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Avendano EE, Blackmon SA, Nirmala N, Chan CW, Morin RA, Balaji S, McNulty L, Argaw SA, Doron S, Nadimpalli ML. Race, ethnicity, and risk for colonization and infection with key bacterial pathogens: a scoping review. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.24.24306289. [PMID: 38712055 PMCID: PMC11071560 DOI: 10.1101/2024.04.24.24306289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Background Racial and ethnic disparities in infectious disease burden have been reported in the USA and globally, most recently for COVID-19. It remains unclear whether such disparities also exist for priority bacterial pathogens that are increasingly antimicrobial-resistant. We conducted a scoping review to summarize published studies that report on colonization or community-acquired infection with pathogens among different races and ethnicities. Methods We conducted an electronic literature search of MEDLINE®, Daily, Global Health, Embase, Cochrane Central, and Web of Science from inception to January 2022 for eligible observational studies. Abstracts and full-text publications were screened in duplicate for studies that reported data for race or ethnicity for at least one of the pathogens of interest. Results Fifty-four observational studies in 59 publications met our inclusion criteria. Studies reported results for Staphylococcus aureus (n=56), Escherichia coli (n=8) , Pseudomonas aeruginosa (n=2), Enterobacterales (n=1), Enterococcus faecium (n=1), and Klebsiella pneumoniae (n=1), and were conducted in the USA (n=42), Israel (n=5), New Zealand (n=4), Australia (n=2), and Brazil (n=1). USA studies most often examined Black and Hispanic minority groups and regularly reported a higher risk of these pathogens in Black persons and mixed results for Hispanic persons. Ethnic minority groups were often reported to be at a higher risk in other countries. Conclusion Sufficient evidence was identified to justify systematic reviews and meta-analyses evaluating the relationship between race, ethnicity, and community-acquired S. aureus and E. coli, although data were rare for other pathogens. We recommend that future studies clarify whether race and ethnicity data are self-reported, collect race and ethnicity data in conjunction with the social determinants of health, and make a concerted effort to include non-English speakers and Indigenous populations from the Americas, when possible.
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Veilumuthu P, Nagarajan T, Magar S, Sundaresan S, Moses LJ, Theodore T, Christopher JG. Genomic insights into an endophytic Streptomyces sp. VITGV156 for antimicrobial compounds. Front Microbiol 2024; 15:1407289. [PMID: 38887720 PMCID: PMC11180775 DOI: 10.3389/fmicb.2024.1407289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/29/2024] [Indexed: 06/20/2024] Open
Abstract
Endophytic Streptomyces sp. are recognized as a potential resource for valuable natural products but are less explored. This study focused on exploring endophytic Streptomyces species residing within tomato plants (Solanum lycopersicum) harboring genes for the production of a novel class of antibiotics. Our research involved the isolation and characterization of Streptomyces sp. VITGV156, a newly identified endophytic Streptomyces species that produces antimicrobial products. VITGV156 harbors a genome of 8.18 mb and codes 6,512 proteins, of which 4,993 are of known function (76.67%) and 1,519 are of unknown function (23.32%). By employing genomic analysis, we elucidate the genome landscape of this microbial strain and shed light on various BGCs responsible for producing polyketide antimicrobial compounds, with particular emphasis on the antibiotic kendomycin. We extended our study by evaluating the antibacterial properties of kendomycin. Overall, this study provides valuable insights into the genome of endophytic Streptomyces species, particularly Streptomyces sp. VITGV156, which are prolific producers of antimicrobial agents. These findings hold promise for further research and exploitation of pharmaceutical compounds, offering opportunities for the development of novel antimicrobial drugs.
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Affiliation(s)
- Pattapulavar Veilumuthu
- Department of Biomedical Sciences, School of BioSciences and Technology, Vellore Institute of Technology, Vellore, India
| | - T. Nagarajan
- Department of Biological Sciences, SRM University-AP, Amaravathi, India
| | - Sharayu Magar
- Department of Biological Sciences, SRM University-AP, Amaravathi, India
| | - Sasikumar Sundaresan
- Department of Biochemistry, School of Biological Sciences, Madurai Kamaraj University, Madurai, India
| | - Lenus Joy Moses
- Department of Biomedical Sciences, School of BioSciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Thomas Theodore
- School of Chemical Engineering, Vellore Institute of Technology, Vellore, India
| | - John Godwin Christopher
- Department of Biomedical Sciences, School of BioSciences and Technology, Vellore Institute of Technology, Vellore, India
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Garvey EA, Jamil TL, Levi JR, Cohen MB. Demographic disparities in children with retropharyngeal and parapharyngeal abscesses. Am J Otolaryngol 2024; 45:104140. [PMID: 38070379 DOI: 10.1016/j.amjoto.2023.104140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/03/2023] [Indexed: 03/16/2024]
Abstract
PURPOSE To explore the impact that demographic and socioeconomic factors such as age, gender, race, and insurance status have on the diagnosis of retropharyngeal (RPA) and parapharyngeal abscesses (PPA) in the pediatric population. METHODS The 2016 HCUP KID was searched for all RPA/PPA discharges using the joint ICD-10 code J39.0. Descriptive statistics, univariate, and multivariate analyses were performed to assess the relationship between demographic factors and their impact on RPA/PPA diagnosis. Results were reported with their corresponding odds ratio with a 95 % confidence interval and p-value. RESULTS 56.4 per 100,000 weighted discharges were discharged with a diagnosis of a RPA/PPA, the average age was 5.7 years old, with a male predominance. Pediatric discharges diagnosed with a RPA/PPA were less likely to identify as Hispanic or Asian/Island Pacific. They were also less likely to be insured by Medicaid and reside in zip codes with a lower median income. CONCLUSION The analysis of this national pediatric database demonstrated significant demographic differences in children diagnosed with RPA/PPAs. Following the multivariate analysis, children from a higher socioeconomic background and those with private insurance were more likely to be diagnosed with a RPA/PPAs. However, disparities in children's overall hospital course and complications is a potential area for future research.
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Affiliation(s)
- Emily A Garvey
- Boston University School of Medicine, 72 East Concord St, Boston, MA 02118, USA
| | - Taylor L Jamil
- Boston University School of Medicine, 72 East Concord St, Boston, MA 02118, USA; Department of Otolaryngology - Head and Neck Surgery, University of Colorado, 12631 E 17th Ave, Aurora, CO 80045, USA
| | - Jessica R Levi
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, 830 Harrison Ave, Boston, MA 02118, USA
| | - Michael B Cohen
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, 830 Harrison Ave, Boston, MA 02118, USA.
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Singhal G, Jain S, Sen K. Clinical Presentation and Microbiological Profile of Deep Neck Space Infections in Different Age Groups. Indian J Otolaryngol Head Neck Surg 2022; 74:1870-1876. [PMID: 36452853 PMCID: PMC9702455 DOI: 10.1007/s12070-020-01869-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/29/2020] [Indexed: 11/29/2022] Open
Abstract
Deep neck space infection (DNI), is defined as infections in the deep fascia enclosing potential spaces of the neck. In the past the diagnosis and treatment of DNI have challenged. The health care personnel at all levels. The complex anatomy and the deep location of this region remains a big problem with significant risks of morbidity and mortality. The aim of this study is to analyse the difference in clinical presentation and microbiology of DNI in different age groups. Eighty two patients with DNI which were managed at the Department of Otorhinolaryngology, ABVIMS and Dr. Ram Manohar Lohia Hospital New Delhi, between November 2017 and March 2019 formed the basis of our prospective cross sectional observational study. We observed that DNI is a frequent and potentially life threatening condition in children and adults despite the use of antibiotics. For appropriate surgical management knowledge of complex spaces of the neck and their communication with the other spaces is necessary.
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Affiliation(s)
- Gaurang Singhal
- Department of ENT, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, Baba Kharag Singh MARG, New Delhi, 110001 India
| | - Shalini Jain
- Department of ENT, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, Baba Kharag Singh MARG, New Delhi, 110001 India
| | - Kanwer Sen
- Department of ENT, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, Baba Kharag Singh MARG, New Delhi, 110001 India
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Glibbery N, Gouliouris T, Bewick J. Methicillin-resistant Staphylococcus aureus (MRSA) submandibular abscess in a neonate. BMJ Case Rep 2021; 14:14/5/e242258. [PMID: 34059545 DOI: 10.1136/bcr-2021-242258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Neonatal suppurative submandibular sialadenitis and abscess formation is an exceedingly rare entity. This report describes a complex case of a male neonate with a methicillin-resistant Staphylococcus aureus (MRSA) submandibular abscess, requiring emergency intubation due to acute airway compromise. The patient was admitted to the paediatric intensive care unit, received appropriate antibiotic treatment and underwent urgent surgical drainage of the abscess. He made a full recovery and remains well 18 months later. No comorbidities or common risk factors for the disease were identified. Although extremely uncommon, neonatal submandibular abscesses can lead to significant morbidity. Neonates tend to present insidiously, and sudden clinical deterioration with airway compromise is possible. MRSA has been increasingly implicated in these infections, even in the absence of relevant risk factors. As such, continued clinical vigilance is essential for prompt diagnosis and prevention of life-threatening complications. Multidisciplinary input is paramount for appropriate management of these complex infections.
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Affiliation(s)
- Natalia Glibbery
- Department of Paediatric Otolaryngology, Addenbrooke's Hospital, Cambridge, UK
| | - Theodore Gouliouris
- Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK
| | - Jessica Bewick
- Department of Paediatric Otolaryngology, Addenbrooke's Hospital, Cambridge, UK
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Angajala V, Hur K, Jacobson L, Hochstim C. Geographic health disparities in the Los Angeles pediatric neck abscess population. Int J Pediatr Otorhinolaryngol 2018; 113:134-139. [PMID: 30173972 DOI: 10.1016/j.ijporl.2018.07.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/24/2018] [Accepted: 07/24/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess geographical sociodemographic differences in neck abscesses that require surgical drainage in Los Angeles. STUDY DESIGN retrospective review. METHODS We reviewed the medical records of 119 consecutive pediatric patients at Children's Hospital Los Angeles (CHLA) from 2014 to 2017 with a diagnosis of a neck abscess requiring incision and drainage. Sociodemographic information including zip code of residence was extracted and analyzed with Chi-square, Fisher's exact test, and multivariate logistic regression. RESULTS The average age of patients with a neck abscess in this study was 3.4 years old, 53.8% were female, 54.6% were Hispanic, and 82.5% had public health insurance. 79% of patients had an abscess located in the superficial neck, and 10.1% had an abscess located in the retropharyngeal space. There were no significant differences in gender, race, type of health insurance, or income between patients that lived within 10 miles of CHLA versus those that lived farther than 10 miles. On multivariate analysis, zip codes with a high volume of neck abscesses were more likely to be lower income neighborhoods. Gender, race, type of health insurance, and distance from CHLA were not associated with zip codes with a high volume of neck abscesses. CONCLUSION Geographic areas in the greater Los Angeles community with a high volume of neck abscesses requiring incision and drainage at our institution were associated with lower income neighborhoods. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Varun Angajala
- Caruso Department of Otolaryngology, Head and Neck Surgery Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kevin Hur
- Caruso Department of Otolaryngology, Head and Neck Surgery Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lia Jacobson
- Caruso Department of Otolaryngology, Head and Neck Surgery Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Otolaryngology, Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Christian Hochstim
- Caruso Department of Otolaryngology, Head and Neck Surgery Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Otolaryngology, Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
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Infants Are More Likely Than Older Children to Have Surgery for Cervical Infections. Int J Otolaryngol 2018; 2018:7824380. [PMID: 29997652 PMCID: PMC5994566 DOI: 10.1155/2018/7824380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 02/25/2018] [Accepted: 04/01/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives To identify differences in cervical infection management in infants versus older children. Methods Charts of patients 0–18 years, diagnosed with a cervical infection at our institution between 2004 and 2015, were included. Age, gender, presenting symptoms, comorbidities, CT scan findings and management including admission, procedures, antibiotics, cultures, length of stay, readmission rates, and complications were included. Results 239 patients were included: mean age was 4.6 years, with 55.6% boys and 44.4% girls. Mean length of stay was 3.2 days, with no significant difference between age categories. 12.55% were readmitted within 30 days with no significant difference when stratified for age (p = 0.268). The most common presenting symptoms were fever (74.3%), swelling (71.4%), and neck pain (48.2%). Infants had fewer symptoms documented than older children. 51% has lateral neck infections, and these were more common in younger children (p < 0.001). The most common antibiotic used was amoxicillin-clavulanic acid in 53.96% of inpatients and 48.05% of outpatients. Infants were most likely to have MRSA isolates (29.2% versus 11.7% of older children, p = 0.011). 70.0% went to the operating room for incision and drainage procedures. Younger children were more likely to undergo surgery, with an odds ratio of 2.38 for children under 1 year. (p = 0.029). 90.9% of infants underwent surgery with radiolucencies of at least 1 cm diameter in contrast to 50% of children over 8 years old. Conclusions This study emphasizes the importance of considering early operative treatment of cervical abscesses in infants despite fewer symptoms and smaller radiolucencies on CT.
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Fellner A, Marom T, Muallem-Kalmovich L, Shlamkovitch N, Eviatar E, Lazarovitch T, Pitaro J. Pediatric neck abscesses: No increase in methicillin-resistant Staphylococcus aureus. Int J Pediatr Otorhinolaryngol 2017; 101:112-116. [PMID: 28964280 DOI: 10.1016/j.ijporl.2017.07.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/17/2017] [Accepted: 07/19/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Recent studies from Western countries showed an increased incidence rate of methicillin-resistant Staphylococcus aureus (MRSA) isolated from pediatric neck abscesses cultures. We sought to examine the microbiology and antibiotic susceptibility of such samples over a 10-year period, and particularly of Staphylococcus aureus (SA), in order to determine whether a similar trend exists in our institution. METHODS A retrospective chart review of children ≤18 years that underwent needle aspiration or surgical drainage of neck abscesses, including suppurative lymphadenitis, retropharyngeal abscesses, and parapharyngeal abscesses was conducted between 1/1/06-31/12/15. RESULTS Sixty-two children were identified with a male predominance (34, 55%). The median age was 2 years. There were 37 (60%) suppurative lymphadenitis, 15 (24%) parapharyngeal abscess, and 10 (16%) retropharyngeal abscess cases. Twenty-nine (47%) children received antibiotic treatment prior to admission, most commonly β-lactam agents. Of them, 15 (52%) had positive cultures, including 7 (47%) with SA. On admission, 45 (73%) children had already received amoxicillin-clavulanate. Of those who did not improve, 16 (26%) received ceftriaxone and clindamycin. Twenty-one (38%) cultures were negative. The most common isolated bacteria were SA in 13 (24%), Streptococcus pyogenes in 7 (13%), and Streptococcus viridians group in 9 (16%). Of the SA isolates, there was only 1 (8%) case of MRSA; however, there were 4 (31%) clindamycin-resistant SA isolates. CONCLUSION Unlike previously published data, there was no increase in MRSA incidence at our institution. However, the high prevalence of clindamycin-resistant SA was in line with previous reports. These findings should be considered when starting empirical therapy in pediatric neck abscesses.
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Affiliation(s)
- Avital Fellner
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300 Zerifin, Israel
| | - Tal Marom
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300 Zerifin, Israel
| | - Limor Muallem-Kalmovich
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300 Zerifin, Israel
| | - Nathan Shlamkovitch
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300 Zerifin, Israel
| | - Ephraim Eviatar
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300 Zerifin, Israel
| | - Tzilia Lazarovitch
- Clinical Microbiology Laboratory, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300 Zerifin, Israel
| | - Jacob Pitaro
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 70300 Zerifin, Israel.
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Bradford BD, Macias D, Liu YF, Inman JC, Dyleski RA. Utility of nasal swab and age in detecting methicillin-resistant Staphylococcus aureus in pediatric head and neck abscesses. Laryngoscope 2017; 127:2407-2412. [PMID: 28271495 DOI: 10.1002/lary.26535] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/27/2016] [Accepted: 01/23/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify risk factors associated with the presence of methicillin-resistant Staphylococcus aureus (MRSA) in surgical cultures taken from incision and drainage (I&D) of head and neck abscesses in the pediatric population. STUDY DESIGN Retrospective case series. METHODS All patients under 18 years of age with a head and neck abscess requiring I&D from 2009 to 2015 were reviewed. MRSA nasal swab cultures were taken from all patients upon hospitalization. Surgical cultures were obtained from all patients and correlated with MRSA nasal swab results. Univariate and multivariate logistic regression was performed, and odds ratios (ORs) along with descriptive statistics were analyzed. RESULTS Of a total of 272 patients, there were 68 (25%) MRSA-positive abscesses. The majority (86.8%) of these abscesses were in children under 2 years of age. Overall, 12 (4.4%) presented with positive admission MRSA nasal swabs. Of these, 91.7% had MRSA-positive abscess cultures. Decreasing age in years showed an OR of 1.650 (P < 0.001) for MRSA-positive abscess, with children less than 1 year old having the highest OR of 10.74 (P < 0.001). CONCLUSION Younger age and MRSA nasal colonization were two statistically significant risk factors for developing an MRSA abscess of the head and neck. This study demonstrates a high positive predictive value for MRSA-positive neck abscesses when nasal swab screenings were MRSA-positive (91.7%). Children under 2 years of age-especially those under 1 year of age-or those with MRSA nasal colonization can be considered a high-risk population that may benefit from empiric antibiotics against MRSA for head and neck abscesses. LEVEL OF EVIDENCE 4. Laryngoscope, 127:2407-2412, 2017.
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Affiliation(s)
- Benjamin D Bradford
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, California, U.S.A
| | - David Macias
- Loma Linda University School of Medicine, Loma Linda, California, U.S.A
| | - Yuan F Liu
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, California, U.S.A
| | - Jared C Inman
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, California, U.S.A
| | - Robin A Dyleski
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, California, U.S.A
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Affiliation(s)
- Eunice E Dixon
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Russell W Steele
- Tulane University School of Medicine, New Orleans, LA, USA University of Queensland School of Medicine, New Orleans, LA, USA
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11
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A. Elnakady Y, Chatterjee I, Bischoff M, Rohde M, Josten M, Sahl HG, Herrmann M, Müller R. Investigations to the Antibacterial Mechanism of Action of Kendomycin. PLoS One 2016; 11:e0146165. [PMID: 26795276 PMCID: PMC4721675 DOI: 10.1371/journal.pone.0146165] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 12/14/2015] [Indexed: 11/25/2022] Open
Abstract
Purpose The emergence of bacteria that are resistant to many currently used drugs emphasizes the need to discover and develop new antibiotics that are effective against such multi-resistant strains. Kendomycin is a novel polyketide that has a unique quinone methide ansa structure and various biological properties. This compound exhibits strong antibacterial activity against Gram-negative and Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Despite the promise of kendomycinin in several therapeutic areas, its mode of action has yet to be identified. Methods In this study, we used a multidisciplinary approach to gain insight into the antibacterial mechanism of this compound. Results The antibacterial activity of kendomycin appears to be bacteriostatic rather than bactericidal. Kendomycin inhibited the growth of the MRSA strain COL at a low concentration (MIC of 5 μg/mL). Proteomic analysis and gene transcription profiling of kendomycin-treated cells indicated that this compound affected the regulation of numerous proteins and genes involved in central metabolic pathways, such as the tricarboxylic acid (TCA) cycle (SdhA) and gluconeogenesis (PckA and GapB), cell wall biosynthesis and cell division (FtsA, FtsZ, and MurAA), capsule production (Cap5A and Cap5C), bacterial programmed cell death (LrgA and CidA), the cellular stress response (ClpB, ClpC, ClpP, GroEL, DnaK, and GrpE), and oxidative stress (AhpC and KatA). Electron microscopy revealed that kendomycin strongly affected septum formation during cell division. Most kendomycin-treated cells displayed incomplete septa with abnormal morphology. Conclusions Kendomycin might directly or indirectly affect the cell division machinery, protein stability, and programmed cell death in S. aureus. Additional studies are still needed to obtain deeper insight into the mode of action of kendomycin.
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Affiliation(s)
- Yasser A. Elnakady
- Department of Microbial Natural Products, Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research and Department of Pharmaceutical Biotechnology, Saarland University, Saarbrücken, Germany
- Faculty of Science, Zoology Department, King Saud University, Riyadh, Saudi Arabia
| | - Indranil Chatterjee
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Markus Bischoff
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Manfred Rohde
- Department of Medical Microbiology, Helmholtz Center for Infection Research, Braunschweig, Germany
| | - Michaele Josten
- Department of Medical Microbiology, Bonn University, Bonn, Germany
| | - Hans-Georg Sahl
- Department of Medical Microbiology, Bonn University, Bonn, Germany
| | - Mathias Herrmann
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Rolf Müller
- Department of Microbial Natural Products, Helmholtz Institute for Pharmaceutical Research Saarland, Helmholtz Centre for Infection Research and Department of Pharmaceutical Biotechnology, Saarland University, Saarbrücken, Germany
- * E-mail:
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Worley ML, Seif JM, Whigham AS, Mims JW, Shetty AK, Evans AK. Suppurative cervical lymphadenitis in infancy: microbiology and sociology. Clin Pediatr (Phila) 2015; 54:629-34. [PMID: 25972051 DOI: 10.1177/0009922815584548] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the associations between patient age, sociological factors, and the microbiology of pediatric neck infections. METHODS Retrospective chart review of children up to 5 years old who underwent surgical management of suppurative cervical lymphadenitis. RESULTS A total of 76 individuals met inclusion criteria; 93% of culture-positive infections were caused by Staphylococcus aureus in infants, compared with 59% in children between 13 months and 5 years of age (P = .002). Of the S aureus isolates, 51% were methicillin-resistant S aureus (MRSA) and 49% were methicillin-sensitive S aureus. Methicillin resistance was associated with African American race (P = .004); 67% of participants received empirical antibiotics prior to admission. Of these, 73% received antibiotics in the β-lactam class, and 25% received treatment with clindamycin. CONCLUSIONS Incidence of MRSA is high in infants with cervical lymphadenitis who fail empirical antibiotic therapy and require surgical management. Empirical coverage for cervical lymphadenitis with β-lactam antibiotics may provide inadequate coverage for early infection in this population.
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Affiliation(s)
| | - Joseph M Seif
- Wake Forest™ School of Medicine, Winston-Salem, NC, USA
| | - Amy S Whigham
- Wake Forest™ School of Medicine, Winston-Salem, NC, USA
| | - James W Mims
- Wake Forest™ School of Medicine, Winston-Salem, NC, USA
| | | | - Adele K Evans
- Wake Forest™ School of Medicine, Winston-Salem, NC, USA
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13
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Raffaldi I, Le Serre D, Garazzino S, Scolfaro C, Bertaina C, Mignone F, Peradotto F, Tavormina P, Tovo PA. Diagnosis and management of deep neck infections in children: the experience of an Italian paediatric centre. J Infect Chemother 2014; 21:110-3. [PMID: 25456894 DOI: 10.1016/j.jiac.2014.10.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 09/20/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
Abstract
Deep neck infection (DNI) is a severe occurrence in children. We've examined the presenting signs and symptoms, the value of single diagnostic procedures, the rate of complications and the impact of the therapeutic options on the final outcome, in children with a DNI. We retrospectively evaluated patients, aged 0-18 years, who were admitted for a DNI, from January 2006 through December 2012, at Regina Margherita Children's Hospital, Turin, Italy. We subdivided them on the basis of type of treatment: pharmacological treatment alone or antimicrobial treatment plus surgery. An univariate analysis has been performed to examine the differences between the two groups. Sixty patients (32 males, 28 females) with diagnosis of DNI were enrolled; 33 children only received medical treatment (group 1), whereas 27 patients underwent also surgical interventions (group 2). The mean abscess size was significantly higher in group 2 than in group 1 (p = 0.01). The predominant organisms were Streptococcus sp. (11 cases, 52.4%, mostly Streptococcus pyogenes). The most frequent antibiotic regimen was a β lactam alone (either III generation cephalosporin or amoxicillin/clavulanate). The duration of intravenous antibiotic varied between the two groups, without statistical significance (p = 0.052); whereas the oral antibiotic administration was significantly shorter in group 1 than in group 2 (p = 0.0003). Three patients (5%) developed complications. This research confirms that the medical approach, with high doses of intravenous antibiotics for a minimum of 5 days, could be a tolerable and safe option for the treatment of patients with stable condition and/or small DNIs.
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Affiliation(s)
- Irene Raffaldi
- Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
| | - Daniele Le Serre
- Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy
| | - Silvia Garazzino
- Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy
| | - Carlo Scolfaro
- Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy
| | - Chiara Bertaina
- Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy; Unit of Immunology and Infectious Diseases, University-Hospital Pediatric Department, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Federica Mignone
- Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy
| | - Federica Peradotto
- Department of Paediatric Otolaryngology, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy
| | - Paolo Tavormina
- Department of Paediatric Otolaryngology, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy
| | - Pier-Angelo Tovo
- Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy
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14
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Mutlu M, Dereci S, Aslan Y. Deep neck abscess in neonatal period: case report and review of literature. Int J Pediatr Otorhinolaryngol 2014; 78:577-82. [PMID: 24512784 DOI: 10.1016/j.ijporl.2014.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 01/08/2014] [Accepted: 01/11/2014] [Indexed: 01/30/2023]
Abstract
Deep neck abscess is very rare in neonatal period. We reported a deep neck abscess caused by methicillin-sensitive Staphylococcus aureus infection (MSSA) in a neonate. A 10-day male infant was admitted to our neonatal unit with the complaints of fever, irritability, and refused to food intake. Ultrasonography and magnetic resonance imaging revealed as an abscess in the neck. Needle aspiration from abscess revealed pus. Antibiotics and drainage were applied. We also reviewed the neonatal deep neck abscess reported in English literature and clinical presentation, risk factors, causing microorganisms, treatment, complication and outcome of deep neck abscesses were discussed.
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Affiliation(s)
- Mehmet Mutlu
- Department of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
| | - Selim Dereci
- Department of Pediatrics, Recep Tayyip Erdoğan University, Faculty of Medicine, Rize, Turkey
| | - Yakup Aslan
- Department of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
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15
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Abstract
In 2000-10 the epidemiology of pediatric MRSA infections in the United States was transformed with an epidemic of CA-MRSA infections. We review the epidemiology of MRSA in the community and in the health care setting, including intensive care units, among infants and CF patients, and in households as well as the impact that the CA-MRSA epidemic has had on hospitalization with MRSA infections. Risk factors for carriage, transmission, and initial and recurrent infection with MRSA are discussed. New studies on the treatment of pediatric MRSA infections and on the efficacy of MRSA decolonization are reviewed.
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Affiliation(s)
- Michael Z David
- Department of Medicine, University of Chicago Medicine, Chicago, IL ; Department of Pediatrics, University of Chicago Medicine, Chicago, IL
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16
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Udo EE. Community-acquired methicillin-resistant Staphylococcus aureus: the new face of an old foe? Med Princ Pract 2013; 22 Suppl 1:20-9. [PMID: 24051949 PMCID: PMC5586812 DOI: 10.1159/000354201] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 02/20/2013] [Indexed: 12/12/2022] Open
Abstract
The burden of infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasing among different patient populations globally. As CA-MRSA has become established in healthcare facilities, the range of infections caused by them has also increased. Molecular characterization of CA-MRSA isolates obtained from different centers has revealed significant diversity in their genetic backgrounds. Although many CA-MRSA strains are still susceptible to non-β-lactam antibiotics, multiresistance to non-β-lactam agents has emerged in some clones, posing substantial problems for empirical and directed therapy of infections caused by these strains. Some CA-MRSA clones have acquired the capacity to spread locally and internationally. CA-MRSA belonging to ST80-MRSA-IV and ST30-MRSA-IV appear to be the dominant clones in the countries of the Gulf Cooperation Council (GCC). The emergence of pandemic CA-MRSA clones not only limits therapeutic options but also presents significant challenges for infection control. Continued monitoring of global epidemiology and emerging drug resistance data is critical for the effective management of these infections.
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Affiliation(s)
- Edet E. Udo
- *Edet E. Udo, PhD, Department of Microbiology, Faculty of Medicine, Health Sciences Centre, Kuwait University, PO Box 24823, Safat 13110 (Kuwait), E-Mail
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17
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2012; 19:486-8. [PMID: 22555543 DOI: 10.1097/moo.0b013e32834e4a77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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The Increased Risk of Community-Acquired Methicillin-Resistant Staphylococcus Aureus in Neck Infections in Young Children. Curr Infect Dis Rep 2012; 14:119-20. [DOI: 10.1007/s11908-012-0247-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Emerging dilemmas with methicillin-resistant Staphylococcus aureus infections in children. Curr Opin Otolaryngol Head Neck Surg 2011; 19:462-6. [PMID: 21897247 DOI: 10.1097/moo.0b013e32834b27a8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW There has been an increase in the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections in recent years. This article reviews the literature on three manifestations of MRSA infections in the head and neck of children: sinonasal infections, otologic infections, and neck abscesses. RECENT FINDINGS Historically nosocomial in origin, MRSA infections more recently are found to occur in otherwise healthy patients with no obvious risk factors. This community-acquired MRSA is known to be responsible for cutaneous abscesses in various regions of the body. Nasal carriage in healthy children is thought to account for increasing incidence of infections involving the respiratory tract as well as deep-space neck infections. Although these community-acquired strains of MRSA often retain susceptibility to nonbeta lactam antibiotics, there are reports of clindamycin resistance. SUMMARY There is an increase in incidence of MRSA among infections involving the head and neck in children. Vigilant monitoring of antibiotic susceptibilities is warranted as well as judicious use of culture-directed antibiotic agents in their treatment. Topical therapy may play an important role in treatment of infections involving the sinonasal tract and ear.
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