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Vena A, Castaldo N, Magnasco L, Bavastro M, Limongelli A, Giacobbe DR, Bassetti M. Current and emerging drug treatment strategies to tackle invasive community-associated methicillin-resistant Staphylococcus aureus (MRSA) infection: what are the challenges? Expert Opin Pharmacother 2023; 24:331-346. [PMID: 36548447 DOI: 10.1080/14656566.2022.2161885] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections represent a leading cause of purulent skin and soft tissue infections in some geographical regions. Traditionally, 'old antibiotics' such as trimethoprim-sulfamethoxazole, tetracyclines, clindamycin, chloramphenicol,vancomycin, and teicoplanin have been used to treat these infections, but these were often associated with low efficacy and excessive side effects and toxicity, especially nephrotoxicity. Along with the development of new compounds, the last decade has seen substantial improvements in the management of CA-MRSA infections. AREAS COVERED In this review, the authors discuss the current and emerging drug treatment strategies to tackle invasive CA-MRSA infections. Articles reported in this review were selected from through literature searches using the PubMed database. EXPERT OPINION The availability of new drugs showing a potent in vitro activity against CA-MRSA represents a unique opportunity to face the threat of resistance while potentially reducing toxicity. All these compounds represent promising options to enhance our antibiotic armamentarium. However, data regarding the use of these new drugs in real-life studies are limited and their best placement in therapy and in terms of optimization of medical resources and balance of cost-effectiveness requires further investigation.
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Affiliation(s)
- Antonio Vena
- Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Nadia Castaldo
- Department of Pulmonology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Laura Magnasco
- Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Martina Bavastro
- Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Alessandro Limongelli
- Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Daniele Roberto Giacobbe
- Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Matteo Bassetti
- Infectious Diseases Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genoa, Italy.,Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
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Zhang X, Chen P, Wan HY, Zhu RJ, Zhou Y, Song MR, Jiang N, Yu B. Antimicrobial potency, prevention ability, and killing efficacy of daptomycin-loaded versus vancomycin-loaded β-tricalcium phosphate/calcium sulfate for methicillin-resistant Staphylococcus aureus biofilms. Front Microbiol 2022; 13:1029261. [PMID: 36406460 PMCID: PMC9669593 DOI: 10.3389/fmicb.2022.1029261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Growing evidence has shown that the efficacy of systemic administration of daptomycin for the treatment of methicillin-resistant Staphylococcus aureus (MRSA)-related infections is satisfactory. However, the clinical efficacy of the local administration of daptomycin for the management of osteoarticular infections remains unclear. This in vitro study compared the efficacy of daptomycin and vancomycin against MRSA biofilms. The elution kinetics of daptomycin and vancomycin, combined with gentamicin and loaded with either β-tricalcium phosphate/calcium sulfate or calcium sulfate, in the presence of MRSA infection, was assessed. Their efficacy in preventing biofilm formation and killing pre-formed biofilms was assessed using colony-forming unit count and confocal laser scanning microscopy. In addition, the efficacy of daptomycin, vancomycin, and gentamicin in prophylaxis and eradication of MRSA biofilms was also evaluated. Daptomycin + gentamicin and vancomycin + gentamicin displayed similar antimicrobial potency against MRSA, by either β-tricalcium phosphate/calcium sulfate or calcium sulfate. In the prevention assays, both daptomycin + gentamicin and vancomycin + gentamicin showed similar efficacy in preventing bacterial colony formation, with approximately 6 logs lower colony-forming units than those in the control group at both 1 and 3 days. The killing effect on pre-formed biofilms showed significant decreases of approximately 4 logs at 1 and 3 days following treatment with daptomycin + gentamicin and vancomycin + gentamicin. In addition, the confocal laser scanning microscopy results support the colony-forming unit data. Moreover, single use of vancomycin and gentamicin showed similar efficacies in preventing and killing MRSA biofilms, both of which were better than that of gentamicin. Our study demonstrated that vancomycin + gentamicin and daptomycin + gentamicin loaded with β-tricalcium phosphate/calcium sulfate or calcium sulfate showed similar prophylactic and killing effects on MRSA biofilms, implying a potential indication of local administration daptomycin for the treatment of MRSA-associated osteoarticular infections, especially if vancomycin administration presents limitations.
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Affiliation(s)
- Xin Zhang
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Orthopaedics and Traumatology, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China
| | - Peng Chen
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Orthopaedics, Hainan General Hospital, Hainan Hospital Affiliated to Hainan Medical University, Haikou, China
| | - Hao-yang Wan
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Run-jiu Zhu
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Zhou
- School of Nursing, Jiangmen Chinese Medicine College of Guangdong Province, Jiangmen, China
| | - Ming-rui Song
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Nan Jiang
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Nan Jiang,
| | - Bin Yu
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Bin Yu,
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Sánchez-Serrano A, García-González N, Bonillo D, Ruiz-Hueso P, Villanova R, Campo-Bes I, Tormo N, Salvador C, Gimeno C, González-Candelas F. Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in a Tertiary Hospital from the Comunidad Valenciana (Spain). Microb Drug Resist 2022; 28:1071-1078. [DOI: 10.1089/mdr.2022.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Andrea Sánchez-Serrano
- Joint Research Unit Infection and Public Health FISABIO-University Valencia, Institute for Integrative Systems Biology I2SysBio (CSIC-UV), Valencia, Spain
| | - Neris García-González
- Joint Research Unit Infection and Public Health FISABIO-University Valencia, Institute for Integrative Systems Biology I2SysBio (CSIC-UV), Valencia, Spain
| | - Daniel Bonillo
- Joint Research Unit Infection and Public Health FISABIO-University Valencia, Institute for Integrative Systems Biology I2SysBio (CSIC-UV), Valencia, Spain
| | - Paula Ruiz-Hueso
- Joint Research Unit Infection and Public Health FISABIO-University Valencia, Institute for Integrative Systems Biology I2SysBio (CSIC-UV), Valencia, Spain
| | - Rebeca Villanova
- Joint Research Unit Infection and Public Health FISABIO-University Valencia, Institute for Integrative Systems Biology I2SysBio (CSIC-UV), Valencia, Spain
| | - Israel Campo-Bes
- Joint Research Unit Infection and Public Health FISABIO-University Valencia, Institute for Integrative Systems Biology I2SysBio (CSIC-UV), Valencia, Spain
| | - Nuria Tormo
- Microbiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Carme Salvador
- Microbiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Concepción Gimeno
- Microbiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Fernando González-Candelas
- Joint Research Unit Infection and Public Health FISABIO-University Valencia, Institute for Integrative Systems Biology I2SysBio (CSIC-UV), Valencia, Spain
- CIBER in Epidemiology and Public Health, Valencia, Spain
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Mitra S, Sultana SA, Prova SR, Uddin TM, Islam F, Das R, Nainu F, Sartini S, Chidambaram K, Alhumaydhi FA, Emran TB, Simal-Gandara J. Investigating forthcoming strategies to tackle deadly superbugs: current status and future vision. Expert Rev Anti Infect Ther 2022; 20:1309-1332. [PMID: 36069241 DOI: 10.1080/14787210.2022.2122442] [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: 11/09/2022]
Abstract
INTRODUCTION Superbugs are microorganisms that cause disease and have increased resistance to the treatments typically used against infections. Recently, antibiotic resistance development has been more rapid than the pace at which antibiotics are manufactured, leading to refractory infections of pathogenic bacteria. Scientists are concerned that a particularly virulent and lethal "superbug" will one day join the ranks of existing bacteria that cause incurable diseases, resulting in a global health disaster on the scale of the Black Death. AREAS COVERED Therefore, this study highlights the current developments in the management of antibiotic-resistant bacteria and recommends strategies for further regulating antibiotic-resistant microorganisms associated with the healthcare system. This review also addresses the origins, prevalence, and pathogenicity of superbugs, and the design of antibacterial against these growing multidrug-resistant organisms from a medical perspective. EXPERT OPINION It is recommended that antimicrobial resistance (AMR) should be addressed by limiting human-to-human transmission of resistant strains, lowering the use of broad-spectrum antibiotics, and developing novel antimicrobials. Using the risk-factor domains framework from this study would assure that not only clinical but also community and hospital-specific factors are covered, lowering the chance of confounders. Extensive subjective research is necessary to fully understand the underlying factors and uncover previously unexplored areas.
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Affiliation(s)
- Saikat Mitra
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Sifat Ara Sultana
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Shajuthi Rahman Prova
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Tanvir Mahtab Uddin
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Fahadul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh
| | - Rajib Das
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka 1000, Bangladesh
| | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Makassar, South Sulawesi 90245, Indonesia
| | - Sartini Sartini
- Department of Pharmaceutical Science and Technology, Faculty of Pharmacy, Hasanuddin University, Makassar 90245, Indonesia
| | - Kumarappan Chidambaram
- Department of Pharmacology and Toxicology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
| | - Fahad A Alhumaydhi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 52571, Saudi Arabia
| | - Talha Bin Emran
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh.,Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh
| | - Jesus Simal-Gandara
- Nutrition and Bromatology Group, Department of Analytical and Food Chemistry, Faculty of Food Science and Technology, University of Vigo - Ourense Campus, E32004 Ourense, Spain
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The Combined Use of Gentamicin and Silver Nitrate in Bone Cement for a Synergistic and Extended Antibiotic Action against Gram-Positive and Gram-Negative Bacteria. MATERIALS 2021; 14:ma14123413. [PMID: 34203010 PMCID: PMC8234965 DOI: 10.3390/ma14123413] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/13/2021] [Accepted: 06/18/2021] [Indexed: 12/30/2022]
Abstract
Using bone cement as a carrier, gentamicin was for years the default drug to locally treat orthopedic infections but has lost favor due to increasing bacterial resistance to this drug. The objective of this study was to investigate the effect of combining gentamicin with silver nitrate in bone cement against S. aureus and P. aeruginosa. Antibacterial effects (CFU counts) of gentamicin and silver were initially studied followed by studies using subtherapeutic concentrations of each in combination. The release rates from cement were measured over 10 days and day 7 release samples were saved and analyzed for antibiotic activity. A strong synergistic effect of combining silver with gentamicin was found using both dissolved drugs and using day 7 bone cement release media for both Gram-positive and Gram-negative bacteria. The cement studies were extended to vancomycin and tobramycin, which are also used in bone cement, and similar synergistic effects were found for day 7 release media with P. aeruginosa but not S. aureus. These studies conclude that the combined use of low loadings of gentamicin and silver nitrate in bone cement may offer an economical and much improved synergistic method of providing anti-infective orthopedic treatments in the clinic.
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ERDOĞAN Z, ÖZTÜRK C, CANGÜR Ş, ÇALIŞKAN E, ÖKSÜZ Ş, KARAMURAT Z. Identification of the Gram Positive Bacterial Sepsis Agent with Rapid Genotype Test. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.834769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Thitiananpakorn K, Aiba Y, Tan XE, Watanabe S, Kiga K, Sato'o Y, Boonsiri T, Li FY, Sasahara T, Taki Y, Azam AH, Zhang Y, Cui L. Association of mprF mutations with cross-resistance to daptomycin and vancomycin in methicillin-resistant Staphylococcus aureus (MRSA). Sci Rep 2020; 10:16107. [PMID: 32999359 PMCID: PMC7527455 DOI: 10.1038/s41598-020-73108-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 08/24/2020] [Indexed: 12/11/2022] Open
Abstract
We first reported a phenomenon of cross-resistance to vancomycin (VCM) and daptomycin (DAP) in methicillin-resistant Staphylococcus aureus (MRSA) in 2006, but mechanisms underlying the cross-resistance remain incompletely understood. Here, we present a follow-up study aimed to investigate genetic determinants associated with the cross-resistance. Using 12 sets of paired DAP susceptible (DAPS) and DAP non-susceptible (DAPR) MRSA isolates from 12 patients who had DAP therapy, we (i) assessed susceptibility to DAP and VCM, (ii) compared whole-genome sequences, (iii) identified mutations associated with cross-resistance to DAP and VCM, and (iv) investigated the impact of altered gene expression and metabolic pathway relevant to the cross-resistance. We found that all 12 DAPR strains exhibiting cross-resistance to DAP and VCM carried mutations in mprF, while one DAPR strain with reduced susceptibility to only DAP carried a lacF mutation. On the other hand, among the 32 vancomycin-intermediate S. aureus (VISA) strains isolated from patients treated with VCM, five out of the 18 strains showing cross-resistance to DAP and VCM carried a mprF mutation, while 14 strains resistant to only VCM had no mprF mutation. Moreover, substitution of mprF in a DAPS strain with mutated mprF resulted in cross-resistance and vice versa. The elevated lysyl-phosphatidylglycerol (L-PG) production, increased positive bacterial surface charges and activated cell wall (CW) synthetic pathways were commonly found in both clinical isolates and laboratory-developed mutants that carry mprF mutations. We conclude that mprF mutation is responsible for the cross-resistance of MRSA to DAP and VCM, and treatment with DAP is more likely to select for mprF-mediated cross-resistance than is with VCM.
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Affiliation(s)
- Kanate Thitiananpakorn
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Yoshifumi Aiba
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Xin-Ee Tan
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Shinya Watanabe
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Kotaro Kiga
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Yusuke Sato'o
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Tanit Boonsiri
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Feng-Yu Li
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Teppei Sasahara
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Yusuke Taki
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Aa Haeruman Azam
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Yuancheng Zhang
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Longzhu Cui
- Division of Bacteriology, Department of Infection and Immunity, Faculty of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
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Real C, Ramos N, Fernández-Vega A, Vivas D, Ortega-Candil A, Nava-Muñoz Á, Hernández-Mateo P, Rodríguez-Rey C, Juez A, Vilacosta I. Successful Conservative Treatment of a Large Infected Saphenous Graft Aneurysm: Usefulness of PET/CT. JACC Case Rep 2020; 2:764-768. [PMID: 34317344 PMCID: PMC8301699 DOI: 10.1016/j.jaccas.2020.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/24/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
We report a case of a 75-year-old man with a medical history of coronary artery bypass graft surgery and a recent graft angioplasty, who presented to our emergency department with fever. An 18F-fluorodeoxyglucose positron emission tomography demonstrated a saphenous graft infected aneurysm, which was successfully treated conservatively with antibiotic therapy. (Level of Difficulty: Beginner.).
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Affiliation(s)
- Carlos Real
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
| | - Noemí Ramos
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
| | | | - David Vivas
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
| | - Aida Ortega-Candil
- Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - Ángel Nava-Muñoz
- Department of Radiology, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Almudena Juez
- Department of Nephrology, Hospital Clínico San Carlos, Madrid, Spain
| | - Isidre Vilacosta
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
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Dai Y, Liu J, Guo W, Meng H, Huang Q, He L, Gao Q, Lv H, Liu Y, Wang Y, Wang H, Liu Q, Li M. Decreasing methicillin-resistant Staphylococcus aureus (MRSA) infections is attributable to the disappearance of predominant MRSA ST239 clones, Shanghai, 2008-2017. Emerg Microbes Infect 2019; 8:471-478. [PMID: 30924398 PMCID: PMC6455123 DOI: 10.1080/22221751.2019.1595161] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A consistently decreasing prevalence of MRSA infections in China has been reported, however, the underlying mechanism of molecular processes responsible for this decline in MRSA infections has been poorly understood. We conducted an epidemiologic investigation to determine the dynamic changes of Staphylococcus aureus infections. A total of 3695 S. aureus isolates was recovered from 2008 to 2017, and subsequently characterized by infection types, resistance profile, and clone types. The frequency of respiratory infection decreased over the study period from 76% to 52%. The proportion of MRSA remarkably decreased (from 83.5% to 54.2%, 2008-2017) (p < .0001). The prevalence of predominant healthcare-associated MRSA (HA-MRSA) clones, ST239-t030 and ST239-t037, significantly decreased (from 20.3% to 1% and 18.4% to 0.5%, 2008-2017, respectively); both of them were replaced by the continually growing ST5-t2460 clone (from 0% to 17.3%, 2008-2017). Epidemic community-acquired MRSA (CA-MRSA) ST59 and ST398 clones also increased (from 1.0% to 5.8% and 1.8% to 10.5%, 2008-2017, respectively). These results demonstrated a significant decrease in the previously dominant HA-MRSA ST239 clones, leading to a marked decrease in the prevalence of MRSA over the past decade, and shed new light on the complex competition of S. aureus clones predominating within the health-care environment.
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Affiliation(s)
- Yingxin Dai
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Junlan Liu
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Wei Guo
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Hongwei Meng
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Qian Huang
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Lei He
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Qianqian Gao
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Huiying Lv
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Yao Liu
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Yanan Wang
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Hua Wang
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Qian Liu
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
| | - Min Li
- a Department of Laboratory Medicine, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , People's Republic of China
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10
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Guzek A, Suwalski G, Tomaszewski D, Rybicki Z. Dalbavancin treatment in a deep sternal wound MRSA infection after coronary artery bypass surgery: a case report. J Cardiothorac Surg 2018; 13:3. [PMID: 29304832 PMCID: PMC5755357 DOI: 10.1186/s13019-017-0690-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 12/20/2017] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND A deep sternal wound infection (DSWI) can become a severe complication after cardiac surgery, with in-hospital mortality rates reaching up to 35%. Staphylococci, particularly methicillin resistant Staphylococcus aureus (MRSA), play important roles in its etiology. CASE PRESENTATION This case report presents a patient who underwent coronary artery bypass surgery, and suffered postoperatively from a DSWI caused by MRSA. The pathogen was susceptible to vancomycin and rifampicin in vitro; however, this therapy was clinically ineffective. Both clinical improvement and MRSA eradication were achieved after surgical debridement of the wound and the intravenous administration of dalbavancin. CONCLUSIONS We decided to administer dalbavancin because of its convenient pharmacological profile. The patient's tolerance of the antimicrobial was good, the biochemical markers of inflammation returned to the normal ranges, and the microbiological results one week after the dalbavancin administration were negative. A good clinical outcome was achieved with both the surgery and antimicrobial administration. In this case, dalbavancin was more effective in the treatment of the sternal and surrounding tissue infections caused by MRSA, when compared to vancomycin.
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Affiliation(s)
- Aneta Guzek
- Department of Microbiology, Military Institute of Medicine, Warsaw, Poland
| | - Grzegorz Suwalski
- Department of Heart Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Dariusz Tomaszewski
- Department of Anesthesiology and Intensive Therapy, Military Institute of Medicine, ul. Szaserów 128, 04-141, Warsaw, Poland.
| | - Zbigniew Rybicki
- Department of Anesthesiology and Intensive Therapy, Military Institute of Medicine, ul. Szaserów 128, 04-141, Warsaw, Poland
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11
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Ergül AB, Işık H, Altıntop YA, Torun YA. A retrospective evaluation of blood cultures in a pediatric intensive care unit: a three year evaluation. Turk Arch Pediatr 2017; 52:154-161. [PMID: 29062249 DOI: 10.5152/turkpediatriars.2017.5451] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 04/19/2017] [Indexed: 12/12/2022]
Abstract
AIM In this study, it was aimed to retrospectively assess the frequency and antibiotic resistance of microorganisms isolated from blood cultures of patients in a pediatric intensive care unit. MATERIAL AND METHODS The study was conducted on blood culture tests obtained from patients in a pediatric intensive care unit and sent to a microbiology laboratory between 2013 and 2016. The species and antibiotic susceptibilities were assessed in microorganisms isolated from the blood cultures. RESULTS Overall, 4239 blood cultures were obtained. Growth was detected in 324 blood cultures (7.6%). Of the microorganisms isolated, 195 (60.2%) were Gram-positive bacteria, and 107 (33.0%) were Gram-negative bacteria; 22 (6.8%) were fungi. The most commonly isolated microorganisms were Coagulase-negative staphylococci (45.1%), followed by Klebsiella pneumonia (14.5%), and Enterococcus faecalis (6.5%). Among the fungi, the most common was Candida albicans (59.1%), followed by Candida parapsilosis. The resistance rate against methicillin was 89.9% in coagulase-negative staphylococci, and 66% in S. aureus strains. The resistance rate against vancomycin was 3.6% in Enterococci spp. There was no resistance against linezolid in Gram-positive microorganisms. The rate of extended-spectrum beta lactamase positivity was found as 34% in Klebsiella spp. and 100% in Escherichia coli. The resistance rate against carbapenem was 44.9% in Gram-negative bacteriae. The resistance rate against carbapenem was 100% in Acinetobacter baumanii. In Candida albicans, resistance to amphotericine B was 61.5%, and resistance to voriconazole was 7.7%. CONCLUSIONS To plan effective empiric antibiotic therapy against nosocomial infections in intensive care units, all units should have information about the characteristics of their own flora.
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Affiliation(s)
- Ayşe Betül Ergül
- Clinic of Pediatrics, Kayseri Education and Research Hospital, University of Health Sciences, Kayseri, Turkey
| | - Halit Işık
- Clinic of Pediatrics, Kayseri Education and Research Hospital, University of Health Sciences, Kayseri, Turkey
| | - Yasemin Ay Altıntop
- Division of Microbiology, Kayseri Education and Research Hospital, University of Health Sciences, Kayseri, Turkey
| | - Yasemin Altuner Torun
- Clinic of Pediatrics, Kayseri Education and Research Hospital, University of Health Sciences, Kayseri, Turkey
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12
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Zhang XM, Guo H, Li ZS, Song FH, Wang WM, Dai HQ, Zhang LX, Wang JG. Synthesis and evaluation of isatin-β-thiosemicarbazones as novel agents against antibiotic-resistant Gram-positive bacterial species. Eur J Med Chem 2015; 101:419-30. [PMID: 26185006 DOI: 10.1016/j.ejmech.2015.06.047] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 06/19/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) have caused an increasing mortality rate, which means that antibiotic resistance is becoming an important health issue. In the course to screen new agents for resistant bacteria, we identified that a series of isatin-β-thiosemicarbazones (IBTs) could inhibit the growth of MRSA and VRE. This was the first time that the "familiar" IBT compounds exhibited significant anti Gram-positive pathogen activity. Against a clinical isolated MRSA strain, 20 of the 51 synthesized compounds showed minimum inhibitory concentration (MIC) data of 0.78 mg/L and another 12 novel compounds had MICs of 0.39 mg/L. Moreover, these compounds also inhibited Enterococcus faecalis and VRE at similar levels, indicating that IBTs might have different mode of action compared with vancomycin. For these IBTs, comparative field analysis (CoMFA) models were further established to understand the structure-activity relationships in order to design new compounds from steric and electrostatic contributions. This work has suggested that IBTs can be considered as potential lead compounds to discover antibacterial inhibitors to combat drug resistance.
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Affiliation(s)
- Xu-Meng Zhang
- State-Key Laboratory and Research Institute of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, China
| | - Hui Guo
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Zai-Shun Li
- State-Key Laboratory and Research Institute of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, China
| | - Fu-Hang Song
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Wei-Min Wang
- State-Key Laboratory and Research Institute of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, China
| | - Huan-Qin Dai
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Li-Xin Zhang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Jian-Guo Wang
- State-Key Laboratory and Research Institute of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, China.
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Mahapa A, Mandal S, Biswas A, Jana B, Polley S, Sau S, Sau K. Chemical and thermal unfolding of a global staphylococcal virulence regulator with a flexible C-terminal end. PLoS One 2015; 10:e0122168. [PMID: 25822635 PMCID: PMC4379015 DOI: 10.1371/journal.pone.0122168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 02/07/2015] [Indexed: 11/19/2022] Open
Abstract
SarA, a Staphylococcus aureus-specific dimeric protein, modulates the expression of numerous proteins including various virulence factors. Interestingly, S. aureus synthesizes multiple SarA paralogs seemingly for optimizing the expression of its virulence factors. To understand the domain structure/flexibility and the folding/unfolding mechanism of the SarA protein family, we have studied a recombinant SarA (designated rSarA) using various in vitro probes. Limited proteolysis of rSarA and the subsequent analysis of the resulting protein fragments suggested it to be a single-domain protein with a long, flexible C-terminal end. rSarA was unfolded by different mechanisms in the presence of different chemical and physical denaturants. While urea-induced unfolding of rSarA occurred successively via the formation of a dimeric and a monomeric intermediate, GdnCl-induced unfolding of this protein proceeded through the production of two dimeric intermediates. The surface hydrophobicity and the structures of the intermediates were not identical and also differed significantly from those of native rSarA. Of the intermediates, the GdnCl-generated intermediates not only possessed a molten globule-like structure but also exhibited resistance to dissociation during their unfolding. Compared to the native rSarA, the intermediate that was originated at lower GdnCl concentration carried a compact shape, whereas, other intermediates owned a swelled shape. The chemical-induced unfolding, unlike thermal unfolding of rSarA, was completely reversible in nature.
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Affiliation(s)
- Avisek Mahapa
- Department of Biotechnology, Haldia Institute of Technology, Haldia, West Bengal, India
| | - Sukhendu Mandal
- Department of Biochemistry, Bose Institute, Kolkata, West Bengal, India
| | - Anindya Biswas
- Department of Biochemistry, Bose Institute, Kolkata, West Bengal, India
| | - Biswanath Jana
- Department of Biochemistry, Bose Institute, Kolkata, West Bengal, India
| | - Soumitra Polley
- Department of Biochemistry, Bose Institute, Kolkata, West Bengal, India
| | - Subrata Sau
- Department of Biochemistry, Bose Institute, Kolkata, West Bengal, India
- * E-mail: (SS); (KS)
| | - Keya Sau
- Department of Biotechnology, Haldia Institute of Technology, Haldia, West Bengal, India
- * E-mail: (SS); (KS)
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14
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The use of bone cement for the localized, controlled release of the antibiotics vancomycin, linezolid, or fusidic acid: effect of additives on drug release rates and mechanical strength. Drug Deliv Transl Res 2015; 1:121-31. [PMID: 25788111 DOI: 10.1007/s13346-011-0015-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Bone cement containing antibiotics is commonly used to treat orthopedic related infections. However, effective treatment (especially of resistant bacteria, methacillin-resistant Staphylococcus aureus (MRSA)) is compromised by very low levels of drug release so that typically less than 10% of loaded drug is released over a 6-week period. The objective of this study was to investigate the effect of incorporation of water soluble excipients (polyethylene glycol, sodium chloride, or dextran) into antibiotic-loaded cement on mechanical strength and drug release properties. Poly(methyl methylacrylate) cement implants containing various amounts of drug (vancomycin, linezolid or fusidic acid (all MRSA active)) and excipients were cast in the form of beads or films and characterized using differential scanning calorimetry. Mechanical strength as assessed by Young's modulus was determined by thermo-mechanical analysis. Drug release was measured by incubation in phosphate buffered saline with analysis by HPLC methods. The inclusion of sodium chloride up to 20% w/w caused only minor reductions in Young's modulus. Vancomycin and linezolid released very slowly from unmodified bone cement beads (less than 3% released by 4 weeks) whereas fusidic acid released more quickly (approximately 8% released by 4 weeks). The inclusion of sodium chloride or dextran in bone cement resulted in major increases in the release rate of vancomycin, linezolid and fusidic acid. These studies support the inclusion of sodium chloride and dextran in bone cement to increase the release rate of vancomycin, linezolid, or fusidic acid without compromising the mechanical strength of the composite material.
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15
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Scott LJ, Frampton JE. Ceftaroline fosamil: a guide to its use in complicated skin and soft tissue infections and community-acquired pneumonia in the EU. DRUGS & THERAPY PERSPECTIVES 2015. [DOI: 10.1007/s40267-014-0174-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Rodvold KA, McConeghy KW. Methicillin-Resistant Staphylococcus aureus Therapy: Past, Present, and Future. Clin Infect Dis 2013; 58 Suppl 1:S20-7. [DOI: 10.1093/cid/cit614] [Citation(s) in RCA: 233] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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17
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Frampton JE. Ceftaroline fosamil: a review of its use in the treatment of complicated skin and soft tissue infections and community-acquired pneumonia. Drugs 2013; 73:1067-94. [PMID: 23801418 DOI: 10.1007/s40265-013-0075-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Ceftaroline, the active metabolite of the prodrug ceftaroline fosamil (Zinforo, Teflaro), is an advanced-generation, parenteral cephalosporin with broad-spectrum antibacterial activity in vitro against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and multidrug resistant Streptococcus pneumoniae and Gram-negative bacteria, including Haemophilus influenzae and Moraxella catarrhalis, but not Pseudomonas aeruginosa. Ceftaroline has demonstrated a low potential for the selection of resistance in vitro for drug-resistant Gram-positive organisms, including MRSA, as well as for Gram-negative respiratory pathogens. In pivotal phase III studies, intravenous ceftaroline fosamil demonstrated noninferiority to intravenous vancomycin plus aztreonam in patients hospitalized with complicated skin and soft tissue infections (cSSTIs) and intravenous ceftriaxone in patients hospitalized with community-acquired pneumonia (CAP) [Pneumonia Outcomes Research Team (PORT) risk class III or IV]; however, patients with CAP admitted to the intensive care unit were not evaluated. Ceftaroline fosamil was generally well tolerated in these trials, with an adverse event profile similar to that of other cephalosporins. Diarrhoea was the most commonly reported adverse event; however, the risk of Clostridium difficile-associated diarrhoea with ceftaroline fosamil appeared to be low. Potential limitations of the drug include the lack of an oral formulation and the requirement for twice-daily administration. Nonetheless, ceftaroline fosamil represents an attractive option (either alone or in combination with other agents) for the initial empirical treatment of patients hospitalized with cSSTIs (including those with suspected MRSA infection) or CAP (PORT risk class III or IV) who require intravenous antimicrobial therapy. As with all antibacterial agents, ceftaroline fosamil should be used in accordance with good antimicrobial stewardship.
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Affiliation(s)
- James E Frampton
- Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, 0754 Auckland, New Zealand.
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18
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Bishal AK, Saha S, Sau K. Synonymous codon usage in forty staphylococcal phages identifies the factors controlling codon usage variation and the phages suitable for phage therapy. Bioinformation 2012; 8:1187-94. [PMID: 23275718 PMCID: PMC3530870 DOI: 10.6026/97320630081187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 10/27/2012] [Indexed: 11/23/2022] Open
Abstract
The immergence and dissemination of multidrug-resistant strains of Staphylococcus aureus in recent years have expedited the research on the discovery of novel anti-staphylococcal agents promptly. Bacteriophages have long been showing tremendous potentialities in curing the infections caused by various pathogenic bacteria including S. aureus. Thus far, only a few virulent bacteriophages, which do not carry any toxin-encoding gene but are capable of eradicating staphylococcal infections, were reported. Based on the codon usage analysis of sixteen S. aureus phages, previously three phages were suggested to be useful as the anti-staphylococcal agents. To search for additional S. aureus phages suitable for phage therapy, relative synonymous codon usage bias has been investigated in the protein-coding genes of forty new staphylococcal phages. All phages appeared to carry A and T ending codons. Several factors such as mutational pressure, translational selection and gene length seemed to be responsible for the codon usage variation in the phages. Codon usage indeed varied phage to phage. Of the phages, phages G1, Twort, 66 and Sap-2 may be extremely lytic in nature as majority of their genes possess high translational efficiency, indicating that these phages may be employed in curing staphylococcal infections.
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19
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Gupta D, Agarwal R, Aggarwal AN, Singh N, Mishra N, Khilnani GC, Samaria JK, Gaur SN, Jindal SK. Guidelines for diagnosis and management of community- and hospital-acquired pneumonia in adults: Joint ICS/NCCP(I) recommendations. Lung India 2012; 29:S27-62. [PMID: 23019384 PMCID: PMC3458782 DOI: 10.4103/0970-2113.99248] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Dheeraj Gupta
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashutosh Nath Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Navneet Singh
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Narayan Mishra
- Department of Pulmonary Medicine, Indian Chest Society, India
| | - G. C. Khilnani
- Department of Pulmonary Medicine, National College of Chest Physicians, India
| | - J. K. Samaria
- Department of Pulmonary Medicine, Indian Chest Society, India
| | - S. N. Gaur
- Department of Pulmonary Medicine, National College of Chest Physicians, India
| | - S. K. Jindal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - for the Pneumonia Guidelines Working Group
- Pneumonia Guidelines Working Group Collaborators (43) A. K. Janmeja, Chandigarh; Abhishek Goyal, Chandigarh; Aditya Jindal, Chandigarh; Ajay Handa, Bangalore; Aloke G. Ghoshal, Kolkata; Ashish Bhalla, Chandigarh; Bharat Gopal, Delhi; D. Behera, Delhi; D. Dadhwal, Chandigarh; D. J. Christopher, Vellore; Deepak Talwar, Noida; Dhruva Chaudhry, Rohtak; Dipesh Maskey, Chandigarh; George D’Souza, Bangalore; Honey Sawhney, Chandigarh; Inderpal Singh, Chandigarh; Jai Kishan, Chandigarh; K. B. Gupta, Rohtak; Mandeep Garg, Chandigarh; Navneet Sharma, Chandigarh; Nirmal K. Jain, Jaipur; Nusrat Shafiq, Chandigarh; P. Sarat, Chandigarh; Pranab Baruwa, Guwahati; R. S. Bedi, Patiala; Rajendra Prasad, Etawa; Randeep Guleria, Delhi; S. K. Chhabra, Delhi; S. K. Sharma, Delhi; Sabir Mohammed, Bikaner; Sahajal Dhooria, Chandigarh; Samir Malhotra, Chandigarh; Sanjay Jain, Chandigarh; Subhash Varma, Chandigarh; Sunil Sharma, Shimla; Surender Kashyap, Karnal; Surya Kant, Lucknow; U. P. S. Sidhu, Ludhiana; V. Nagarjun Mataru, Chandigarh; Vikas Gautam, Chandigarh; Vikram K. Jain, Jaipur; Vishal Chopra, Patiala; Vishwanath Gella, Chandigarh
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20
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The safety and efficacy of linezolid and daptomycin as an additive in Optisol-GS against methicillin-resistant Staphylococcus aureus. Cornea 2012; 31:551-8. [PMID: 22378113 DOI: 10.1097/ico.0b013e318226c6b3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the efficacy of adding either linezolid or daptomycin to Optisol-GS donor storage medium in reducing methicillin-resistant Staphylococcus aureus (MRSA) contamination of donor corneas. METHODS Optisol-GS was supplemented with either linezolid at 2×, 4×, or 10× minimum inhibitory concentration (MIC) or daptomycin and calcium at 5× or 50× MIC. Unsupplemented control groups were also used. Gentamicin-sensitive and gentamicin-resistant isolates of MRSA were added, and vials were refrigerated for 48 hours followed by sampling for viable colony counts immediately upon removal from refrigeration and after warming to room temperature for 3 hours. Safety studies of Optisol-GS supplemented with 50× MIC daptomycin and calcium were performed by evaluating the central corneal thickness and endothelial cell density of the donor cornea. Stability of daptomycin in Optisol-GS at storage was also tested. RESULTS No added benefit was observed with linezolid supplementation to Optisol-GS against gentamicin-sensitive MRSA, with reduction in viable colony counts by >90% in all groups. No benefit was observed with linezolid supplementation against gentamicin-resistant MRSA, with the majority of inocula remaining viable in all groups. Viable counts of gentamicin-sensitive MRSA and gentamicin-resistant MRSA were effectively reduced with both 5× MIC and 50× MIC daptomycin supplementation. 50× MIC daptomycin-supplemented Optisol-GS had no appreciable effect on the central corneal thickness or endothelial cell density of the donor cornea and was stable at storage for 14 days. CONCLUSIONS The addition of daptomycin to Optisol-GS significantly increases the anti-MRSA activity of the medium without any apparent negative effects on donor corneal tissue.
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Hao H, Cheng G, Dai M, Wu Q, Yuan Z. Inhibitors targeting on cell wall biosynthesis pathway of MRSA. MOLECULAR BIOSYSTEMS 2012; 8:2828-38. [DOI: 10.1039/c2mb25188d] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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22
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Lemaire S, Van Bambeke F, Pierard D, Appelbaum PC, Tulkens PM. Activity of fusidic acid against extracellular and intracellular Staphylococcus aureus: influence of pH and comparison with linezolid and clindamycin. Clin Infect Dis 2011; 52 Suppl 7:S493-503. [PMID: 21546626 DOI: 10.1093/cid/cir165] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Emergence of multidrug-resistant Staphylococcus aureus has triggered a reassessment of fusidic acid (CEM-102, sodium fusidate). METHODS Fusidic acid was examined for (1) activity against recent methicillin-resistant S. aureus (MRSA) isolates; (2) modulation of activity by acidic pH; and (3) accumulation by phagocytic cells and intracellular activity against methicillin-susceptible S. aureus (MSSA) and MRSA. RESULTS About 96% of strains (N = 94) were susceptible (European Committee on Antimicrobial Susceptibility Testing breakpoint [≤ 1 mg/L]). Activity was enhanced at pH 5.5 (6 dilutions decrease for minimum inhibitory concentration) in parallel with an increase of drug bacterial accumulation (opposite effects for clindamycin; linezolid remained unaffected). Fusidic acid accumulated in THP-1 cells (about 5.5 fold), with further accumulation at pH 5.5 vs pH 7.4. The intracellular activity of Fusidic acid was similar to that of clindamycin and linezolid (maximal relative activity, 0.4-0.6 log(10) colony-forming unit decrease). No cross-resistance to vancomycin or daptomycin was observed. CONCLUSIONS Fusidic acid is active against S. aureus in broth as well as intracellularly, with no cross-resistance to other antibiotics.
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Affiliation(s)
- Sandrine Lemaire
- Cellular and Molecular Pharmacology, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
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23
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Ikeda E, Inoue T, Asari S, Toyokawa M, Hori Y, Maeda N. Local treatment of methicillin-resistant Staphylococcus aureus conjunctivitis with short-term high-concentrated minocycline ointment. Jpn J Ophthalmol 2011; 55:576-578. [PMID: 21789624 DOI: 10.1007/s10384-011-0059-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2010] [Accepted: 03/16/2011] [Indexed: 11/29/2022]
Affiliation(s)
- Eriko Ikeda
- Department of Ophthalmology, Osaka University Medical School, Room E7, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Tomoyuki Inoue
- Department of Ophthalmology, Osaka University Medical School, Room E7, 2-2 Yamadaoka, Suita, 565-0871, Japan.
| | - Seishi Asari
- Clinical Laboratory, Osaka University Hospital, Suita, Japan
| | | | - Yuichi Hori
- Department of Ophthalmology, Toho University Sakura Medical Center, Sakura, Japan
| | - Naoyuki Maeda
- Department of Ophthalmology, Osaka University Medical School, Room E7, 2-2 Yamadaoka, Suita, 565-0871, Japan
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Hansra NK, Shinkai K. Cutaneous community-acquired and hospital-acquired methicillin-resistant Staphylococcus aureus. Dermatol Ther 2011; 24:263-72. [PMID: 21410616 DOI: 10.1111/j.1529-8019.2011.01402.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The clinical presentation of methicillin-resistant Staphylococcus aureus (MRSA) infection ranges from asymptomatic colonization to cutaneous and invasive involvement. This review discusses the cutaneous presentations of community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA) that one may encounter in the hospital or outpatient setting. Cutaneous CA-MRSA and HA-MRSA are often clinically indistinguishable, although they have different epidemiologic profiles and virulence factors. Bacterial culture is necessary for diagnosis and guides treatment, as infection with CA-MRSA and HA-MRSA require distinct clinical management. Guidelines for surgical interventions and antibiotic treatment of CA-MRSA and HA-MRSA will be discussed. Strategies for MRSA decolonization and prevention of further spread will also be reviewed.
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Affiliation(s)
- Nina Kaur Hansra
- Department of Dermatology, University of California-San Francisco, 1701 Divisadero Street, San Francisco, CA 94143, USA
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25
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Rasmussen RV, Fowler VG, Skov R, Bruun NE. Future challenges and treatment of Staphylococcus aureus bacteremia with emphasis on MRSA. Future Microbiol 2011; 6:43-56. [PMID: 21162635 DOI: 10.2217/fmb.10.155] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Staphylococcus aureus bacteremia (SAB) is an urgent medical problem due to its growing frequency and its poor associated outcome. As healthcare delivery increasingly involves invasive procedures and implantable devices, the number of patients at risk for SAB and its complications is likely to grow. Compounding this problem is the growing prevalence of methicillin-resistant S. aureus (MRSA) and the dwindling efficacy of vancomycin, long the treatment of choice for this pathogen. Despite the recent availability of several new antibiotics for S. aureus, new strategies for treatment and prevention are required for this serious, common cause of human infection.
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Affiliation(s)
- Rasmus V Rasmussen
- Department of Cardiology, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
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26
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Doléans-Jordheim A, Bergeron E, Bereyziat F, Ben-Larbi S, Dumitrescu O, Mazoyer MA, Morfin F, Dumontet C, Freney J, Jordheim LP. Zidovudine (AZT) has a bactericidal effect on enterobacteria and induces genetic modifications in resistant strains. Eur J Clin Microbiol Infect Dis 2011; 30:1249-56. [PMID: 21494911 DOI: 10.1007/s10096-011-1220-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 03/06/2011] [Indexed: 11/28/2022]
Abstract
The spread of multiresistant bacteria increases the need for new antibiotics. The observation that some nucleoside analogues have antibacterial activity led us to further investigate the antimicrobial activity and resistance of zidovudine (AZT). We determined the minimum inhibition concentration (MIC), studied time-kill curves, induced resistant bacteria and sequenced the gene for thymidine kinase. We demonstrate that AZT has a bactericidal effect on some enterobacteria. However, AZT could induce resistance in Escherichia coli. These resistances were associated with various modifications in the thymidine kinase gene. In particular, we observed the presence in this gene of an insertion sequence (IS) similar to IS911 of Shigella dysenteriae in two resistant clones. No cross-resistance with classical antibiotics in strains with modified thymidine kinase gene was observed. Finally, an additive or synergistic activity between AZT and the two aminoglycoside antibiotics amikacin and gentamicin was observed. We demonstrate the bactericidal activity of AZT and show synergy in association with gentamicin. Genetic modifications in resistant bacteria were identified. Our results indicate that AZT could potentially be added in the treatment of infections with enterobacteria or represent the basis for the development of derivatives with better activity and inducing less resistance.
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Mazu TK, Etukala JR, Jacob MR, Khan SI, Walker LA, Ablordeppey SY. δ-Carbolines and their ring-opened analogs: synthesis and evaluation against fungal and bacterial opportunistic pathogens. Eur J Med Chem 2011; 46:2378-85. [PMID: 21459492 DOI: 10.1016/j.ejmech.2011.03.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 03/06/2011] [Accepted: 03/10/2011] [Indexed: 12/31/2022]
Abstract
Previous studies have indicated that the δ-carboline (2) ring system derived from the natural product cryptolepine (1) may represent a pharmacophore for anti-infective activity. This paper describes the design and synthesis of a small library of substituted δ-carbolines and the evaluation of the anti-fungal and anti-bacterial activities. An evaluation of the anti-bacterial activity of a previously reported library of ring-opened analogs was also conducted to provide an opportunity to test the hypothesis that both group of compounds may have the same biological target. Results indicate that against a selected group of fungal pathogens, substituted δ-carbolinium analogs displayed higher potency and several fold lower cytotoxicity than cryptolepine the parent natural product. Both the δ-carbolinium compounds and their ring-opened analogs, exhibited equally high anti-bacterial activity against the selected pathogens and especially against the gram positive bacteria evaluated.
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Affiliation(s)
- Tryphon K Mazu
- Florida A&M University, College of Pharmacy and Pharmaceutical Sciences, Tallahassee, FL 32307, USA
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Efficacy of topically delivered moxifloxacin against wound infection by Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2011; 55:2325-34. [PMID: 21343458 DOI: 10.1128/aac.01071-10] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Wound infection is a common risk for patients with chronic nonhealing wounds, causing high morbidity and mortality. Currently, systemic antibiotic treatment is the therapy of choice, despite often leading to several side effects and the risk of an insufficient tissue penetration due to impaired blood supply. If systemically delivered, moxifloxacin penetrates well into inflammatory blister fluid, muscle, and subcutaneous adipose tissues and might therefore be a possible option for the topical treatment of skin and infected skin wounds. In this study, topical application of moxifloxacin was investigated in comparison to mupirocin, linezolid, and gentamicin using a porcine wound infection and a rat burn infection model. Both animal models were performed either by an inoculation with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa. Wound fluid, tissue, and blood samples were taken, and bacterial counts as well as the moxifloxacin concentration were determined for a 14-day follow-up. A histological comparison of the rat burn wound tissues was performed. Both strains were susceptible to moxifloxacin and gentamicin, whereas mupirocin and linezolid were effective only against MRSA. All antibiotics showed efficient reduction of bacterial counts, and except with MRSA, infected burn wounds reached bacterial counts below 10(5) CFU/g tissue. Additionally, moxifloxacin was observed to promote wound healing as determined by histologic analysis, while no induction of bacterial resistance was observed during the treatment period. The use of topical antibiotics for the treatment of infected wounds confers many benefits. Moxifloxacin is therefore an ideal candidate, due to its broad antibacterial spectrum, its high efficiency, and its potential to promote wound healing.
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Duplessis C, Crum-Cianflone NF. Ceftaroline: A New Cephalosporin with Activity against Methicillin-Resistant Staphylococcus aureus (MRSA). CLINICAL MEDICINE REVIEWS IN THERAPEUTICS 2011; 3:a2466. [PMID: 21785568 PMCID: PMC3140339 DOI: 10.4137/cmrt.s1637] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Microbial resistance has reached alarming levels, threatening to outpace the ability to counter with more potent antimicrobial agents. In particular, methicillin-resistant Staphylococcus aureus (MRSA) has become a leading cause of skin and soft-tissue infections and PVL-positive strains have been associated with necrotizing pneumonia. Increasing reports of growing resistance to glycopeptides have been noted, further limiting the efficacy of standard antibiotics, such as vancomycin. Ceftaroline is a novel fifth-generation cephalosporin, which exhibits broad-spectrum activity against Gram-positive bacteria, including MRSA and extensively-resistant strains, such as vancomycin-intermediate S. aureus (VISA), heteroresistant VISA (hVISA), and vancomycin-resistant S. aureus (VRSA). In addition to being an exciting new agent in the anti-MRSA armamentarium, ceftaroline provides efficacy against many respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Ceftaroline (600 mg intravenously every 12 hours) has been shown effective in phase III studies in the treatment of complicated skin and soft tissue infections and community-acquired pneumonia. To date, this unique antibiotic exhibits a low propensity for inducing resistance and has a good safety profile, although further post-marketing data and clinical experience are needed. In summary, ceftaroline provides an additional option for the management of complex multidrug resistant infections, including MRSA.
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Affiliation(s)
- Christopher Duplessis
- Infectious Disease Division, Naval Medical Center San Diego, San Diego, CA United States
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Abstract
Several studies have shown that the rates of resistant Gram-positive pathogens, such as methicillin-resistant Staphylococcus aureus, vancomycin-intermediate S. aureus (VISA), hetero-VISA, and penicillin-resistant Streptococcus pneumoniae have witnessed a substantial global increase. Ceftaroline fosamil is the prodrug form of ceftaroline, a new cephalosporin active against resistant Gram-positive pathogens and common Gram-negative organisms that do not produce extended-spectrum-β-lactamases and do not express AmpC. Ceftaroline fosamil was found to be effective and well-tolerated for the treatment of complicated skin and skin-structure infections and community-acquired bacterial pneumonia compared with standard therapy. The drug has recently been granted US FDA approval for both indications.
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Affiliation(s)
- Zeina A Kanafani
- American University of Beirut Medical Center, PO Box 11-0236/11D, Riad El Solh 1107 2020, Beirut, Lebanon.
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Santayana EM, Jourjy J. Treatment of methicillin-resistant Staphylococcus aureus surgical site infections. AACN Adv Crit Care 2011; 22:5-12; quiz 14. [PMID: 21297385 DOI: 10.1097/nci.0b013e3181ef86fe2049019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Elena M Santayana
- University of Chicago Medical Center, 5841 S Maryland Ave, MC 0010, Chicago, IL 60637, USA.
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Mondal R, Chanda PK, Bandhu A, Jana B, Lee CY, Sau S. Detection of the cell wall-affecting antibiotics at sublethal concentrations using a reporter Staphylococcus aureus harboring drp35 promoter - lacZ transcriptional fusion. BMB Rep 2010; 43:468-73. [PMID: 20663407 DOI: 10.5483/bmbrep.2010.43.7.468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Previously, various inhibitors of cell wall synthesis induced the drp35 gene of Staphylococcus aureus efficiently. To determine whether drp35 could be exploited in antistaphylococcal drug discovery, we cloned the promoter of drp35 (P(d)) and developed different biological assay systems using an engineered S. aureus strain that harbors a chromosomally-integrated P(d) - lacZ transcriptional fusion. An agarose-based assay showed that P(d) is induced not only by the cell wall-affecting antibiotics but also by rifampicin and ciprofloxacin. In contrast, a liquid medium-based assay revealed the induction of P(d) specifically by the cell wall-affecting antibiotics. Induction of P(d) by sublethal concentrations of cell wall-affecting antibiotics was even assessable in a microtiter plate assay format, indicating that this assay system could be potentially used for high-throughput screening of new cell wall-inhibiting compounds.
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Affiliation(s)
- Rajkrishna Mondal
- Department of Biochemistry, Bose Institute, Kolkata, West Bengal, India
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Abstract
An increasing proportion of Staphylococcus aureus infections are caused by methicillin-resistant S aureus. Treatment of infections caused by this organism is challenging, especially because therapy with vancomycin, the traditional antibiotic of choice for methicillin-resistant S aureus infections, is associated with an increasing frequency of treatment failure, and vancomycin insensitive and vancomycin-resistant strains have emerged. In addition, Enterococcus sp. isolated from human infections are increasingly resistant to multiple antimicrobial agents. Newer drugs available for treatment of resistant Gram-positive bacterial infections in the United States include linezolid, daptomycin, tigecycline and telavancin. The precise role for these newer agents is still evolving. Organisms resistant to each of these antimicrobials have emerged. New drugs in development include cephalosporins and carbapenems with MRSA activity.
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35
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Harik NS, Smeltzer MS. Management of acute hematogenous osteomyelitis in children. Expert Rev Anti Infect Ther 2010; 8:175-81. [PMID: 20109047 DOI: 10.1586/eri.09.130] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In children, osteomyelitis is primarily hematogenous in origin and acute in nature. The principal cause of osteomyelitis in children is Staphylococcus aureus, and both the epidemiology and pathogenesis of S. aureus infections, including osteomyelitis, have changed in recent years owing to the emergence of community-associated methicillin-resistant S. aureus. This review focuses on advances in the diagnosis and overall management of acute hematogenous osteomyelitis in children with these changes in mind.
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Affiliation(s)
- Nada S Harik
- Department of Pediatrics and Department of Microbiology and Immunology, University of Arkansas for Medical Sciences and the Arkansas Children's Hospital, Little Rock, AR 72205, USA.
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Grossi PA. Early appropriate therapy of Gram-positive bloodstream infections: the conservative use of new drugs. Int J Antimicrob Agents 2009; 34 Suppl 4:S31-4. [DOI: 10.1016/s0924-8579(09)70563-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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