frequency of etiologically significant pathogens in the Russian Federation. The study included patients of both sexes of all age groups with definite and probable infective endocarditis. 406 cases of infectious endocarditis (240 in retrospect and 166 in the prospective part) were analyzed. Etiologically significant pathogen was isolated in 144 cases (35.5%). The structure of pathogens was dominated by gram (+) cocci (90.3%), most often - Staphylococcus aureus (46.5% of all isolated pathogens). Aminoglycosides (22.8%), parenteral cephalosporins of the III generation (22.1%) and glycopeptides (14.5%) were most frequently used in the course of starting antimicrobial therapy. When changing the mode of antimicrobial therapy, glycopeptides (18.6%), aminoglycosides (15.3%), fluoroquinolones (11.2%) and parenteral cephalosporins of generation III (9.5%) were most often prescribed.
Asunto(s)
Antibacterianos/uso terapéutico , Endocarditis Bacteriana/tratamiento farmacológico , Cocos Grampositivos/efectos de los fármacos , Staphylococcus aureus/efectos de los fármacos , Cefalosporinas , Resistencia a Medicamentos , Endocarditis Bacteriana/epidemiología , Endocarditis Bacteriana/microbiología , Femenino , Cocos Grampositivos/patogenicidad , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Farmacoepidemiología , Estudios Prospectivos , Federación de Rusia/epidemiología , Staphylococcus aureus/aislamiento & purificación , Staphylococcus aureus/patogenicidadRESUMEN
Introduction. Among the causative agents of bloodstream infections (BSIs), methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) are the key causative pathogens. Their rapid detection directly from Gram-positive cocci-positive blood culture specimens will promote timely treatment and help to implement effective infection control measures.Aim. We aim to develop a PCR-dipstick technique for the rapid detection of MRSA and VRE directly from positive blood culture specimens.Methodology. PCR-dipstick is a PCR-based multiplex detection technique where DNA-DNA hybridization is employed, and the results are interpreted with the naked eye. It was designed to target three drug resistance genes: mecA in MRSA and vanA/vanB in VRE from positive blood culture specimens. A total of 120 clinical isolates were used to evaluate the sensitivity and specificity of PCR-dipstick. Then, PCR-dipstick was examined for MRSA and VRE detection directly from positive blood cultures.Results. PCR-dipstick showed 100â% sensitivity and specificity in detecting mecA, vanA and vanB genes directly from bacterial colonies in comparison with multiplex PCR for genomic DNA followed by agarose gel electrophoresis. Further, it could differentially detect multiple resistant genes in pooled bacterial colonies (n=10). Ultimately, PCR-dipstick could detect MRSA and VRE in positive blood cultures in ~3 h.Conclusion. The results of the current study substantiate that PCR-dipstick can be used as an efficient detection system for MRSA and VRE directly from Gram-positive cocci-positive blood cultures. Its affordability and rapidity indicate that PCR-dipstick can be an effective tool for controlling nosocomial pathogens.
Asunto(s)
Proteínas Bacterianas/genética , Infecciones por Bacterias Grampositivas/microbiología , Cocos Grampositivos/genética , Reacción en Cadena de la Polimerasa Multiplex/métodos , Antibacterianos/farmacología , Proteínas Bacterianas/metabolismo , Sangre/microbiología , Cultivo de Sangre , Farmacorresistencia Bacteriana , Infecciones por Bacterias Grampositivas/sangre , Infecciones por Bacterias Grampositivas/diagnóstico , Cocos Grampositivos/clasificación , Cocos Grampositivos/efectos de los fármacos , Cocos Grampositivos/aislamiento & purificación , Humanos , Reacción en Cadena de la Polimerasa Multiplex/instrumentaciónRESUMEN
Introduction: Several studies have investigated the genes encoding aminoglycoside-modifying enzymes (AMEs) among gram-positive cocci (GPC) such as Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), coagulase-negative staphylococci (CoNS), and Enterococcus spp. in Iran; however, a comprehensive analysis has not yet been performed. Thus, the present systematic review and meta-analysis was conducted to determine the prevalence of genes encoding AMEs among GPC in Iran. Methods: A systematic review of the data published in the English and Persian languages from January 2000 to October 2018 was performed by searching different electronic databases (Medline, Embase, Web of Science, and the Iranian Database). Meta-analysis was performed by using the Comprehensive Meta-Analysis (Biostat V2.2) software. Cochran's Q and I2 statistics were used to test heterogeneity, and publication bias was assessed by using funnel plot and Begg's and Egger's tests. Results: Out of 117 studies, 28 were considered eligible for inclusion in the current meta-analysis. The most prevalent AMEs gene among GPC was aac(6')-Ie-aph(2'')-Ia, with a prevalence of 97.7% (95% CI; 94.4-99) in high-level gentamicin-resistant enterococci and 67.7% (95% CI; 59.2-75.2) in MRSA. The second most common gene was ant(4')Ia, with a prevalence of 45.3% (95% CI; 23.9-68.6) in MRSA. Conclusions: It was ultimately determined that the prevalence of AMEs genes among GPC had reached alarming levels in Iran; therefore, aminoglycosides should be prescribed with caution by clinicians. The implementation of a regional and nationwide surveillance system to monitor antimicrobial resistance, especially aminoglycosides, and increasing the awareness of AMEs genes among clinicians are essential to guiding empirical and pathogen-specific therapy.
Asunto(s)
Aminoglicósidos/farmacología , Antibacterianos/farmacología , Cocos Grampositivos/efectos de los fármacos , Cocos Grampositivos/genética , Farmacorresistencia Bacteriana Múltiple/genética , Humanos , IránRESUMEN
A 5-year-old girl was referred to our institution with complaints of right hip pain and fever (39.0°C); blood tests and magnetic resonance imaging (MRI) were performed. Blood biochemical results revealed a high inflammatory reaction. MRI results revealed inflammation in the hip joint. She was diagnosed with pediatric septic arthritis of the hip, which required arthrotomy and lavage drainage. Treatment with intravenous vancomycin was initiated on the assumption that the causative bacterial species was Staphylococcus aureus. However, Group A Streptococcus pyogenes (GAS) was subsequently isolated from an intraoperative sample, and the antimicrobial agent was switched to aminobenzylpenicillin (ABPC). Clindamycin (CLDM) was added to the treatment regimen 14 days after surgery as MRI indicated the development and spread of osteomyelitis. Three months post-surgery, MRI findings indicated that the osteomyelitis had resolved and antimicrobial therapy was discontinued. To prevent the spread of osteomyelitis, a combination of CLDM and ABPC should be considered at an early stage, particularly in pediatric patients with GAS-induced septic arthritis.
Asunto(s)
Antibacterianos/uso terapéutico , Artritis Infecciosa/tratamiento farmacológico , Clindamicina/uso terapéutico , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Cadera/microbiología , Osteomielitis/tratamiento farmacológico , Antibacterianos/administración & dosificación , Artritis Infecciosa/diagnóstico , Artritis Infecciosa/cirugía , Preescolar , Clindamicina/administración & dosificación , Femenino , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/cirugía , Cocos Grampositivos/efectos de los fármacos , Cocos Grampositivos/aislamiento & purificación , Cadera/diagnóstico por imagen , Cadera/cirugía , Humanos , Imagen por Resonancia Magnética , Osteomielitis/diagnóstico , Osteomielitis/cirugíaAsunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/microbiología , Infecciones por Bacterias Grampositivas/microbiología , Cocos Grampositivos/efectos de los fármacos , Infecciones Urinarias/microbiología , Adolescente , Adulto , Anciano , Bacteriemia/epidemiología , Bacteriemia/microbiología , Canadá/epidemiología , Monitoreo Epidemiológico , Femenino , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Grampositivas/epidemiología , Cocos Grampositivos/aislamiento & purificación , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/microbiología , Infecciones Urinarias/epidemiología , Infección de Heridas/epidemiología , Infección de Heridas/microbiología , Adulto JovenRESUMEN
A total of 368 Gram-positive cocci from ABSSI were included in the study. S. aureus and S. pyogenes were susceptible to dalbavancin with MIC50 0.016â¯mg/L and MIC90 0.032â¯mg/L for MSSA and MIC50 0.032â¯mg/L and MIC90 0.047â¯mg/L for MRSA; MICs for S. pyogenes were ≤0.002-0.008â¯mg/L; for E. faecalis and E. faecium, ranging 0.016-0.12â¯mg/L and 0.012-≥32â¯mg/L, respectively; MICs for VRE were 0.032-0.125â¯mg/L.
Asunto(s)
Antibacterianos/farmacología , Cocos Grampositivos/efectos de los fármacos , Infecciones de los Tejidos Blandos/microbiología , Teicoplanina/análogos & derivados , Monitoreo Epidemiológico , Cocos Grampositivos/aislamiento & purificación , Humanos , Pruebas de Sensibilidad Microbiana , Polonia/epidemiología , Infecciones de los Tejidos Blandos/epidemiología , Teicoplanina/farmacologíaAsunto(s)
Cocos Grampositivos/efectos de los fármacos , Insuficiencia Multiorgánica/prevención & control , Sepsis/tratamiento farmacológico , Ticagrelor/farmacología , Ticagrelor/uso terapéutico , Adenosina/metabolismo , Animales , Antibacterianos/farmacocinética , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Plaquetas/efectos de los fármacos , Plaquetas/metabolismo , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Humanos , Insuficiencia Multiorgánica/microbiología , Inhibidores de Agregación Plaquetaria/uso terapéutico , Antagonistas del Receptor Purinérgico P2Y/uso terapéutico , Sepsis/microbiología , Ticagrelor/farmacocinéticaRESUMEN
BACKGROUND: Peritoneal dialysis-associated peritonitis (PDAP) is one of the major causes of peritoneal dialysis (PD) failure and death. Therefore, it is important to determine how to effectively treat patients with PDAP. MATERIALS AND METHODS: We analyzed the pathogen spectrum and bacterial resistance in 203 PDAP cases that were enrolled in this study from January 1, 2015 to December 31, 2017. All patients were infected with peritonitis and had been treated with antibiotics while at our center. Bacterial culture results of PD fluid and pathogen drug resistance were collected and analyzed. A total of 159 cases (78.3%) had a positive bacterial culture of PD fluid. RESULTS: A total of 47 pathogens were identified, including 19 (40.4%) Gram-positive cocci strains (the most common was Staphylococcus spp.), 15 (31.9%) Gram-negative bacilli strains (the most common was Escherichia coli, 4 fungal strains, and 9 other strains. The drug sensitivity test showed that Gram-positive cocci were sensitive to vancomycin (94.9%), but had a high resistance to cefazolin (67.7%). Gram-negative bacilli were sensitive to imipenem (96.2%), but had a high resistance to ceftriaxone (60.0%). Voriconazole and itraconazole were sensitive in fungal infections. A total of 162 cases were cured, 37 cases were unresponsive to antibiotic treatment and converted to hemodialysis after Tenckhoff catheter removal, and 4 cases resulted in death. CONCLUSION: Gram-positive cocci are still the primary pathogen of PDAP cases in our center, but demonstrate a high resistance to first-generation cephalosporin, which is the suggested treatment per International Society for Peritoneal Dialysis 2016 Peritonitis Recommendations. Therefore, an individualized treatment based on the distribution of pathogens and drug resistance in different centers is more conducive to improve the cure rate of PDAP.
Asunto(s)
Antibacterianos/uso terapéutico , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Cocos Grampositivos/efectos de los fármacos , Diálisis Peritoneal/efectos adversos , Peritonitis/microbiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Antifúngicos/uso terapéutico , Infecciones Bacterianas , Cefazolina/uso terapéutico , Ceftriaxona/uso terapéutico , Farmacorresistencia Bacteriana , Femenino , Humanos , Imipenem/uso terapéutico , Itraconazol/uso terapéutico , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Micosis/tratamiento farmacológico , Peritonitis/etiología , Vancomicina/farmacología , Voriconazol/uso terapéutico , Adulto JovenRESUMEN
Bacterial keratitis is an aggressive infectious corneal disease. With the continuing rise in antibiotic resistance and a decline in the discovery of new antibiotics, new antimicrobial drugs are now required. In the present study, we determined the antibacterial activity of diacerein, an anti-inflammatory drug, against 76 Gram-positive cocci isolated from bacterial keratitis patients in vitro and anti-Staphylococcus aureus activity in a mouse bacterial keratitis model in vivo The MICs of diacerein were tested using the broth microdilution method in vitro A BALB/c Staphylococcus aureus keratitis animal model was selected and the corneal clinical observation, viable bacteria, and hematoxylin-eosin and Gram staining of infected corneas were measured to evaluate the antibacterial efficacy of diacerein eye drops in vivo An in vivo eye irritation study was carried out by a modified Draize test in rabbits. Our in vitro results showed that diacerein possesses satisfactory antibacterial activity against the majority of Gram-positive cocci (60/76), including all 57 tested Staphylococcus spp. and 3 Enterococcus spp. The in vivo experiment showed that diacerein eye drops reduced bacterial load and improved ocular clinical scores after topical administration of diacerein drops on infected corneas. The ocular irritation test revealed that diacerein eye drop had excellent ocular tolerance. These results indicated that diacerein possesses in vivo anti-Staphylococcus aureus activity. We suggest that diacerein is a possible topically administered drug for Staphylococcus aureus-infected patients, especially those with ocular surface inflammatory disorders.
Asunto(s)
Antraquinonas/farmacología , Antibacterianos/farmacología , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/microbiología , Cocos Grampositivos/efectos de los fármacos , Queratitis/microbiología , Animales , Antraquinonas/metabolismo , Infecciones Bacterianas del Ojo/microbiología , Infecciones Bacterianas del Ojo/patología , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Cocos Grampositivos/aislamiento & purificación , Humanos , Queratitis/tratamiento farmacológico , Ratones Endogámicos BALB C , Pruebas de Sensibilidad Microbiana , Soluciones Oftálmicas , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/patología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/patogenicidadRESUMEN
INTRODUCTION: Over recent years we have witnessed an increase in the resistance of microorganisms to the available antimicrobials and a decrease in the number of new antimicrobials. Fosfomycin is a safe and cheap broad-spectrum antibiotic which has shown very promising results in combination therapy, mainly against gram-negative microorganisms. Little is known, however, about its clinical efficacy against gram-positive microorganisms. METHODS: We performed a retrospective review of all patients with severe gram-positive infections who received fosfomycin as part of their treatment from 2011 to 2017. We also performed in vitro time-kill assays to study the behaviour of fosfomycin with different antimicrobials against two strains of methicillin-resistant Staphylococcus aureus (MRSA) and two strains of methicillin-susceptible S. aureus (MSSA). RESULTS: Seventy-five patients were treated with different fosfomycin combinations. Among them, 61 (81%) were successfully treated. Daptomycin plus fosfomycin was the most effective combination. Overall, the treatment with fosfomycin was safe, and side effects were minor. There was only one major side effect that resolved after discontinuation of therapy. Time-kill studies demonstrated increased activity of fosfomycin combinations, with daptomycin-fosfomycin being the most active combination against both MRSA and MSSA strains. CONCLUSIONS: Our results suggest that antimicrobial combinations including fosfomycin are an alternative and effective approach for gram-positive infections.