[Multiresistant bacteria in ophthalmology]

Broad-Spectrum Antimicrobial Action of Cell-Free Culture Extracts and Volatile Organic Compounds Produced by Endophytic Fungi Curvularia Eragrostidis

Endophytes are the mutualistic microorganisms that reside within the host plant and promote plant growth in adverse conditions. Plants and their endophytes are engaged in a symbiotic relationship that enables endophytes to access bioactive genes of the ethnomedicinal plants, and, as a result, endophytes are constantly addressed in the sector of pharmaceuticals and agriculture for their multidomain bio-utility. The gradual increase of antimicrobial resistance can be effectively countered by the endophytic metabolites. In these circumstances, in the present investigation, endophytic Curvularia eragrostidis HelS1 was isolated from an ethnomedicinally valuable plant Helecteris isora from East India's forests. The secondary volatile and non-volatile metabolites are extracted from HelS1 and are found to be effective broad-spectrum antimicrobials. A total of 26 secondary metabolites (9 volatiles and 17 non-volatiles) are extracted from the isolate, which exhibits effective antibacterial [against six Gram-positive and seven Gram-negative pathogens with a minimum inhibitory concentrations (MIC) value ranging from 12.5 to 400 μg ml-1] and antifungal (against seven fungal plant pathogens) activity. The secondary metabolite production was optimised by one variable at a time technique coupled with the response surface methodology. The results revealed that there was a 34% increase in antibacterial activity in parameters with 6.87 g L-1 of fructose (as a carbon source), 3.79 g L-1 of peptone (as a nitrogen source), pH 6.75, and an inoculation period of 191.5 h for fermentation. The volatile metabolite production was also found to be optimum when the medium was supplemented with yeast extract and urea (0.2 g L-1) along with dextrose (40 g L-1). Amongst extracted volatile metabolites, 1-H-indene 1 methanol acetate, tetroquinone, N, N-diphenyl-2-nitro-thio benzamide, Trans 1, 2-diethyl-trans-2-decalinol, naphthalene, and azulene are found to be the most effective. Our investigation opens up opportunities in the sector of sustainable agriculture as well as the discovery of novel antimicrobials against dreadful phyto and human pathogens.

Antimicrobial Resistance Patterns in Methicillin-Resistant Staphylococcus aureus from Patients Hospitalized during 2015-2017 in Hospitals in Poland

OBJECTIVE

The aim of this study was to determine antimicrobial resistance profiles of methicillin-resistant Staphylococcus aureus (MRSA) isolates from clinical samples from patients hospitalized during 2015-2017 in hospitals of -Masovian district in Poland.

MATERIALS AND METHODS

Antimicrobial resistance of 112 MRSA isolates was tested with a disc diffusion method. Isolates were examined for methicillin resistance using a 30 µg cefoxitin disk. Resistance was confirmed by PCR detection of the mecA gene. PCR was also used to determine spa gene polymorphism in X-region.

RESULTS

A large number of MRSA isolates showed resistance to levofloxacin (83.9%), ciprofloxacin (83%), erythromycin (77.7%) and clindamycin (72.3%). A lower number of MRSA isolates showed resistance to tetracycline (10.7%), amikacin (14.2%), gentamicin and trimethoprim with sulfamethoxazole (8.0%). None of the MRSA isolates were resistant to linezolid and teicoplanin. Among MRSA isolates, 92.9% were multidrug-resistant (MDR). Resistance to erythromycin, clindamycin, ciprofloxacin and levofloxacin was the most common resistance pattern among MDR MRSA isolates. The highest number of isolates was resistant to 4 groups of antimicrobials (53.8%). The number of drugs to which MRSA isolates were resistant in 2017 was significantly higher than that in 2016 (p = 0.002). The size polymorphism analysis of X fragment of the spa gene revealed high genetic diversity of the investigated group MRSA isolates.

CONCLUSION

This study demonstrates that in the hospital environment, MRSA isolates can quickly acquire new antimicrobial resistance determinants and that knowledge of current resistance patterns is important for the effective treatment of infections caused by MDR MRSA.

Susceptibility Assessment of Methicillin-Resistant Staphylococcus aureus Strains to Lepidium sativum Extract

Many plant-derived compounds have been used to treat microbial infections. Staphylococcus aureus a common cause of many organ infections, has generated increasing concern due to its resistance to antibacterial drugs. This work was carried out to explore the susceptibility of 6 strains (LN872136, LN872137, LN871238, LN871239, LN872140, and LN871241) of methicillin-resistant Staphylococcus aureus to aqueous extract of Lepidium sativum seeds in vitro. Various concentrations (5-20 mg/mL) were used to evaluate the effect of the extract on bacteria growth via the assessment of the microbial biomass and the inhibition zone (IZ). The results showed that the plant extract at 15 or 20 mg/mL, significantly decreased the the biomass of S aureus strains after 24 or 48 hours exposure period. Staphylococcus aureus (LN871241) showed the largest IZ at 20 mg/mL and documented by scanning electron microscope. The current work may suggest that L sativum seed extract can be candidate as a promising antimicrobial agent to treat infection with methicillin-resistant S aureus.

Biofilm Formation by Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus Strains from Hospitalized Patients in Poland

Biofilm-mediated infections in the hospital environment have a significant negative impact on patient health. This study aimed to investigate biofilm production in vitro and the presence of icaABCD genes in methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains isolated from hospitalized patients. MRSA (73) and MSSA (57) strains were evaluated for biofilm production by the microtiter plate method. The presence of ica operon was investigated by PCR. Out of 130 strains, 99.2% were biofilm producers. Strong biofilms were formed by 39.7% of MRSA and 36.8% of MSSA strains. The highest percentage of strong biofilm producers was found among the strains isolated from sputum and tracheostomy tube (66.7%), nose and catheter (50%), throat (44.4%), and bronchoalveolar washings (43.8%). The strains isolated from bronchoalveolar washings produced significantly more biofilm than strains isolated from wound and anus. The ability of biofilm forming by fecal strains was significantly lower compared to strains from other materials. MRSA strains had significantly higher ability of biofilm formation than MSSA strains (P = 0.000247). The presence of ica operon in MRSA was detected in all strains. Comparison of strong biofilm biomass of the strains with icaABCD, icaABD, and icaAD revealed that strains with icaABCD and icaABD produced highly significantly more biofilm than strains with icaAD. Biofilm forming by both MRSA and MSSA strains indicates high ability of theses strains to persist in hospital environment which increases the risk of disease development in hospitalized patients.

[Hygiene in ophthalmological practices : Results from ophthalmological practices in Frankfurt am Main in 2012-2015]

BACKGROUND

Hygiene regulations must be taken into consideration for all diagnostic and therapeutic measures in order to avoid transfer of pathogens and infections. The Infection Protection Act assigns the responsibility for prevention of infections to managers of medical institutions, i.e. the owners of a practice and public health authorities are obligated to counsel and monitor medical institutions with respect to hygiene and prevention of infections. This article presents the results of the surveillance of all ophthalmological practices in Frankfurt am Main in 2012-2015, which are assessed and discussed against the background of the valid recommendations of the Committee for Hospital Hygiene (KRINKO).

METHODS

Based on a checklist, all 35 ophthalmological practices in Frankfurt am Main received counseling and were monitored by an official from the Public Health Office.

RESULTS

The basic principles of hygiene organization as well as the prerequisites for appropriate hand hygiene and surface disinfection were present in the majority of practices. In 11 practices (31.4 %) disposable medical products were exclusively utilized but medical products were prepared in-house in 24 practices (68.6 %). Contact pads for tonometry were prepared in-house in 13 (37.1 %) practices of which 6 were deficient so that improvements had to be implemented. In 6 out of the 7 practices where even critical medical products were prepared, this preparation was prohibited due to significant errors and the practices had to switch to disposable materials.

DISCUSSION

In total, the practices could be certified as having a good general level of hygiene; however, in some cases major errors were found in the preparation of medical products, which had to be immediately corrected.

[Bacteriological analysis in the management of conjunctivitis. Comparison of antibiotic resistance between 1982 and 2008]

OBJECTIVE

To demonstrate the need for bacteriological analysis for the rational treatment of infections of the corneal surface, including conjunctivitis.

METHODS

The results of 1,970 consecutive bacteriological analysis obtained from 2001 to 2008 in patients with ocular hyperemia and discharge were analysed and compared with a similar study done in 1982 in the same geographical area.

RESULTS

Bacterial growth was obtained in 1,044 cases (53%). The most frequent bacteria were Staphylococci spp. (56.6%), followed by Streptococci spp. (21.4%), Haemophili spp. (12.1%), and other gram-negative bacteria (9.9%). No antibiotic was effective against all the bacteria isolated. The frequency of resistant bacteria against neomycin, tobramycin, erythromycin and gentamicin was significantly increased with respect to the study of 1982.

CONCLUSIONS

Bacteriological analysis of conjunctival specimens are necessary to ensure the choice of an effective antibiotic against bacteria of the ocular surface when the initial treatment fails.