Fabrication of antibacterial polydopamine-carboxymethyl cellulose-Ag nanoparticle hydrogel coating for urinary catheters.

Urinary tract infections caused by catheter insertion are prevalent in hospital clinics, which can induce serious complications such as bacteriuria and sepsis, and even lead to patient death. The disposable catheters currently used in clinical practice suffer from poor biocompatibility and high infection rate. In this paper, we developed a polydopamine (PDA)-carboxymethylcellulose (CMC)-Ag nanoparticles (AgNPs) coating with both good antibacterial and anti-adhesion properties to bacteria on the surfaces of a disposable medical latex catheter by a simple dipping method. The antibacterial efficiency of the coated catheters against Gram-negative E. coli and Gram-positive S. aureus bacteria was evaluated with both inhibition zone tests and fluorescence microscopy. Compared with the untreated catheter, the PDA-CMC-AgNPs coated catheters showed both good antibacterial and anti-adhesion properties to bacteria, which inhibited the adhesion of live bacteria and dead bacteria by 99.0% and 86.6%, respectively. This novel PDA-CMC-AgNPs composite hydrogel coating has great potential in applications in catheters and other biomedical devices to reduce infections.

Agar dilution method for detection of inducible clindamycin resistance in Staphylococcus spp.

We describe the development and validation of an agar dilution method for the detection of inducible clindamycin resistance by using 227 previously characterized erythromycin-resistant, clindamycin-susceptible Staphylococcus sp. isolates. Mueller-Hinton agar with defibrinated horse blood containing a range of erythromycin concentrations (1 to 8 mg/liter) combined with clindamycin at 0.5 mg/liter was used to determine the optimal concentration that produced growth of inducible isolates while inhibiting that of isolates without the inducible phenotype. A concentration of clindamycin of 0.5 mg/liter with erythromycin at 1 mg/liter was the optimal combination for detection of inducible resistance and resulted in a sensitivity of 100% (95% confidence interval [CI], 97.9 to 100) and a specificity of 100% (95% CI, 93.0 to 100). Attention must be paid to ensuring that a sufficient inoculum has been used, since an inoculum below the standard 10(7) bacteria/ml may result in false-negative results. This method has been incorporated into routine use in our laboratory.

Comparison of single- and multilocus sequence typing and toxin gene profiling for characterization of methicillin-resistant Staphylococcus aureus.

We compared three novel methicillin-resistant Staphylococcus aureus (MRSA) genotyping methods with multilocus sequence typing (MLST) and spa typing to assess their utility for routine strain typing. The new methods were femA and nuc sequence typing and toxin gene profiling (TGP), using a multiplex-PCR-based reverse line blot assay to detect 13 pyrogenic superantigen and exfoliative toxin genes. Forty-two well-characterized MRSA strains, representing 15 MLSTs or 9 clonal clusters (CCs), were genotyped by all methods. Twenty-two spa, nine femA, and seven nuc sequence types were identified. The femA sequence types correlated exactly with CCs; nuc sequences types were less discriminatory but generally correlated well with femA types and CCs. Ten isolates contained none of 13 toxin genes; TGPs of the remainder comprised 1 to 5 toxin genes. The combination of spa typing and TGPs identified 26 genotypes among the 42 strains studied. A combination of two or three rapid, inexpensive genotyping methods could potentially provide rapid MRSA strain typing as well as useful information about clonal origin and virulence.

Influence of disk separation distance on accuracy of the disk approximation test for detection of inducible clindamycin resistance in Staphylococcus spp.

We undertook this study to assess the accuracy of the clindamycin-erythromycin disk approximation test (D-test) for detection of inducible clindamycin resistance in Staphylococcus spp. One hundred sixty-three Staphylococcus aureus and 68 coagulase-negative Staphylococcus (CoNS) spp. which were erythromycin nonsusceptible but clindamycin susceptible were tested using the D-test performed at both 15-mm and 22-mm disk separations and compared with genotyping as the "gold standard." The rate of inducible clindamycin resistance was 96.3% for S. aureus and 33.8% for CoNS spp. The sensitivities of the D-tests performed at 15 mm and 22 mm were 100% and 87.7%, respectively, and specificities were 100% for both. The use of 22-mm disk separation for the D-test to detect inducible clindamycin resistance results in an unacceptably high very major error rate (12.3%). All isolates with false-negative results harbored the ermA gene, and the majority were methicillin-resistant Staphylococcus aureus. False-negative results were associated with smaller clindamycin zone sizes and double-edged zones. We recommend using a disk separation distance of