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1.
R I Med J (2013) ; 103(2): 18-20, 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32122094

RESUMO

Hospital antibiograms, because they are typically derived from samples obtained from hospitalized patients, may overestimate the prevalence of methicillin resistance in S. aureus in individuals presenting to the hospital for surgery. Because hospital antibiograms are commonly used to justify empiric perioperative prophylactic antibiotic selection prior to surgery, this may lead to unnecessary treatment with broad-spectrum antibiotics such as vancomycin. In a single-institution study, we observed that in our hospital antibiogram the proportion of S. aureus that are methicillin-resistant (MRSA) was significantly higher (45%) than isolates in preoperative nasal cultures obtained at the same hospital in outpatients prior to their lower extremity joint replacement surgery (13%): mean difference 0.32, [95% CI 0.25, 0.39], p <0.0001. These data suggest that hospital antibiograms may overstate the true prevalence of MRSA in those at risk for MRSA surgical site infections who present from the outpatient setting.


Assuntos
Antibacterianos/farmacologia , Portador Sadio/microbiologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Cavidade Nasal/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Adulto , Antibacterianos/uso terapêutico , Portador Sadio/epidemiologia , Feminino , Humanos , Masculino , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Período Pré-Operatório , Prevalência , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/efeitos dos fármacos
2.
BMC Infect Dis ; 20(1): 29, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924177

RESUMO

BACKGROUND: Streptococcus pneumoniae carriage is often asymptomatic but can cause invasive pneumococcal disease. Pneumococcal carriage is a prerequisite for disease, with children as main reservoir and transmitters. Childhood carriage can therefore be used to determine which serotypes circulate in the population and which may cause disease in the non-vaccinated population. In 2006, a pneumococcal conjugate vaccine (PCV7) was introduced into the Norwegian Childhood Immunisation Programme, which was replaced by the more valent PCV13 in 2011. We investigated changes in pneumococcal carriage prevalence 4 years after switching to PCV13 compared to three previous surveys, and analysed factors associated with carriage in children. METHODS: We conducted a cross-sectional study in Norway, autumn 2015, among children attending day-care centres. We collected questionnaire data and nasopharyngeal swabs to identify pneumococcal serotypes. We compared the carriage prevalence in 2015 with surveys conducted in the same setting performed before widespread vaccination (2006; n = 610), 2 years after PCV7 introduction (2008; n = 600), and 2 years after switching to PCV13 (2013; n = 874). Using multilevel logistic regression we determined the association between pneumococcal carriage and previously associated factors. RESULTS: In 2015, 896 children participated, with age ranging from 8 to 80 months. The overall carriage prevalence was 48/100 children [95%CI 44-53] in 2015, 38% [29-46] lower than in 2006 pre-PCV7, and 23% [12-32] lower than in 2013, 2 years after switching to PCV13. The PCV13 carriage prevalence was 2.8/100 children [1.9-4.2] in 2015. Increasing age (p < 0.001), recent antimicrobial use (odds ratio = 0.42 [0.21-0.57]) and being vaccinated (odds ratio = 0.37 [0.29-0.47]) were negatively associated with carriage. CONCLUSIONS: Our study showed a continued decrease in overall pneumococcal carriage, mainly fuelled by the decline in vaccine serotypes after vaccine introduction. Childhood vaccination with PCV13 should be continued to keep low PCV13 carriage, transmission and disease. Furthermore, the low prevalence of PCV13-type carriage in children endorse the choice of not recommending PCV13 in addition to the 23-valent pneumococcal polysaccharide vaccine to most medical risk groups in Norway, as little disease caused by these serotypes can be expected.


Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Fatores Imunológicos/uso terapêutico , Vacinas Pneumocócicas/uso terapêutico , Streptococcus pneumoniae/imunologia , Portador Sadio/prevenção & controle , Criança , Pré-Escolar , Estudos Transversais , Análise Fatorial , Feminino , Vacina Pneumocócica Conjugada Heptavalente/uso terapêutico , Humanos , Programas de Imunização/tendências , Lactente , Testes de Fixação do Látex , Masculino , Noruega/epidemiologia , Razão de Chances , Prevalência , Sorogrupo , Inquéritos e Questionários , Vacinação , Vacinas Conjugadas/uso terapêutico
3.
J Hosp Infect ; 104(3): 293-297, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31870885

RESUMO

BACKGROUND: Little is known about patient risk factors associated with environmental contamination. AIM: To evaluate the rate of environmental contamination and to investigate individual risk factors. METHODS: A prospective cohort study was conducted. Each day, five rooms occupied by patients were selected. Five critical surfaces were systematically swabbed twice a day before and after cleaning. Clinical characteristics of all patients were collected. Logisitic regression was performed to evaluate the association between environmental contamination and patients' characteristics. FINDINGS: A total of 107 consecutive patients were included and 1052 environmental samples were performed. Nineteen (18%) patients were known previously colonized/infected with a multidrug-resistant organism (MDRO). Respectively, 723 (69%) and 112 (11%) samples grew with ≥1 and >2.5 cfu/cm2 bacteria, resulting in 62 (58%) contaminated rooms. Considering positive samples with at least one pathogenic bacterium, 16 (15%) rooms were contaminated. By univariate and multivariate analysis, no variables analysed were associated with the environmental contamination. Considering contaminated rooms with >2.5 cfu/cm2, three factors were protective for environmental contamination: known MDRO carriers/infected patients (odds ratio: 0.25; 95% confidence interval: 0.09-0.72; P = 0.01), patients with urinary catheter (0.19; 0.04-0.89; P = 0.03) and hospitalization in single room (0.3; 0.15-0.6; P < 0.001). CONCLUSION: This study was conducted in a non-outbreak situation and showed a low rate of environmental contamination with pathogenic bacteria. Only 11% of environmental samples grew with >2.5 cfu/cm2, and they were related to non-pathogenic bacteria. No risk factors associated with environmental contamination were identified.


Assuntos
Bactérias/isolamento & purificação , Infecção Hospitalar/microbiologia , Microbiologia Ambiental , Portador Sadio/microbiologia , Portador Sadio/transmissão , Estudos de Coortes , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Reservatórios de Doenças , Humanos , Quartos de Pacientes , Estudos Prospectivos
4.
APMIS ; 128(1): 35-40, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31628868

RESUMO

Kingella kingae colonizes the upper airways in children and has been recognized as the most common causative agent of osteoarticular infections (OAI) in children below 4 years of age. This is the first Scandinavian study to investigate oropharyngeal K. kingae carriage in healthy children. From June 2015 to August 2016, we recruited 198 healthy children aged 11-14 months from routine consultations at health promotion centers in Hordaland County, Norway for a cross-sectional study. After their parents had provided informed consent; demographic data were registered, and an oropharyngeal swab was collected. The oropharyngeal swab was analyzed with a real-time PCR assay specific to K. kingae targeting the RTX toxin locus. Results showed an asymptomatic carriage rate of 12.6%. A striking and highly significant difference was observed between the children that had started attending day care facilities as compared with children still being at home (33.33% vs 8.5%; p < 0.001). K. kingae is prevalent in young children in Norway. This study emphasize that K. kingae should be considered an important etiological agent in OAI. Transmission seems to be facilitated in day care facilities. The correlation between oropharyngeal carriage and OAI needs to be further explored.


Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Creches , Kingella kingae/isolamento & purificação , Infecções por Neisseriaceae/epidemiologia , Orofaringe/microbiologia , Infecções Assintomáticas/epidemiologia , Proteínas de Bactérias/genética , Estudos Transversais , Feminino , Humanos , Lactente , Kingella kingae/genética , Masculino , Noruega/epidemiologia , Osteomielite/diagnóstico , Osteomielite/microbiologia , Reação em Cadeia da Polimerase , Prevalência , Estudos Prospectivos
5.
BMC Infect Dis ; 19(1): 1023, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791276

RESUMO

BACKGROUND: Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and identify S. aureus lineages that cause infection in Uganda. METHODS: Nasopharyngeal samples from 742 healthy children less than 5 years residing in the Iganga/Mayuge Health and Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic susceptibility testing based on minimum inhibitory concentrations (MICs) was determined by the BD Phoenix™ system. Genotyping was performed by spa and SCCmec typing. RESULTS: The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All isolates were susceptible to rifampicin, vancomycin and linezolid. Moreover, all MRSA were susceptible to vancomycin, linezolid and clindamycin. Compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials -trimethoprim/sulfamethoxazole 73.3% (33/45) vs. 27.3% (27/99) [p < 0.0001]; erythromycin 75.6% (34/45) vs. 24.2% (24/99) [p < 0.0001]; chloramphenicol 60% (27/45) vs. 19.2% (19/99) [p < 0.0001]; gentamicin 55.6% (25/45) vs. 25.3% (25/99) [p = 0.0004]; and ciprofloxacin 35.6% (16/45) vs. 2% (2/99) [p < 0.0001]. Furthermore, 42 MRSA (93.3%) were multidrug resistant (MDR) and one exhibited high-level resistance to mupirocin. Overall, 61 MSSA (61.6%) were MDR, including three mupirocin and clindamycin resistant isolates. Seven spa types were detected among MRSA, of which t037 and t064 were predominant and associated with SCCmec types I and IV, respectively. Fourteen spa types were detected in MSSA which consisted mainly of t645 and t4353. CONCLUSIONS: S. aureus carriage rate in healthy children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.


Assuntos
Antígenos de Bactérias/análise , Portador Sadio/epidemiologia , Farmacorresistência Bacteriana , Nariz/microbiologia , Faringe/microbiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Antígenos de Bactérias/classificação , Antígenos de Bactérias/genética , Portador Sadio/microbiologia , Pré-Escolar , Estudos Transversais , Farmacorresistência Bacteriana/genética , Feminino , Técnicas de Genotipagem/métodos , Humanos , Lactente , Recém-Nascido , Masculino , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Tipagem Molecular/métodos , Mupirocina/farmacologia , Mupirocina/uso terapêutico , Mucosa Nasal/microbiologia , Vigilância da População/métodos , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/genética , Uganda/epidemiologia
6.
Pan Afr Med J ; 33: 239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692895

RESUMO

Introduction: Streptococcus pneumonia is a leading cause of bacterial pneumonia, meningitis and sepsis in children, and pneumococcal carriage is an important source of horizontal spread of these pathogens within the community. Methods: A questionnaire was addressed to parents for the collection of sociodemographic and medical information. Nasopharyngeal swabbing was processed using a molecular method. We used logistic regression models to examine independent associations between pneumococcal carriage and potential risk factors. All associations with a p-value of < 0.25 in the bivariate regression analyses were subsequently entered in the multivariate regression model. Results: A total of 637 children aged 1 to 59 months admitted for acute respiratory infection were included. The rate of respiratory virus carriage was 76%, whereas that of bacteria was 47% and that of bacteria-virus co-colonization was 42%. A bivariate analysis showed that carriage was not related to gender, father's or mother's education level, father's occupation, type of housing or lighting, or passive exposure to cigarette smoking in the house. It was also not linked to complete vaccination with PCV-13 or PPSV-23 and antibiotic treatment prior to hospitalization. A multivariate analysis showed that carriage was related to age greater than 3 months, maternal occupation, house flooring type, and co-colonization of another bacterium and virus. Conclusion: These results can be helpful to understand the dynamics of pneumococcal nasopharyngeal colonization; they confirm the interest of vaccinating infants before the age of 3 months with appropriate vaccine to prevent spread nasopharyngeal colonization and pneumococcal diseases in children.


Assuntos
Portador Sadio/epidemiologia , Nasofaringe/microbiologia , Infecções Respiratórias/epidemiologia , Streptococcus pneumoniae/isolamento & purificação , Antibacterianos/administração & dosagem , Portador Sadio/microbiologia , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Níger , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Vacinas Pneumocócicas/administração & dosagem , Infecções Respiratórias/microbiologia , Fatores de Risco , Inquéritos e Questionários
7.
Klin Lab Diagn ; 64(11): 693-699, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31747501

RESUMO

Staphylococcus aureus asymptomatically persists on the nasal mucosa, and also causes serious diseases in carriers (endogenous infection) and in patients in a hospital (nosocomial infection). Decolonization of nasal carriers of S. aureus is an important measure aimed at reducing the incidence of staphylococcal infections. Carriage is a form of nasal dysbiosis, therefore, the effectiveness of antibiotics for the decolonization of carriers, by definition, is low. The review discusses the prospects of using probiotics to restore the nasal microbiota. The commercial production of nasal probiotics has not yet been established, but developments in this direction are being carried out in different countries. The experimental substantiation of the possibility of using corynebacteria and other representatives of the nasal microbiota for the decolonization of staphylococcal carriers is presented, as well as the authors' ideas on how to improve the methods of microbial therapy. In particular, it was proposed to use biofilm probiotics, autoprobiotics, and autovaccines for this purpose.


Assuntos
Portador Sadio/microbiologia , Probióticos/uso terapêutico , Infecções Estafilocócicas/terapia , Antibacterianos/uso terapêutico , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Humanos , Staphylococcus aureus
8.
Ann Clin Microbiol Antimicrob ; 18(1): 28, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31601221

RESUMO

BACKGROUND: The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) has become a global concern for public health. The proximity of vancomycin-resistant enterococcus (VRE) and methicillin-resistant S. aureus (MRSA) is considered to be one of the foremost risk factors for the development of VRSA. This study aimed to determine the incidence, risk factors, and clinical outcomes of intestinal co-colonization with VRE and MRSA. METHODS: A case-control study was conducted in 52-bed intensive care units (ICUs) of a university-affiliated hospital from September 2012 to October 2017. Active surveillance using rectal cultures for VRE were conducted at ICU admission and on a weekly basis. Weekly surveillance cultures for detection of rectal MRSA were also conducted in patients with VRE carriage. Patients with intestinal co-colonization of VRE and MRSA were compared with randomly selected control patients with VRE colonization alone (1:1). Vancomycin minimum inhibitory concentrations (MICs) for MRSA isolates were determined by the Etest. RESULTS: Of the 4679 consecutive patients, 195 cases and 924 controls were detected. The median monthly incidence and duration of intestinal co-colonization with VRE and MRSA were 2.3/1000 patient-days and 7 days, respectively. The frequency of both MRSA infections and mortality attributable to MRSA were higher in the case group than in the control group: 56.9% vs. 44.1% (P = 0.011) and 8.2% vs. 1.0% (P = 0.002), respectively. Independent risk factors for intestinal co-colonization were enteral tube feeding (odds ratio [OR], 2.09; 95% confidence interval [CI] 1.32-3.32), metabolic diseases (OR, 1.75; 95% CI 1.05-2.93), male gender (OR, 1.62; 95% CI 1.06-2.50), and Charlson comorbidity index < 3 (OR, 3.61; 95% CI 1.88-6.94). All MRSA isolates from case patients were susceptible to vancomycin (MIC ≤ 2 mg/L). CONCLUSIONS: Our study indicates that intestinal co-colonization of VRE and MRSA occurs commonly among patients in the ICU with MRSA endemicity, which might be associated with poor clinical outcomes.


Assuntos
Portador Sadio/epidemiologia , Coinfecção/epidemiologia , Trato Gastrointestinal/microbiologia , Infecções por Bactérias Gram-Positivas/epidemiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Enterococos Resistentes à Vancomicina/isolamento & purificação , Idoso , Antibacterianos/farmacologia , Portador Sadio/microbiologia , Estudos de Casos e Controles , Coinfecção/microbiologia , Feminino , Infecções por Bactérias Gram-Positivas/microbiologia , Hospitais Universitários , Humanos , Incidência , Unidades de Terapia Intensiva , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Fatores de Risco
9.
BMC Res Notes ; 12(1): 565, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31506105

RESUMO

OBJECTIVES: Pharyngeal carriers such as H. influenzae seem to constitute the only reservoir and probably the only transmission vehicle of the invasive disease. The aims of this study were to estimate the prevalence of H. influenzae carriage, to characterize antibiotic susceptibility, and to explore genetic diversity of H. influenzae isolates. Sampling was carried out as nasopharynx swabs among children less than 6 years old volunteers. After traditional biochemical tests, isolates were confirmed by targeting omp6 sequence. Following the susceptibility tests, genomic diversity of strains was analyzed by Pulsed-Field Gel Electrophoresis procedure. RESULTS: Out of 328 nasopharynx swabs, 73 strains were identified as H. influenzae. Among H. influenzae isolates, resistance to chloramphenicol (42%) and ampicillin (43%) was observed. Levofloxacin is the most effective antibiotic and the least effect belonged to tetracycline. By genomic analysis of selected H. influenza, 28 PFGE patterns were achieved among which 11 patterns included at least 2 strains. All strains clustered into 25 different clones. The dendrogram analysis of the isolated H. influenzae strains showed that some of these strains had a clonal relationship and common genetic origin. According to our results, antibiotic resistance didn't show any significant correlation with the clonality of strains.


Assuntos
Antibacterianos/uso terapêutico , Portador Sadio/tratamento farmacológico , Variação Genética , Infecções por Haemophilus/tratamento farmacológico , Haemophilus influenzae/genética , Nasofaringe/efeitos dos fármacos , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Pré-Escolar , Análise por Conglomerados , Eletroforese em Gel de Campo Pulsado , Feminino , Infecções por Haemophilus/epidemiologia , Infecções por Haemophilus/microbiologia , Haemophilus influenzae/classificação , Haemophilus influenzae/fisiologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Testes de Sensibilidade Microbiana/métodos , Nasofaringe/microbiologia , Especificidade da Espécie
10.
Genes (Basel) ; 10(9)2019 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-31500179

RESUMO

We used whole genome sequencing (WGS) analysis to investigate the population structure of 877 Streptococcus pneumoniae isolates from five carriage studies from 2002 (N = 346), 2010 (N = 127), 2013 (N = 153), 2016 (N = 187) and 2018 (N = 64) in UK households which covers the period pre-PCV7 to post-PCV13 implementation. The genomic lineages seen in the population were determined using multi-locus sequence typing (MLST) and PopPUNK (Population Partitioning Using Nucleotide K-mers) which was used for local and global comparisons. A Roary core genome alignment of all the carriage genomes was used to investigate phylogenetic relationships between the lineages. The results showed an influx of previously undetected sequence types after vaccination associated with non-vaccine serotypes. A small number of lineages persisted throughout, associated with both non-vaccine and vaccine types (such as ST199), or that could be an example of serotype switching from vaccine to non-vaccine types (ST177). Serotype 3 persisted throughout the study years, represented by ST180 and Global Pneumococcal Sequencing Cluster (GPSC) 12; the local PopPUNK analysis and core genome maximum likelihood phylogeny separated them into two clades, one of which is only seen in later study years. The genomic data showed that serotype replacement in the carriage studies was mostly due to a change in genotype as well as serotype, but that some important genetic lineages, previously associated with vaccine types, persisted.


Assuntos
Portador Sadio/microbiologia , Genoma Bacteriano , Programas de Imunização/estatística & dados numéricos , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/genética , Adolescente , Adulto , Portador Sadio/epidemiologia , Criança , Pré-Escolar , Características da Família , Vacina Pneumocócica Conjugada Heptavalente/uso terapêutico , Humanos , Filogenia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Infecções Pneumocócicas/transmissão , Vacinas Pneumocócicas/uso terapêutico , Sorogrupo , Streptococcus pneumoniae/imunologia , Streptococcus pneumoniae/isolamento & purificação , Reino Unido
11.
Ann Clin Microbiol Antimicrob ; 18(1): 25, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488199

RESUMO

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of a medically important Gram-positive bacteria, which can be harboured majorly in the nasal cavity. Risk of consequent infection in a person colonized with S. aureus as well as MRSA upsurges with time and remains insistently increased. Hence, the objective of this meta-analysis was to determine the prevalence of S. aureus and MRSA nasal colonization in Ethiopia at large. METHODS: PubMed, Google Scholar, Embase, Hinari, Sci Hub, Scopus, and the Directory of Open Access Journals were searched and a total of 10 studies have been selected for meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for the literature search strategy, selection of publications, data extraction, and the reporting of results for the review. All statistical analyses were performed using STATA version 11 software via random effects model. The pooled prevalence was presented in forest plots and figure with 95% CI. RESULTS: A total of ten studies with 2495 nasal swab samples were included in this meta-analysis, and the overall pooled estimated prevalence of S. aureus and MRSA nasal colonization in Ethiopia were 30.90% [95% CI 21.81-39.99%], 10.94% [95% CI 8.13-13.75%] respectively. Subgroup analysis was also noted in different regions of Ethiopia, henceforth Oromia region ranked first 21.28% [95% CI 8.22-34.35%], followed by Amhara region 6.78% [95% CI 3.02-10.54%], whereas relatively low magnitude of MRSA colonization was demonstrated from Tigray region 4.82% [95% CI 2.18-7.45%]. CONCLUSION: The analysis showed that the overall prevalence of S. aureus and MRSA nasal colonization in Ethiopia were comparable with the global prevalence. But a huge variation between the regions, so the Ministry of Health of Ethiopia should design appropriate decolonization program that can address the specific regional groups as well as the national population.


Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Mucosa Nasal/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
12.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31488697

RESUMO

Mycoplasma pneumoniae pneumonia is prevalent in children and can be followed by upper airway carriage for months. Treatment of M pneumoniae pneumonia with macrolides is widespread and can lead to the development of macrolide resistance. The clinical consequences of chronic M pneumoniae carriage are unknown. In this article, we describe a child with acute lymphoblastic leukemia who developed macrolide-susceptible M pneumoniae pneumonia confirmed by nasopharyngeal secretions polymerase chain reaction and culture with good response to azithromycin. Five months later, the patient developed another M pneumoniae pneumonia that was diagnosed with positive macrolide-resistant M pneumoniae polymerase chain reaction and culture from the bronchoalveolar lavage. The child responded well to fluoroquinolones and eventually was discharged from the hospital. The M pneumoniae recovered from the second pneumonia is a novel strain and is genetically identical to the M pneumoniae that caused the first pneumonia, apart from the macrolide-resistance 23S ribosomal RNA gene. Both isolates are identical in both P1 (subtype 2 with a novel variant, 2bv) and multiple-locus variable number tandem repeat analysis type (53662). This is indicative of chronic M pneumoniae carriage with de novo macrolide-resistance mutation and subsequent breakthrough pneumonia that is reported for the first time here. Children with immunosuppression may be at increased risk of life-threatening macrolide-resistant pneumonia after M pneumoniae carriage. Further studies are required to evaluate the impact of this phenomenon. This will then guide strategies to limit the associated morbidity, such as testing for macrolide resistance, treatment of M pneumoniae pneumonia in high-risk children with bactericidal antibiotics (such as fluoroquinolones), and possibly eradication protocols of M pneumoniae carriage to prevent subsequent life-threatening infections.


Assuntos
Portador Sadio/microbiologia , Farmacorresistência Bacteriana/genética , Mycoplasma pneumoniae/genética , Pneumonia Bacteriana/tratamento farmacológico , Pneumonia Bacteriana/microbiologia , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Líquido da Lavagem Broncoalveolar/microbiologia , Pré-Escolar , Feminino , Humanos , Levofloxacino/uso terapêutico , Reação em Cadeia da Polimerase , Leucemia-Linfoma Linfoblástico de Células Precursoras , RNA Ribossômico 23S/genética
13.
Theor Biol Med Model ; 16(1): 14, 2019 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-31500635

RESUMO

BACKGROUND: Group A streptococcus (GAS) is the most frequent cause of bacterial pharyngitis in school-aged children. The postinfection sequel as acute rheumatic fever (ARF) and rheumatic heart disease that cause morbidity and mortality among young people is public health concerns in several developing countries. Asymptomatic carriage state of GAS is not fully understood in terms of host and bacterial factors. Although the ability of transmitting GAS of the asymptomatic carriers is relatively low, they may present the reservoir of the epidemic. A fraction of GAS carriers is difficult to estimate in practice and may greatly vary between populations. Understanding the role of carriage on the transmission dynamic of GAS is important for assessing the public health impact of the ARF. METHOD: This study investigates the effect of GAS carriers on both the transmission and dynamic of ARF cases by using a mathematical model. RESULT: We derive the sufficient conditions for which the GAS can spread or extinct from the naive population under the variation of the fraction of symptomatic cases over the incidence of GAS. The threshold is possible to occur in general, but the last condition which is rather restrictive and involves parameter uncertainty. The increasing of carriers in the endemic state leads to the reduction in magnitude of the reproduction number and the number of ARF patients. We demonstrate that the adjustment of parameters can be carried out by the use of endemic state and some specific data. CONCLUSION: We show theoretically that the presence of asymptomatic carriers may induce the epidemic threshold and reduce the virulence of GAS and the prevalence of ARF.


Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Febre Reumática/epidemiologia , Febre Reumática/microbiologia , Streptococcus pyogenes/fisiologia , Número Básico de Reprodução , Calibragem , Epidemias , Humanos , Modelos Biológicos
14.
BMC Res Notes ; 12(1): 564, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31500654

RESUMO

OBJECTIVES: The aim of this study was to determine the asymptomatic pharyngeal carriage rate of S. pyogenes, antimicrobial pattern and related risk factors among school children in Hawassa, southern Ethiopia. RESULTS: Out of 287 school children's screened, 35 (12.2%) were colonized with S. pyogenes. The carriage rate was significantly associated with factors such as sex (female p = 0.013) occupational status of mother (p = 0.002), lower income source (500-900 ETB, 1000-1500 ETB) (p = 0.001, and p = 0.042), history of hospitalization (p = 0.00) and residence of the children (p = 0.002). High level resistant to tetracycline and low level to vancomycin were observed, while penicillin, amoxicillin, erythromycin, chloramphenicol, and ceftriaxone were found to be effective.


Assuntos
Antibacterianos/uso terapêutico , Portador Sadio/tratamento farmacológico , Faringe/efeitos dos fármacos , Infecções Pneumocócicas/tratamento farmacológico , Streptococcus pyogenes/efeitos dos fármacos , Adolescente , Infecções Assintomáticas/epidemiologia , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Faringe/microbiologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Instituições Acadêmicas , Fatores Sexuais , Streptococcus pyogenes/fisiologia
15.
Emerg Microbes Infect ; 8(1): 1195-1204, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31393224

RESUMO

Listeria monocytogenes is a high risk pathogen which can cause invasive diseases in humans. We previously reported that black-headed gulls from Dianchi Lake of Kunming carrying L. monocytogenes, while the characteristics of these isolates and the relationship with habitats of migratory gulls have not been explored. In this study, we investigated the prevalence and molecular characteristics of Listeria monocytogenes from black-headed gulls in Dianchi Lake, and phylogenetic analysis based on core genome SNPs was used to determine the genetic relationship of the strains from Dianchi Lake and other regions. Occurrence of L. monocytogenes in black-headed gull feces in 2016, 2017 and 2018 was 1.0%, 1.0% and 0.6% respectively. The predominant serotype of 28 isolates was 4b, while the predominant sequence types were ST145 and ST201. Based on their prevalence and genomic relationships, ST5 and ST87 were likely to be sourced locally while ST145 and ST201 were likely to be non-local. L. monocytogenes may travel along the bird migration route leading to transmission over a large geographical span carried by black-headed gull. Although the prevalence of L. monocytogenes was low, its carriage by the migratory black-headed gulls poses potential public health risks in regions where the migratory birds passage and reside.


Assuntos
Doenças das Aves/microbiologia , Portador Sadio/veterinária , Charadriiformes , Transmissão de Doença Infecciosa , Leptospirose/veterinária , Listeria monocytogenes/classificação , Listeria monocytogenes/isolamento & purificação , Animais , Portador Sadio/microbiologia , China , Variação Genética , Genótipo , Lagos , Leptospirose/microbiologia , Listeria monocytogenes/genética , Epidemiologia Molecular , Filogenia , Polimorfismo de Nucleotídeo Único , Prevalência , Análise de Sequência de DNA , Sorogrupo
16.
J Med Microbiol ; 68(10): 1526-1533, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31418669

RESUMO

Introduction. Among beta-haemolytic streptococci, Streptococcus pyogenes (GAS) is the prototype agent of bacterial pharyngitis and causes other human infections. Streptococcus dysgalactiae subsp. equisimilis (SDSE) causes GAS-like infections, while Streptococcus agalactiae (GBS) is a common neonate pathogen that is rarely associated with pharyngitis.Aim. To determine the prevalence and persistence of beta-haemolytic streptococci throat carriage and type the bacterial population.Methods. Throat swabs were collected from 121 children and 127 young adult volunteers and cultured. Colonized volunteers were screened quarterly, for up to 1 year, while beta-haemolytic streptococci could be detected. Isolates were identified and submitted to antimicrobial susceptibility testing and epidemiological typing.Results. Carriage was detected in 34 (13.7 %) volunteers. Seventeen children carried GAS (14 %), while 17 young adults carried SDSE (8, 6.3 %), GBS (4, 3.1 %), GAS (3, 2.4 %) and the Streptococcus anginosus group (2, 1.6 %). Persistent carriage was detected for up to 6 months in two children and for up to 1 year in three young adults. Three new emm subtypes were found, emm87.16 and emm90.9 (GAS) and stC36.11 (SDSE). While the GAS population among children was unexpectedly clonal, substantial genetic diversity was found among the isolates recovered from young adults. Resistance to erythromycin, clindamycin and tetracycline was detected in GAS, GBS and SDSE recovered from young adults.Conclusions. Prevalence was slightly greater among children, but persistent carriage was greater among young adults, with SDSE being the species most associated with persistence. Few sources seemed to disseminate GAS among children, since only two clonal types were found. The volunteers hosted pathogenic streptococci persistently, including macrolide-resistant strains.


Assuntos
Portador Sadio/microbiologia , Faringe/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/isolamento & purificação , Adolescente , Adulto , Antibacterianos/farmacologia , Brasil/epidemiologia , Portador Sadio/epidemiologia , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Feminino , Humanos , Macrolídeos/farmacologia , Masculino , Faringite/epidemiologia , Faringite/microbiologia , Estudos Prospectivos , Infecções Estreptocócicas/epidemiologia , Streptococcus/classificação , Streptococcus/efeitos dos fármacos , Streptococcus/genética , Tetraciclina/farmacologia , Adulto Jovem
17.
J Med Microbiol ; 68(10): 1408-1418, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31418679

RESUMO

Respiratory tract infections are responsible for over 2.8 million deaths per year worldwide. Colonization is the first step in the process of microbes occupying the respiratory tract, which may lead to subsequent infection. Carriage, in contrast, is defined as the occupation of microbial species in the respiratory tract. The duration of carriage may be affected by host immunity, the composition and interactions between members of the microbial community, and the characteristics of colonizing bacteria, including physiology associated with being present in a bacterial biofilm. Numerous vaccines have been implemented to control infections caused by bacteria that can colonize and be subsequently carried. Such vaccines are often species-specific and may target a limited number of strains thereby creating a vacant niche in the upper respiratory tract. Epidemiological changes of bacteria found in both carriage and disease have therefore been widely reported, since the vacant niche is filled by other strains or species. In this review, we discuss the use of carriage-prevalence studies in vaccine evaluation and argue that such studies are essential for (1) examining the epidemiology of carriage before and after the introduction of new vaccines, (2) understanding the dynamics of the respiratory tract flora and (3) identifying the disease potential of emerging strains. In an era of increasing antibiotic resistance, bacterial carriage-prevalence studies are essential for monitoring the impact of vaccination programmes.


Assuntos
Infecções Bacterianas/microbiologia , Vacinas Bacterianas/imunologia , Portador Sadio/microbiologia , Infecções Respiratórias/microbiologia , Animais , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/imunologia , Infecções Bacterianas/prevenção & controle , Vacinas Bacterianas/administração & dosagem , Vacinas Bacterianas/genética , Portador Sadio/epidemiologia , Portador Sadio/imunologia , Portador Sadio/prevenção & controle , Humanos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/imunologia , Infecções Respiratórias/prevenção & controle , Vacinação
18.
Ethiop J Health Sci ; 29(4): 487-494, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447522

RESUMO

Background: Nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization is of public health concern due to increased risk of developing invasive infections and the therapeutic challenges. This concern is more among the vulnerable group. We determined the prevalence and associated risk factors of MRSA nasal carriage among children in a tertiary hospital in Nigeria. Method: We conducted a hospital-based, cross-sectional study among 300 children attending the outpatient clinic of a tertiary hospital recruited through systematic sampling technique. An interviewer-administered, structured questionnaire was used to obtain sociodemographic characteristics and exposure factors. Nasal swabs samples were collected and inoculated on mannitol salt agar and subcultured on nutrient agar to isolate Staphylococcus aureus. We used the conventional Polymerase Chain Reaction (PCR) technique to detect the presence of mecA gene for MRSA. We calculated the prevalence, prevalence odds ratio to determine risk factors for MRSA acquisition at 5% level of significance. Results: The median age was 1.7 years (6 months-16 years). Males accounted for 60.7%, and 75% of the participants were under 5 years. Staphylococcus aureus colonization was found in 36.3% of the participants while 5.3% of the participants had MRSA identified by detecting the mecA gene. History of recent surgery in the last six months was the only independent predictor of nasal MRSA colonization among the participants (aOR=12.5; 95%CI: 2.7-50.0.). Conclusion: The high prevalence of MRSA colonization observed among the children in this study suggests the need to consider screening children with history of previous surgery as infection control and prevention intervention for MRSA.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Mucosa Nasal/microbiologia , Infecções Estafilocócicas/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/microbiologia
19.
Genome Biol ; 20(1): 173, 2019 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-31451108

RESUMO

BACKGROUND: Diarrhea is the second leading cause of death in children under 5 years of age. Enhanced understanding of causal pathways, pathogenesis, and sequelae of diarrhea is urgently needed. Although the gut microbiota is believed to play a role in susceptibility to diarrheal diseases, our understanding of this association remains incomplete. Infant rhesus macaques (Macaca mulatta) are susceptible to diarrhea making them an ideal model to address this question. RESULTS: The maturation of the infant rhesus macaque gut microbiome throughout the first 8 months of life occurs in a similar pattern as that described for human infants. Moreover, the microbiome of the captive reared infant rhesus macaque more closely resembles that of human infants in the developing world than in the western world. Importantly, prior to disease onset, the gut microbiome of infants that later develop diarrhea is enriched in pathways of immunomodulatory metabolite synthesis, while those of infants that remain asymptomatic are enriched in pathways for short-chain fatty acid production. We identify Prevotella strains that are more abundant at 1 month in infants that later develop diarrhea. At 8 months, the microbiomes of animals that experience diarrhea show increased abundance of Campylobacter and a reduction in Helicobacter macacae. CONCLUSION: The composition of the microbial community could provide a phenotypic marker of an infant's susceptibility to diarrheal disease. Given the significant physiological and immunological similarities between human and nonhuman primates, these findings provide potential markers of susceptibility to diarrhea that could be modulated to improve infant health, especially in the developing world.


Assuntos
Diarreia/microbiologia , Microbioma Gastrointestinal , Envelhecimento , Animais , Animais Recém-Nascidos , Antibacterianos/uso terapêutico , Bactérias/genética , Biomarcadores/metabolismo , Portador Sadio/microbiologia , Criança , Pré-Escolar , Países Desenvolvidos , Países em Desenvolvimento , Diarreia/tratamento farmacológico , Suscetibilidade a Doenças , Feminino , Genoma Bacteriano , Humanos , Lactente , Macaca mulatta , Masculino , Metagenômica , Filogenia
20.
Future Microbiol ; 14: 1035-1042, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31469012

RESUMO

Aim: This study reports on a surveillance in an Italian hospital focused on carbapenemase-producing Escherichia coli (CP-Ec). Materials & methods: Eighteen isolates (nine from clinical specimens and nine from rectal swab) were characterized for antibiotic susceptibilities, typing features, main carbapenemase, extended-spectrum ß-lactamases (ESBLs) and other bla genes, and their transferability by conjugation and transformation. Results: An increase in CP-Ec isolates was observed during 3-year surveillance period. Compared with the clinical isolates, all belonging to one sequence type (ST), ST131, those from rectal swab were very heterogeneous and belonged to eight STs. Transfer data confirmed the role of conjugative plasmids in the spreading of carbapenemase genes. Conclusion: The prevalence of CP-Ec in Italy has risen, with a substantial increase over the last year.


Assuntos
Proteínas de Bactérias/metabolismo , Enterobacteriáceas Resistentes a Carbapenêmicos/isolamento & purificação , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/isolamento & purificação , beta-Lactamases/metabolismo , Proteínas de Bactérias/genética , Enterobacteriáceas Resistentes a Carbapenêmicos/enzimologia , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Conjugação Genética , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Monitoramento Epidemiológico , Escherichia coli/enzimologia , Hospitais , Itália , Tipagem Molecular , Plasmídeos/análise , Prevalência , beta-Lactamases/genética
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